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•Glycopeptide resistance remains low in Enterococcus faecalisin Germany but achieved 26% in E. faecium.•More than 70% of glycopeptide-resistant E. faeciumwere VanB type (vancomycin-resistant but teicoplanin-susceptible).•Level of glycopeptide resistance in E. faeciumwas significantly lower in isolates from patients in ICUs vs. regular wards.•10.6% of CoNS were teicoplanin-resistant, with resistance only detected in S. epidermidis, S. haemolyticusand S. hominis.•Dalbavancin at ≤0.25 mg/L inhibited all VanB-type isolates and 96% of teicoplanin-resistant CoNS.

ABSTRACTBecause of the increasing bacterial resistance of uropathogens against standard antibiotics, such as trimethoprim (TMP), older antimicrobial drugs, such as nitroxoline (NTX), should be reevaluated. This randomized crossover study investigated the urinary concentrations of parent drugs and their metabolites and their antibacterial activities (urinary inhibitory titers [UITs] and urinary bactericidal titers [UBTs]) against uropathogens at three different urinary pH values within 24 h in six healthy volunteers after a single oral dose of NTX at 250 mg versus TMP at 200 mg. In three additional volunteers, urinary bactericidal kinetics (UBK) were studied after oral administration of NTX at 250 mg three times a day. The mean urinary concentrations of NTX and NTX sulfate in 24 h were 0.012 to 0.507 mg/liter and 0.28 to 27.83 mg/liter, respectively. The mean urinary concentrations of TMP were 18.79 to 41.59 mg/liter. The antibacterial activity of NTX was higher in acidic urine than in alkaline urine, and that of TMP was higher in alkaline urine than in acidic urine. The UITs and UBTs of NTX were generally lower than those of TMP except for a TMP-resistant Escherichia colistrain, for which NTX showed higher UITs/UBTs than did TMP. UBK showed mainly bacteriostatic activity of NTX in urine. NTX exhibits mainly bacteriostatic activity and TMP also shows bactericidal activity in urine against susceptible strains. NTX is a more active antibacterial in acidic urine, and TMP is more active in alkaline urine. The cumulative effects of multiple doses or inhibition of bacterial adherence could not be evaluated. (This study has been registered at EudraCT under registration no. 2009-015631-32.)

Finafloxacin is a novel fluoroquinolone that exhibits enhanced antibacterial activity under acidic conditions. The aim of this study was to define the in vitro pH-activity relationship. Finafloxacin exhibited optimal antibacterial activity between pH 5.0 and 6.0 at which MICs were 4- to 8-fold lower than those determined at neutral pH. These observations were then confirmed against a larger collection of bacteria. These data suggest that finafloxacin could potentially offer a therapeutic advantage within acidic foci of infection.

ABSTRACTFinafloxacin is a novel fluoroquinolone that exhibits enhanced antibacterial activity under acidic conditions. The aim of this study was to define the in vitropH-activity relationship. Finafloxacin exhibited optimal antibacterial activity between pH 5.0 and 6.0 at which MICs were 4- to 8-fold lower than those determined at neutral pH. These observations were then confirmed against a larger collection of bacteria. These data suggest that finafloxacin could potentially offer a therapeutic advantage within acidic foci of infection.

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AbstractObjective:To investigate the background of changes of resistance phenotypes in methicillin-resistant Staphylococcus aureus(MRSA) from nosocomial infections in German hospitals by molecular typing and identification of particular resistance genes.Methods:Isolates from the network for monitoring the spread of MRSA in Germany were subjected to quantitative susceptibility testing, to molecular typing, and to polymerase chain reaction identification of resistance genes.Participants:The network consists of 175 German clinical microbiological laboratories collaborating with the German Reference Center for Staphylococci, which performs typing of staphylococcal isolates from nosocomial infections and data analysis.Results:During the past 5 years, MRSA susceptible to other antibiotics such as oxytetracycline, erythromycin, and gentamicin became more frequent. The proportion of epidemic MRSA clones that had been disseminated in the past and that exhibited broad resistance phenotypes decreased, whereas the proportion of recently emerging MRSA carrying only a few other resistance determinants has increased (1994, 11.5%; 1998, 39%).Conclusions:The changing pattern of resistance phenotypes of MRSA from nosocomial infections in Germany is mainly due to the spread of recently emerging epidemic strains that are less frequently resistant to antibacterials other than oxacillin. The observed changes cannot simply be attributed to overall antibiotic consumption.

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ABSTRACTIn a prospective multicenter study (1996 to 1999), 156 episodes of bacteremic streptococcal infections of neutropenic patients were evaluated. Streptococcus oralis(26.3%),S. pneumoniae(26.3%), S. agalactiae(11.5%),S. mitis(9%), and S. pyogenes(5.8%) were the predominant species. Four strains (2.6%) were found to be intermediately resistant to penicillin. One strain (0.6%) was found to be highly resistant to penicillin (MIC, 8 mg/liter). Reduced susceptibility to penicillin was detected among S. oralis(14.6%), S. mitis(7.1%), and S. pneumoniae(4.9%) isolates but was not recorded among S. agalactiaeand S. pyogenes. Resistance rates and intermediate resistance rates for other antimicrobials were as follows (all species): amoxicillin, 1.3 and 3.2%; erythromycin, 16 and 2.6%; clindamycin, 5.8 and 0%; ciprofloxacin, 1.9 and 7.7%. Quinupristin-dalfopristin showed good in vitro activity against most streptococcal isolates (MIC at which 50% of the isolates were inhibited [MIC50], 0.5 mg/liter; MIC90, 1 mg/liter, MIC range, 0.25 to 4 mg/liter).

ABSTRACTAntibiotic-resistant gram-positive bacteria have become an increasing problem in the last two decades. In order to evaluate the prevalence of antibiotic resistance in staphylococcal bloodstream isolates in Germany, 2,042 staphylococci collected in 21 tertiary-care hospitals were investigated during a 3-year period (March 1996 to March 1999). Altogether, 1,448 S. aureusisolates and 594 coagulase-negative staphylococci (CoNS) that comprised 13 different species were included. Furthermore, the antistaphylococcal activities of quinupristin-dalfopristin were compared with those of eight other compounds by the broth microdilution method. The rates of oxacillin resistance in Staphylococcus aureus, S. epidermidis, S. haemolyticus, and other CoNS were 13.5, 69, 90, and 34%, respectively. In oxacillin-resistant strains high rates of resistance (up to 100%) to erythromycin, clindamycin, ciprofloxacin, and gentamicin were also observed. However, no strain appeared to be resistant to vancomycin or quinupristin-dalfopristin. The streptogramin combination exhibited excellent in vitro activity against all staphylococcal species tested, regardless of the patterns of resistance to other drug classes. In terms of MICs at which 90% of the isolates are inhibited, quinupristin-dalfopristin was 2 times more active against S. aureusisolates, 4 to 16 times more active against S. haemolyticus, and 8 to 32 times more active against S. epidermidisthan vancomycin or teicoplanin.

to present data on prevalence and interregional spread of methicillin-resistant Staphylococcus aureus(MRSA) in Germany.

Objective: to present data on prevalence and interregional spread of methicillin‐resistant Staphylococcus aureus(MRSA) in Germany.

ABSTRACTOf 595 isolates of Streptococcus pneumoniaefrom outpatients with respiratory tract infections, collected from 17 microbiology laboratories, 14.1% were resistant to erythromycin. Eighty-three erythromycin-resistant isolates were genetically analyzed, 83.1% of which harbored the ermBgene. Only four isolates (4.8%) harbored the mefAgene. Telithromycin exhibited potent activity against all isolates.

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In a multicentre study conducted by the Paul Ehrlich Society we tested 3482 Staphylococcus aureus strains, isolated in different hospitals in West Germany, Austria and Switzerland, against 12 antibiotics with standardized techniques between 1976 and 1982. In order to avoid mistakes in the classification of the strains into sensitive, intermediate and resistant, we adapted breakpoints to the population distribution. There were no marked changes in the incidence of sensitive strains during the period. Striking differences from one hospital to another were observed. The percentage of strains sensitive to penicillin remains low (27%). The other antibiotics studied show activity against 80–100% of strains.