Comparative antimicrobial activity of gatifloxacin with ciprofloxacin and beta-lactams against gram-positive bacteria.

Gatifloxacin is a new 8-methoxy fluoroquinolone. The in-vitro antibacterial activity of gatifloxacin was compared to that of ciprofloxacin, ceftriaxone, imipenem, piperacillin/tazobactam and amoxicillin/clavulanic acid against 165 streptococcal isolates, 369 staphylococcal isolates, and 50 enterococcal isolates recently recovered from clinical isolates. Gatifloxacin was the most active agent tested against streptococci including penicillin-nonsusceptible Streptococcus pneumoniae (MIC(90) 0.5 microg/mL). Imipenem and gatifloxacin (MIC(90) 0.5 microg/mL) were the most active agents tested against viridans group streptococci. All the agents demonstrated excellent activity against methicillin-susceptible S. aureus. Imipenem, piperacillin/tazobactam, amoxicillin/clavulanic acid, and gatifloxacin had good activity against methicillin-sensitive S. epidermidis. Among the methicillin-sensitive and methicillin-resistant coagulase-negative staphylococci tested, gatifloxacin was the most active agent. Amoxicillin/clavulanic acid and gatifloxacin were the most active agents against E. faecalis. Thus, gatifloxacin possesses equal or superior activity when compared to ciprofloxacin and beta-lactams making it a promising new fluoroquinolone for clinical use in treating Gram-positive infections.

Molecular typing demonstrating transmission of gram-negative rods in a neonatal intensive care unit in the absence of a recognized epidemic.

Molecular typing techniques have been used in outbreak investigations. In this study, molecular typing techniques were used to track the spread of gram-negative rods (GNRs) in a neonatal intensive care unit (NICU) in the absence of an outbreak. Stool or rectal swab cultures for GNRs were obtained from all infants on admission, weekly, and on discharge. GNRs were tested for gentamicin susceptibility and were typed by contour-clamped homogeneous electric field electrophoresis. Transmission of identical strains of GNRs among infants was noted. Shared strains were more gentamicin resistant compared with unique strains (53% vs. 10%; P=.0001). Infants first colonized when they were >1 week of age had more total days of antibiotic treatment and had a higher rate of acquiring a shared and gentamicin-resistant strain, compared with infants colonized earlier. Antibiotic use increases colonization of infants in the NICU with resistant and shared strains of GNRs.

Comparison of in vitro activity of trovafloxacin against gram-positive and gram-negative organisms with quinolones and beta-lactam antimicrobial agents.

The in vitro activity of trovafloxacin against 721 Gram-negative and 498 Gram-positive organisms was determined by the standard microdilution broth method using commercially prepared frozen microtiter plates. The activity of trovafloxacin was compared to ofloxacin, ciprofloxacin, amoxicillin/clavulanate, ampicillin/sulbactam (1:1), piperacillin/tazobactam, ceftriaxone, and imipenem. Trovafloxacin had equal or greater activity compared with the other agents tested against Citrobacter diversus, Enterobacter aerogenes, Enterobacter cloacae, Escherichia coli, Haemophilus influenzae, Stenotrophomonas maltophilia, Serratia marcescens, staphylococci, Streptococcus pneumoniae, Streptococcus pyogenes, Streptococcus viridans, group G streptococci, Enterococcus faecalis, and E. faecium. The reliability of the commercially prepared plates for testing the in vitro activity of the quinolones was evaluated by comparing identical isolates also tested by broth microdilution using laboratory prepared plates. The commercially prepared plates generally correlated, within one- to twofold dilutions, with the laboratory prepared plates. There was, however, a large discrepancy obtained when testing Enterobacter agglomerans and E. cloacae, where the commercially prepared plates yielded a significantly higher MIC90 value.

In-vitro activity of trovafloxacin against sensitive and resistant aerobic bacteria using the standard microdilution broth method and Etest.

A comparison of MICs of trovafloxacin (CP-99,219) determined by the standard microdilution broth method versus the Etest was performed for multiple strains of Gram-positive and Gram-negative bacteria. A comparison was also made of the in-vitro activity of trovafloxacin versus ciprofloxacin and ofloxacin. The MIC50 and MIC90 were determined by both methods for each species tested. The Etest resulted in MICs one to two dilutions higher than the microdilution broth method. Trovafloxacin was the most active agent against Gram-positive organisms. Ciprofloxacin was the most active agent against Citrobacter freundii, Proteus mirabilis, Proteus vulgaris, Morganella morganii and Serratia marcescens, while trovafloxacin had equal or greater activity compared with ciprofloxacin and ofloxacin against the other Gram-negative organisms tested. Overall, ofloxacin was the least active agent tested. In addition, the in-vitro activity of trovafloxacin or ciprofloxacin in combination with ampicillin/sulbactam, gentamicin or vancomycin was evaluated. The combination of trovafloxacin and gentamicin was synergic against two of 20 Enterococcus faecium isolates, the combination of trovafloxacin and ampicillin/sulbactam was synergic against two of 24 Enterococcus faecalis isolates, and the combination of ciprofloxacin and gentamicin was synergic against one of 25 Stenotrophomonas maltophilia isolates. All other antibiotic combinations resulted in an additive or indifferent effect.