Abstract
Quinupristin and dalfopristin combination has been advocated as a drug of choice for multi-drug resistant (MDR) gram-positive cocci (GPC). We are reporting two cases of neonatal septicemia, caused by the methicillin resistant Staphylococcus aureus (MRSA), showing primary in vitro pristinamycin resistance. The Minimum inhibitory concentrations (MIC) for pristinamycin in these two cases were 30 μg and 25 μg, respectively. Universal advocacy of pristinamycin for the therapy of MDR GPC infections should be re-evaluated.
Highlights
Quinupristin and dalfopristin (SYNECID) is a combination of a streptogramin B, quinupristin, with a streptogramin A, dalfopristin, in a 30 : 70 ratio
The first staphylococcal isolate resistant to the pristinamycin was reported in France, in 1975.[3]. Staphylococcal resistance always pertains to dalfopristin, but not necessarily for quinupristin.[4]
We have isolated two clinical isolates of Staphylococcus aureus, which were resistant to pristinamycin
Summary
Quinupristin and dalfopristin (SYNECID) is a combination of a streptogramin B, quinupristin, with a streptogramin A, dalfopristin, in a 30 : 70 ratio. These compounds are semisynthetic derivatives of naturally occurring pristinamycins, produced by Streptomyces pristinaspiralis. Quinupristin and dalfopristin are more soluble derivatives of pristinamycin ΙA and pristinamycin ΙΙA respectively.[1] They bind with different targets in the peptidyltransferase domain of 23 ribosomal subunit, and inhibit protein elongation steps. We have isolated two clinical isolates of Staphylococcus aureus, which were resistant to pristinamycin (quinupristin/dalfopristin)
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