The comparative activity of norfloxacin with other antimicrobial agents against Gram-positive and Gram-negative bacteria

Norfloxacin (MK0366) displayed appreciable activity against the great majority of Gram-negative and Gram-positive bacteria. The minimum inhibitory concentration for 90% of isolates (MIC90) of the Enterobacteriaceae was 0.5 mg/l or less while for Campylobacter, Neisseria, Haemophilus MIC90s were 0.25 mg/l or less. Norfloxacin was also among the most active drugs tested against methicillin susceptible and resistant Staphylococcus aureus, Staph. epidermidis, enterococci and Pseudomonas aeruginosa with MIC90s between 0.5 and 4 mg/l.     

In vitro activity of tigecycline and comparator agents against a global collection of Gram-negative and Gram-positive organisms: Tigecycline Evaluation and Surveillance Trial 2004 to 2007

The Tigecycline Evaluation and Surveillance Trial began in 2004 to monitor the in vitro activity of tigecycline and comparator agents against a global collection of Gram-negative and Gram-positive pathogens. Against Gram negatives (n = 63 699), tigecycline MIC₉₀'s ranged from 0.25 to 2 mg/L for Escherichia coli, Haemophilus influenzae, Acinetobacter baumannii, Klebsiella oxytoca, Enterobacter cloacae, Klebsiella pneumoniae, and Serratia marcescens (but was ≥32 for Pseudomonas aeruginosa). Against Gram-positive organisms (n = 32 218), tigecycline MIC₉₀'s were between 0.06 and 0.25 mg/L for Streptococcus pneumoniae, Enterococcus faecium, Streptococcus agalactiae, Staphylococcus aureus, and Enterococcus faecalis. The in vitro activity of tigecycline was maintained against resistant phenotypes, including multidrug-resistant A. baumannii (9.2% of isolates), extended-spectrum β-lactamase–producing E. coli (7.0%) and K. pneumoniae (14.0%), β-lactamase–producing H. influenzae (22.2%), methicillin-resistant S. aureus (44.5%), vancomycin-resistant E. faecium (45.9%) and E. faecalis (2.8%), and penicillin-resistant S. pneumoniae (13.8%). Tigecycline represents a welcome addition to the armamentarium against difficult to treat organisms.     

Antibacterial activity of sphingoid bases and fatty acids against Gram-positive and Gram-negative bacteria

There is growing evidence that the role of lipids in innate immunity is more important than previously realized. How lipids interact with bacteria to achieve a level of protection, however, is still poorly understood. To begin to address the mechanisms of antibacterial activity, we determined MICs and minimum bactericidal concentrations (MBCs) of lipids common to the skin and oral cavity--the sphingoid bases D-sphingosine, phytosphingosine, and dihydrosphingosine and the fatty acids sapienic acid and lauric acid--against four Gram-negative bacteria and seven Gram-positive bacteria. Exact Kruskal-Wallis tests of these values showed differences among lipid treatments (P < 0.0001) for each bacterial species except Serratia marcescens and Pseudomonas aeruginosa. D-sphingosine (MBC range, 0.3 to 19.6 μg/ml), dihydrosphingosine (MBC range, 0.6 to 39.1 μg/ml), and phytosphingosine (MBC range, 3.3 to 62.5 μg/ml) were active against all bacteria except S. marcescens and P. aeruginosa (MBC > 500 μg/ml). Sapienic acid (MBC range, 31.3 to 375.0 μg/ml) was active against Streptococcus sanguinis, Streptococcus mitis, and Fusobacterium nucleatum but not active against Escherichia coli, Staphylococcus aureus, S. marcescens, P. aeruginosa, Corynebacterium bovis, Corynebacterium striatum, and Corynebacterium jeikeium (MBC > 500 μg/ml). Lauric acid (MBC range, 6.8 to 375.0 μg/ml) was active against all bacteria except E. coli, S. marcescens, and P. aeruginosa (MBC > 500 μg/ml). Complete killing was achieved as early as 0.5 h for some lipids but took as long as 24 h for others. Hence, sphingoid bases and fatty acids have different antibacterial activities and may have potential for prophylactic or therapeutic intervention in infection.     

阿莫西林-双氯西林的体外抗菌作用研究

目的评价阿莫西林-双氯西林对常见感染临床分离菌的体外抗菌作用.方法收集临床分离菌按CLSI/NCCLS推荐的琼脂对倍稀释法测定阿莫西林-双氯西林的最低抑菌浓度（MIC）,并与相关抗菌药物进行比较.结果收集临床分离菌共513株,其中需氧革兰阳性菌248株,需氧革兰阴性菌265株.阿莫西林-双氯西林对受试的需氧革兰阳性球菌,包括肺炎链球菌、化脓性链球菌等链球菌属、甲氧西林敏感葡萄球菌、粪肠球菌具有高度抗菌活性,大多与阿莫西林-克拉维酸相仿,亦优于其他受试药,该药对卡他莫拉菌、流感嗜血杆菌抗菌作用强,其中对流感嗜血杆菌的产酶株作用略差;对伤寒沙门菌具有良好抗菌作用,对大肠埃希菌、肺炎克雷伯菌、奇异变形杆菌和志贺菌的抗菌作用较差.结论阿莫西林-双氯西林对社区获得的上、下呼吸道感染和单纯性皮肤软组织感染的常见病原菌具有良好抗菌作用,对伤寒沙门菌作用亦强,提示该药为治疗上述感染的适宜选用药物之一.     

Pyrrolobenzodiazepine dimers: novel sequence-selective, DNA-interactive, cross-linking agents with activity against Gram-positive bacteria

OBJECTIVES: Pyrrolo[2,1-c][1,4]benzodiazepine (PBD) dimers are synthetic sequence-selective interstrand DNA minor-groove cross-linking agents developed from anthramycins. We investigated the antibacterial activity of three dimers, SJG-136, DRG-16 and ELB-21, which differ in the structure of the PBD monomeric unit and the length of the linker region between the two identical PBD monomers. METHODS: MICs were determined against 38 methicillin-resistant Staphylococcus aureus (MRSA), 20 vancomycin-resistant enterococci (VRE), 12 isolates of Streptococcus pyogenes, 12 of Streptococcus agalactiae, 12 of Listeria monocytogenes and 24 Gram-negative clinical isolates. Binding to double-stranded DNA was assessed by determination of the DNA melting temperature (T(m)). RESULTS: MIC(90) values for SJG-136 were 0.5 mg/L against MRSA, VRE and L. monocytogenes, 0.06 mg/L against S. pyogenes and 0.03 mg/L against S. agalactiae; these were below the maximum tolerated dose of the drug. MIC(90)s for DRG-16 were 0.125, >0.5, 0.125, 0.015 and <0.008 mg/L, respectively. The most potent compound was ELB-21, with corresponding MIC(90) values of 0.03, 0.06, 0.06, 0.015 and 0.015 mg/L. There was little or no variation in sensitivity amongst isolates from any one species. All Gram-negative species (Acinetobacter, Pseudomonas, Klebsiella, Proteus spp.) were not susceptible due to the barrier function of the outer membrane. PBD dimers showed bactericidal activity against MRSA and VRE and there was a significant post-antibiotic effect (1.5--3.5 h). Incubation of EMRSA-16 genomic DNA (50 microM) with 20 microM ELB-21 resulted in a large increase in T(m) suggesting that PBD dimers exert their antibacterial effect by cross-linking of the two DNA strands. CONCLUSIONS: These data indicate that this novel class of antibacterial agents warrants further investigation as potential antibiotics for the treatment of severe infections caused by Gram-positive pathogens.     

In vitro activity of para-guanidinoethylcalix[4]arene against susceptible and antibiotic-resistant Gram-negative and Gram-positive bacteria

OBJECTIVES: Emergence of multidrug-resistant bacteria has encouraged vigorous efforts to develop antimicrobial agents with new mechanisms of action. In this study, the in vitro antibacterial activity of para-guanidinoethylcalix[4]arene was evaluated and compared with that of its constitutive monomer, para-guanidinoethylphenol. Hexamidine, a widely used antiseptic, and synthalin A, an old antidiabetic and anti-trypanosomal compound, were chosen as references. METHODS: MIC and MBC were determined for five reference strains (Escherichia coli ATCC 25922, Staphylococcus aureus ATCC 25923 and ATCC 29213, Enterococcus faecalis ATCC 29212 and Pseudomonas aeruginosa ATCC 27853), as well as five antibiotic-resistant clinical isolates. Toxicity on MRC-5 and HaCaT eukaryotic cell lines was also evaluated by MTT and Neutral Red assays. RESULTS: No antibacterial activity was observed for para-guanidinoethylphenol (MIC >or= 512 mg/L) and synthalin A (MIC >or= 64 mg/L). Conversely, para-guanidinoethylcalix[4]arene and hexamidine: (i) showed a broad antibacterial spectrum, both on Gram-positive and on Gram-negative bacteria (MIC = 4 mg/L against E. coli and 8 mg/L against S. aureus for para-guanidinoethylcalix[4]arene), to a lesser degree against E. faecalis and P. aeruginosa (MIC = 32 mg/L); (ii) were bacteriostatic (MBC >or= 256 mg/L); and (iii) MICs and MBCs obtained for clinical isolates were similar to those obtained with reference strains. Both compounds, the monomer and the calixarene, showed no apparent cytotoxicity, whereas hexamidine and synthalin A had significant toxic effects that increased with time and concentration and in a range of 100-1000 times that for calixarene. CONCLUSIONS: In conclusion, results confirm para-guanidinoethylcalix[4]arene as a broad-spectrum new agent or an auxiliary in antimicrobial chemotherapy.     

Pharmacodynamic studies of trovafloxacin and grepafloxacin in vitro against Gram-positive and Gram-negative bacteria

Grepafloxacin and trovafloxacin are two novel fluoroquinolones with extended Gram-positive bacterial spectra compared with older quinolones. The aim of the present study was to investigate the different pharmacodynamic parameters of grepafloxacin in comparison with those of trovafloxacin. The following studies were performed against various Gram-positive and Gram-negative bacteria: (i) determination of the rate and extent of killing at a concentration corresponding to the 1 h non-protein-bound human serum level following an oral dose of 800 mg grepafloxacin and 300 mg trovafloxacin; (ii) determination of the rate and extent of killing of the two quinolones at different concentrations; (iii) determination of the post-antibiotic effects (PAEs); (iv) determination of the post-antibiotic sub-MIC effects (PA SMEs); (iv) determination of the rate and extent of killing in an in vitro kinetic model. It was shown that both grepafloxacin and trovafloxacin exhibited concentration-dependent killing against both Gram-positive and Gram-negative bacteria. Grepafloxacin exhibited a slower bactericidal effect against all the Gram-positive strains investigated in comparison with trovafloxacin in spite of a similar C(max)/MIC in the static experiments and a similar AUC/MIC ratio in the kinetic experiments. No major differences in the extent and rate of killing were noted against the Gram-negative strains, which were killed almost completely after 3 h except for Pseudomonas aeruginosa. A PAE of both quinolones was noted for all strains investigated. Trovafloxacin induced longer PAEs against the Gram-positive strains but shorter PAEs in comparison with those of grepafloxacin against the Gram-negative strains. A prolonging of the PAEs was noted for all bacteria when exposed to sub-MICs in the post-antibiotic phase. With a similar AUC/MIC of 310 for the penicillin-sensitive strain of Streptococcus pneumoniae and 143 for the penicillin-resistant strain, the time for 99.9% eradication for both strains was 2 h for trovafloxacin and 6 h for grepafloxacin.     

Prevalence of beta-lactam nonsusceptible Gram-negative bacilli and use and interpretation of current susceptibility breakpoints: a survey of infectious disease physicians

Beta-lactam–resistant Enterobacteriaceae represent an important public health problem; however, questions exist about their prevalence and the impact of recent breakpoint changes on clinical practice. We surveyed infectious disease physicians to better understand these issues. Many reported encountering resistant Enterobacteriaceae; respondents generally favored a more conservative interpretation of antimicrobial susceptibility results.     

In vitro and bactericidal activities of ABT-492, a novel fluoroquinolone, against Gram-positive and Gram-negative organisms

In vitro activities of ABT-492, ciprofloxacin, levofloxacin, trovafloxacin, moxifloxacin, gatifloxacin, and gemifloxacin were compared. ABT-492 was more potent against quinolone-susceptible and -resistant gram-positive organisms, had activity similar to that of ciprofloxacin against certain members of the family Enterobacteriaceae, and had comparable activity against quinolone-susceptible, nonfermentative, gram-negative organisms. Bactericidal activity of ABT-492 was also evaluated.     

Susceptibility studies of piperazinyl-cross-linked fluoroquinolone dimers against test strains of Gram-positive and Gram-negative bacteria

Susceptibility testing was used to evaluate potential spectrum of action for piperazinyl-cross-linked fluoroquinolone dimers against test strains of Streptococcus pneumoniae, Streptococcus pyogenes, Escherichia coli, Pseudomonas aeruginosa, Mycobacterium tuberculosis, and vancomycin-resistant Enterococcus faecium (VRE) and to evaluate dimers against fluoroquinolone-resistant and fluoroquinolone-susceptible strains of streptococci. Individual dimers displayed equivalent or lowered MIC values compared with parent fluoroquinolone monomers against test strains of S. pneumoniae, S. pyogenes, E. coli, and VRE. Raised MIC values were observed for all dimers in comparison to monomers against test strains of P. aeruginosa and E. coli. In comparison to parent fluoroquinolones, all dimers displayed decreased percent inhibition of growth against M. tuberculosis. Structural requirements for activity of dimers and partial dimers against all organisms, including lower MICs against certain fluoroquinolone-resistant and fluoroquinolone-susceptible strains of streptococci, were consistent with requirements previously observed for dimers against fluoroquinolone-susceptible and fluoroquinolone-resistant strains of S. aureus. In contrast, the 10- to 100-fold lowering of MICs against wild-type and fluoroquinolone-resistant strains of S. aureus previously observed for individual cross-linked dimers was not observed with test strains of the various organisms used here.     

Activity of CD101, a long-acting echinocandin,against clinical isolates of Candida auris

CD101 is a new echinocandin with a prolonged half-life. CD101 was tested by broth microdilution against 100 isolates of the emerging yeast Candida auris. It showed activity against most isolates, including some that were resistant to other echinocandins.     

Antimicrobial activity of ceftobiprole, a novel anti-methicillin-resistant Staphylococcus aureus cephalosporin, tested against contemporary pathogens: results from the SENTRY Antimicrobial Surveillance Program (2005-2006)

Ceftobiprole is a 1st-in-class anti–methicillin-resistant Staphylococcus aureus (MRSA) extended-spectrum cephalosporin currently in clinical trials for the treatment of complicated skin and skin structure infections (cSSSIs) and nosocomial pneumonia. This agent is also active against other prominent Gram-positive and Gram-negative pathogens, making it an attractive candidate for broad-spectrum therapy. We evaluated the in vitro potency of ceftobiprole tested against the most commonly occurring bacterial pathogens as part of a global surveillance study for the years 2005 to 2006 (>60 medical centers in North America, Latin America, and Europe). All isolates (40 675) were susceptibility tested using reference broth microdilution methods. Ceftobiprole inhibited 100% and >99% of tested S. aureus and coagulase-negative staphylococci at ≤4 and ≤8 μg/mL, respectively, although MIC₉₀ values for oxacillin-resistant strains were 4-fold and 8-fold higher than oxacillin-susceptible isolates for the 2 groups. Ceftobiprole was also broadly active against Streptococcus pneumoniae, β-hemolytic and viridans group streptococci, inhibiting >98% of isolates at ≤0.5 μg/mL. Although ceftobiprole was generally inactive against Enterococcus faecium, the majority of Enterococcus faecalis strains (95.7%) were inhibited at ≤4 μg/mL. This agent was similar in potency to the “3rd- and 4th-generation” cephems (MIC₅₀ values, ≤0.06 μg/mL) for all tested Enterobacteriaceae. Although cefepime provided enhanced coverage against Klebsiella spp. (86.5% at ≤8 μg/mL versus 76.9–81.7% for ceftobiprole and ceftazidime), ceftobiprole and cefepime were superior to ceftazidime against Enterobacter spp. and Citrobacter spp. Against Pseudomonas aeruginosa, ceftobiprole was equal in potency to ceftazidime (MIC₅₀, 2 μg/mL) and 2-fold more potent than cefepime. None of these agents inhibited >45% of Acinetobacter spp. at 8 μg/mL. Ceftobiprole is a new anti-MRSA β-lactam with recognized activity against the most commonly occurring Enterobacteriaceae and P. aeruginosa, similar to that of extended-spectrum cephems. These characteristics warrant continued evaluation of the agent as empiric therapy for cSSSIs, and in pneumonia, especially in those institutions/regions where MRSA and P. aeruginosa may be prevalent.     

Comparative in vitro activity of levofloxacin and ofloxacin against Gram-positive bacteria

The in vitro activity of levofloxacin against 506 Gram-positive bacteria was compared with those of D(−)-ofloxacin, ofloxacin, ciprofloxacin, and sparfloxacin. Levofloxacin was generally twice as active as ofloxacin against these organisms (range, 0–3 twofold dilutions). Sparfloxacin appeared to have the greatest activity overall, but for several groups of organisms minimum inhibitory concentrations (MIC₉₀s) of this com pound were within one twofold dilution of those of levofloxacin. Resistance to levofloxacin (MIC⩾8 μg/ml) was not encountered among streptococcal species, was rare in methicillin-susceptible staphylococci (1.7%), and was infrequent in vancomycin-susceptible Enterococcus faecalis and Enterococcus faecium (8.7%). Resistance was more common among vancomycin-resistant enterococci and methicillin-resistant staphylococci.     

肺炎链球菌对泰利霉素等抗菌药物的体外抗菌活性

目的了解本院分离的肺炎链球菌对泰利霉素等抗菌药物的体外抗菌活性。方法对本院2005--2007年从各种临床标本收集的97株肺炎链球菌，用K—B纸片法进行药敏试验，测定这些菌株对泰利霉素等3种新近上市和其他7种临床常用抗菌药物的耐药性。结果97株肺炎链球菌对泰利霉素和利奈唑胺的敏感率均为100％，对喹奴普丁-达福普汀也未发现耐药菌株，只是有18．8％的菌株表现为中介。其他抗菌药物的耐药情况如下：对红霉素、克林霉素、万古霉素、左氧氟沙星、氯霉素和四环素的耐药率分别为60．8%、58．8％、0％、2．1％、12．8%和64．5％，对青霉素的敏感率为85．6％。结论本院尚未用于临床的3种新近上市的抗菌药物泰利霉素、利奈唑胺和喹奴普丁-达福普汀，对本院分离的肺炎链球菌有良好的体外抗菌活性。而上述细菌对红霉素、林可霉素以及四环素有较高的耐药性。     

Comparative in vitro activities of the novel antibacterial finafloxacin against selected Gram-positive and Gram-negative bacteria tested in Mueller-Hinton broth and synthetic urine

Kill kinetics and MICs of finafloxacin and ciprofloxacin against 34 strains with defined resistance mechanisms grown in cation-adjusted Mueller-Hinton broth (CAMHB) at pH values of 7.2 and 5.8 and in synthetic urine at pH 5.8 were determined. In general, finafloxacin gained activity at low pH values in CAMHB and remained almost unchanged in artificial urine. Ciprofloxacin MICs increased and bactericidal activity decreased strain dependently in acidic CAMHB and particularly in artificial urine.