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The purpose of this study was to investigate the in-vitro bacteriostatic activity of levofloxacin in comparison with that of ofloxacin, sparfloxacin and ciprofloxacin against 205 strains of Streptococcus pneumoniae (101 penicillin-susceptible, 51 penicillin-intermediate and 53 penicillin-resistant). The isolates were provided between September 1996 and October 1996 by French hospitals participating in the National Co-operative Survey of Pneumococcal Infections. The determination of MICs (mg/L) was made by the agar dilution method. The MIC50 and MIC90 values of the four fluoroquinolones for the three classes of S. pneumoniae (penicillin-susceptible, penicillin-intermediate and penicillin-resistant) were not significantly different. In contrast, the differences in in-vitro activity observed among the four fluoroquinolones against the 205 strains allowed them to be separated into three groups: sparfloxacin (MIC50/90 0.25 mg/L); ciprofloxacin and levofloxacin (MIC50 0.5 and 1 mg/L respectively, MIC90 1 mg/L); and ofloxacin (MIC50 1 mg/L, MIC90 2 mg/L). A total of 204 of the strains had a levofloxacin MIC between 0.25 mg/L and 1 mg/L, and only one of the 205 strains was highly resistant (MIC 16 mg/L). Whatever the level of susceptibility to penicillin, the relative bacteriostatic activity was, in descending order of activity, sparfloxacin, levofloxacin/ciprofloxacin and ofloxacin. These results suggest levofloxacin has potential for the treatment of pneumococcal infections.
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MSSA strains showed lower homology than MRSA strains, in which only two clones were seen. Trovafloxacin showed the best activity against these clinical isolates of S. aureus, since strains carrying one amino acid change in both GyrA and GrlA subunits remained susceptible to this antimicrobial agent. Furthermore, trovafloxacin did not seem to be a substrate for NorA.
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A total of 331 invasive nonduplicated Streptococcus pneumoniae isolates from three sampling periods during 1996 to 2001 were tested for susceptibility to recently developed fluoroquinolones. Five major serotypes, 23F, 6B, 14, 19F, and 3, were frequently encountered in this collection. Penicillin nonsusceptible isolates constituted 52.9% from 1996 to 1997, 61.6% from 1998 to 1999, and 60.0% from 2000 to 2001. Fifty-seven percent of the isolates were susceptible to cefotaxime, 56.5% to ceftriaxone, 54.1% to cefepime, and 52.6% to cefuroxime. Macrolide-susceptible isolates constituted less than 14% of the total sample, and no vancomycin-resistant isolates were detected. For fluoroquinolones, MIC90 was lowest for gemifloxacin (MIC90 = < or = 0.12 microg/ml), followed by moxifloxacin (MIC90 = 0.25 microg/ml), gatifloxacin (MIC90 = 0.5 microg/ml), sparfloxacin (MIC90 = 0.5 microg/ml), levofloxacin (MIC90 = 1 microg/ml), and ciprofloxacin (MIC90 = 2 microg/ml). All isolates were susceptible to sparfloxacin, levofloxacin, gatifloxacin, and gemifloxacin apart from one isolate (0.3%), which was simultaneously resistant to sparfloxacin, levofloxacin, and gatifloxacin. Mutations at the positions S81F of GyrA and D435N and I460V of ParC were detected for this multiple drug resistant isolate. The in vitro results suggest that recently developed fluoroquinolones are very effective against invasive S. pneumoniae isolates in Taiwan. Nevertheless, emerging fluoroquinolone resistance should be acknowledged and clinicians alerted. Surveillance should be carried out to monitor any changes in antibiotic resistance of S. pneumoniae.
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The implementation of an education-based ASP achieved a significant improvement in all antimicrobial agent prescriptions in the surgical unit and a reduction in antimicrobial drug consumption, even when no restrictive measures were implemented.
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The effect of subinhibitory concentrations (1/2-1/32 x MIC) of ciprofloxacin, ofloxacin and levofloxacin on the adherence of three strains of Escherichia coli (a mannose-resistant haemagglutinating clinical isolate, a non-haemagglutinating clinical isolate and the mannose-resistant haemagglutinating ATCC 25922 strain) were studied. Ciprofloxacin had the lowest MIC values but only the 1/2 MIC concentration inhibited adherence of mannose-resistant haemagglutinating strains after exposure to subMIC values. Significant inhibition of adherence was observed with 1/4 x MIC ofloxacin for both haemagglutinating isolate (27096) and the ATCC strain. Levofloxacin might be more effective and safer than ciprofloxacin and ofloxacin as a long acting fluoroquinolone at subMIC values in patients with UTI.
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MRSA isolated in Canadian ICUs in 2005 and 2006 was predominately health care-associated (90.7%), ESBL-producing E coli were all CTX-M producers (72% bla(CTX-M-15)) and VRE primarily harboured a vanA genotype (88.2%). MRSA, ESBL-producing E coli and VRE were frequently multidrug resistant.