2ea8059121b590fd5ed0bcacf33d40b4 306042.pdf 4f4f423881a2bf710986d96a601e0956b74f4ee7 306042.pdf 86ab89dddba9e66b1f54151bd8a484adf4f5f6e85b4341c34961729bd4fe3550 306042.pdf Title: In Vitro Activity of Ampicillin Plus Ceftriaxone Against Non-faecalis and Non-faecium Enterococcal Isolates With/Without VanC Phenotype: Clinical Implications for Infective Endocarditis Subject: (1) Background: Alternative antibiotics are needed to treat infective endocarditis (IE) caused by non-faecalis/non-faecium enterococci; we aimed to assess the in vitro activity of ampicillin plus ceftriaxone (AMP + CTR) against these enterococci and to describe its clinical efficacy in IE cases. (2) Methods: Time–kill curves with standard (ISI) and high (IHI) inocula were performed to test VanC isolates [3 E. casseliflavus (ECAS) and 1 E. gallinarum (EGALL)] and non-VanC isolates [1 E. durans (EDUR), 1 E. hirae (EHIR) and 1 E. raffinosus (ERAF)]. The narrative literature review of IE cases treated with AMP + CTR was analyzed alongside three study cases. Clinical outcomes were relapse and death. (3) Results: Ampicillin plus gentamicin (AMP + GEN) showed synergistic and bactericidal activity against most isolates. AMP + CTR was synergistic at ISI for EGALL, EDUR, and EHIR and bactericidal against EHIR. At IHI, indifferent activity was observed for all isolates. In IE cases treated with AMP + CTR, it was only effective for EDUR and EHIR. Clinical information for EGALL IE is lacking. For IE caused by ECAS and ERAF, AMP + CTR seems suboptimal or ineffective, respectively. (4) AMP + CTR cannot be recommended for treating IE due to ECAS/ERAF. In contrast, this combination was effective in IE caused by EDUR/EHIR and could be recommended. Keywords: enterococcal endocarditis; in vitro study; time–kill curves; synergy; E. casseliflavus; E. gallinarum; E. durans; E. hirae; E. raffinosus Author: Javier García-González, María A. Cañas, Guillermo Cuervo, Marta Hernández-Meneses, Miguel A. Verdejo, Marta Bodro, Javier Díez de los Ríos, Oriol Gasch, Alba Ribera, Carles Falces, Andrés Perissinotti, Bárbara Vidal, Eduard Quintana, Asunción Moreno, Maria Piquet, Ignasi Roca, Mariana Fernández-Pittol, Sol M. San José-Villar, Cristina García-de-la-Mària, José M. Miró and the Hospital Clínic Endocarditis Study Group Creator: LaTeX with hyperref Producer: pdfTeX-1.40.25 CreationDate: Thu Dec 5 14:39:31 2024 CET ModDate: Thu Dec 5 15:34:44 2024 CET Custom Metadata: no Metadata Stream: no Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 16 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 2506526 bytes Optimized: no PDF version: 1.7 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- JUXSQN+VnURWPalladioL-Bold Type 1 Custom yes yes yes 10 0 HAMFXX+URWPalladioL-Bold Type 1 Custom yes yes yes 16 0 AIQNXS+URWPalladioL-Roma Type 1 Custom yes yes yes 22 0 PGRMFA+URWPalladioL-Ital Type 1 Custom yes yes yes 27 0 MWEEAH+URWPalladioL-BoldItal Type 1 Custom yes yes yes 32 0 KORLVE+VnURWPalladioL Type 1 Custom yes yes yes 37 0 RWBCRL+CMSY10 Type 1 Builtin yes yes yes 67 0 AHCBEA+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 84 0 AHCBEB+PalatinoLinotype CID TrueType Identity-H yes yes yes 87 0 AHCBEC+PalatinoLinotype TrueType WinAnsi yes yes no 93 0 AHCBFE+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 96 0 AHCCCD+PalatinoLinotype TrueType MacRoman yes yes no 107 0 AHCBEA+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 110 0 AHCBEB+PalatinoLinotype CID TrueType Identity-H yes yes yes 113 0 AHCBEC+PalatinoLinotype TrueType WinAnsi yes yes no 119 0 AHCBFE+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 122 0 AHCBEA+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 133 0 AHCBEC+PalatinoLinotype TrueType WinAnsi yes yes no 136 0 AHCBFE+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 139 0 AHCCCD+PalatinoLinotype TrueType MacRoman yes yes no 149 0 AHCBEA+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 152 0 AHCBEC+PalatinoLinotype TrueType WinAnsi yes yes no 155 0 AHCBFE+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 158 0 AHCCCD+PalatinoLinotype TrueType MacRoman yes yes no 168 0 AHCBEA+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 171 0 AHCBEB+PalatinoLinotype CID TrueType Identity-H yes yes yes 174 0 AHCBEC+PalatinoLinotype TrueType WinAnsi yes yes no 180 0 AHCBFE+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 183 0 AHCBNE+PalatinoLinotype,Italic TrueType MacRoman yes yes no 186 0 AHCBEA+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 223 0 AHCBEB+PalatinoLinotype CID TrueType Identity-H yes yes yes 226 0 AHCBEC+PalatinoLinotype TrueType WinAnsi yes yes no 232 0 AHCBFE+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 235 0 Jhove (Rel. 1.28.0, 2023-05-18) Date: 2025-01-16 02:40:51 CET RepresentationInformation: 306042.pdf ReportingModule: PDF-hul, Rel. 1.12.4 (2023-03-16) LastModified: 2025-01-15 14:39:11 CET Size: 2506526 Format: PDF Version: 1.7 Status: Well-Formed and valid SignatureMatches: PDF-hul MIMEtype: application/pdf PDFMetadata: Objects: 409 FreeObjects: 1 IncrementalUpdates: 0 DocumentCatalog: PageLayout: SinglePage PageMode: UseNone Outlines: Item: Title: Introduction Destination: section.1 Item: Title: Materials and Methods Destination: section.2 Children: Item: Title: Bacterial Isolates Destination: subsection.2.1 Item: Title: Clonality Studies Destination: subsection.2.2 Item: Title: Antimicrobial Agents Destination: subsection.2.3 Item: Title: Susceptibility Testing Destination: subsection.2.4 Item: Title: Synergy Study by Time Kill Curves Destination: subsection.2.5 Item: Title: Clinical Data Destination: subsection.2.6 Item: Title: Literature Research Destination: subsection.2.7 Item: Title: Results Destination: section.3 Children: Item: Title: Recovered Isolates Destination: subsection.3.1 Item: Title: Susceptibility Testing Destination: subsection.3.2 Item: Title: In Vitro Time Kill Synergy Studies Destination: subsection.3.3 Item: Title: Clinical Data Destination: subsection.3.4 Item: Title: Clonality Studies Destination: subsection.3.5 Item: Title: Literature Search Destination: subsection.3.6 Item: Title: Discussion Destination: section.4 Item: Title: Conclusions Destination: section.5 Item: Title: References Destination: appendix.A. Info: Title: In Vitro Activity of Ampicillin Plus Ceftriaxone Against Non-faecalis and Non-faecium Enterococcal Isolates With/Without VanC Phenotype: Clinical Implications for Infective Endocarditis Author: Javier García-González, María A. Cañas, Guillermo Cuervo, Marta Hernández-Meneses, Miguel A. Verdejo, Marta Bodro, Javier Díez de los Ríos, Oriol Gasch, Alba Ribera, Carles Falces, Andrés Perissinotti, Bárbara Vidal, Eduard Quintana, Asunción Moreno, Maria Piquet, Ignasi Roca, Mariana Fernández-Pittol, Sol M. San José-Villar, Cristina García-de-la-Mària, José M. Miró and the Hospital Clínic Endocarditis Study Group Subject: (1) Background: Alternative antibiotics are needed to treat infective endocarditis (IE) caused by non-faecalis/non-faecium enterococci; we aimed to assess the in vitro activity of ampicillin plus ceftriaxone (AMP + CTR) against these enterococci and to describe its clinical efficacy in IE cases. (2) Methods: Time kill curves with standard (ISI) and high (IHI) inocula were performed to test VanC isolates [3 E. casseliflavus (ECAS) and 1 E. gallinarum (EGALL)] and non-VanC isolates [1 E. durans (EDUR), 1 E. hirae (EHIR) and 1 E. raffinosus (ERAF)]. The narrative literature review of IE cases treated with AMP + CTR was analyzed alongside three study cases. Clinical outcomes were relapse and death. (3) Results: Ampicillin plus gentamicin (AMP + GEN) showed synergistic and bactericidal activity against most isolates. AMP + CTR was synergistic at ISI for EGALL, EDUR, and EHIR and bactericidal against EHIR. At IHI, indifferent activity was observed for all isolates. In IE cases treated with AMP + CTR, it was only effective for EDUR and EHIR. Clinical information for EGALL IE is lacking. For IE caused by ECAS and ERAF, AMP + CTR seems suboptimal or ineffective, respectively. (4) AMP + CTR cannot be recommended for treating IE due to ECAS/ERAF. In contrast, this combination was effective in IE caused by EDUR/EHIR and could be recommended. 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