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• W2047996386 abstract "Background: Antimicrobial susceptibility levels of enterococci (including those to glycopeptides) are borne by a broad range of variations, due to the numerous involved variables. Methods: To assess the epidemiology and antimicrobial resistance profile of enterococci identified in all clinical specimens cultured at the bacteriology laboratory of a large Italian teaching hospital in a 2-year period, with special attention deserved to differences between Enterococcus faecalis and Enterococcus faecium and the role of novel compounds effective on multiresistant gram-positive cocci (dalfopristin-quinupristin, linezolid, and levofloxacin), 4628 E. faecalis strains and 648 E. faecium isolates were examined. Results: Compared with the year 2000, during the year 2001, a proportional increase of E. faecium isolates was found opposed to E. faecalis (P < 0.0001), associated with a greater involvement of cardiovascular (P < 0.0001), intra-abdominal (P < 0.0001), and genital tract (P < 0.003). When considering the in vitro susceptibility pattern, E. faecalis proved more sensitive to penicillin, ampicillin, and amoxicillin, and also to nitrofurantoin, levofloxacin, and streptomycin (P < 0.0001). On the other hand, E. faecium had a significantly more elevated susceptibility to gentamicin and dalfopristin-quinupristin (P < 0.0001). Tetracyclines showed a comparable activity against E. faecalis and E. faecium (around 30% of tested strains), as well as linezolid (nearly 99%) and glycopeptides-these last drugs, together with linezolid, showed the greatest activity against enterococci as a whole, as only 2 E. faecalis strains recovered from urine were resistant (0.04% of the 4628 tested strains), and all the 648 E. faecium isolates were susceptible to both teicoplanin and vancomycin. When comparing antimicrobial susceptibility levels, no significant difference was found between years 2000 and 2001, when excluding a slight increase of sensitivity to penicillin, ureidopenicillins, gentamicin, streptomycin, nitrofurantoin, and linezolid for E. faecalis, and penicillin, tetracyclines, and linezolid for E. faecium. Discussion: Our experience of microbiologic monitoring conducted on over 5000 Enterococcus spp. strains evaluated during 24 months pointed out an increased amount of isolates in the year 2001, especially involving E. faecium. The in vitro susceptibility studies confirmed a significantly different profile of E. faecalis opposed to E. faecium. When E. faecalis is of concern, penicillin and ureidopenicillins are still highly effective, but are not in the case of E. faecium, an emerging pathogen in our experience. The maintained in vitro efficacy of nitrofurantoin, gentamicin, and streptomycin is of particular interest. Among recently introduced molecules, linezolid proves effective against around 99% of examined strains, including multiresistant E. faecium isolates. On the other hand, dalfopristin-quinupristin and levofloxacin are characterized by a significantly greater activity against E. faecium and E. faecalis, respectively. Glycopeptides showed lower resistance levels compared with most of literature series and therefore remain the reference compounds for the entire Enterococcus spp., especially when multiresistant baterial strains are of concern. A permanent surveillance of the epidemiology of these organisms in both hospital-acquired and community-acquired infections, the assessment of specific risk factors, the evolution of antibiotic sensitivity levels, and eventual consequences on morbidity and mortality rates are the mainstay of adequate programs of control and prevention. The initial spread of resistance against recently available molecules (last-generation quinolones, streptogramines, and linezolid) recommends a prudent exploitation of older therapeutic resources, which remain effective against most enterococci." @default.
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• W2047996386 date "2004-05-01" @default.
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• W2047996386 title "A 2-Year Survey of Bacteriologic Profile and Antimicrobial Susceptibility Levels of Enterococci in a Large Italian Teaching Hospital" @default.
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• W2047996386 doi "https://doi.org/10.1097/01.idc.0000129848.49755.d0" @default.
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