Treatment Options for Chronic Prostatitis due to Vancomycin-Resistant Enterococcus faecium

Taylor, Shirley; Paterson, David L.; Yu, Victor L.

doi:10.1007/s100960050190

Cited by 20 publications

(3 citation statements)

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“…The patient was treated with oral rifampin (600 mg/day for 6 weeks) and nitrofurantoin (200 mg four times daily for 2 weeks, followed by 100 mg four times daily for 4 weeks). The patient improved clinically, and all subsequent urine cultures were negative (15). As it is known that nitrofurantoin penetrates the prostate poorly, its exact role in the cure of this patient's infection is unclear (2).…”

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confidence: 97%

“…Of the remaining 30% of vancomycin-resistant isolates, most exhibit a vanB phenotype, which is characterized by resistance to vancomycin and susceptibility to teicoplanin (5, 10). Vancomycin-resistant enterococci not only colonize the gastrointestinal tract but also have been associated with various infections including bacteremias, surgical site infections, peritonitis, pelvic abscesses, skin and soft tissue infections, and urinary tract infections including chronic prostatitis (1,9,13,15,17). Recently, seven cases of urinary tract infection caused by VRE were characterized (9).…”

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Nitrofurantoin Is Active against Vancomycin-Resistant Enterococci

Zhanel

Hoban

Karlowsky

2001

Antimicrob Agents Chemother

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The activity of nitrofurantoin was tested against 300 isolates of Enterococcus faecium, Enterococcus faecalis, and Enterococcus gallinarum. No isolates tested were resistant to nitrofurantoin (MIC, >128 g/ml), including vancomycin-resistant E. faecium isolates with vanA-and vanB-positive genotypes and vancomycin-resistant E. gallinarum isolates. We conclude that nitrofurantoin may provide effective treatment of urinary tract infections caused by vancomycin-resistant enterococci.Enterococci are constitutive members of the intestinal flora of humans and animals but may also colonize the upper respiratory tracts, biliary tracts, and vaginas of otherwise healthy persons. The isolation of clinical isolates of enterococci generally denotes colonization rather than infection; however, enterococci may also cause infection, most commonly, urinary tract infection, but also cholecystitis, cholangitis, peritonitis, septicemia, endocarditis, meningitis, and simple wound infections (5). Although more than a dozen species of Enterococcus have been identified, two species, Enterococcus faecalis and Enterococcus faecium, account for approximately 85 to 90% and 5 to 10% of human enterococcal infections, respectively. The emergence of vancomycin resistance, most commonly in E. faecium, has introduced additional challenges to therapy, as these isolates are frequently resistant to additional antibiotics as well. The purpose of the current study was to assess the activities of nitrofurantoin and comparative antibiotics against isolates of E. faecium, E. faecalis, and Enterococcus gallinarum including vancomycin-resistant isolates.The E. faecium, E. faecalis, and E. gallinarum stool isolates tested in this study were taken from previous and ongoing Canadian surveillance studies of vancomycin-resistant enterococci (VRE) (8,17). In total, 100 vancomycinsusceptible E. faecium isolates, 100 vancomycin-susceptible E. faecalis isolates, 50 vancomycin-resistant E. faecium isolates, 25 vancomycin-susceptible E. gallinarum isolates, and 25 vancomycin-resistant E. gallinarum isolates were tested. Each stool isolate was from a different patient (8, 17) and had been identified to the species level by a conventional algorithm (4) supplemented with methyl-␣-D-glycopyranoside testing (16). The identities of all discrepant organisms were determined by 16S rRNA gene sequencing (16). The genotypes of vancomycin-resistant isolates were determined by a previously described multiplex PCR protocol for vanA, vanB, vanC1 and vanC2-vanC3 (3).Antibiotics for susceptibility testing were obtained from their various manufacturers as standard powders. Prior to antibiotic susceptibility testing all isolates were subcultured twice onto blood agar. MICs were determined by the standard broth microdilution method of NCCLS (M7-A4) with Mueller-Hinton broth (11) and were interpreted by using the breakpoints suggested by NCCLS (12).None of the 300 isolates of enterococci tested were resistant to nitrofurantoin (MICs, Ն128 g/ml) including vancomycinresistant isolates of E...

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Nitrofurantoin Is Active against Vancomycin-Resistant Enterococci

Zhanel

Hoban

Karlowsky

2001

Antimicrob Agents Chemother

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“…In a European study of 63 patients with vancomycin-susceptible enterococcal infection, clinical and microbiological responses were observed in 84% and 87% of cases, respectively. 59 This agent remains unstudied for VanB enterococcal infection, perhaps in part due to the development of teicoplanin resistance among VanB E. faecalis during teicoplanin therapy. 60,61 Nitrofurantoin has in vitro activity against both VanA and VanB enterococci.…”

Section: Specific Antimicrobials For the Treatment Of Vancomycin-resimentioning

confidence: 99%

Optimizing Therapy for Vancomycin-Resistant Enterococci (VRE)

Linden¹

2007

Semin Respir Crit Care Med

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Enterococci are gram-positive, facultative bacteria with low intrinsic virulence but capable of causing a diverse variety of infections such as bacteremia with or without endocarditis, and intra-abdominal, wound, and genitourinary infection. During the past 2 decades the incidence of hospital-acquired enterococcal infection has significantly risen and is increasingly due to multidrug-resistant strains, primarily to the coacquisition of genetic determinants that encode for the stable expression of high-level beta-lactam, aminoglycoside, and glycopeptide resistance. Because enterococci constitute part of the normal colonizing flora, careful clinical interpretation of cultures that grow enterococci is paramount to avoid unnecessary and potentially deleterious antimicrobial therapy. Traditional antimicrobial treatment for ampicillin- and glycopeptide-susceptible enterococcal infection remains a penicillin-, ampicillin-, semisynthetic penicillin-based regimen, or vancomycin in a penicillin-intolerant individual. The need for a bactericidal combination with a cell-wall active agent combined with an aminoglycoside is most supported for native- or prosthetic valve endocarditis but is unproven for the majority of infections due to enterococci. The emergence of vancomycin-resistant enterococci prompted the clinical development of several novel and modified antimicrobial compounds approved for VRE infection (quinupristin-dalfopristin, linezolid) and several approved for non-VRE indications (daptomycin, tigecycline). There is a paucity of comparative clinical trial data with these new agents, although linezolid, based upon its efficacy and tolerability, appears to be the cornerstone of current treatment approaches. Despite a relatively short period of clinical use, enterococcal resistance has now been described for quinupristin-dalfopristin and linezolid and more recently even for daptomycin and tigecycline. Moreover, the optimal treatment of endocarditis due to VRE strains is unknown because, with the exception of daptomycin, current treatment options only yield bacteriostasis. Nonantimicrobial measures to treat VRE infection, such as foreign body removal and percutaneous or surgical drainage of close-spaced infection, reduce both the need for and the duration of anti-enterococcal treatment and the emergence of resistance to the newer antimicrobials.

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Vancomycin-resistant Enterococci

Nannini¹,

Murray²

2004

Reemergence of Established Pathogens in the 21st Century

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Treatment Options for Chronic Prostatitis due to Vancomycin-Resistant Enterococcus faecium

Cited by 20 publications

References 7 publications

Nitrofurantoin Is Active against Vancomycin-Resistant Enterococci

Nitrofurantoin Is Active against Vancomycin-Resistant Enterococci

Optimizing Therapy for Vancomycin-Resistant Enterococci (VRE)

Vancomycin-resistant Enterococci

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