The in vitro antifungal activities of micafungin in comparison to caspofungin, fluconazole, itraconazole, voriconazole, and amphotericin B were evaluated against 93 Candida and 23 Aspergillus isolates recovered from pediatric patients with fungal infections. MICs were determined by the CLSI M27-A2 and M38-A for Candida and Aspergillus species, respectively. Micafungin showed potent activity against Candida albicans, Candida tropicalis, and Candida glabrata with a MIC range of <= 0.002 to 0.015mug/ml. In contrast, micafungin demonstrated higher MIC levels against Candida parapsilosis with a MIC range of 0.12 to 2 mug/ml. Micafungin showed potent antifungal activity against Aspergillus species tested with a MIC range of 0.004 to 0.015 mug/ml. Overall, micafungin had excellent in vitro antifungal activities against Candida and Aspergillus species recovered from pediatric patients with fungal infections.

In vitro antimicrobial activity of telavancin, a rapidly bactericidal lipoglycopeptide, was evaluated against 1500 strains of MRSA recently isolated in Japan. Telavancin had potent activity, with MIC values that ranged from 0.12 m g/ml to 0.5 m g/ml and a MIC 90 value of 0.5 mg/ml. The MIC 90 s of vancomycin and linezolid were 1.0m g/ml and 2 m g/ml, respectively. No vancomycin intermediate resistant or vancomycin-resistant MRSAs were detected in this surveillance study.Keywords telavancin, S. aureus, MRSA, surveillance, vancomycin, Japan, lipoglycopeptideThe global emergence of severe infections caused by Gram-positive pathogens with resistance or reduced susceptibility to antibiotics has become a major public health concern. Importantly, among Staphylococcus aureus isolates, the frequency with which methicillin-resistant strains (MRSA) are isolated is rising [1]. In addition, MRSA strains with reduced susceptibility to vancomycin, teicoplanin and linezolid are reported with increasing frequency [2ϳ4]. Failure of vancomycin to effectively treat serious staphylococcal infections has been reported and many experts believe that this may be due to its limited bactericidal activity [5,6].Telavancin (Fig. 1), a novel lipoglycopeptide antibiotic with a unique, multifunctional mechanism of action and rapid, concentration-dependent bactericidal activity, has completed two Phase III trials for complicated skin and skin structure infections, and is currently under evaluation for the treatment of hospital-acquired pneumonia [7]. Unlike vancomycin and teicoplanin, telavancin disrupts bacterial cell membrane integrity in addition to inhibiting peptidoglycan synthesis [8]. This dual mechanism of action may be the reason for the potent bactericidal activity observed with telavancin, which may also be a factor in limiting the emergence of resistance

The effect of entry delayed blood culture bottles until the start of incubation for mechanical detection of organism were compared using 2 major blood culture systems; BACTEC 9240 system and BacT/ALERT 3D system. Total of 13 bacterial strains; 5 gram-positive cocci, 7 gram-negative bacilli and Candida parapsilosis which were isolated mainly from blood cultures were used as the test strains. BACTEC 92F, 93F and BacT/ALERT FA, FN bottles were used as the blood culture bottles. All the bottles inoculated with the test strains were incubated and evaluated immediately after standing at room temperature for 24, 42, 48, 54 or 72 hours, using the respective automated blood culture systems. All the bottles were subcultured. The effect of entry delay the blood culture bottles for the mechanical detection was observed in many gram-negative organisms in BACTEC 9240 system. The blood cultures were evaluated not to be positive in 4 of the 10 samples on delaying for 24 hours or in any of the samples on delaying for 42 hours in the BACTEC 92F bottles inoculated with Escherichia coli. In Serratia marcescens, the blood cultures were evaluated not to be positive in 5 of the 10 samples on delaying for 24 hours or in any of the samples on delaying for 42 hours in the BACTEC 92F bottles. In Klebsiella pneumoniae, the blood cultures were evaluated not to be positive in 9 of the 10 samples on delaying for 42 hours. In Enterococcus faecalis, Pseudomonas aeruginosa and Proteus mirabilis, the blood cultures were evaluated not to be positive in 5-6 of the 10 samples on delaying for 42 hours. On the other hand, the blood cultures were evaluated to be positive in most of the samples of Acinetobacter calcoaceticus (except 3 of the 10 samples which were evaluated not to be positive) on delaying for 42 hours in BacT/ALERT 3 D system. The samples except part of Streptococcus spp. were detected by subculture in both the bottles. These results indicate that the delayed time of blood culture bottles before inoculation with the test bacterial samples affects the positive detection of blood cultures markedly in the blood culture system. Therefore, the immediate incubation was considered to be necessary.

Capilia TB, a lateral flow immunochromatographic slide test kit for directly identifying Mycobacterium tuberculosis complex (MTC), was evaluated by using culture-positive specimens from Mycobacteria Growth Indicator Tubes (MGIT). Sputum specimens from patients suspected of having tuberculosis were treated with NALC-NaOH and cultivated in MGIT960. Liquid specimens were collected from the positive tubes and directly inoculated with Capilia TB. Liquid specimens were also directly tested with AccuProbe. Of the organisms isolated from the 100 MGIT positive tubes, M. tuberculosis complex was identified in 49 (49%) tubes with Capilia TB and not identified in 51 (51%) with Capilia TB. Mycobacterium avium-intracellulare complex (MAC) was identified in 46 (46%) with AccuProbe MAC and other acid-fast bacteria were identified in 5 (5%) by DNA-DNA hybridization method. There were one tube in which M. tuberculosis complex was detected with Capilia TB and M. tuberculosis complex was not detected with AccuProbe MTC, but no tubes in which M. tuberculosis complex was detected with AccuProbe MTC and M. tuberculosis complex was not detected with Capilia TB. Capilia TB is excellent in sensitivity and specificity and very suitable for rapid diagnosis of tuberculosis and is considered to contribute to public health intervention measures taken for the tuberculosis control in Japan.

No abstract