Daptomycin and Tigecycline Susceptibility of Vancomycin Resistant Enterococci Isolated from Rectal Swab Cultures

Year 2014, Volume: 4 Issue: 03, 107 - 110, 01.09.2014

Şerife Altun Hatice Uludağ Altun Çiğdem Ataman Hatipoğlu Cemal Bulut Sami Kınıklı Ali Pekcan Demiröz

https://doi.org/10.5799/ahinjs.02.2014.03.0149

Abstract

Objective: Vancomycin resistant enterococci (VRE) are important healthcare associated multidrug resistant organisms because of their easily spread in the hospital environment, difficulty to cure and high mortality rate. The aim of this study was to evaluate in vitro activity of daptomycin and tigecycline against VRE strains isolated from rectal swab samples of hospitalized patients. Methods: Sixty non-duplicate VRE strains isolated from rectal swabs of hospitalized patients between October 2010 and February 2013 at Ankara Training and Research Hospital were included into the study. Ankara Training and Research Hospital in Ankara in Turkey is a 600 bed, tertiary care, teaching hospital. Minimum inhibitory concentration (MIC) values of daptomycin and tigecycline were determined by E-test method (bioMerieux, France). Results: All of the strains were susceptible to daptomycin, three of them (5%) were resistant to tigecycline. MIC50 and MIC90 values of daptomycin were 1.5 µg/ml and 2 µgr/ml, and of tigecycline were 0.64 µg/ml and 0.125 µg/ml, respectively. Conclusion: As a result; all of the strains were susceptible to daptomycin. On the other hand, resistance to tigecycline was exhibited by 5% of VRE isolates. Clinicians should be aware of the possibility of the emergence of tigecycline nonsusceptibility and should closely monitor tigecycline MICs of enterococci.

Keywords

VRE, daptomycin, tigecycline, susceptibility

Daptomycin and Tigecycline Susceptibility of Vancomycin Resistant Enterococci Isolated from Rectal Swab Cultures

Abstract

Amaç: Hastane ortamında kolay yayılımı, infeksiyonlarının tedavisinin zor ve mortalite oranlarının yüksek olması nedeni ile çoklu ilaca dirençli vankomisin dirençli enterokoklar (VRE) önemli organizmalardır. Bu çalışmanın amacı; yatan hastalardan alınan rektal sürüntü örneklerinden izole edilen VRE suşlarında in vitro daptomisin ve tigesiklin duyarlılığını belirlemektir.Yöntemler: Çalışmaya Ekim 2010- Şubat 2013 tarihleri arasında Ankara Eğitim ve Araştırma Hastanesinde yatan hastaların rektal sürüntülerinden izole edilen 60 VRE suşu dahil edildi. Ankara Eğitim ve Araştırma hastanesi 600 yataklı 3. basamak bir araştırma hastanesidir. Daptomisin ve tigesiklin için minimum inhibitor konsantrasyon (MIK) değerleri E-test yöntemi (bioMerieux, Fransa) ile belirlendi.Bulgular: Tüm suşlar daptomisine duyarlı olup; üçü (%5) tigesikline dirençli saptandı. Daptomisin için MIK50 ve MIK90 değerleri sırasıyla 1.5 µgr/ml ve 2 µgr/ml saptanırken tigesiklin için 0.064 µg/ml ve 0.125 µg/ml olarak saptandı. Sonuç: Sonuç olarak; tüm suşlar daptomisine duyarlı saptandı. Diğer yandan VRE izolatlarında tigesiklin direnci %5 olarak saptandı. Klinisyenler enterokoklarda tigesiklin direncine karşı dikkatli olmalı ve tigesiklin MIK değerini yakından takip etmelidir

Keywords

VRE, daptomisin, tigesiklin, duyarlılık

References

• Eliopoulos GM. Microbiology of drugs for treating multiply drug- resistant gram-positive bacteria. J Infect 2009;59:17–24.
• Diekema DJ, Jones RN. Oxazolidinone antibiotics. Lancet 2001;358:1975-1982.
• Klare I, Witte W, Wendt C, Werner G. Vancomycin-Resistant Enterococci (VRE). Recent results and trends in develop- ment of antibiotic resistance. Bundesgesunddheitsblatt Gesundheitsforschung Gesundheitssschutz 2012;55:1387- 1400.
• Kristich CJ, Rice LB, Arias CA. Enterococcal Infection-Treat- ment and Antibiotic Resistance. In: Gilmore MS, Clewell DB, Ike Y, Shankar N, eds. Enterococci: From Commensals to Leading Causes of Drug Resistant İnfection (Internet) Bos- ton: Massachusetts Eye and Ear Infirmary 2014.
• Entenza JM, Moreillon P. Tigecycline in combination with other antimicrobials: a review of in vitro, animal and case report studies. Int J Antimicrob Agents 2009;34:8.
• Steenbergen JN, Mohr JF, Thorne GM. Effects of daptomycin incombination with other antimicrobial agents: a review of in vitro and animal model studies. J Antimicrob Chemother 2009;64:1130-1138.
• Kelesidis T, Humphries R, Uslan DZ, Pegues DA. Daptomycin nonsusceptible enterococci: an emerging challenge for clini- cians. Clin Infect Dis 2011;52:228-234.
• Clinical and Laboratory Standards Institute. 2011. Performance standards for antimicrobial susceptibility testing; twenty-first informational supplement, CLSI document M100-S21. Clini- cal and Laboratory Standards Institute, Wayne, PA.
• Sader HS, Jones RN. Antimicrobial susceptibility of Gram- positive bacteria isolated from US medical centers: results of the Daptomycin Surveillance Program (2007–2008). Diagn Microbiol Infect Dis 2009;65:158–162.
• Brink AJ, Bizos D, Boffard KD, et al. Guideline: Appropriate use of tigecycline. S Afr Med J 2010;100:388-394.
• Hoban DJ, Bouchillon SK, Johnson BM, et al. Tigecycline Evaluation and Surveillance Trial (TEST program) Group. In- vitro activity of tigecycline against 6792 Gram-Negative and Gram-positive clinical isolates from the global Tigecycline Evaluation and Surveillance Trial (TEST program 2004). Di- agn Microbiol Infect Dis 2005;52:215-217.
• Reinert RR, Low DE, Rossi F, et al. Antimicrobial suscepti- bility among organisms from Asia/Pasific Rim, Europe and Latin and North America collected as part of TEST and the in vitro activity of tigecycline. J Antimicrob Chemother 2007;60:1018-1029.
• Wyeth Pharmaceuticals. Tygacil (tigecycline) for injection (Package Insert). 2005. Wyeth Pharmaceuticals Inc., Phila- delphia, PA.
• Leclerq R, Courvalin P. Resistance to glycopeptides in En- terococci. Clin Infect Dis 1997; 24:545-554.
• Akıncı E, Balık İ, Tekeli E. Antimirobial susceptibility of En- terococcus species collected from clincal specimens. Flora 1999;4:4045.
• Cottagnoud P. Daptomycin: A new treatment for insidious in- fections due to gram-positive pathogens. Swess Med Wkly 2008;138:93-99.
• Cai Y, Wang R, Liang B, et al. Systematic review and meta- analysis of the effectiveness and safety of tigecycline for treatment of infectious disease. Antimicrob Agents Chemoth- er 2011;55:1162-1172.
• Sader HS, Farrell DJ, Jones RN. Antimicrobial activity of daptomycin tested against gram-positive strains collected in European hospitals: results from 7 years of resistance sur- veillance (2003-2009). J Chemother 2011;23:200-206.
• Aktaş G, Derbentli Ş. In vitro activity of daptomycin against VRE and MRSA strains. Mikrobiyol Bul 2014;48:123-128.
• Şamlıoğlu P, Ece G, Atalay S, Köse Ş. Daptomycin suscepti- bility in gram positive cocci isolated from intensive care units. ANKEM Derg 2011;25:173-177.
• Ertem GT, Öztürk B, Hatipoğlu ÇA et al. In vitro susceptibili- ties of Staphylococcus and E. species isolates to linezolid, daptomycin, teicoplanin and fucidic acid. Turkiye Klinikleri J Med Sci 2012;33:1381-1387.
• Chitnis S, Katara G, Hemvani N, et al. In vitro activity of daptomycin & linezolid against methicillin resistant Staphylo- coccus aureus & vancomycin resistant enterococci isolated from hospitalized cases in Central India. Indian J Med Res 2013;137:191-196.
• Canton R, Ruiz-Garbajosa P, Chaves RL, Johnsn AP. A po- tential role for daptomycin in enterococcal infections: what is the evidence? J Antimicrob Chemother 2010;65:1126-1136.
• Kamboj M, Cohen N, Gilhuley K, Babady NE, Seo SK, Sep- kowitz KA. Emergence of daptomycin-resistant VRE: Experi- ence of a single institution. Infect Control Hosp Epidemiol 2011:32;391-394.
• Sader HS, Flamm RK, Jones RN. Tigecycline activity tested against antimicrobial resistant surveillance subsets of clini- cal bacteria collected worldwide. Diagn Microbiol Infect Dis 2011:76:217-221.
• Jones RN, Guzman-Blanco M, Gales AC, et al. Susceptibility rates in Latin American nations: report from a regional resis- tance surveillance program (2011). Braz J Infect Dis. 2013 :17:672-681.
• Chen YH, Lu PL, Huang CH, et al. Trends in susceptibility of clinically important resistant bacteria to tigecycline: results from the tigecycline in vitro surveillance in Taiwan study, 2006 to 2010. Antimicrob Agents Chemother 2012;53:1452- 1457.
• Karaoğlan İ, Zer Y, Namıduru M. In vitro activity of tigecycline for Vancomycin-resistant E. species Strains. ANKEM Derg 2008;22:153-155.