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Objectives: Tedizolid and comparator agent in vitro activities were assessed against clinically relevant gram-positive pathogens causing pneumonia in patients in European and US hospitals. Tedizolid was approved in the United States, Europe, and other regions to treat adults with acute bacterial skin and skin structure infections (ABSSSIs) and is being evaluated for treating nosocomial pneumonia. Methods: A total of 6,019 unique clinical isolates deemed to be responsible for community-acquired (CAP) and healthcare-associated pneumonia (HCAP), including hospital-acquired (HAP) in hospitalized patients, were included. A separate analysis included the HAP subset. Isolates originated from 33 and 30 institutions in Europe and the United States, respectively, between 2014 and 2016. Results: No substantive differences in tedizolid MIC values were found for the different species/organism groups over time or by geographic region. Isolates causing HAP showed slightly decreased activity to comparator agents compared to CAP/HCAP isolates. Tedizolid (100.0% susceptible) showed MIC50/90 results of 0.12/0.12 mg/L (US) and 0.12/0.25 mg/L (Europe) when tested against S. aureus HAP isolates, regardless of methicillin susceptibility or year of isolation. Coagulase-negative staphylococci from the United States and Europe (MIC50, 0.12 mg/L) demonstrated identical MIC50 values for tedizolid. Tedizolid exhibited MIC50 results of 0.25 mg/L and 0.12 mg/L when tested against β-hemolytic streptococci and viridans group streptococci isolates, respectively, regardless of geographic region. Conclusions: Tedizolid had potent activity in vitro against this contemporary collection of European and US gram-positive pneumonia isolates that was sustained over a period of 3 years (2014–2016).

In the summer of 1991, simultaneous outbreaks of bloody diarrhea and hemolytic-uremic syndrome caused by Escherichia coli O157:H7 and of bloody diarrhea caused by Shigella sonnei were traced to a lakeside park near Portland, Oregon.We identified cases primarily from routine surveillance reports. In case-control studies, the activities of persons with park-associated E. coli O157:H7 or S. sonnei infections were compared independently with those of three sets of controls. We also evaluated environmental conditions at the park and subtyped the bacterial isolates.We identified 21 persons with park-associated E. coli O157:H7 infections (all of them children; median age, six years) and 38 persons with S. sonnei infections (most of them children). These 59 people had visited the park over a 24-day period. Their illnesses were not associated with food or beverage consumption. All the case patients reported swimming, however, and in case-control studies swimming was strongly associated with both types of infection (P = 0.015 or less). The case patients were more likely than the controls to report having swallowed lake water, and they had spent more time in the lake. Numbers of enterococci indicative of substantial fecal contamination (geometric mean,50 per deciliter) were detected in the swimming area during some but not all of the outbreak period. Park-associated E. coli O157:H7 isolates were identical by pulsed-field gel electrophoresis and were distinguishable from other isolates in the Portland area.Lake water that was fecally contaminated by bathers was the most likely vehicle for the transmission of both the E. coli O157:H7 and the S. sonnei infections. The unusually prolonged outbreak suggests both the survival of these enteric organisms in lake water and a low infectious dose.

Fluconazole in vitro susceptibility test results for 256,882 isolates of Candida spp. were collected from 142 sites in 41 countries from June 1997 to December 2007. Data were collected for 197,619 isolates tested with voriconazole from 2001 to 2007. A total of 31 different species of Candida were isolated. Increased rates of isolation of the common non- albicans species C. glabrata (10.2% to 11.7%), C. tropicalis (5.4% to 8.0%), and C. parapsilosis (4.8% to 5.6%) were noted when the time periods 1997 to 2000 and 2005 to 2007 were compared. Investigators tested clinical isolates of Candida spp. by the CLSI M44-A disk diffusion method. Overall, 90.2% of Candida isolates tested were susceptible (S) to fluconazole; however, 13 of 31 species identified exhibited decreased susceptibility (C. glabrata and C. krusei . Among 197,619 isolates of Candida spp. tested against voriconazole, 95.0% were S and 3% were R. About 30% of fluconazole-R isolates of C. albicans , C. glabrata , C. tropicalis , C. rugosa , C. lipolytica , C. pelliculosa , C. apicola , C. haemulonii , C. humicola , C. lambica , and C. ciferrii remained S to voriconazole. An increase in fluconazole resistance over time was seen with C. parapsilosis , C. guilliermondii , C. lusitaniae , C. sake , and C. pelliculosa . Among the emerging fluconazole-R species were C. guilliermondii (11.4% R), C. inconspicua (53.2% R), C. rugosa (41.8% R), and C. norvegensis (40.7% R). The rates of isolation of C. rugosa , C. inconspicua , and C. norvegensis increased by 5- to 10-fold over the 10.5-year study period. C. guilliermondii and C. rugosa were most prominent in Latin America, whereas C. inconspicua and C. norvegensis were most common in Eastern European countries. This survey identifies several less-common species of Candida with decreased susceptibility to azoles. These organisms may pose a future threat to optimal antifungal therapy and underscore the importance of prompt and accurate species identification and antifungal susceptibility testing.