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Comparative efficacy of linezolid and vancomycin for endotracheal tube MRSA biofilms from ICU patients.
Fernández-Barat, Laia; Motos, Ana; Panigada, Mauro; Álvarez-Lerma, Francisco; Viña, Lucía; Lopez-Aladid, Ruben; Ceccato, Adrian; Bassi, Gianluigi Li; Nicolau, David P; Lopez, Yuli; Muñoz, Laura; Guerrero, Laura; Soy, Dolors; Israel, Trinidad; Castro, Pedro; Torres, Antoni.
Afiliación
  • Fernández-Barat L; Cellex Laboratory, CibeRes ((Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, 06/06/0028), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), School of Medicine, University of Barcelona, C/ Casanova 143, 08036, Cellex laboratory, Barcelona, Spain. lfernan1@cli
  • Motos A; Respiratory Intensive Care Unit Pneumology Department, Hospital Clínic, Barcelona, Spain. lfernan1@clinic.cat.
  • Panigada M; Cellex Laboratory, CibeRes ((Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, 06/06/0028), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), School of Medicine, University of Barcelona, C/ Casanova 143, 08036, Cellex laboratory, Barcelona, Spain.
  • Álvarez-Lerma F; Respiratory Intensive Care Unit Pneumology Department, Hospital Clínic, Barcelona, Spain.
  • Viña L; Department of Anesthesiology, Intensive Care and Emergency, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy.
  • Lopez-Aladid R; Critical Care Department, Hospital del Mar, Critical Illness Research Group (GREPAC), Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain.
  • Ceccato A; Servicio de Medicina Intensiva, Hospital Universitario Central de Asturias, Oviedo, Spain.
  • Bassi GL; Cellex Laboratory, CibeRes ((Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, 06/06/0028), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), School of Medicine, University of Barcelona, C/ Casanova 143, 08036, Cellex laboratory, Barcelona, Spain.
  • Nicolau DP; Respiratory Intensive Care Unit Pneumology Department, Hospital Clínic, Barcelona, Spain.
  • Lopez Y; Cellex Laboratory, CibeRes ((Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, 06/06/0028), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), School of Medicine, University of Barcelona, C/ Casanova 143, 08036, Cellex laboratory, Barcelona, Spain.
  • Muñoz L; Respiratory Intensive Care Unit Pneumology Department, Hospital Clínic, Barcelona, Spain.
  • Guerrero L; Cellex Laboratory, CibeRes ((Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, 06/06/0028), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), School of Medicine, University of Barcelona, C/ Casanova 143, 08036, Cellex laboratory, Barcelona, Spain.
  • Soy D; Respiratory Intensive Care Unit Pneumology Department, Hospital Clínic, Barcelona, Spain.
  • Israel T; Center for Anti-Infective Research and Development, Hartford Hospital, Hartford, CT, USA.
  • Castro P; Microbiology Department, Hospital Clínic, CRESIB ISglobal, Barcelona, Spain.
  • Torres A; Microbiology Department, Hospital Clínic, CRESIB ISglobal, Barcelona, Spain.
Crit Care ; 23(1): 251, 2019 07 10.
Article en En | MEDLINE | ID: mdl-31291978
PURPOSE: To compare the efficacy of systemic treatment with linezolid (LNZ) versus vancomycin (VAN) on methicillin-resistant Staphylococcus aureus (MRSA) burden and eradication in endotracheal tube (ETT) biofilm and ETT cuff from orotracheally intubated patients with MRSA respiratory infection. METHODS: Prospective observational clinical study was carried out at four European tertiary hospitals. Plasma and endotracheal aspirate (ETA) levels of LNZ and VAN were determined 72 h after treatment initiation through high-performance liquid chromatography or bioassay. LNZ or VAN concentration in the ETT biofilm and MRSA burden and eradication was determined upon extubation. The minimum inhibitory concentration (MIC) for LNZ and VAN was assessed by E-test strips (Biomerieux®). Scanning electron microscopy images were obtained, and ETT biofilm thickness was compared between groups. RESULTS: Twenty-five patients, 15 treated with LNZ and 10 with VAN, were included in the study. LNZ presented a significantly higher concentration (µg/mL) than VAN in ETT biofilm (72.8 [1.3-127.1] vs 0.4 [0.4-1.3], p < 0.001), although both drugs achieved therapeutic plasma levels 72 h after treatment initiation. Systemic treatment with LNZ achieved lower ETT cuff MRSA burdens than systemic treatment with VAN. Indeed, LNZ increased the MRSA eradication rate in ETT cuff compared with VAN (LNZ 75%, VAN 20%, p = 0.031). CONCLUSIONS: In ICU patients with MRSA respiratory infection intubated for long periods, systemic treatment with LNZ obtains a greater beneficial effect than VAN in limiting MRSA burden in ETT cuff.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Vancomicina / Staphylococcus aureus Resistente a Meticilina / Linezolid / Intubación Intratraqueal Tipo de estudio: Clinical_trials / Observational_studies Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Crit Care Año: 2019 Tipo del documento: Article País de afiliación: España Pais de publicación: Reino Unido
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Vancomicina / Staphylococcus aureus Resistente a Meticilina / Linezolid / Intubación Intratraqueal Tipo de estudio: Clinical_trials / Observational_studies Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Crit Care Año: 2019 Tipo del documento: Article País de afiliación: España Pais de publicación: Reino Unido