United States resistance surveillance results for linezolid (LEADER Program for 2007)

ZAAPS International Surveillance Program (2007) for linezolid resistance: results from 5591 Gram-positive clinical isolates in 23 countries

The 2007 ZAAPS Program reports the results from the 6th year of oxazolidinone (linezolid) resistance surveillance among Gram-positive pathogens from 23 nations. For 2007, a total of 5591 organisms were systematically sampled from Asia, Australia, Canada, Europe, and Latin America including Staphylococcus aureus (3000 isolates, 38.2% methicillin resistant), coagulase-negative staphylococci (CoNS, 716 isolates), enterococci (906 isolates), Streptococcus pneumoniae (452 isolates), viridans group streptococci (155 isolates), and beta-hemolytic streptococci (362 isolates). The overall linezolid MIC distribution (MIC(50) and MIC(90) at 1 and 2 microg/mL, respectively) was unchanged since 2002. At published linezolid breakpoints (, or = 2 microg/mL), all streptococci were susceptible; however, resistance was observed very rarely among S. aureus (0.03%), CoNS (0.28%), and the enterococci (0.11%, 0.55% intermediate). These oxazolidinone-nonsusceptible isolates occurred in Ireland, Italy, China, and Brazil (9 strains), and the rate was not increased since 2006. The detected mechanism of resistance was G2576 target mutations; no cfr-mediated patterns were observed. Clonal outbreaks with patient-to-patient dissemination were documented in 1 Italian site. Linezolid appears to retain excellent activity against monitored Gram-positive pathogens at a level of >99.8%.

The biochemistry of disease: desperately seeking syzygy

The elucidation of the precise molecular structure and dynamics of biological processes is the great work of biochemistry. From this, insights into the changes leading to process dysfunction or disease are derived, as well as the possible approaches to restore healthy function. Translating this information into effective and safe treatments for disease requires a coordinated interdisciplinary effort, a fusion of creativity and practicality, and a healthy dose of luck. Using several reviews in this volume as springboards, I discuss the broader issues of drug development, highlighting some recent successes and future directions. Such occurrences inspire awe but remain too rare for comfort.

Antistaphylococcal activity of dihydrophthalazine antifolates, a family of novel antibacterial drugs

For a panel of 153 Staphylococcus aureus clinical isolates (including 13 vancomycin-intermediate or heterogeneous vancomycin-intermediate and 4 vancomycin-resistant strains), MIC(50)s and MIC(90)s of three novel dihydrophthalazine antifolates, BAL0030543, BAL0030544, and BAL0030545, were 0.03 and 0.25 microg/ml, respectively, for methicillin-susceptible strains and 0.03 and 128 microg/ml), although rates of endogenous resistance development were much lower for the dihydrophthalazines than for trimethoprim. Single-step platings of naïve staphylococci onto media containing dihydrophthalazine antifolates indicated considerable variability among strains with respect to preexistent subpopulations nonsusceptible to dihydrophthalazine antifolates.