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Emergence of pristinamycin resistance in India

Shyam Sunder Keshari1, Arun Kumar Kapoor, Nira Kastury

  • 1Department of Pharmacology and Microbiology, Moti Lal Nehru Medical College, Allahabad, Uttar Pradesh, India.

Indian Journal of Pharmacology
|February 24, 2010
PubMed

Insights

Quinupristin and dalfopristin are recommended for multi-drug resistant (MDR) gram-positive cocci. However, two neonatal septicemia cases caused by methicillin-resistant Staphylococcus aureus (MRSA) showed resistance to pristinamycin, questioning its universal use.

Area of Science:

  • Microbiology
  • Infectious Diseases
  • Neonatal Care

Background:

  • Quinupristin/dalfopristin is a recommended treatment for multi-drug resistant (MDR) gram-positive cocci (GPC).
  • Methicillin-resistant Staphylococcus aureus (MRSA) is a significant cause of hospital-acquired and community-acquired infections.

Purpose of the Study:

  • To report two cases of neonatal septicemia caused by MRSA with primary in vitro pristinamycin resistance.
  • To question the universal recommendation of pristinamycin for MDR GPC infections.

Main Methods:

  • Case reporting of neonatal septicemia.
  • In vitro susceptibility testing using Minimum Inhibitory Concentration (MIC) for pristinamycin.

Main Results:

  • Two neonates with MRSA septicemia exhibited high pristinamycin MICs (30 µg/mL and 25 µg/mL).
  • These results indicate primary in vitro resistance to pristinamycin in these specific MRSA isolates.

Conclusions:

  • The universal advocacy of quinupristin/dalfopristin for MDR GPC infections may need re-evaluation.
  • Pristinamycin resistance in MRSA warrants further investigation, especially in neonatal settings.
Keywords:
Dalfopristin/quinupristinpristinamycin resistancestaphylococcus

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