Abstract
BackgroundQuinupristin/dalfopristin (Q/D) is a valuable alternative antibiotic to vancomycin for the treatment of multi-drug resistant Enterococcus faecium infections. However, resistance to Q/D in E. faecium clinical isolates and nosocomial dissemination of Q/D-resistant E. faecium have been reported in several countries and should be of concern.ResultsFrom January 2012 to December 2015, 911 E. faecium clinical isolates were isolated from various specimens of inpatients at the first Affiliated Hospital of Wenzhou Medical University located in Wenzhou, east China. Of 911 E. faecium clinical isolates, 9 (1.0 %, 9/911) were resistant to Q/D, with the Q/D MIC values of 64 mg/L(1), 32 mg/L(1), 16 mg/L(3), 8 mg/L(1) and 4 mg/L(3) determined by broth microdilution. All Q/D-resistant isolates were susceptible to vancomycin, tigecycline and teicoplanin but resistant to penicillin, ampicillin and erythromycin. vatE was only found in one Q/D-resistant E. faecium isolate while vatD was not detected in any of the isolates tested. 8 of 9 Q/D-resistant E. faecium isolates were found be positive for both ermB and msrC. The combinations of Q/D resistance determinants were ermB-msrC (7 isolates) and ermB-msrC-vatE (one isolate). ST78, ST761, ST94, ST21 and ST323 accounted for 4, 2, 1, 1 and 1 isolate, respectively, among which ST78 was the prevalent ST.ConclusionQ/D-resistant E. faecium clinical isolates were first described in China. Carriage of vatE, ermB and msrC was responsible for Q/D resistance.
Highlights
Quinupristin/dalfopristin (Q/D) is a valuable alternative antibiotic to vancomycin for the treatment of multi-drug resistant Enterococcus faecium infections
Prevalence of Q/D resistance among E. faecium clinical isolates Among 911 E. faecium clinical isolates over the study period, 9 (1.0 %, 9/911) were resistant to Q/D determined by the Vitek-2 Automated Microbiology Analyzer with GPS card and disk diffusion method
The Q/D minimum inhibitory concentration (MIC) values for 9 Q/D-resistant E. faecium clinical isolates determined by broth microdilution method were as follows: 64 mg/L, 1; 32 mg/L, 1; 16 mg/L, 3; 8 mg/L, 1 and 4 mg/L, 3 (Table 1)
Summary
Quinupristin/dalfopristin (Q/D) is a valuable alternative antibiotic to vancomycin for the treatment of multi-drug resistant Enterococcus faecium infections. Enterococci, which are the normal commensals in the intestinal tract of humans and animals, are the common cause of nosocomial infections. Enterococcus faecalis and Enterococcus faecium are responsible for most of enterococcal infections, such as urinary-tract infections, intra-abdominal infections, bacteremia, and endocarditis [1]. With an intrinsic and acquired resistance to some antimicrobial agents, Enterococci have become important nosocomial pathogens [2]. Infections caused by multidrug -resistant Enterococci, especially multiple resistances to vancomycin, penicillin, and aminoglycoside The synergic behavior of the combination results in Q/D rapidly bactericidal against the majority of Gram-positive organisms [3]. Q/D is mainly used for the treatment of infections caused by multidrug-resistant Gram-positive cocci [4, 5]. Q/D is effective against E. faecium, but not against E. faecalis [6]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
