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CORRESPONDENCE
Year : 2014  |  Volume : 32  |  Issue : 3  |  Page : 353-354
 

Daptomycin as a promising antimicrobial agent for the treatment of serious infections caused by resistant gram-positive organisms


1 Department of Microbiology, Institute of Laboratory, Max Super Speciality Hospital, Saket, New Delhi, India
2 Department of Medicine, Max Super Speciality Hospital, Saket, New Delhi, India

Date of Submission17-Jun-2013
Date of Acceptance10-Aug-2013
Date of Web Publication10-Jul-2014

Correspondence Address:
B Tarai
Department of Microbiology, Institute of Laboratory, Max Super Speciality Hospital, Saket, New Delhi
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0255-0857.136616

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How to cite this article:
Tarai B, Das P, Kumar D. Daptomycin as a promising antimicrobial agent for the treatment of serious infections caused by resistant gram-positive organisms. Indian J Med Microbiol 2014;32:353-4

How to cite this URL:
Tarai B, Das P, Kumar D. Daptomycin as a promising antimicrobial agent for the treatment of serious infections caused by resistant gram-positive organisms. Indian J Med Microbiol [serial online] 2014 [cited 2019 Sep 15];32:353-4. Available from: http://www.ijmm.org/text.asp?2014/32/3/353/136616


Dear Editor,

Multidrug-resistant (MDR) Gram-positive bacteria have posed a major therapeutic challenge in the past few years. We aimed to evaluate the in vitro antimicrobial efficacy of daptomycin (DAP), teicoplanin (TEIC), linezolid (LNZ) and vancomycin (VAN) against 183 clinical isolates of methicillin-resistant Staphylococcus aureus (MRSA) (n = 80), methicillin-resistant coagulase-negative Staphylococcus species (MR-CoNS) (n = 80) and vancomycin-resistant Enterococci (VRE) (n = 23) at a super-specialty hospital in north India in February 2013. Identification and antimicrobial susceptibility testing was done by Vitek 2 system (bioMérieux, Marcy i etoile, France) according to manufacturer's instructions using CLSI breakpoints. [1] For DAP, MIC testing by Etest was also done (bioMérieux) for further confirmation. S. aureus ATCC 29213 and E. faecalis ATCC 29212 strains were used for internal quality control.

All MRSA isolates were susceptible to DAP, LNZ, VAN and TEIC. MICs were found to be high for VAN, i.e., MIC 50 (VAN 1 μg/mL vs. DAP 0.25 μg/mL) and MIC 90 (VAN 1.5 μg/mL vs. DAP 0.75 μg/mL) [Table 1]. All MR-CoNS isolates were susceptible to DAP and VAN, 95.5% to LNZ, and 91.1% to TEIC [Table 1]. Among VRE also, DAP showed 100% susceptibility (MIC 50 = 1.5 μg/mL, MIC 90 = 3.0 μg/mL), 87% isolates were susceptible to LNZ (MIC 50 = 2 μg/mL, MIC 90 = 8 μg/mL); while 13% were resistant to LNZ. Only 8.7% VRE isolates were susceptible to TEIC.
Table 1: Antimicrobial activity of antibiotics tested against MRSA, MR-CoNS and VRE


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The present study suggests superior activity of DAP as compared to VAN against MRSA, MR-CoNS and VRE isolates. DAP also showed superior activity against MR-CoNS and VRE isolates as compared to LNZ and TEIC, and equivalent activity as compared to LNZ and TEIC against MRSA. Various large multicentre studies have shown that VAN susceptibility has significantly changed over time. [2] Recent consensus guidelines recommend alternative agents for MRSA infections when the VAN MIC is> 1 μg/mL. [3] In wake of increasing MICs to VAN, judicious use of VAN should be enforced, at the same time using alternative drugs when appropriate.


 ~ Acknowledgement Top


I thank Ms. Chongtham Geeta Chanu for her support in data management during the study.

 
 ~ References Top

1.Clinical and Laboratory Standards Institute. Performance standards for antimicrobial susceptibility testing; twenty-second informational supplement. Document M100-S22. CLSI 2012, Wayne, PA.  Back to cited text no. 1
    
2.Steinkraus G, White R, Friedrich L. Vancomycin MIC creep in non-vancomycin-intermediate Staphylococcus aureus (VISA), vancomycin-susceptible clinical methicillin-resistant S. aureus (MRSA) blood isolates from 2001-05. J Antimicrob Chemother 2007;60:788-94.  Back to cited text no. 2
    
3.Moore CL, Osaki-Kiyan P, Haque NZ, Perri MB, Donabedian S, Zervos MJ. Daptomycin versus vancomycin for bloodstream infections due to methicillin-resistant Staphylococcus aureus with a high vancomycin minimum inhibitory concentration: A case-control study. Clin Infect Dis 2012;54:51-8.  Back to cited text no. 3
    



 
 
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