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Antimicrobial Agents and Chemotherapy, May 1998, p. 1088-1092, Vol. 42, No. 5
0066-4804/98/$04.00+0
Copyright © 1998, American Society for Microbiology. All rights reserved.

Characterization of Vancomycin-Resistant Enterococcus faecium Isolates from the United States and Their Susceptibility In Vitro to Dalfopristin-Quinupristin

G. M. Eliopoulos,1,2,* C. B. Wennersten,1 H. S. Gold,1,2 T. Schülin,1,2 M. Souli,1,2 M. G. Farris,1 S. Cerwinka,3 H. L. Nadler,3 M. Dowzicky,3 G. H. Talbot,3 and R. C. Moellering Jr.1,2

Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts 022151; Harvard Medical School, Boston, Massachusetts 021152; and Rhône-Poulenc Rorer Pharmaceuticals, Inc., Collegeville, Pennsylvania 194263

Received 16 July 1997/Returned for modification 1 December 1997/Accepted 25 February 1998

In the course of clinical studies with the investigational streptogramin antimicrobial dalfopristin-quinupristin, isolates of vancomycin-resistant Enterococcus faecium were referred to our laboratory from across the United States. Seventy-two percent of the strains were of the VanA type, phenotypically and genotypically, while 28% were of the VanB type. High-level resistance to streptomycin or gentamicin was observed in 86 and 81%, respectively, of the VanA strains but in only 69 and 66%, respectively, of the VanB strains. These enterococci were resistant to ampicillin (MIC for 50% of the isolates tested [MIC50] and MIC90, 128 and 256 µg/ml, respectively) and to the other approved agents tested, with the exception of chloramphenicol (MIC90, 8 µg/ml) and novobiocin (MIC90, 1 µg/ml). Considering all of the isolates submitted, dalfopristin-quinupristin inhibited 86.4% of them at concentrations of <= 1 µg/ml and 95.1% of them at <= 2 µg/ml. However, for the data set comprised of only the first isolate submitted for each patient, 94.3% of the strains were inhibited at concentrations of <= 1 µg/ml and 98.9% were inhibited at concentrations of <= 2 µg/ml. Multiple drug resistance was very common among these isolates of vancomycin-resistant E. faecium, while dalfopristin-quinupristin inhibited the majority at concentrations that are likely to be clinically relevant.

* Corresponding author. Mailing address: Department of Medicine-West Campus, BI Deaconess Medical Center, One Deaconess Road, Boston, MA 02215. Phone: (617) 632-8586. Fax: (617) 632-7442. E-mail: geliopou{at}bidmc.harvard.edu.

Antimicrobial Agents and Chemotherapy, May 1998, p. 1088-1092, Vol. 42, No. 5
0066-4804/98/$04.00+0
Copyright © 1998, American Society for Microbiology. All rights reserved.


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