novobiocin and Bacteremia

The aim of this study was to determine the efficacy of novobiocin and rifampin as oral antibiotic prophylaxis for the prevention of catheter-related infection in melanoma patients treated with interleukin-2 (IL-2) plus interferon-alpha and chemotherapy (biochemotherapy).. Patients with advanced melanoma who were treated with biochemotherapy at the University of Texas M. D. Anderson Cancer Center were randomized in a crossover study to receive either oral antibiotic prophylaxis consisting of novobiocin and rifampin or observation alone over a 35-day course period. Patients were subsequently "crossed over" to the opposite arm of the study for an additional 35-day period, with each serving as his or her own control.. Twenty-six patients were enrolled. Nine patients (35%) failed to tolerate oral antibiotics because of severe nausea and vomiting; 17 patients (65%) were crossed over and considered evaluable. During the control patient courses, 71% of evaluable patients had infectious complications, 41% had a catheter-associated bacteremia, and 53% had a local catheter infection. In contrast, of the patients treated with antibiotic prophylaxis, only 12% had an infectious complication (P = 0.001), 12% had a local catheter infection (P = 0.008), and 6% had catheter-associated bacteremias (P = 0.04). Thirty-six episodes of catheter infections occurred during the 17 control courses, whereas only 3 episodes occurred during antibiotic prophylaxis (P < 0.001).. Although more than one-third of patients receiving IL-2 treatment with biochemotherapy failed to tolerate novobiocin and rifampin, this oral antibiotic regimen was efficacious in preventing the infectious complications, especially those associated with vascular catheters, in this high risk patient population.

Topics: Administration, Oral; Adult; Anti-Bacterial Agents; Antineoplastic Agents; Antineoplastic Combined Chemotherapy Protocols; Bacteremia; Bacterial Infections; Catheterization, Central Venous; Catheterization, Peripheral; Catheters, Indwelling; Chemoprevention; Cross-Over Studies; Equipment Contamination; Female; Humans; Immunologic Factors; Interferon-gamma; Interleukin-2; Male; Melanoma; Middle Aged; Nausea; Novobiocin; Prospective Studies; Rifampin; Vomiting

Five coagulase-negative, novobiocin-susceptible staphylococcal strains were isolated from human blood cultures in different German and Belgian medical facilities. A novel species, 'Staphylococcus pettenkoferi' was proposed recently to accommodate two of these strains (B3117(T) and A6664), although the name was not validly published. All five strains belonged to the genus Staphylococcus because they were non-motile, Gram-positive, catalase-positive cocci with peptidoglycan type (A3 alpha type L-lys-gly(2-4)-L-Ser-Gly), menaquinone pattern (MK-7, MK-6 and MK-8) and major cellular fatty acids (ai-C(15 : 0), ai-C(17 : 0) and i-C(15 : 0)) that corresponded to those of staphylococci. Phenotypically, the isolates most closely resembled Staphylococcus capitis subsp. capitis and Staphylococcus auricularis, but they could be distinguished from these species by physiological tests and chemotaxonomic investigations. The results of DNA-DNA hybridization, chemotaxonomic investigations and 16S rRNA gene and RNA polymerase B gene (rpoB) sequence analysis enabled strains B3117(T), K6999, 229 and 230 to be differentiated genotypically and phenotypically from known Staphylococcus species, indicating that these isolates are representatives of a novel species. The name Staphylococcus pettenkoferi sp. nov. is proposed for this novel species, with strain B3117(T) (=CIP 107711(T)=CCUG 51270(T)) as the type strain. Due to differences in the results of physiological and chemotaxonomic investigations and DNA-DNA hybridization data, strain A6664 was not included in the description of the novel species.

Topics: Anti-Bacterial Agents; Bacteremia; Bacterial Typing Techniques; Belgium; Cluster Analysis; Coagulase; DNA-Directed RNA Polymerases; DNA, Bacterial; DNA, Ribosomal; Fatty Acids; Genes, rRNA; Genotype; Germany; Humans; Locomotion; Microbial Sensitivity Tests; Molecular Sequence Data; Novobiocin; Nucleic Acid Hybridization; Peptidoglycan; Phylogeny; Ribotyping; RNA, Bacterial; RNA, Ribosomal, 16S; Sequence Analysis, DNA; Sequence Homology, Nucleic Acid; Staphylococcal Infections; Staphylococcus; Vitamin K 2

A new subspecies, Staphylococcus hominis subsp. novobiosepticus, isolated from human blood cultures, a wound, a breast abscess and a catheter tip, is described on the basis of a study of 26 strains isolated between 1989 and 1996. DNA-DNA reassociation reactions, conducted under stringent conditions, and macrorestriction pattern analysis demonstrated that these strains are closely related to previously characterized S. hominis strains isolated from human skin and clinical specimens, but are significantly divergent. S. hominis subsp. novobiosepticus can be distinguished from S. hominis (now named S. hominis subsp. hominis) by its combined characteristics of novobiocin resistance and failure to produce acid aerobically from D-trehalose and N-acetyl-D-glucosamine. Furthermore, all 26 strains of the new subspecies are resistant to nalidixic acid, penicillin G, oxacillin, kanamycin and streptomycin, and were either resistant or had intermediate resistance to methicillin and gentamicin. Most strains were also resistant to erythromycin, clindamycin, chloramphenicol, trimethoprim/sulfamethoxazole and ciprofloxacin. Based on a comparison of the sequences of a 1001 bp mecA amplification product from reference methicillin-resistant staphylococci, the mecA gene present in S. hominis subsp. novobiosepticus was identified as homologue A, commonly found in S. aureus and many coagulase-negative staphylococcal species. The type strain of S. hominis subsp. novobiosepticus is ATCC 700236T. Descriptions of S. hominis subsp. novobiosepticus subsp. nov and S. hominis subsp. hominis are given and the description of S. hominis is emended.

Topics: Acetylglucosamine; Bacteremia; Bacterial Proteins; Base Composition; Base Sequence; DNA, Bacterial; Drug Resistance, Microbial; Humans; Molecular Sequence Data; Novobiocin; Phenotype; Plasmids; Restriction Mapping; Staphylococcus; Trehalose

The susceptibility of clinical isolates of methicillin-susceptible and -resistant staphylococci from cancer patients with central venous catheter bacteremia to quinupristin/dalfopristin, a semisynthetic streptogramin, was determined in vitro. Susceptibility of these isolates to nine other antistaphylococcal antibiotics was also determined for comparison. A total of 197 staphylococcal strains were tested from 1983 to 1992. Quinupristin/dalfopristin was bactericidal against all isolates, independent of their resistance to methicillin. Its activity was similar to that of vancomycin but superior to that of teicoplanin. Quinupristin/dalfopristin may prove to be an important addition to our armamentarium against catheter-related staphylococcal infections.

Topics: Anti-Bacterial Agents; Anti-Infective Agents; Antibiotics, Antitubercular; Bacteremia; Catheterization, Central Venous; Cefamandole; Cephalosporins; Ciprofloxacin; Clindamycin; Daptomycin; Humans; Methicillin; Methicillin Resistance; Microbial Sensitivity Tests; Neoplasms; Novobiocin; Oxacillin; Penicillins; Rifampin; Staphylococcal Infections; Staphylococcus aureus; Staphylococcus epidermidis; Teicoplanin; Vancomycin; Virginiamycin

Topics: Aeromonas; Alcoholism; Ascites; Bacteremia; Escherichia coli Infections; Geriatrics; Humans; Intestines; Liver Cirrhosis; Liver Function Tests; Neomycin; Novobiocin; Penicillins; Peritonitis; Sepsis; Streptococcal Infections; Streptomycin; Tetracycline

Topics: Anti-Bacterial Agents; Bacteremia; Micrococcus; Novobiocin; Osteomyelitis; Sepsis