scholarly journals Nitrofurantoin Is Active against Vancomycin-Resistant Enterococci

2001 ◽  
Vol 45 (1) ◽  
pp. 324-326 ◽  
Author(s):  
George G. Zhanel ◽  
Daryl J. Hoban ◽  
James A. Karlowsky
Keyword(s):  
Urinary Tract ◽  
Effective Treatment ◽  
Enterococcus Faecalis ◽  
Urinary Tract Infections ◽  
Enterococcus Faecium ◽  
Vancomycin Resistant Enterococci ◽  
Vancomycin Resistant ◽  
Enterococcus Gallinarum ◽  
Tract Infections

ABSTRACT The activity of nitrofurantoin was tested against 300 isolates ofEnterococcus faecium, Enterococcus faecalis, and Enterococcus gallinarum. No isolates tested were resistant to nitrofurantoin (MIC, ≥128 μg/ml), including vancomycin-resistant E. faecium isolates withvanA- and vanB-positive genotypes and vancomycin-resistant E. gallinarum isolates. We conclude that nitrofurantoin may provide effective treatment of urinary tract infections caused by vancomycin-resistant enterococci.

scholarly journals Antibody-Based Therapy for Enterococcal Catheter-Associated Urinary Tract Infections

mBio ◽  
2016 ◽  
Vol 7 (5) ◽  
Author(s):  
Ana L. Flores-Mireles ◽  
Jennifer N. Walker ◽  
Aaron Potretzke ◽  
Henry L. Schreiber ◽  
Jerome S. Pinkner ◽  
...  
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Urinary Tract Infections ◽  
Host Protein ◽  
Medical Procedure ◽  
Vancomycin Resistant Enterococci ◽  
Fibrinogen Binding ◽  
Vancomycin Resistant ◽  
Tract Infections

ABSTRACT Gram-positive bacteria in the genus Enterococcus are a frequent cause of catheter-associated urinary tract infection (CAUTI), a disease whose treatment is increasingly challenged by multiantibiotic-resistant strains. We have recently shown that E. faecalis uses the Ebp pilus, a heteropolymeric surface fiber, to bind the host protein fibrinogen as a critical step in CAUTI pathogenesis. Fibrinogen is deposited on catheters due to catheter-induced inflammation and is recognized by the N-terminal domain of EbpA (EbpA NTD ), the Ebp pilus’s adhesin. In a murine model, vaccination with EbpA NTD confers significant protection against CAUTI. Here, we explored the mechanism of protection using passive transfer of immune sera to show that antisera blocking EbpA NTD -fibrinogen interactions not only is prophylactic but also can act therapeutically to reduce bacterial titers of an existing infection. Analysis of 55 clinical CAUTI, bloodstream, and gastrointestinal isolates, including E. faecalis , E. faecium , and vancomycin-resistant enterococci (VRE), revealed a diversity of levels of EbpA expression and fibrinogen-binding efficiency in vitro . Strikingly, analysis of 10 strains representative of fibrinogen-binding diversity demonstrated that, irrespective of EbpA levels, EbpA NTD antibodies were universally protective. The results indicate that, despite diversity in levels of fibrinogen binding, strategies that target the disruption of EbpA NTD -fibrinogen interactions have considerable promise for treatment of CAUTI. IMPORTANCE Urinary catheterization is a routine medical procedure, and it has been estimated that 30 million Foley catheters are used annually in the United States. Importantly, placement of a urinary catheter renders the patient susceptible to developing a catheter-associated urinary tract infection, accounting for 1 million cases per year. Additionally, these infections can lead to serious complications, including bloodstream infection and death. Enterococcus strains are a common cause of these infections, and management of enterococcal infections has been more difficult in recent years due to the development of antibiotic resistance and the ability of strains to disseminate, resulting in a major threat in hospital settings. In this study, we developed an antibiotic-sparing treatment that is effective against diverse enterococcal isolates, including vancomycin-resistant enterococci, during catheter-associated urinary tract infections.

scholarly journals Comparison of Simple and Rapid Methods for Identifying Enterococci Intrinsically Resistant to Vancomycin

1999 ◽  
Vol 37 (3) ◽  
pp. 815-817 ◽  
Author(s):  
Kevan L. Hanson ◽  
Charles P. Cartwright
Keyword(s):  
Enterococcus Faecalis ◽  
Enterococcus Faecium ◽  
Rapid Methods ◽  
Vancomycin Resistant Enterococci ◽  
Litmus Milk ◽  
Overnight Incubation ◽  
Enterococcus Casseliflavus ◽  
Vancomycin Resistant ◽  
Enterococcus Gallinarum

Three different methodologies, reduction of litmus milk (LM) and acidification of arabinose (ARA), acidification of methyl-α-d-glucopyranoside (MGP), and rapid motility (RM), for differentiating isolates of Enterococcus casseliflavus and Enterococcus gallinarum(intrinsically vancomycin-resistant enterococci [IVRE]) fromEnterococcus faecalis and Enterococcus faeciumwere evaluated. All 33 isolates of E. faecalis tested reduced LM within 4 h and were negative in all other tests, while the 53 isolates of E. faecium were ARA positive only. In contrast, 45 of 46 (98%) IVRE isolates examined (26 E. casseliflavus and 20 E. gallinarum isolates) acidified MGP, 41 of 46 (89%) were LM and ARA positive, and 45 of 46 (98%) were RM positive. Acidification of MGP was therefore the single most useful test for differentiating IVRE from vancomycin-resistantE. faecium and E. faecalis; however, a combination of LM-ARA and RM testing enabled the correct designation of organisms without the need for overnight incubation.

scholarly journals Analysis of Susceptibility to Selected Antibiotics in Klebsiella pneumoniae, Escherichia coli, Enterococcus faecalis and Enterococcus faecium Causing Urinary Tract Infections in Kidney Transplant Recipients over 8 Years: Single-Center Study

Antibiotics ◽  
2020 ◽  
Vol 9 (6) ◽  
pp. 284 ◽  
Author(s):  
Olga Maria Rostkowska ◽  
Robert Kuthan ◽  
Anna Burban ◽  
Jagoda Salińska ◽  
Michał Ciebiera ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Urinary Tract ◽  
Klebsiella Pneumoniae ◽  
Clavulanic Acid ◽  
Enterococcus Faecalis ◽  
Urinary Tract Infections ◽  
Enterococcus Faecium ◽  
Cefuroxime Axetil ◽  
Amoxicillin Clavulanic Acid ◽  
Tract Infections

Background: Urinary tract infections (UTIs) are the most common bacterial infections among kidney transplant (KTX) recipients. The purpose of this study was to analyze antimicrobial resistance (AMR) in four most common pathogens responsible for UTIs in KTX recipients and determine risk factors (RF) for resistance in the same group. Methods: Analyzed antibiograms were based on urine samples positive for bacterial growth of 105 colony-forming units (CFU)/mL obtained from hospitalized adult KTX recipients presenting with UTI symptoms upon admission to the center in years 2011–2018. Results: In total, 783 antibiograms were analyzed for Klebsiella pneumoniae (258 samples, 33.0%), Escherichia coli (212, 27.0%), Enterococcus faecalis (128, 24.0%), and Enterococcus faecium (125, 16.0%). The decrease in susceptibility of E. coli to amoxicillin/clavulanic acid (62.9% vs. 40.0%) and ciprofloxacin (100% to 40.0%) was observed. Susceptibility to gentamicin increased from 33.3% to 92.9% in E. faecium. Susceptibility to tigecycline remained 100% through all years in case of E. faecalis and E. faecium. Male gender was a RF for resistance to amoxicillin/clavulanic acid (p = 0.008), ciprofloxacin (p = 0.0003), trimethoprim/sulfamethoxazole (p = 0.00009), ceftriaxone (p = 0.0001), and cefuroxime axetil (p = 0.00038) in K. pneumoniae and against gentamicin in E. faecalis (p = 0.015). Higher resistance to ampicillin in E. faecalis (p = 0.012) and to ciprofloxacin (p = 0.0003), trimethoprim/sulfamethoxazole (p = 0.007), piperacillin/tazobactam (p = 0.003), ceftriaxone (p = 0.001), and cefuroxime axetil (p = 0.013) in K. pneumoniae was observed in higher age groups of patients. Diabetes as a cause of kidney insufficiency (p = 0.026) and kidney-pancreas transplantation (p = 0.014) was RF for resistance to ceftriaxone in K. pneumoniae. Conclusions: AMR in uropathogens from KTX recipients fluctuated. There were identifiable RFs for resistance in the examined bacteria–antibiotic combinations. We recommend continuous mapping of site-specific microorganisms as etiology and susceptibility may vary between institutions and over time.

scholarly journals Urinary Excretion and Bactericidal Activities of Gemifloxacin and Ofloxacin after a Single Oral Dose in Healthy Volunteers

2001 ◽  
Vol 45 (12) ◽  
pp. 3524-3530 ◽  
Author(s):  
Christoph K. Naber ◽  
Michaela Hammer ◽  
Martina Kinzig-Schippers ◽  
Christian Sauber ◽  
Fritz Sörgel ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Staphylococcus Aureus ◽  
Urinary Tract ◽  
Urinary Excretion ◽  
Enterococcus Faecalis ◽  
Urinary Tract Infections ◽  
Parent Drug ◽  
Oral Dosage ◽  
Tract Infections ◽  
Cumulative Excretion

ABSTRACT In a randomized crossover study, 16 volunteers (8 men, 8 women) received single oral doses of 320 mg of gemifloxacin and 400 mg of ofloxacin on two separate occasions in the fasting state to assess the urinary excretion and urinary bactericidal titers (UBTs) at intervals for up to 144 h. Ofloxacin showed higher concentrations in urine compared with those of gemifloxacin. The median (range) cumulative excretion of gemifloxacin was 29.7% (8.4 to 48.7%) of the parent drug administered, and median (range) cumulative excretion of ofloxacin was 84.3% (46.5 to 95.2%) of the parent drug administered. The UBTs, i.e., the highest twofold dilutions (with antibiotic-free urine as the diluent) of urine that were still bactericidal, were determined for a reference strain and nine uropathogens for which the MICs of gemifloxacin and ofloxacin were as follows:Escherichia coli ATCC 25922, 0.016 and 0.06 μg/ml, respectively; Klebsiella pneumoniae, 0.03 and 0.06 μg/ml, respectively; Proteus mirabilis, 0.125 and 0.125 μg/ml, respectively; Escherichia coli, 0.06 and 0.5 μg/ml, respectively; Pseudomonas aeruginosa, 1 and 4 μg/ml, respectively; Staphylococcus aureus, 0.008 and 0.25 μg/ml, respectively; Enterococcus faecalis, 0.06 and 2 μg/ml, respectively;Staphylococcus aureus, 0.25 and 4 μg/ml, respectively;Enterococcus faecalis, 0.5 and 32 μg/ml, respectively; and Staphylococcus aureus, 2 and 32 μg/ml, respectively. Generally, the UBTs for gram-positive uropathogens were higher for gemifloxacin than for ofloxacin and the UBTs for gram-negative uropathogens were higher for ofloxacin than for gemifloxacin. According to the UBTs, ofloxacin-resistant uropathogens (MICs, ≥4 mg/liter) should also be considered gemifloxacin resistant. Although clinical trials have shown that gemifloxacin is effective for the treatment of uncomplicated urinary tract infections, whether an oral dosage of 320 mg of gemifloxacin once daily is also adequate for the treatment of complicated urinary tract infections has yet to be confirmed.

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