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Dalbavancin (DECIDE) tested against indicated Gram-positive species in European medical centres: results from France

Abstract number: P541

Leclercq R., Soussy C., Rio Y., Roussel-Delvallez M., Etienne J., Biedenbach D., Jones R.

Objective: To assess the dalbavancin (DAL) spectrum and potency when tested against recent clinical isolates from five medical centres in France from October to December, 2007 (374 strains).

Methods: Standardised and reference-quality susceptibility (S) methods of agar diffusion were applied by each investigator. Etest (ET; AB BIODISK, Solna, Sweden) and CLSI (M2-A9) disk diffusion (DD) tests were performed with concurrent quality control (CLSI M100-S17, 2007) and repeated testing of strains showing unusual resistance (R) patterns in linezolid (LZD)-R, vancomycin (VAN) or DAL-non-S. A total of 374 strains were tested against DAL and VAN by ET; and LZD, cefoxitin (meticillin susceptibility surrogate), levofloxacin (LEV), gentamicin (GEN), tetracycline (TC), erythromycin (ERY), clindamycin (CC; plus D-test, penicillin (PEN) and ceftriaxone (CRO) by DD. All five French sites had acceptable quality control results. DAL-S was defined at leqslant R: less-than-or-eq, slant0.25 mg/L for staphylococci and streptococci.

Results: DAL exhibited geqslant R: gt-or-equal, slanted16-fold greater activity than VAN against the 251 S. aureus (MIC50/90, 0.094/0.125 mg/L), 50 coagulase-negative staphylococci (CoNS; MIC50/90, 0.064/0.125 mg/L) and 73 beta-haemolytic streptococci (BHS; MIC50/90, leqslant R: less-than-or-eq, slant0.016/0.032 mg/L). The most common beta-streptococci group was S. pyogenes (approx. 60% of strains). MRSA rates were uniform from 20 to 29% (average at 25%) among sites and S rates across all staphylococci were LZD (100%), LEV (55–74%), ERY (59–73%), CC (80–86% with additional 9–18% inducible R), TC (93–94%) and GEN (63–98%). D-test positive rates in BHS and CoNS were 0 and 47% of ERY-R/CC-S isolates, respectively. LEV-R BHS (one each of gr. A and G) were detected in Paris. The most elevated DAL MIC results were 0.25 mg/L (two strains, SA and CoNS) from Paris and Lyon.

Conclusions: DAL, a novel glycolipopeptide (t1/2 at 6–8 days; once weekly dosing) showed high activity (MIC90 range, leqslant R: less-than-or-eq, slant0.032–0.125 mg/L) against tested staphylococci and BST from France. The documented DAL activity (geqslant R: gt-or-equal, slanted16-fold greater than VAN) exhibited wide spectrum of coverage of contemporary Gram-positive pathogens endemic to the five centres including strains R to other antimicrobial classes.

Table: Comparative activity of DAL in France (5 sites)

Session Details

Date: 19/04/2008
Time: 00:00-00:00
Session name: 18th European Congress of Clinical Microbiology and Infectious Diseases
Subject:
Location: Barcelona, Spain
Presentation type:
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