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Objective: Infections caused by bacteria growing in blood cultures are important medical problems that cause high morbidity and mortality. The aim of this study is to examine the changes in antibiotic susceptibility and the bacteria isolated from blood samples from various clinics in the five-year period and to determine the antimicrobials that can be chosen in empirical treatment in blood stream infection in our hospital. Methods: Blood samples from our laboratories were evaluated retrospectively between during 2013- 2017. Samples were incubated in an automated system of BACTEC-FX(BD,USA). Conventional methods and automated systems (Phoenix,BD,USA) have been used to identify bacteria. Antibiotic susceptibilities of isolated bacteria were evaluated using the automated systems (Phoenix,BD,USA). Results: A total of 4597 bacterial reproductions that isolated from the blood samples including 1972 (42.9%) gram positive and 2625 (57.1%) gram negative were included in the study. The most frequently isolated gram positive bacteria were Staphylococcus aureus (15.3%) and the gram negative bacteria were Escherichia coli (18,6%). Staphylococcus aureus and coagulase negative staphylococci (CNS) isolates no resistance to glycopeptide or linezolid was found. Resistance of vancomycin and teicoplanin in enterococci was determined as 9.7% while linezolid resistance was 2%. Extended spectrum beta lactamase production was detected in E. coli isolates 46.7%, Klebsiella pneumoniae isolates 63.4%, an increase has been observed in E. coli isolates over the last three years. Over the years it has been determined that resistance of trimethoprim-sulfamethoxazole in S. aureus and CNS isolates were decreases. However, it has been determined that increased resistance rates of netilmisin in E. coli and K. pneumoniae isolates, aztreonam, imipenem and meropenem resistance in Pseudomonas aeruginosa isolates. The most effective antimicrobials were linezolid and glycopeptides in staphylococci and enterococci, carbapenems and amikacin in E. coli, and colistin in K. pneumoniae, Acinetobacter baumannii and P. aeruginosa isolates in our study. Conclusion: The diversity of bacteria isolated from blood cultures and susceptibility to antibiotics varies according to geographical regions, hospital flora and antibiotics used in the hospital. For this reason, it was think that each hospital should determine its own bacterial distribution and antibiotic susceptibility at certain intervals and rational drug use policies have to be designated according to these results to provide benefits in fighting with resistant microorganisms. [ABSTRACT FROM AUTHOR]

Background: Many infections due to Gram-positive cocci (GPC; staphylococci, streptococci and enterococci) regularly involve prolonged systemic antibiotic use. Dalbavancin has demonstrated activity against GPC isolates and has been approved for the treatment of acute bacterial skin and skin structure infections (ABSSSIs) in adults.Objectives: To evaluate the activity of dalbavancin against GPC isolated from a variety of infection types in the USA and Europe.Methods: A total of 14 319 Staphylococcus aureus, 1992 CoNS, 3269 β-haemolytic streptococci (BHS), 2071 Enterococcus faecalis, 936 Enterococcus faecium, 71 Enterococcus gallinarum/casseliflavus and other Enterococcus spp., 3487 Streptococcus pneumoniae and 1063 viridans group streptococci (VGS) causing clinical infections were consecutively collected (2015-16) and tested for susceptibility by broth microdilution methods.Results: All S. aureus (36.4% MRSA) isolates were susceptible to dalbavancin, teicoplanin and vancomycin, while daptomycin and linezolid showed susceptibility rates of >99.9% (according to CLSI criteria). Dalbavancin MIC results were at least 16-fold lower than these comparators against all S. aureus. Dalbavancin was the most potent agent against CoNS [62.2%/59.6% methicillin-resistant (CLSI/EUCAST)], followed by daptomycin, linezolid and vancomycin. All vancomycin-susceptible E. faecalis isolates were inhibited by dalbavancin at ≤0.25 mg/L (FDA susceptible breakpoint). Dalbavancin was very active against BHS (MIC90 0.03 mg/L) and the most active agent against S. pneumoniae and VGS (highest MIC 0.25 mg/L). Ceftriaxone, daptomycin, levofloxacin and vancomycin were also active (93.5%-100.0% susceptible) against VGS, whereas clindamycin, erythromycin, penicillin and tetracycline had lower activity.Conclusions: Dalbavancin appears to be a viable candidate for treating serious infections caused by GPC. [ABSTRACT FROM AUTHOR]

Abstract: Dalbavancin (DAL) is an investigational lipoglycopeptide with a prolonged serum half-life allowing once weekly dosing. DAL potency was assessed in the 2011 SENTRY Antimicrobial Surveillance Program among 1555 isolates sampled from all 9 US Census regions. Monitored Gram-positive cocci included Staphylococcus aureus (SA; 1,036/50.4% MRSA), coagulase-negative staphylococci (CoNS; 115), Enterococcus faecalis (25), E. faecium (31), Streptococcus pyogenes (155), Streptococcus agalactiae (153), and viridans group streptococci (VGS; 40). All susceptibility (S) testing used Clinical and Laboratory Standards Institute reference broth microdilution methods and interpretations. DAL (MIC50/90, 0.06/0.06 μg/mL) was 8- and 16-fold more active than daptomycin (DAP) and vancomycin (VAN), respectively against SA, with MSSA and MRSA having the same MIC90 results. CoNS was slightly more DAL-S (MIC50, ≤0.03μg/mL). The highest staphylococcal DAL MIC was only 0.25 μg/mL. β-Haemolytic streptococci (βHS) and VGS had DAL MIC results ranging from ≤0.03 to 0.25 μg/mL (MIC90, 0.06–0.12 μg/mL), and only enterococci showed elevated DAL MIC results. VanA phenotype–resistant E. faecalis or E. faecium had DAL MIC values at ≥1 μg/mL; VanB strains were DAL-S (MIC, ≤0.25 μg/mL). All cited DAL quantitative values were consistent with earlier surveillance data (2006–2009), without evidence of MIC creep. In conclusion, year 2011 SENTRY Program data for DAL documents sustained potent activity against SA, CoNS, βHS, VGS, and VAN-S enterococci, which averaged 4- to 32-fold greater than VAN, DAP, or linezolid. [Copyright &y& Elsevier]

Clostridium difficile-associated disease (CDAD) has become an important public health problem. The causative organism is acquired by the oral route from an environmental source or by contact with an infected person or a health care worker who serves as a vector. Disruption of the bowel microflora, generally by antibiotics, creates an environment that allows C. difficile to proliferate. Organisms produce toxins A and B, which cause intense inflammation of the colonic mucosa. The syndrome that results includes severe diarrhea, fever, abdominal pain, and leukocytosis. A new strain of C. difficile has become prevalent in the United States, Canada, and the United Kingdom. Identified by pulsed-field gel electrophoresis (PFGE), this strain is called North America PFGE type 1, abbreviated as NAP-1. Clostridium difficile NAP-1 characteristically generates large amounts of toxins A and B, as well as an additional binary toxin and is associated with enhanced morbidity and a poor response to antibiotic therapy. Mild cases of CDAD may respond to cessation of antibiotic therapy, perhaps related to antibody production by the infected person, but most infected persons require antimicrobial therapy. Vancomycin has been approved by the United States Food and Drug Administration for treatment of CDAD, but reluctance to use this antibiotic in the hospital setting has led to reliance on metronidazole as first-line therapy. Recent studies show a high rate of failure, due either to infection by NAP-1 or to the presence, in hospitals, of older and sicker adults who have been treated with many broad-spectrum antibiotics. Nitazoxanide, bacitracin, teicoplanin, and fusidic acid are additional agents that have published efficacy for this indication in humans. Rifaximin and PAR-101 are under investigation. Other therapies, including polymers that bind C. difficile toxin and monoclonal antibodies to toxins, and preventive measures such as toxoid vaccines are also under study. [ABSTRACT FROM AUTHOR]

The article presents a study which is focused on analyzing the effect of weekly dose of dalbavancin drug and daily dose of vancomycin drug on the patients suffering from acute bacterial skin and skin-structure infection (SSSI). The study was conducted on 573 patients of mean age 49 years and 739 adults of mean age 50 years. According to the results of the study, dalbavancin is more effective than vancomycin in the treatment of SSSI.

MDL 62211 is the amide derivative of the teicoplanin complex and MDL 62873 is a more focused amide derivative of the teicoplanin A2-2 peak. Each investigational compound had nearly identical activity and was 2- to 16-fold more active than teicoplanin or vancomycin. The MDL 62873 MICs for 90% of the strains tested were as follows: Staphylococcus aureus, oxacillin susceptible, 0.12 micrograms/ml; S. aureus, oxacillin resistant, 0.25 micrograms/ml; coagulase-negative staphylococci (CNS), oxacillin susceptible, 0.25 micrograms/ml; and CNS, oxacillin resistant, 2 micrograms/ml. CNS isolates from France were generally more susceptible than those tested in the United States. Teicoplanin-resistant U.S. isolates were usually Staphylococcus haemolyticus (1.8% of all tested strains), for which MICs ranged from 32 to greater than 128 micrograms/ml. MDL 62873 was not active against the Bacteroides fragilis group but was generally effective against gram-positive anaerobic strains.