In vitro activity of oritavancin and comparator agents against staphylococci, streptococci and enterococci from clinical infections in Europe and North America, 2011-2014.

Oritavancin is a lipoglycopeptide that has been approved for the treatment of acute bacterial skin and skin-structure infections (ABSSSIs) caused by susceptible organisms. Oritavancin causes cell death by inhibiting cell wall synthesis as well as depolarising and permeabilising the cellular membrane of Gram-positive pathogens. The activities of oritavancin in comparison with vancomycin, daptomycin and linezolid were determined against a collection of over 11000 recent clinical Gram-positive isolates from patient infections (2011-2014), including skin and skin-structure infections. A total of 7253 Staphylococcus aureus, 839 coagulase-negative staphylococci (CoNS), 1464 enterococci and 1637 ß-haemolytic streptococci (ßHS) were collected from the USA and Europe. Minimum inhibitory concentrations (MICs) were determined using Clinical and Laboratory Standards Institute (CLSI) broth microdilution methods, and susceptibility was determined using CLSI and US Food and Drug Administration (FDA) (for oritavancin) breakpoint criteria. Equivalent in vitro activity (MIC50/90, 0.015-0.03/0.06 µg/mL) was observed for oritavancin against meticillin-resistant S. aureus (MRSA), meticillin-susceptible S. aureus (MSSA) and Enterococcus faecalis in both regions. Slightly higher oritavancin MICs were obtained against CoNS, Streptococcus agalactiae, Enterococcus faecium (MIC90, 0.12 µg/mL) and against other ßHS (MIC90, 0.25 µg/mL). Oritavancin demonstrated comparatively lower MICs than daptomycin and vancomycin when tested against multidrug-resistant S. aureus, vancomycin-resistant enterococci and erythromycin-resistant ßHS. Oritavancin exhibited potent in vitro activity against the most common pathogens associated with ABSSSIs in the USA and Europe.

Saving our smallest patients.

The feedback from the staff that participated in the Full Scale Drill was overwhelmingly positive. Working and becoming acquainted with members from other supporting departments is critical to a successful evacuation. They enjoyed being a part of the drill and expressed that having ownership of an evacuation plan is vital in the care of our babies. This turned out to be a remarkable team building exercise on many levels. The planning team achieved its overall goal of creating a sense of control over a potentially chaotic environment and now believes that they could execute an evacuation for any reason with maximum protection for their patients. In a similar way various groups in and outside of the Medical Center have an understanding of the complexities of this patient group and what would be needed to effectively support their needs in a disaster. The NICU/CCN Evacuation Committee looks back over almost a year of hard work with tremendous satisfaction and renewed confidence.

Taking the trauma out of security.

At Baystate Medical Center (BMC) in Springfield, MA, security and psychiatric nursing staff in BMC's Adult Psychiatric Training Unit (APTU) were at odds after a radical change in APTU patient behavioral modification practices made the security department believe that its resource were being wasted. To bridge the misunderstanding between the groups, calm tensions, and foster cooperation, a staff training and shadowing program was developed and implemented.