In vitro activity of daptomycin against various VanA VRE species derived from clinical specimens

Abstract number: P1720

Stylianakis A., Tsiplakou S., Papaioannou V., Paraskevopoulou D., Pantazis E., Sardiniari S., Koutsoukou A.

Objectives: To evaluate the in vitro activity of daptomycin against a collection of Vancomycin Resistant Enterococcus (VRE) type VanA isolates belonging to various species, derived from clinical specimens.

Methods: We examined 48 VRE clinical isolates originated from diverse specimens (pus [n = 24], blood [n = 19], urine [n = 3] and bronchoalveolar excretions [n = 2]) of 48 patients treated in different wards of our hospital during a three year time period (2005–2007). These isolates were identified to species level using the automated system VITEK 2 (Biomerieux, France).

The enterococci were characterised as VanA phenotypically, by susceptibility to teicoplanin (i.e teicoplanin MIC of geqslant R: gt-or-equal, slanted32 mg/L, as probable VanA), and were confirmed genotypically by a sandwich hybridisation method using the commercial EVIGENETM VRE detection kit (Statens Serum Institut, Denmark). The MIC levels of teicoplanin, vancomycin and daptomycin were determined using the E-test strips (AB Biodisk, Solna, Sweden) according to the manufacturer's recommendations. As sensitive to daptomycin VRE isolates were considered those with MIC < 4 mg/Ln in accordance to CLSI guidelines (issue M100 S17).

Results: The identification of the isolates showed Enterococcus faecium (n = 32), Enterococcus faecalis (n = 13), Enterococcus avium (n = 2) and Enterococcus durans (n = 1). All the examined VRE isolates belonged to VanA genotype. Both vancomycin and teicoplanin MIC values ranged between 96 and geqslant R: gt-or-equal, slanted256 mg/L. The MIC levels of daptomycin varied between 1 mg/L and 4 mg/L. All the 4 VanA VRE species corresponding to the examined isolates were sensitive to daptomycin.

Conclusion: Daptomycin showed very good in vitro activity against this collection of various VanA VRE species. There were no resistant isolates to daptomycin regardless to enterococcal species. This new antibiotic could be an new option in the treatment of some infections caused by diverse VanA glycopeptide-resistant enterococcus species.

Session Details

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