Publications

molecular epidemiology of enterococci with high-level resistance to aminoglycosides.	dna-based methodologies are considerably more powerful than other phenotype-based typing systems, providing a finer level of epidemiological discrimination, differentiating both closely and distantly related independent isolates that otherwise may appear as identical. in this study, plasmid analysis and pulsed-field gel electrophoresis were used to compare 28 isolates of enterococci (respectively 13 strains of enterococcus faecalis and 15 strains of enterococcus faecium) with high-level resistan ...	1995	9158799
in vitro activity of rp 59500 (quinupristin/dalfopristin) and ramoplanin against vancomycin-resistant enterococcus faecium.	vancomycin-resistant enterococcus faecium (vref) collected between july 1991 and february 1994 were tested in vitro against rp 59500 and ramoplanin using agar dilution and standard macro broth dilution procedures. colony counts were determined at 0, 4, and 24 h. rp 59500 had an mic range of < or = 0.5-8 micrograms/ml with an mic90 of 2 micrograms/ml and a mbc range of < or = 0.5-16 micrograms/ml with an mbc90 of 16 micrograms/ml. ramoplanin had an mic range of < or = 0.125-1 microgram/ml with an ...	1995	9158806
epidemic vancomycin-resistant enterococcus faecium in the uk.		1995	11866744
in vitro activity of wy-49605, a penem antimicrobial.	the in vitro activity of the penem antimicrobial wy-49605 was compared with those of other agents available for oral administration. based on concentrations inhibiting 90% of isolates (mic(90)s), the penem inhibited methicillin-susceptible staphylococci (mic(90) = 0.25 microg/ml), penicillin-susceptible streptococci (mic(90) < or = 0.12 microg/ml) and several other gram-positive genera at concentrations comparable or superior to the most active comparison agents. wy-49605 and cefpodoxime were th ...	1995	18611676
anti-mutagenic and immuno-stimulatory properties of lactic acid bacteria.	statistically significant antigenotoxic activity was exerted by six of nine strains of lactic acid bacteria tested (lactobacillus delbrueckii subsp. bulgaricus, staphylococcus carnosus, streptococcus thermophilus, l. rhamnosus, enterococcus faecium and en. faecalis) against nitrovin and 2-aminofluorene in salmonella typhimurium ta100 and ta97. the mutagenic activity of both mutagens was substantially decreased by viable bacteria; cells heated to 100°c for 15 min were ineffective. in vitro, en. f ...	1995	24414651
observations on the control of campylobacter jejuni infection of poultry by 'competitive exclusion'.	various bacteria were isolated aerobically from caecal mucus of campylobacter-free broilers sampled at slaughter. the organisms were mainly presumptive coliform bacteria, enterococci and micrococcus/staphylococcus spp. none showed any inhibitory activity against campylobacter jejuni in a plate assay. on the other hand, adult hens yielded nine strains of escherichia coli and one strain of enterococcus faecium that were positive in the plate assay and most of which utilized mucin as an energy sour ...	1996	18645838
vancomycin-resistant enterococci (vre) as normal flora of the intestine in patients at a tertiary care hospital.	there has been a rapid increase in the incidence of infection and colonization with vancomycin-resistant enterococci (vre) in american and european hospitals in the last six years, with fecal carriage reported to be as high as 86% on some services. in order to determine the frequency of vre as normal flora of the intestine in saudi patients, microbiological analysis of stool specimens from 4276 patients from a tertiary care referral hospital was performed. vre, identified as enterococcus faecium ...	1996	17429236
surveillance of intestinal colonization and of infection by vancomycin-resistant enterococci in hospitalized cancer patients.	objective: to study epidemiologic features of and risk factors for intestinal colonization and infection by vancomycin-resistant enterococci (vre) in cancer patients. methods: during a 41-month period, over 7600 fecal samples and all samples from sterile sites from hospitalized cancer patients were screened for vre. species were identified and isolates analyzed by pulsed-field gel electrophoresis (pfge) of smai dna restriction fragments. antibiotic resistance was characterized by mic determinati ...	1996	11866843
[enterococcal endocarditis: clinical and microbiological features of our series].	of 81 cases of infectious endocarditis seen at our institution from 1988 to 1995, 61 had positive culture (75%) and, of these, 10 (16%) were caused by enterococcal strains (9 by enterococcus faecalis, 1 by enterococcus faecium). the 10 cases consisted of 5 native valve endocarditis and 5 late prosthetic valve endocarditis. median age of patients was 50 years (range 21-58); 6, were males. diagnostic or surgical procedures on the abdomen, genito-urinary tract, or chest preceded the onset of fever ...	1996	14976434
treatment of vancomycin-resistant enterococcus faecium infections with an investigational streptogramin antibiotic (quinupristin/dalfopristin): a report of fifteen cases.	new therapies for vancomycin-resistant enterococcus faecium (vref) infections are urgently needed. we describe the treatment of 15 patients with vref infection with quinupristin/dalfopristin (rp 59500), a new injectable streptogramin antibiotic. primary infections treated were bacteremia (4), urinary tract (4), intraabdominal (5), otitis externa (1), and meningitis (1). minimum inhibitory concentrations for quinupristin/dalfopristin ranged from 0.5 microgram/ml or less to 2 micrograms/ml, and mi ...	1996	9158811
persistence of vancomycin-resistant enterococcus faecium gastrointestinal tract colonization in antibiotic-treated mice.	colonization with vancomycin-resistant enterococcus faecium (vref) is strongly associated with previous antimicrobial therapy. the gastrointestinal (gi) tract appears to be the major reservoir for this organism. we used antibiotic-treated swiss webster mice to study gi tract colonization with a characterized strain of vref (e. faecium 228). mice were pretreated with antibiotics in their daily drinking water and inoculated with 10(9) colony-forming units (cfu) of e. faecium 228 by oral gavage. we ...	1996	9158812
manipulation of a hospital antimicrobial formulary to control an outbreak of vancomycin-resistant enterococci.	infection control practices are not uniformly successful in limiting outbreaks of vancomycin-resistant enterococci (vre). despite the implementation of barrier precautions for vre-infected patients, nearly one-half of the inpatients at our center were found to have gastrointestinal colonization by vre. in an attempt to control the outbreak, we altered the antibiotic formulary by restricting the use of cefotaxime and vancomycin and adding beta-lactamase inhibitors to replace third-generation ceph ...	1996	8922796
epidemiology of an outbreak due to glycopeptide-resistant enterococcus faecium on a leukaemia unit.	the clinical and molecular epidemiology of two clusters of colonization and infection of patients by glycopeptide-resistant enterococci (gre) on a leukaemia and bone marrow transplantation unit was studied over a two-and-a half-year period. thirty-five patients became colonized, of whom six developed clinical infections. of the 53 isolates of gre, 49 were enterococcus faecium, multiply-resistant to vancomycin and ampicillin. dna fingerprinting of 48 e. faecium isolates by pulsed-field gel electr ...	1996	8923271
efficacy of abt-719, a 2-pyridone antimicrobial, against enterococci, escherichia coli, and pseudomonas aeruginosa in experimental murine pyelonephritis.	abt-719 is a 2-pyridone antimicrobial which inhibits dna gyrase activity. it has considerable subcutaneous (sc) and oral efficacy in the treatment of experimental pyelonephritis induced in carrageenan-treated mice by clinical isolates of enterococcus faecalis, enterococcus faecium, escherichia coli, and pseudomonas aeruginosa. therapeutic ed50s, defined here as producing a 2 log10 reduction in kidney bacterial burden, provide a reliable end point for comparison of drug efficacy in this experimen ...	1996	8937959
high-level gentamicin-resistant enterococci: in vitro activity of double and triple combinations of antimicrobial drugs.	the ability of double and triple combinations of antimicrobials with different mechanisms of action, such as teicoplanin, meropenem, gentamicin and sparfloxacin, to achieve synergisms was investigated in vitro on some moderate-level gentamicin-resistant (mlgr: 8 < or = mic < or = 256 mg/l) and high-level gentamicin-resistant (hlgr: mic > 500 mg/l) enterococci. on mlgr strains, a constant synergistic effect was achieved by a combination of teicoplanin with gentamicin or with meropenem, while gene ...	1996	8751265
influence of lipoteichoic acid structure on recognition by the macrophage scavenger receptor.	lipoteichoic acids (ltas) belong to the immunostimulatory class of molecules of gram-positive bacteria (gpb). previous investigations showed that the macrophage scavenger receptor (sr), a glycosylated trimeric transmembrane protein, binds directly to many gpb, possibly via lta. sr binding to other ligands is dependent upon the spatial characteristics of the repeating negative charge of the ligand. we therefore investigated sr recognition of lta species with various charge densities and distribut ...	1996	8757870
structure of the low-affinity penicillin-binding protein 5 pbp5fm in wild-type and highly penicillin-resistant strains of enterococcus faecium.	among its penicillin-binding proteins (pbps), enterococcus faecium possesses a low-affinity pbp5, pbp5fm, which is the main target involved in beta-lactam resistance. a 7.7-kb ecori chromosomal fragment of e. faecium d63r containing the pbp5fm gene was cloned and sequenced. two open reading frames (orfs) were found. a 2,037-bp orf encoded the deduced 73.8-kda pbp5fm, the amino acid sequences of which were, respectively, 99.8, 78.5, and 62% homologous to those of the low-affinity plasmid-encoded ...	1996	8759860
[enterococcal endocarditis].		1996	8765882
factors influencing the vitek gram-positive susceptibility system's detection of vanb-encoded vancomycin resistance among enterococci.	studies were conducted to identify factors contributing to the inability of the vitek gram-positive susceptibility system (gps; biomerieux, vitek, inc., hazelwood, mo.) to reliably detect vanb-mediated vancomycin resistance among enterococci. to some extent the accuracy of the gps depended on a particular strain's level of resistance, as all isolates for which vancomycin mics were > or = 128 mu g/ml were readily detected but detection of resistance expressed by several strains for which mics wer ...	1996	8904441
overgrowth of enterococcus faecium in the feces of patients with hematologic malignancies.	the objective of this study was to characterize the overgrowth and susceptibility of enterococcus faecium, compared with that of other enterococci, in the feces of patients with hematologic malignancy. during a 52-week period, surveillance samples of feces were cultured weekly. three hundred thirty-three samples were obtained from 92 patients. e. faecium outnumbered other enterococci in 170 (44%) of the samples, while the opposite was true in 119 (31%) of the samples. fecal overgrowth of e. faec ...	1996	8909828
nosocomial infections with vancomycin-resistant enterococcus faecium in liver transplant recipients: risk factors for acquisition and mortality.	the risk factors for acquisition of and mortality due to nosocomial infection with vancomycin-resistant enterococcus faecium (vref) in orthotopic liver transplant (olt) recipients were studied at a tertiary care hospital; 32 vref-infected olt patients (cases) were compared with 33 randomly selected olt recipients (controls). more antibiotics were administered preoperatively to cases (mean, 4 antibiotics per patient for 474 antibiotic-days) than to controls (mean, 1.8 antibiotics per patient for ...	1996	8909841
risk factors associated with vancomycin-resistant enterococcus faecium infection or colonization in 145 matched case patients and control patients.	risk factors and mortality associated with vancomycin-resistant enterococcus faecium (vref) infection or colonization were examined at a tertiary care hospital by comparing 145 patients who had vref isolates (cases) to 145 patients with vancomycin-susceptible enterococcus faecium (vsef) isolates (controls). the number of deaths per 100 person-days of hospitalization after diagnosis did not differ significantly between vref patients (1.2) and vsef patients (0.8). multivariate analyses found that ...	1996	8909842
gentamicin resistance gene transfer from enterococcus faecalis and e. faecium to staphylococcus aureus, s. intermedius and s. hyicus.	transfer of gentamicin resistance from enterococcus faecalis and e. faecium to staphylococcus aureus, s. hyicus and s. intermedius was accomplished by filter mating. transfer from e. faecalis was plasmid mediated and a probe to the gentamicin resistance gene aac(6')-aph(2") hybridized to hindiii fragments of various sizes (7.5, 6.2 and 4.7 kbp) of these plasmids. transfer from e. faecium was apparently to the chromosome in 9 of 10 instances with hindiii fragments of 3.3 or 3.0 kbp hybridizing to ...	1996	8914258
2-amino-4-oxo-5-substituted-pyrrolo[2,3-d]pyrimidines as nonclassical antifolate inhibitors of thymidylate synthase.	six novel 2-amino-4-oxo-5-[(substituted phenyl)sulfanyl]pyrrolo[2,3-d]pyrimidines 7-12 were synthesized as potential inhibitors of thymidylate synthase (ts) and as antitumor and/or antibacterial agents. the analogues contain a 5-thio substituent with a phenyl, 4'-chlorophenyl, 3',4'-dichlorophenyl, 4'-nitrophenyl, 3',4'-dimethoxyphenyl, and 2'-naphthyl on the sulfur, and were synthesized from the key intermediate 2-(pivaloylamino)-4-oxo-6-methylpyrrolo[2,3-d]-pyrimidine, 17. appropriately substi ...	1996	8917644
characterization and sequence analysis of a stable cryptic plasmid from enterococcus faecium 226 and development of a stable cloning vector.	a small cryptic plasmid, pmbb1, isolated from enterococcus faecium 226 was characterized. the plasmid contained an extremely stable replicon which has limited homology to the lactococcal plasmid pci305. sequence analysis of the replicon detected one open reading frame of 822 bp capable of encoding a 32-kda protein. no detectable single-stranded intermediates were found for the replicon, suggesting that pmbb1 may be included in the same family as pci305, although pci305 exhibits a more narrow hos ...	1996	8919818
in vitro activities of u-100592 and u-100766, novel oxazolidinone antibacterial agents.	oxazolidinones make up a relatively new class of antimicrobial agents which possess a unique mechanism of bacterial protein synthesis inhibition. u-100592 (s)-n-[[3-[3-fluoro-4-[4-(hydroxyacetyl)-1-piperazinyl]- phenyl]-2-oxo-5-oxazolidinyl]methyl]-acetamide and u-100766 (s)-n-[[3-[3-fluoro-4-(4-morpholinyl)phenyl]- 2-oxo-5-oxazolidinyl]methyl]-acetamide are novel oxazolidinone analogs from a directed chemical modification program. mics were determined for a variety of bacterial clinical isolate ...	1996	8849237
intracellular activities of rp 59500 (quinupristin-dalfopristin) and sparfloxacin against enterococcus faecium.	rp 59500, a combination of the streptogramins quinupristin and dalfopristin, and sparfloxacin are new antibiotics with good in vitro activities against enterococcus faecium, which is an increasingly important nosocomial pathogen with resistance to multiple antimicrobials. since fluoroquinolones and related macrolides have displayed high intracellular concentrations inside host cells, we evaluated the intracellular activities of these agents inside neutrophils against three strains each of vancom ...	1996	8849245
vancomycin-resistant enterococci in cats and dogs.		1996	8855893
vancomycin-resistant enterococcus faecium infections in the icu and quinupristin/dalfopristin.	the incidence of vancomycin resistance among enterococci, and enterococcus faecium in particular, has increased sharply in the last few years. this shift toward infection with resistant gram-positive organisms is thought to be the consequence of certain features specific to the intensive care setting: a high concentration of severely compromised patients; continued use of indwelling devices and invasive procedures; and widespread, empiric use of antimicrobial agents directed against gram-negativ ...	1996	8856757
escherichia coli transcytosis in a caco-2 cell model: implications in neonatal necrotizing enterocolitis.	necrotizing enterocolitis (nec) is a serious gastrointestinal disorder of preterm infants. other than an association with prematurity and gastrointestinal feeding, no single factor or mechanism has been consistently linked to this disease. we have previously demonstrated that escherichia coli isolates obtained from the stool of infants with nec caused nec-like injury in a weanling rabbit ileal loop model; this injury, in turn, could be blocked by coinfection with selected gram(+) bacteria (enter ...	1996	8865278
epidemiology and control of multiresistant enterococci.		1996	8869836
quinupristin-dalfopristin (rp 59500): an injectable streptogramin combination.	the pharmacology, pharmacokinetics, activity, and potential clinical role of quinupristin-dalfopristin (rp 59500) are described. quinupristin-dalfopristin is the first injectable formulation of the streptogramin antibiotics. streptogramin drug products are each composed of two chemically distinct compounds, which when administered together act synergistically by inhibiting bacterial protein synthesis. quinupristin-dalfopristin has shown activity in vitro against many strains of streptococci and ...	1996	8870891
a new selective differential medium for isolation of stenotrophomonas maltophilia.	a new selective differential medium for the isolation of stenotrophomonas (formerly xanthomonas) maltophilia was developed. the medium, via agar, contained vancomycin, imipenem, and amphotericin b as selective agents and incorporated a mannitol/bromothymol blue indicator system. compared with xanthomonas maltophilia selective medium (xmsm), via agar was less inhibitory to stenotrophomonas maltophilia and was more selective than xmsm in preventing the growth of unwanted bacteria from contaminated ...	1996	8874082
quinupristin-dalfopristin.	quinupristin-dalfopristin (rp 59500) is an injectable streptogramin antibiotic. it possesses a wide spectrum of activity against gram-positive bacteria including methicillin-resistant staphylococci, glycopeptide-resistant. enterococcus faecium and penicillin-resistant pneumococci. quinupristin-dalfopristin has activity against some anaerobes and selected gram-negative pathogens. quinupristin-dalfopristin, by way synergism of between its 2 components, is unaffected by most forms of bacterial resi ...	1996	8875130
in-vitro activity of ramoplanin (a novel lipoglycopeptide), vancomycin, and teicoplanin against gram-positive clinical isolates from cancer patients.	the in-vitro activities of ramoplanin, vancomycin, and teicoplanin against gram-positive organisms isolated from cancer patients were determined. ramoplanin was the most active agent tested inhibiting all isolates at a concentration of < or = 0.5 mg/l. although all isolates were also susceptible to vancomycin and teicoplanin, their activities were surpassed by that of ramoplanin. the activity of teicoplanin was moderately better than that of vancomycin against bacillus cereus, enterococcus faeci ...	1996	8877541
in vitro activity of the trinem sanfetrinem (gv104326) against gram-positive organisms.	the in vitro activity of the trinem sanfetrinem (formerly gv104326) (gv) was compared with that of vancomycin, ampicillin, and/or nafcillin against 287 gram-positive bacteria, including methicillin-resistant staphylococcus aureus and multiresistant enterococci, by the agar and microbroth dilution methods. gv demonstrated 2 to 16 times more activity than ampicillin and nafcillin against the majority of these organisms. the mic range of gv was 16 to 64 micrograms/ml for 19 enterococcus faecium str ...	1996	8878596
semisynthetic glycopeptide antibiotics derived from ly264826 active against vancomycin-resistant enterococci.	certain derivatives of the glycopeptide antibiotic ly264826 with n-alkyl-linked substitutions on the epivancosamine sugar are active against glycopeptide-resistant enterococci. six compounds representing our most active series were evaluated for activity against antibiotic-resistant, gram-positive pathogens. for enterococcus faecium and e. faecalis resistant to both vancomycin and teicoplanin, the mics of the six semisynthetic compounds for 90% of the strains tested were 1 to 4 micrograms/ml, co ...	1996	8878606
acidification of methyl-alpha-d-glucopyranoside: a useful test to differentiate enterococcus casseliflavus and enterococcus gallinarum from enterococcus faecium species group and from enterococcus faecalis.	enterococcus gallinarum and e. casseliflavus are difficult to differentiate from other enterococci, particularly e.faecium. the former two species were found to produce acid from methyl-alpha-d-glucopyranoside in phenol red broth, while e.faecalis strains and strains of the e.faecium species group, including e.faecium, e.durans, e. hirae, and e.mundtii, failed to produce acid from this substrate.	1996	8880532
heat tolerance of vancomycin resistant enterococcus faecium.	the heat tolerance of 27 enterococcus faecium isolates in water was studied. stationary phase cultures including vancomycin resistant and sensitive clinical and food isolates were exposed to heat at 60 degrees, 65 degrees, 71 degrees, and 80 degrees c for one, three, 10, and 30 minutes and the log10 reductions in bacterial counts were determined. exposure at 71 degrees and 80 degrees c resulted in > 6 log10 reduction in viable counts for all isolates. seven (24%) isolates survived (< 5 log10 red ...	1996	8881927
investigation of bacterial resistance to hatchery disinfectants.	three commercial chicken hatcheries were sampled for environmental bacteria. isolated bacteria were tested for resistance to commercial preparations of quaternary ammonia, phenolic, and glutaraldehyde liquid disinfectants. bacterial isolates were exposed to several disinfectant dilutions bracketing the dilutions recommended by the manufacturer for 5-, 10-, and 15-min exposure periods before subculturing to broth medium. approximately 8% of the isolates from two of three hatcheries were resistant ...	1996	8883778
presence of vancomycin-resistant enterococci in farm and pet animals.	enterococcus faecium strains with vana-mediated glycopeptide resistance were isolated by enrichment culture from the intestines and feces of several animal species, mainly horses and dogs (8% positive), chickens (7% positive), and pigs (6% positive). other vana-positive enterococcal strains were identified as e. durans in gallinaceous birds, e. faecalis in a horse, and e. gallinarum in a pheasant. samples from pigeons, cage birds, and ruminants were negative. it was concluded that vancomycin res ...	1996	8891131
inhibition of peptidoglycan biosynthesis in vancomycin-susceptible and -resistant bacteria by a semisynthetic glycopeptide antibiotic.	ly191145 is a p-chlorobenzyl derivative of ly264826 (a82846b) with activity against both vancomycin-susceptible and -resistant enterococci. incorporation of l-[14c]lysine into peptidoglycan of intact vancomycin-susceptible and -resistant enterococcus faecium was inhibited by ly191145 (50% inhibitory concentrations of 1 and 5 microgram/ml, respectively). inhibition was accompanied by accumulation of udp-muramyl-peptide precursors in the cytoplasm. this agent inhibited late-stage steps in peptidog ...	1996	8891144
a vancomycin-inducible lacz reporter system in bacillus subtilis: induction by antibiotics that inhibit cell wall synthesis and by lysozyme.	we have constructed a bacillus subtilis strain in which expression of a vanh::lacz gene fusion is regulated by vanr and vans of enterococcus faecium. this construct allows a nonpathogenic bacterial strain to be used as a model system for studying regulation of vancomycin resistance. antibiotics and enzymes that affect cell wall biosynthesis and stability were tested for the ability to induce lacz expression. as a result, fosfomycin and d-cycloserine were added to the group of peptidoglycan synth ...	1996	8892834
vancomycin-resistant enterococcus faecium on a pediatric oncology ward: duration of stool shedding and incidence of clinical infection.	to determine the duration of stool shedding and incidence of clinical infection among pediatric oncology patients colonized with vancomycin-resistant enterococcus faecium (vre) in our institution.	1996	8895914
pseudo-outbreak of enterococcus durans infections and colonization associated with introduction of an automated identification system software update.	enterococci are an important cause of hospital-acquired infections. since 1989, there has been an increase in the number of nosocomial enterococcal infections caused by strains resistant to vancomycin in the united states. although many enterococcal species can colonize humans, only enterococcus faecalis, e. faecium, e. raffinosus, and e. casseliflavus have been implicated in clusters of infection. in january 1996, the centers for disease control and prevention received a report of an outbreak o ...	1996	8897165
comparative in vitro activity of quinupristin/dalfopristin against multidrug resistant enterococcus faecium.	the in vitro susceptibilities of 82 strains of vancomycin resistant enterococcus faecium (vref), (49 vana and 33 vanb) from over 13 hospitals in europe and united states were studied. the mic for several antibiotics showed high levels of resistance to vancomycin, ampicillin, gentamicin, and imipenem. all vref strains were highly susceptible to quinupristin/dalfopristin with a mic 90% of 0.5 microgram/ml for both vana and vanb phenotypes. time-kill and synergy studies of vref for quinupristin/dal ...	1996	8902408
[the use of the polymerase chain reaction method for the identification of representatives of the genus enterococcus].	the possibility of the use of repetitive extragenic palindrome (rep)-specific primers to pcr-fingerprint analysis of enterococcus genomes has been shown for the first time. presence of the similar pcr products, and first of all the fragment 950 bp in size, has been observed in all the strains studied. differences in pcr-product composition displayed genetical heterogeneity between enterococcus faecium strains. these data evidence for the wide distribution of the rep, and rather high level of hom ...	1996	9044717
vancomycin-resistant enterococci at a large university hospital in denmark.	enterococci are part of the normal human fecal flora and also part of the fecal flora of many animals. vancomycin- and ampicillin-resistant enterococci give rise to infections that may virtually be untreatable with antibiotics. antibiotic use in humans is a risk factor for development or selection of vancomycin-resistant enterococci. in animals the related glycopeptide avoparcin is used, especially in poultry, as a food additive to promote growth. selective pressures for vancomycin-resistant ent ...	1996	8774678
emerging resistance in clinically important gram-positive cocci.	in the first half of the decade of the 1990s, we in the united states have seen the emergence and escalation of substantial antimicrobial resistance in medically important gram-positive cocci. the incidence of methicillin resistance of staphylococcus aureus continues to increase (now 18%), resulting in many more isolates that are multiply resistant; all s aureus isolates are still susceptible to vancomycin. enterococci, particularly enterococcus faecium, have increasingly developed resistance to ...	1996	8779198
[in vitro antibacterial activity of a new parenteral penem, sulopenem].	eighty percent minimum inhibitory concentrations (mic80) of sulopenem against clinically isolated 12 to 80 strains of each of different bacteria were as follows: methicillin-susceptible staphylococcus aureus (mssa): 0.20 micrograms/ml, methicillin-resistant s. aureus (mrsa): 50 micrograms/ml, coagulase-negative staphylococci: 3.13 micrograms/ml, streptococcus pyogenes: < or = 0.013 microgram/ml, streptococcus pneumoniae: < or = 0.013 microgram/ml, beta-streptococci: 0.05 microgram/ml, enterococc ...	1996	8786624
penicillin tolerance and modification of lipoteichoic acid associated with expression of vancomycin resistance in vanb-type enterococcus faecium d366.	induction of vancomycin resistance in enterococcus faecium d366, which exhibits a vanb-type resistance, as well as its constitutive expression in mt9, a derivative of d366, was associated with penicillin tolerance as shown by decreased lysis and killing of the cells. this phenomenon was linked neither to decreased expression of the different autolysins nor to their decreased lytic activity on the different cell walls. the only change observed was that almost twice the normal amount of d-alanine ...	1996	8787919
vancomycin-resistant enterococci on a renal ward in an ontario hospital.		1996	8791860
vancomycin resistant enterococci in hospitals in the united kingdom--1995.		1996	8791882
first documented isolation of vancomycin-resistant enterococcus faecium in sweden.	in recent years enterococci, and enterococcus faecium in particular, have emerged as important nosocomial pathogens. of major concern is the increasing antimicrobial resistance to traditionally used agents such as ampicillin, gentamicin and vancomycin. we present a patient with prosthetic heart valves colonized with vancomycin-resistant e. faecium. this is the first reported isolation of vancomycin-resistant e. faecium in sweden.	1996	8792490
vancomycin-resistant enterococci.	to review vancomycin resistance in enterococci (enterococcus faecalis and enterococcus faecium) with respect to history, epidemiology, mechanism of resistance, and management.	1996	8792949
production and characterization of enterocin 900, a bacteriocin produced by enterococcus faecium bfe 900 from black olives.	enterococcus faecium bfe 900 isolated from black olives produced a bacteriocin termed enterocin 900, which was antagonistic towards lactobacillus sake, clostridium butyricum, enterococci as well as listeria spp. including listeria monocytogenes. enterocin 900 was inactivated by pepsin, alpha-chymotrypsin, proteinase k and trypsin but not by catalase, alpha-amylase, or other non-proteolytic enzymes tested. the bacteriocin was heat stable, retaining activity after heating at 121 degrees c for 15 m ...	1996	8796427
the comparative in vitro activity of clinafloxacin and other antimicrobials against vancomycin-susceptible and vancomycin-resistant enterococci.	the susceptibilities of 50 unique vancomycin-susceptible (n = 15) and vancomycin-resistant (n = 35) enterococci to 6 antimicrobials were compared. teicoplanin was consistently the most active agent for all strains. ampicillin and imipenem were active primarily for vancomycin-sensitive enterococcus faecalis. clinafloxacin and ciprofloxacin showed poorer activity compared to prior studies, suggesting that the emergence of quinolone resistance is now occurring in enterococci.	1996	8804789
induction signals for vancomycin resistance encoded by the vana gene cluster in enterococcus faecium.	the induction of vancomycin resistance in enterococci containing the vana gene cluster is thought to be controlled by a two-component sensor-response regulator system encoded by vanr and vans. eight inducing compounds were identified by screening a panel of more than 6,800 antibiotics and synthetic compounds including the three tested glycopeptides (vancomycin, avoparcin, and ristocetin), two other cell wall biosynthesis inhibitors (moenomycin and bacitracin), two cyclic peptide antibiotics (ant ...	1996	8807055
synthesis and evaluation of inhibitors of bacterial d-alanine:d-alanine ligases.	d-alanine:d-alanine ligase is essential for bacterial cell wall synthesis, assembling one of the subunits used for peptidoglycan crosslinking. the resulting aminoacyl-d-ala-d-ala strand is the achilles' heel of vancomycin-susceptible bacteria; binding of vancomycin to this sequence interferes with crosslinking and blocks cell-wall synthesis. a mutant enzyme (vana) from vancomycin-resistant enterococcus faecium has been found to incorporate alpha-hydroxy acids at the terminal site instead of d-al ...	1996	8807826
limiting vancomycin use to combat vancomycin-resistant enterococcus faecium.	the implementation, monitoring, and impact of a program to restrict vancomycin use are described. a vancomycin restriction program was implemented in february 1995 at an acute care teaching hospital after guidelines for vancomycin use were established by a multidisciplinary group. pharmacists reviewed each vancomycin order, suggested alternative treatments when vancomycin use did not comply with the guidelines, and set duration limits for all orders. orders requiring greater clinical experience ...	1996	8809278
a highly vancomycin-resistant laboratory mutant of staphylococcus aureus.	a resistant mutant with vancomycin mic of 100 micrograms/ml was isolated relatively easily through step pressure in the laboratory from a staphylococcus aureus strain with initial mic of 1.5 micrograms/ml for the antibiotic. upon addition of vancomycin (50 micrograms/ml) to the growth medium mass increase of the culture and peptidoglycan synthesis continued but cell division (daughter cell separation), cell wall turnover and autolysis were inhibited, resulting in the production of multicellular ...	1996	8810499
selective isolation of vancomycin-resistant enterococci.	broth formulations of two media selective for enterococci, enterococcel, m-enterococcosel broths were supplemented with 6 micrograms of vancomycin per ml and evaluated for isolation of vancomycin-resistant enterococci (vre). each broth was challenged with various concentrations of staphylococcus aureus, escherichia coli, pseudomonas aeruginosa, and vancomycin-susceptible and vancomycin-resistant enterococci and with 193 perianal specimens obtained from patients at risk in our institution for vre ...	1996	8815109
vancomycin-resistant enterococcus faecium colonisations.		1996	8816691
vancomycin-resistant enterococcus: case reviews after transplantation.	increased and inappropriate use of vancomycin during the past 35 years has led to the development of vancomycin-resistant enterococcal (vre) species that are difficult and expensive to treat. this article presents case reviews of patients who experienced vancomycin-resistant enterococcus faecium (vref) infections during prolonged hospitalizations after transplantation. the risk factors for the development of vre infection, prevention measures, and the interventions to be implemented once vre inf ...	1996	8826402
investigation of an outbreak of vancomycin-resistant enterococcus faecium by random amplified polymorphic dna (rapd) assay.	in this study, 122 isolates of vancomycin-resistant enterococcus faecium (vref) obtained from 103 patients over a four-year period in a london teaching hospital, were typed by a random amplified polymorphic dna method. all the isolates exhibited high-level resistance to vancomycin (mic 128-1024 mg/l), and were resistant to teicoplanin (32-256 mg/l). nine rapd types were distinguished by using a single primer. clustering of certain types in time and space was noted. these results suggest that alt ...	1996	8827505
screening patients for glycopeptide-resistant enterococci.		1996	8827510
selection of enterococcus faecium strains with stable and unstable resistance to the streptogramin rp 59500 using stepwise in vitro exposure.	therapy of vancomycin-resistant enterococcal infections is an increasing problem for many large medical centers. one promising agent for use against enterococcus faecium is rp 59500 (quinupristin/dalfopristin). to assess the potential for emergence of resistant strains during clinical trials with this new compound, we collected and tested 11 vancomycin-resistant and three vancomycin-susceptible e. faecium strains. the strains were exposed to doubling dilutions of rp 59500, beginning at drug conc ...	1996	8831040
direct application of etest to gram-positive cocci from blood cultures: quick and reliable minimum inhibitory concentration data.	the etest was applied directly to 100 gram-positive bacterial strains from blood cultures to measure their minimum inhibitory concentration (mic). results showed 100% concordance of mic data between a direct etest method and the standard etest method for streptococcus pneumoniae, beta-hemolytic streptococci, and viridans group streptococci. in addition, direct etest for staphylococcus aureus, coagulase negative staphylococci, enterococcus faecium, and enterococcus faecalis showed 83 to 100% corr ...	1996	8831041
comparative in vitro activity of levofloxacin and ofloxacin against gram-positive bacteria.	the in vitro activity of levofloxacin against 506 gram-positive bacteria was compared with those of d(-)-ofloxacin, ofloxacin, ciprofloxacin, and sparfloxacin. levofloxacin was generally twice as active as ofloxacin against these organisms (range, 0-3 twofold dilutions). sparfloxacin appeared to have the greatest activity overall, but for several groups of organisms minimum inhibitory concentrations (mic90s) of this compound were within one twofold dilution of those of levofloxacin. resistance t ...	1996	8831043
application of direct-fed microbial bacteria and fructooligosaccharides for salmonella control in broilers during feed withdrawal.	providing direct-fed-microbial (dfm) bacteria and fructooligosaccharides (fos) for the control of potential escalation of salmonella colonization during simulated feed withdrawal and confinement was assessed. eight hundred and eighty broilers (16 pens; 55 chicks per pen) were reared to 6 wk of age. chicks were sprayed with a solution containing 10(6) nalidixic-acid resistant salmonella typhimuriumnr cells per milliliter on the 2nd d after hatching. because this first challenge did not yield a hi ...	1996	8833368
modification of penicillin-binding protein 5 associated with high-level ampicillin resistance in enterococcus faecium.	high-level ampicillin resistance in enterococcus faecium has been shown to be associated with the synthesis of a modified penicillin-binding protein 5 (pbp 5) which had apparently lost its penicillin-binding capability (r. fontana, m. aldegheri, m. ligozzi, h. lopez, a. sucari, and g. satta. antimicrob. agents chemother. 38:1980-1983, 1994). the pbp5 gene of the highly resistant strain e. faecium 9439 was cloned and sequenced. the deduced amino acid sequence showed 77 and 54% homologies with the ...	1996	8834879
glycopeptide susceptibility among danish enterococcus faecium and enterococcus faecalis isolates of animal and human origin and pcr identification of genes within the vana cluster.	the mics of vancomycin and avoparcin were determined for isolates of enterococcus faecium and isolates of enterococcus faecalis recovered from the feces of humans and animals in denmark. two hundred twenty-one of 376 (59%) isolates of e. faecium and 2 of 133 (1.5%) isolates of e. faecalis were resistant to vancomycin (mics, 128 to > or = 256 micrograms/ml), and all vancomycin-resistant isolates were resistant to avoparcin (mics, 64 to > or = 256 micrograms/ml). all vancomycin-resistant isolates ...	1996	8843309
quantitative analysis of the metabolism of soluble cytoplasmic peptidoglycan precursors of glycopeptide-resistant enterococci.	transposon tn1546 from enterococcus faecium bm4147 mediates high-level resistance to the glycopeptide antibiotics vancomycin and teicoplanin. tn 1546 encodes a dehydrogenase (vanh) and a ligase (vana) that synthesize d-alanyl-d-lactate (d-ala-d-lac), a d,d-dipeptidase (vanx) that hydrolyses d-ala-d-ala and a two-component regulatory system (vanr-vans) that controls transcription of the vanhax operon. strains of enterococcus faecalis harbouring various copy numbers of the vanrshax cluster were te ...	1996	8843432
unorthodox antibiotic combinations including ciprofloxacin against high-level gentamicin resistant enterococci.	development of high-level gentamicin resistance among enterococci represents a serious therapeutic problem as it precludes synergy between aminoglycosides and cell-wall active agents. as part of a search for active antibiotic combinations against enterococci with high-level gentamicin resistance, we tested by the time kill curve method the efficacy of ciprofloxacin combined with ampicillin, trimethoprim-sulphamethoxazole, vancomycin or teicoplanin against ten isolates of enterococcus faecium, th ...	1996	8722538
antibacterial activity of quinupristin/dalfopristin. rationale for clinical use.	most gram-positive organisms are highly susceptible to the streptogramin, quinupristin/dalfopristin (rp 59500; synercid). minimum inhibitory concentrations for 90% of isolates (mic90) were < or = 1 mg/l for staphylococcus aureus, s. epidermidis, s. haemolyticus, streptococcus pneumoniae, s. pyogenes and listeria monocytogenes. importantly, quinupristin/dalfopristin shows similar activity against methicillin-susceptible and -resistant strains of s. aureus, and streptococci with benzylpenicillin ( ...	1996	8724814
future prospects and therapeutic potential of streptogramins.	dramatic changes in the epidemiology and susceptibility patterns of gram-positive cocci during the last decade have mandated new approaches to the management of many bacterial infections. for example, there has been a sharp increase in the incidence of infections caused by staphylococcus aureus, particularly those resistant to methicillin (mrsa), and methicillin-resistant coagulase-negative staphylococci, particularly those associated with foreign bodies and indwelling medical devices. additiona ...	1996	8724815
antibiotic-resistant endocarditis in a hemodialysis patient.	a chronic dialysis patient developed persistent bacteremia as a result of infection with enterococcus faecium. during the patient's illness, resistance to ampicillin, gentamicin, vancomycin, and teicoplanin developed. despite arteriovenous (av) graft removal and an extensive but inconclusive search for the source of the infection, bacteremia persisted. on autopsy, the patient was found to have had aortic-valve endocarditis. endocarditis is a well-known complication in dialysis patients. multidru ...	1996	8724886
in vivo activities of u-100592 and u-100766, novel oxazolidinone antimicrobial agents, against experimental bacterial infections.	the upjohn oxazolidinones, u-100592 and u-100766, are orally bioavailable synthetic antimicrobial agents with spectra of activity against antibiotic-susceptible and -resistant gram-positive pathogens. in several mouse models of methicillin-resistant staphylococcus aureus infection, u-100592 and u-100766 yielded oral 50% effective doses (ed50) ranging from 1.9 to 8.0 mg/kg of body weight, which compared favorably with vancomycin subcutaneous ed50 values of 1.1 to 4.4 mg/kg. similarly, both compou ...	1996	8726028
gastrointestinal tract colonization with vancomycin-resistant enterococcus faecium in an animal model.	vancomycin-resistant enterococci have become important nosocomial pathogens in many institutions. the gastrointestinal tract of susceptible hosts serves as the likely reservoir from which the organism is disseminated. to study factors promoting colonization and the efficacy of decontamination therapy with antimicrobial agents, a model of gastrointestinal colonization with vancomycin-resistant enterococcus faecium was developed in cf1 mice. at baseline, all animals were colonized with non-vancomy ...	1996	8726031
control of endemic glycopeptide-resistant enterococci.	to evaluate the epidemiology of, and control measures for, vancomycin-resistant enterococcus (vre) in a renal unit.	1996	8727617
random amplified polymorphic dna typing versus pulsed-field gel electrophoresis for epidemiological typing of vancomycin-resistant enterococci.	sixty vancomycin-resistant vana mutant enterococcus faecium (vre) isolates, collected during a 40-month period from 48 patients hospitalized in a french cancer referral center, were typed by using random amplified polymorphic dna (rapd), and the results were compared with those previously obtained by typing with smai pulsed-field gel electrophoresis (pfge), which is currently recognized as the "gold standard." the discriminating power of rapd typing, with seven primers and 11 combinations of pri ...	1996	8727883
differences in outcomes for patients with bacteremia due to vancomycin-resistant enterococcus faecium or vancomycin-susceptible e. faecium.	to determine the differences in outcome in cases of enterococcal bacteremia due to vancomycin-resistant organisms, we compared consecutive patients on a liver transplant service who had clinically significant bacteremia due to vancomycin-resistant enterococcus faecium (vref) (n = 54) with a contemporaneous cohort of patients who had vancomycin-susceptible e. faecium (vsef) bacteremia (n = 48). vref bacteremia occurred significantly later in the hospitalization than did vsef bacteremia (43 days v ...	1996	8729206
comparative in-vitro activity of the new fluoroquinolone trovafloxacin (cp-99,219) against gram-positive cocci.	the in-vitro activities of the new fluoroquinolone trovafloxacin (cp-99,219) and ciprofloxacin were determined against 225 gram-positive cocci. trovafloxacin was 4-32 fold more active than ciprofloxacin against staphylococci and streptococci and also showed greater activity against enterococci including vancomycin resistant enterococcus faecium and enterococcus faecalis that were highly resistant to aminoglycosides and/or produced beta-lactamase. trovafloxacin was also bactericidal at 3 mg/l aga ...	1996	8737152
mechanism and treatment of diarrhoea due to vibrio cholerae and escherichia coli: roles of drugs and prostaglandins.	the primary objectives of these studies were to determine the clinical efficacy and safety of the potential antisecretory and antimicrobial drugs in the treatment of diarrhoea due to vibrio cholerae and enterotoxigenic escherichia coli (etec). the drugs evaluated were chlorpromazine (cpz), nicotinic acid, berberine, indomethacin, chloroquine, tetracycline, furazolidone, and bioflorin. additionally, the role of prostaglandins (pgs) in the pathogenesis of cholera diarrhoea has been studied. the dr ...	1996	8741209
comparative assessment of bacterial inoculation and propionic acid treatment of aerobic stability and microbial populations of ensiled high-moisture ear corn.	high-moisture ear corn (hmec) was untreated, treated with propionic acid (pa), or inoculated with a mixture of lactobacillus plantarum and enterococcus faecium and allowed to ensile in laboratory silos for 0, 7, 21, 42, 138, or 202 d. the silages were evaluated for fermentation quality, microbial populations, and aerobic stability. in all treatments, silage ph declined rapidly within 7 d, but the rate of decline seemed greatest with the inoculum. the lactic acid content of inoculated hmec was hi ...	1996	8690682
2,4-diamino-5-deaza-6-substituted pyrido[2,3-d]pyrimidine antifolates as potent and selective nonclassical inhibitors of dihydrofolate reductases.	fifteen novel nonclassical and two classical 2,4-diamino-6-(benzylamino)pyrido[2,3-d]pyrimidine antifolates were synthesized as potential inhibitors of pneumocystis carinii, (pc) toxoplasma gondii, (tg) rat liver (rl), and human (h) recombinant dihydrofolate reductases (dhfr). these analogues lack a 5-methyl substitution which has been shown to be important for increased hdhfr inhibitory activity. in addition, they contain a reversal of the c9-n10 bridge present in folates and most antifolates. ...	1996	8691474
comparison of antimicrobial properties of monoterpenes and their carbonylated products.	some monoterpenes and their carbonylated products were evaluated for their antibacterial and antifungal properties. the carbonylation of tested monoterpenes was shown to increase the bacteriostatic and fungistatic activities specifically by the contact method. concerning the killing effects, only (1r,2s,5r)-isopulegol, its carbonylated products, and (r)-carvone showed significant bactericidal activities, particularly against enterococcus faecium and escherichia coli above a concentration of 10 m ...	1996	8693045
survival of model bacterial strains and helminth eggs in the course of mesophilic anaerobic digestion of pig slurry.	the effect of methanogenesis on the survival of model bacterial strains (escherichia coli ec 5, staphylococcus aureus sa 11, enterococcus faecium ccm 4231) and non-embryonated helminth eggs (ascaris suum) was investigated in pig slurry. two pilot-plant experiments were carried out in two anaerobic digesters (800 and 1,000 litre) in a mesophilic thermal range (35-37 degrees c). the mean hydraulic retention time of the digesters was 20 days. the methanogenesis process was monitored by determining ...	1996	8693668
purification and n-terminal amino acid sequence of enterocin crl 35, a 'pediocin-like' bacteriocin produced by enterococcus faecium crl 35.	enterocin crl 35, a bacteriocin produced by enterococcus faecium crl 35 that inhibits food-borne pathogens, was purified by precipitation with (nh4)2so4, gel filtration, ion exchange and reverse phase chromatography. the partial n-terminal amino acid sequence indicated a strong homology with other 'pediocin-like bacteriocins' previously described.	1996	8695065
a novel tetracycline-resistant determinant, tet(u), is encoded on the plasmid pkq10 in enterococcus faecium.	nine tetracycline (tc)-resistant clinical isolates of enterococcus faecium were screened for plasmid content using agarose gel electrophoresis. pkq10, a 1.9-kb plasmid carrying a novel tc resistance determinant, was isolated from one of the isolates. the nucleotide sequence of this plasmid revealed an open reading frame corresponding to an 11.8-kda protein and containing 105 amino acid residues. there was some limited similarity between this protein and tet(m), tet(o), tet(q), tet(s), tetb(p), a ...	1996	8700968
treatment of experimental endocarditis caused by multidrug resistant enterococcus faecium with ramoplanin and penicillin.	antibiotic resistant strains of enterococci are being isolated with increasing frequency. effective treatment of infections caused by enterococcus faecium resistant to ampicillin, vancomycin and aminoglycosides has not been established. we studied the activity of ramoplanin, a new lipoglycopeptide antibiotic, against two strains of multidrug resistant e. faecium. in time kill studies, ramoplanin was bactericidal against both strains, but not in the presence of 50% serum. the combination of ramop ...	1996	8707742
neomycin blood agar as a selective medium for vancomycin resistant enterococcus faecium.		1996	8707969
protecting your patients from vre.		1996	8712235
antimicrobial-resistant pathogens in the 1990s.	streptococcus pneumoniae, enterococcus faecalis, enterococcus faecium, staphylococcus aureus, and klebsiella pneumoniae have become increasingly resistant to antimicrobial agents. this chapter reviews the epidemiology of this resistance, its detection in the laboratory, the mechanisms of resistance, and the options for therapy and infection control.	1996	8712771
mobilization of vancomycin resistance by transposon-mediated fusion of a vana plasmid with an enterococcus faecium sex pheromone-response plasmid.	a striking feature of recent outbreaks of vancomycin-resistant (vmr) enterococci is the apparent horizontal dissemination of resistance determinants. the plasmids phkk702 and phkk703 from enterococcus faecium clinical isolate r7 have been implicated in the conjugal transfer of vmr. phkk702 is a 41-kb plasmid that contains an element indistinguishable from the glycopeptide-resistance transposon tn1546. phkk703 is an approx. 55-kb putative sex pheromone-response plasmid that is required for conjug ...	1996	8675038
bloodstream infections with vancomycin-resistant enterococci.	to describe the population in whom bloodstream infections with vancomycin-resistant enterococci occur and the clinical and microbiologic features of infection.	1996	8678715
relevance and risk factors of enterococcal bacteremia following liver transplantation.	to analyze the clinical characteristics of and identify specific risk factors for enterococcal bacteremia following liver transplantation, we performed a study in 405 consecutive liver transplantation recipients prophylaxed with a selective bowel decontamination regimen. seventy enterococcal bacteremias in 52 patients were identified. enterococcus faecalis (50) outnumbered enterococcus faecium isolates (18), and 49% of enterococcal bacteremias were polymicrobial. biliary tree complications were ...	1996	8610417
peptidoglycan structure of enterococcus faecium expressing vancomycin resistance of the vanb type.	resistance to glycopeptide antibiotics in enterococci is due to the synthesis of udp-murnac-tetrapeptide-d-lactate (where mur is muramic acid) replacing the normal udp-murnac-pentapeptide precursor. the peptidoglycan structures of an inducible vanb-type glycopeptide-resistant enterococcus faecium, d366, and its constitutively resistant derivative, mt9, were determined. using hplc, 17 muropeptides were identified and were present regardless of whether resistance was expressed or not. the structur ...	1996	8611145
effective treatment of multidrug-resistant enterococcal experimental endocarditis with combinations of cell wall-active agents.	the efficacy of treatment with a combination of ampicillin, imipenem, and vancomycin was compared with that of two-drug combinations or monotherapy in a model of experimental endocarditis using a strain of enterococcus faecium with high-level resistance to vancomycin and moderate intrinsic resistance to ampicillin and imipenem. in vitro time-kill synergy studies demonstrated bactericidal synergistic activity only for the triple combination. in vivo, monotherapy with vancomycin was not effective. ...	1996	8603970
augmented production of extracellular superoxide by blood isolates of enterococcus faecalis.	to assess the frequency of extracellular superoxide (o-2) production by enterococci, multiple species were surveyed in a whole organism assay for their ability to reduce ferricytochrome c in a superoxide dismutase-inhibitable fashion. for stool and clinical enterococcal isolates and 12 type strains, only enterococcus faecalis (87/91 isolates and atcc 19433), enterococcus faecium (5/13 isolates), enterococcus casseliflavus (atcc 25778), and enterococcus gallinarum (atcc 35038) produced extracellu ...	1996	8627044