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Journal of Clinical Microbiology, August 2000, p. 2819-2823, Vol. 38, No. 8
0095-1137/00/$04.00+0
Copyright © 2000, American Society for Microbiology. All rights reserved.

Nationwide German Multicenter Study on Prevalence of Antibiotic Resistance in Staphylococcal Bloodstream Isolates and Comparative In Vitro Activities of Quinupristin-Dalfopristin

Christof von Eiff,1 Ralf René Reinert,2,* Michael Kresken,3 Johannes Brauers,3 Dieter Hafner,4 and Georg Peters1,dagger for the Multicenter Study on Antibiotic Resistance in Staphylococci and Other Gram-Positive Cocci Study (Mars) Group

Institute of Medical Microbiology, Westfälische Wilhelms-Universität, D-48149 Münster,1 Institute for Medical Microbiology, National Reference Center for Streptococci, University Hospital, D-52057 Aachen,2 Rhône-Poulenc Rorer Arzneimittel GmbH, D-50829 Cologne,3 and Institute for Pharmacology, Heinrich-Heine-Universität, D-40225 Düsseldorf,4 Germany

Received 22 February 2000/Returned for modification 28 April 2000/Accepted 19 May 2000

Antibiotic-resistant gram-positive bacteria have become an increasing problem in the last two decades. In order to evaluate the prevalence of antibiotic resistance in staphylococcal bloodstream isolates in Germany, 2,042 staphylococci collected in 21 tertiary-care hospitals were investigated during a 3-year period (March 1996 to March 1999). Altogether, 1,448 S. aureus isolates and 594 coagulase-negative staphylococci (CoNS) that comprised 13 different species were included. Furthermore, the antistaphylococcal activities of quinupristin-dalfopristin were compared with those of eight other compounds by the broth microdilution method. The rates of oxacillin resistance in Staphylococcus aureus, S. epidermidis, S. haemolyticus, and other CoNS were 13.5, 69, 90, and 34%, respectively. In oxacillin-resistant strains high rates of resistance (up to 100%) to erythromycin, clindamycin, ciprofloxacin, and gentamicin were also observed. However, no strain appeared to be resistant to vancomycin or quinupristin-dalfopristin. The streptogramin combination exhibited excellent in vitro activity against all staphylococcal species tested, regardless of the patterns of resistance to other drug classes. In terms of MICs at which 90% of the isolates are inhibited, quinupristin-dalfopristin was 2 times more active against S. aureus isolates, 4 to 16 times more active against S. haemolyticus, and 8 to 32 times more active against S. epidermidis than vancomycin or teicoplanin.

* Corresponding author. Mailing address: Institute for Medical Microbiology, National Reference Center for Streptococci, University Hospital, Pauwelsstr. 30, D-52057 Aachen, Germany. Phone: 49 241 8089787. Fax: 49 241 8888 483. E-mail: Reinert{at}rwth-aachen.de.

dagger Members of the Multicenter Study on Antibiotic Resistance in Staphylococci and other Gram-Positive Cocci Study Group (all in Germany) are U. Hadding and F. J. Schmitz, Institute for Medical Microbiology and Virology, Heinrich-Heine-Universität, Düsseldorf; D. Mack, Institute for Medical Microbiology and Immunology, University Hospital Eppendorf, Hamburg; U. Göbel and E. Halle, Institute for Medical Microbiology and Hygiene, Universitätsklinikum Charité, Humboldt-Universität, Berlin; J. Bader and B. Grabein, Max-von-Pettenkofer-Institute for Medical Microbiology and Hygiene, Klinikum Grosshadern, Munich; W. Pfister and E. Straube, Institute for Medical Microbiology, Friedrich-Schiller-Universität, Jena; A.-F. Saleh, Städtisches Klinikum Merheim, Cologne; W. Bredt and A. Serr, Institute for Medical Microbiology and Hygiene, Albert-Ludwigs-Universität, Freiburg; B. Ganster and H. Geiss, Institute for Hygiene, Ruprecht-Karls-Universität, Heidelberg; S. Korn and P. M. Shah, Department of Infectious Diseases, Johann-Wolfgang-Goethe Universität, Frankfurt; F. D. Daschner, U. Frank, and D. Mlangeni, Institute for Environmental Medicine and Hospital Hygiene, Albert-Ludwigs-Universität, Freiburg; E. Pleß and A. C. Rodloff, Institute for Medical Microbiology and Epidemiology of Infectious Diseases, Universität Leipzig; V. Brade and V. Schäfer, Institute for Hygiene, Johann-Wolfgang-Goethe-Universität, Frankfurt; H. Seifert, Institute for Hygiene, Universität Köln, Cologne; H. Hahn and J. Wagner, Institute for  Medical Microbiology, Universitätsklinikum Benjamin Franklin, Freie Universität, Berlin; K. Kamereck and T. Max, Institute for Medical Microbiology, Immunology and Hygiene, Technische Universität, Munich; O. Zimmermann and E. Eiffert, Institute for Hygiene, Georg-August-Universität, Göttingen; G. Wichmann and E. Jacobs, Institute for Medical Microbiology and Hygiene, Technische Universität, Dresden; N. Lehn, Institute for Medical Microbiology and Hygiene, Friedrich Alexander-Universität, Regensburg; D. Bitter-Suermann and S. Weber, Institute for Medical Microbiology, Medizinische Hochschule, Hanover; G. Peters and C. von Eiff, Institute of Medical Microbiology, Westfälische-Wilhelms-Universität, Münster; and J. Brauers and M. Kresken, Rhône-Poulenc Rorer Arzneimittel GmbH, Cologne.

Journal of Clinical Microbiology, August 2000, p. 2819-2823, Vol. 38, No. 8
0095-1137/00/$04.00+0
Copyright © 2000, American Society for Microbiology. All rights reserved.


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