In vitro susceptibility to everninomycin of gram-positive nosocomial pathogens isolated from intensive care units in Germany

Background: Gram-positive bacteria are increasingly found to be causative p athogens in nosocomial infections, and the occurrence of vancomycin resista nce in enterococci as well as staphylococci has prompted the investigation of alternative antimicrobial agents active against these strains. Everninom ycin, a new oligosaccharide antibiotic, has excellent in vitro activity aga inst gram-positive bacteria, including those resistant to vancomycin. Howev er, avilamycin, a related compound, has been used in Europe as a growth pro moter in animal food for years and concern has been raised that cross-resis tance in clinical isolates may arise. Methods: We studied a collection of 2 68 nosocomial gram-positive isolates from intensive care unit patients with nosocomial pneumonia, urinary tract infection and sepsis, using standard i n vitro susceptibility testing. Results: It could be shown that all species tested were exquisitely sensitive to everninomycin (MIC90 of 0.38 mug/ml f or Staphylococcus aureus, 0.5 mug/ml for enterococci and 0.75 mug/ml for co agulase-negative staphylococci). Furthermore, no difference could be observ ed between methicillin-resistant and methicillin-sensitive S. aureus or bet ween Enterococcus faecium and Enterococcus faecalis. Conclusions: These res ults suggest that everninomycin is a promising antibiotic for the treatment of nosocomial infections in intensive care unit patients and that the use of a related substance as an additive in animal food has not yet promoted r esistance in clinical isolates. Copyright (C) 2001 S. Karger AG, Basel.