DOCSLIB.ORG

205436Orig1s000

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
205436Orig1s000 CENTER FOR DRUG EVALUATION AND RESEARCH APPLICATION NUMBER: 205436Orig1s000 MICROBIOLOGY / VIROLOGY REVIEW(S) DIVISION OF ANTI-INFECTIVE PRODUCTS CLINICAL MICROBIOLOGY NDA REVIEW NDA: 205435/205436 DATE REVIEW COMPLETED: 02/24/2014 Tedizolid Phosphate (Sivextro) Date Company Submitted: 10/18/2016 Date received by CDER: 10/21/2013 Reviewer: Avery Goodwin, Ph.D NAME AND ADDRESS OF APPLICANT: Trius Therapeutics, Inc. 6310 Nancy Ridge Drive Suite 101, San Diego, CA 92121 CONTACT PERSON: Karen Potts, Ph.D. Tel No: 858-452-0370 Ex 299 Fax No: 858-201-8431 Email: [email protected] DRUG PRODUCT NAME: Proprietary Name: Sivextro Established Name: TR-701; Tedizolid phosphate Structural Formula: PROPOSED DOSAGE FORM AND STRENGTH: Tedizolid phosphate: Injection for intravenous use and tablet. Injection 200 mg sterile lyophilized powder; 200 mg tablet ROUTE OF ADMINISTRATION AND DURATION OF TREATMENT: For oral administration and IV administration: the recommended dosage of TRADENAME is 200 mg administered once daily for six (6) days either orally (with or without food) or as an intravenous (IV) infusion in patients (b) (4) PROPOSED INDICATION: Tedizolid phosphate (Sivextro) is indicated for the treatment of acute bacterial skin and skin structure infections (ABSSSI) caused by susceptible isolates of the following gram- positive microorganisms: Staphylococcus aureus (including methicillin-resistant [MRSA] and methicillin-susceptible [MSSA] isolates, and cases with concurrent bacteremia), Staphylococcus haemolyticus, Staphylococcus lugdunensis, Streptococcus 1 Reference ID: 3503934 DIVISION OF ANTI-INFECTIVE PRODUCTS CLINICAL MICROBIOLOGY NDA REVIEW NDA: 205435/205436 DATE REVIEW COMPLETED: 02/24/2014 Tedizolid Phosphate (Sivextro) pyogenes, Streptococcus agalactiae, Streptococcus anginosus Group (including Streptococcus anginosus, Streptococcus intermedius and Streptococcus constellatus), and Enterococcus faecalis. RELATED SUBMISSION REVIEWED: IND 77,872; IND 106,307 TYPE OF SUBMISSION: NDA submission REVIEWER’S COMMENTS: Based on the clinical microbiology data submitted by the Applicant, this NDA submission may be approved, provided that the Applicant makes the changes in the microbiology subsection of the proposed label recommended by the Agency. (b) (4) FDA’s version of the Tedizolid label: 12.4 Microbiology Mechanism of Action The antibacterial activity of tedizolid is mediated by binding to the 50S subunit of the bacterial ribosome resulting in inhibition of protein synthesis. (b) (4) (b) (4) Mechanism of Resistance (b) (4) (b) (4) 2 Reference ID: 3503934 DIVISION OF ANTI-INFECTIVE PRODUCTS CLINICAL MICROBIOLOGY NDA REVIEW NDA: 205435/205436 DATE REVIEW COMPLETED: 02/24/2014 Tedizolid Phosphate (Sivextro) (b) (4) (b) (4) Frequency of Resistance Spontaneous mutations conferring reduced susceptibility to tedizolid occur in vitro at a frequency rate of approximately 10-10. (b) (4) Interaction with Other Antimicrobials In vitro drug combination studies with tedizolid and aztreonam, ceftriaxone, ceftazidime, imipenem, rifampin, trimethoprim/sulfamethoxazole, minocycline, clindamycin, ciprofloxacin, daptomycin, vancomycin, gentamicin, amphotericin B, ketoconazole, and terbinafine demonstrate neither synergy nor antagonism. Spectrum of Activity Tedizolid has been shown to be active against most isolates of the following bacteria, both in vitro and in clinical infections, as described in (b) (4) Indications and Usage (1) (b) (4) Aerobic and Facultative Gram-positive Microorganisms Staphylococcus aureus (including methicillin-resistant [MRSA] and methicillin-susceptible [MSSA] isolates) (b) (4) Streptococcus pyogenes Streptococcus agalactiae Streptococcus anginosus Group (including S. anginosus, S. intermedius, and S. constellatus) Enterococcus faecalis (b) (4) The following in vitro data are available, but their clinical significance has not been established. At least 90% of the following microorganisms exhibit an in vitro minimum inhibitory concentration (MIC) less than or equal to (b) (4) for tedizolid. However, the safety and effectiveness of TRADENAME in treating 3 Reference ID: 3503934 DIVISION OF ANTI-INFECTIVE PRODUCTS CLINICAL MICROBIOLOGY NDA REVIEW NDA: 205435/205436 DATE REVIEW COMPLETED: 02/24/2014 Tedizolid Phosphate (Sivextro) clinical infections due to these microorganisms have not been established in adequate and well-controlled clinical trials. Aerobic and Facultative Anaerobic Gram-positive Microorganisms Staphylococcus epidermidis (including methicillin-susceptible and methicillin-resistant strains) Staphylococcus haemolyticus Staphylococcus lugdunensis (b) (4) Enterococcus faecium (b) (4) Susceptibility Test Methods When available, the clinical microbiology laboratory should provide cumulative results of the in vitro susceptibility test results for antibacterial drugs used in local hospitals and practice areas to the physician as periodic reports that describe the susceptibility profile of nosocomial and community-acquired pathogens. These reports should aid the physician in selecting the most effective antibacterial drug product for treatment. Dilution Techniques Quantitative methods are used to determine antibacterial minimum inhibitory concentrations (MICs). These MIC values provide estimates of the susceptibility of bacteria to antibacterial compounds. The MIC values should be determined using a standardized procedure based on dilution methods (broth, agar, or microdilution)1,3 or equivalent using standardized inoculum and concentrations of tedizolid. The MIC values should be interpreted according to the criteria provided in Table 3. Table 1 Susceptibility Interpretive Criteria for TRADENAME Minimum Inhibitory Concentrations Disk Diffusion Zone Diameter (mm) (µg/mL) Pathogen S I R S I R Staphylococcus aureus (methicillin-resistant and methicillin- ≤0.5 1 ≥2 ≥19 16-18 ≤15 susceptible isolates) (b) (4) Streptococcus pyogenes ≤0.5 - - ≥18 - - Streptococcus agalactiae ≤0.5 - - ≥18 - - Streptococcus anginosus Group* ≤0.25 - - ≥17 - - Enterococcus faecalis ≤0.5 - - ≥19 - - S=susceptible, I=intermediate, R=resistant 4 Reference ID: 3503934 DIVISION OF ANTI-INFECTIVE PRODUCTS CLINICAL MICROBIOLOGY NDA REVIEW NDA: 205435/205436 DATE REVIEW COMPLETED: 02/24/2014 Tedizolid Phosphate (Sivextro) *Includes S. anginosus, S. intermedius, S. constellatus Diffusion techniques Quantitative methods that require measurement of zone diameters also provide reproducible estimates of the susceptibility of bacteria to antibacterial compounds. The standardized procedure2,3 requires the use of standardized inoculum concentrations. This procedure uses paper disks impregnated with 20 mcg tedizolid to test the susceptibility of microorganisms to tedizolid. Reports from the laboratory providing results of the standard single-disk susceptibility test with a 20 mcg tedizolid disk should be interpreted according to the criteria in Table 3. A report of “Susceptible” indicates that the (b) (4) is likely to inhibit growth of the pathogen if the antibacterial (b) (4) reaches the concentration (b) (4) A report of “Intermediate” indicates that the result should be considered equivocal, and if the microorganism is not fully susceptible to alternative (b) (4) drugs, the test should be repeated. This category implies possible clinical (b) (4) in body sites where the drug is physiologically concentrated. This category also provides a buffer zone that prevents small uncontrolled technical factors from causing major discrepancies in interpretation. A report of “Resistant” indicates that the (b) (4) is not likely to inhibit growth of the pathogen if the (b) (4) reaches the concentrations usually achievable at the infection site; other therapy should be selected. Quality Control Standardized susceptibility test procedures require the use of laboratory control microorganisms to monitor and ensure the accuracy and precision of supplies and reagents used in the assay, and the techniques of the individuals performing the test.1, 2, 3 Standardized tedizolid powder should provide the following range of MIC values noted in Table 4. For the diffusion technique using the 20 mcg tedizolid disk, results within the ranges specified in Table 4 should be observed. Table 2 Acceptable Quality Control Ranges for Susceptibility Testing Minimum Inhibitory Disk Diffusion Quality Control Organism Concentrations (µg/mL) (zone diameter in mm) Staphylococcus aureus 0.25 - 1 Not Applicable ATCC 29213 Staphylococcus aureus Not Applicable 22 - 29 ATCC 25923 Enterococcus faecalis 0.25 - 1 Not Applicable ATCC 29212 Streptococcus pneumoniae 0.12 - 0.5 24 - 30 ATCC 49619 5 Reference ID: 3503934 DIVISION OF ANTI-INFECTIVE PRODUCTS CLINICAL MICROBIOLOGY NDA REVIEW NDA: 205435/205436 DATE REVIEW COMPLETED: 02/24/2014 Tedizolid Phosphate (Sivextro) 15 REFERENCES 1. Clinical and Laboratory Standards Institute (CLSI). Methods for Dilution Antimicrobial Susceptibility Tests for Bacteria that Grow Aerobically; Approved Standard – 9th ed., CLSI document M7 A9. Wayne, PA: Clinical and Laboratory Standards Institute; 2012. 2. Clinical and Laboratory Standards Institute (CLSI). Performance Standards for Antimicrobial Disk Susceptibility Tests, Approved Standard – 11th ed. CLSI document M2 A11 (ISBN 1-56238-781-2 [Print]; ISBN 1-56238-782-0 [Electronic]). Clinical and Laboratory Standards Institute, 950 West Valley Road, Suite 2500, Wayne, Pennsylvania 19087 USA, 2012. 3. Clinical and Laboratory Standards Institute (CLSI). Performance Standards for Antimicrobial Susceptibility Testing – 24th
Load more

Recommended publications
  • Streptococcus Agalactiae, Invasive (Group B Streptococcus)Rev Jan 2018
    Streptococcus agalactiae, Invasive (Group B Streptococcus) Streptococcus agalactiae, Invasive (Group B Streptococcus) rev Jan 2018 BASIC EPIDEMIOLOGY Infectious Agent Streptococcus agalactiae (group B Streptococcus [GBS]) are beta-hemolytic, Gram-positive cocci. Transmission Transmission of group B Streptococcus from mother to infant occurs just before or during delivery. After delivery, infants are occasionally infected via person-to-person transmission in the nursery. In adults, GBS can be acquired through person-to-person transmission from healthy carriers (colonized but asymptomatic) in the community. Incubation Period The incubation period for early onset GBS disease in neonates is <7 days. The incubation period for late onset GBS disease in infants, children and adults is unknown. Communicability An estimated 10%–30% of women are carriers. GBS colonization occurs primarily in the gastrointestinal and genital tracts. Colonization is most often asymptomatic and does not require treatment. About half the infants born to colonized mothers are also colonized on the skin and mucosal surfaces as a result of passage through the birth canal or as a result of GBS ascending into the amniotic fluid. The majority of colonized infants, 98%, are asymptomatic. Clinical Illness In neonates two syndromes exist: early-onset disease (<7 days old) and late-onset disease (7-90 days old). Both syndromes can include sepsis, pneumonia and meningitis. Pregnancy-related infections include sepsis, amnionitis, urinary tract infection and stillbirth. In adults, pneumonia, bacteremia, meningitis, joint infections or soft tissue infections can occur. Severity The Centers for Disease Control and Prevention estimates that 0.53 deaths per 100,000 people occur annually. GBS is the leading cause of neonatal sepsis in the US.
    [Show full text]
  • Molecular Mechanisms of Inhibition of Streptococcus Species by Phytochemicals
    molecules Review Molecular Mechanisms of Inhibition of Streptococcus Species by Phytochemicals Soheila Abachi 1, Song Lee 2 and H. P. Vasantha Rupasinghe 1,* 1 Faculty of Agriculture, Dalhousie University, Truro, NS PO Box 550, Canada; [email protected] 2 Faculty of Dentistry, Dalhousie University, Halifax, NS PO Box 15000, Canada; [email protected] * Correspondence: [email protected]; Tel.: +1-902-893-6623 Academic Editors: Maurizio Battino, Etsuo Niki and José L. Quiles Received: 7 January 2016 ; Accepted: 6 February 2016 ; Published: 17 February 2016 Abstract: This review paper summarizes the antibacterial effects of phytochemicals of various medicinal plants against pathogenic and cariogenic streptococcal species. The information suggests that these phytochemicals have potential as alternatives to the classical antibiotics currently used for the treatment of streptococcal infections. The phytochemicals demonstrate direct bactericidal or bacteriostatic effects, such as: (i) prevention of bacterial adherence to mucosal surfaces of the pharynx, skin, and teeth surface; (ii) inhibition of glycolytic enzymes and pH drop; (iii) reduction of biofilm and plaque formation; and (iv) cell surface hydrophobicity. Collectively, findings from numerous studies suggest that phytochemicals could be used as drugs for elimination of infections with minimal side effects. Keywords: streptococci; biofilm; adherence; phytochemical; quorum sensing; S. mutans; S. pyogenes; S. agalactiae; S. pneumoniae 1. Introduction The aim of this review is to summarize the current knowledge of the antimicrobial activity of naturally occurring molecules isolated from plants against Streptococcus species, focusing on their mechanisms of action. This review will highlight the phytochemicals that could be used as alternatives or enhancements to current antibiotic treatments for Streptococcus species.
    [Show full text]
  • Beta-Haemolytic Streptococci (BHS)
    technical sheet Beta-Haemolytic Streptococci (BHS) Classification Transmission Gram-positive cocci, often found in chains Transmission is generally via direct contact with nasopharyngeal secretions from ill or carrier animals. Family Animals may also be infected by exposure to ill or Streptococcaceae carrier caretakers. β-haemolytic streptococci are characterized by Lancefield grouping (a characterization based on Clinical Signs and Lesions carbohydrates in the cell walls). Only some Lancefield In mice and rats, generally none. Occasional groups are of clinical importance in laboratory rodents. outbreaks of disease associated with BHS are Streptococci are generally referred to by their Lancefield reported anecdotally and in the literature. In most grouping but genus and species are occasionally used. cases described, animals became systemically ill after experimental manipulation, and other animals Group A: Streptococcus pyogenes in the colony were found to be asymptomatic Group B: Streptococcus agalactiae carriers. In a case report not involving experimental Group C: Streptococcus equi subsp. zooepidemicus manipulation, DBA/2NTac mice and their hybrids were Group G: Streptococcus canis more susceptible to an ascending pyelonephritis and subsequent systemic disease induced by Group B Affected species streptococci than other strains housed in the same β-haemolytic streptococci are generally considered barrier. opportunists that can colonize most species. Mice and guinea pigs are reported most frequently with clinical In guinea pigs, infection with Group C streptococci signs, although many rodent colonies are colonized leads to swelling and infection of the lymph nodes. with no morbidity, suggesting disease occurs only with Guinea pigs can be inapparent carriers of the organism severe stress or in other exceptional circumstances.
    [Show full text]
  • Use of the Diagnostic Bacteriology Laboratory: a Practical Review for the Clinician
    148 Postgrad Med J 2001;77:148–156 REVIEWS Postgrad Med J: first published as 10.1136/pmj.77.905.148 on 1 March 2001. Downloaded from Use of the diagnostic bacteriology laboratory: a practical review for the clinician W J Steinbach, A K Shetty Lucile Salter Packard Children’s Hospital at EVective utilisation and understanding of the Stanford, Stanford Box 1: Gram stain technique University School of clinical bacteriology laboratory can greatly aid Medicine, 725 Welch in the diagnosis of infectious diseases. Al- (1) Air dry specimen and fix with Road, Palo Alto, though described more than a century ago, the methanol or heat. California, USA 94304, Gram stain remains the most frequently used (2) Add crystal violet stain. USA rapid diagnostic test, and in conjunction with W J Steinbach various biochemical tests is the cornerstone of (3) Rinse with water to wash unbound A K Shetty the clinical laboratory. First described by Dan- dye, add mordant (for example, iodine: 12 potassium iodide). Correspondence to: ish pathologist Christian Gram in 1884 and Dr Steinbach later slightly modified, the Gram stain easily (4) After waiting 30–60 seconds, rinse with [email protected] divides bacteria into two groups, Gram positive water. Submitted 27 March 2000 and Gram negative, on the basis of their cell (5) Add decolorising solvent (ethanol or Accepted 5 June 2000 wall and cell membrane permeability to acetone) to remove unbound dye. Growth on artificial medium Obligate intracellular (6) Counterstain with safranin. Chlamydia Legionella Gram positive bacteria stain blue Coxiella Ehrlichia Rickettsia (retained crystal violet).
    [Show full text]
  • Growth Performance, Immune Response, and Resistance of Nile Tilapia Fed Paraprobiotic Bacillus Sp. NP5 Against Streptococcus Agalactiae Infection
    Jurnal Akuakultur Indonesia 20 (1), 34–46 (2021) Original article DOI: 10.19027/jai.20.1.34-46 Growth performance, immune response, and resistance of Nile tilapia fed paraprobiotic Bacillus sp. NP5 against Streptococcus agalactiae infection Kinerja pertumbuhan, respons imun, dan resistansi ikan nila yang diberi paraprobiotik Bacillus sp. NP5 terhadap infeksi Streptococcus agalactiae Aldy Mulyadin1, Widanarni1*, Munti Yuhana1, Dinamella Wahjuningrum1 1Department of Aquaculture, Faculty of Fisheries and Marine Science, IPB University, Bogor, West Java, Indonesia *Corresponding author: [email protected] (Received October 2, 2020; Accepted October 23, 2020) ABSTRACT This study was aimed to evaluate the effectiveness of Bacillus sp. NP5 paraprobiotic administration through commercial feed on growth performance, immune response, and resistance of Nile tilapia against Streptococcus agalactiae infection. Bacillus sp. NP5 paraprobiotic was produced through heat-inactivation at 95°C for 1 h, then performed a viability test on tryptic soy agar (TSA) media and incubated for 24 hours. Paraprobiotics could be used whether the bacteria did not grow on the TSA media. This study used a completely randomized design, containing three treatments with five replications, i.e. 1% (v/w) probiotic addition, 1% (v/w) paraprobiotic addition, and no addition of probiotic or paraprobiotic (control). The experimental fish were reared for 30 days. On day 31 of rearing, fish were challenged with S. agalactiae (107 CFU/mL) through intraperitoneal injection route, while the negative control was injected with PBS. This study results significantly improved growth performances and immune responses (P<0.05), compared to control after 30 days of probiotic and paraprobiotic Bacillus sp.
    [Show full text]
  • Streptococcosis Humans and Animals
    Zoonotic Importance Members of the genus Streptococcus cause mild to severe bacterial illnesses in Streptococcosis humans and animals. These organisms typically colonize one or more species as commensals, and can cause opportunistic infections in those hosts. However, they are not completely host-specific, and some animal-associated streptococci can be found occasionally in humans. Many zoonotic cases are sporadic, but organisms such as S. Last Updated: September 2020 equi subsp. zooepidemicus or a fish-associated strain of S. agalactiae have caused outbreaks, and S. suis, which is normally carried in pigs, has emerged as a significant agent of streptoccoccal meningitis, septicemia, toxic shock-like syndrome and other human illnesses, especially in parts of Asia. Streptococci with human reservoirs, such as S. pyogenes or S. pneumoniae, can likewise be transmitted occasionally to animals. These reverse zoonoses may cause human illness if an infected animal, such as a cow with an udder colonized by S. pyogenes, transmits the organism back to people. Occasionally, their presence in an animal may interfere with control efforts directed at humans. For instance, recurrent streptococcal pharyngitis in one family was cured only when the family dog, which was also colonized asymptomatically with S. pyogenes, was treated concurrently with all family members. Etiology There are several dozen recognized species in the genus Streptococcus, Gram positive cocci in the family Streptococcaceae. Almost all species of mammals and birds, as well as many poikilotherms, carry one or more species as commensals on skin or mucosa. These organisms can act as facultative pathogens, often in the carrier. Nomenclature and identification of streptococci Hemolytic reactions on blood agar and Lancefield groups are useful in distinguishing members of the genus Streptococcus.
    [Show full text]
  • Milk Microbiota: a Source of Antimicrobial-Producing Bacteria with Potential Application in Food Safety †
    Proceedings Milk Microbiota: A Source of Antimicrobial-Producing Bacteria with Potential Application in Food Safety † Alexandre Lamas *, Laura Sanjulián, Alberto Cepeda, Cristina Fente and Patricia Regal Laboratorio de Higiene Inspección y Control de Alimentos, Departamento de Química Analítica, Nutrición y, Bromatología, Universidad de Santiago de Compostela, 27002 Lugo, Spain; [email protected] (L.S.); [email protected] (A.C.); [email protected] (C.F.); [email protected] (P.R.) * Correspondence: [email protected]; Tel.: +34-982822455 † Presented at the 1st International Electronic Conference on Food Science and Functional Foods, 10–25 November 2020; Available online: https://foods_2020.sciforum.net/. Abstract: Antimicrobial and biocide resistance is a major public health problem today. Therefore, one of the main scientific challenges nowadays is the search for alternatives to these substances. One of these potential alternatives are the bacteriocins. Microbiota are a potential source of bacteriocin- producing bacteria that need to be studied. In this study, a total of 40 samples of human milk and 10 samples of cow milk were collected from healthy individuals and stored at −20 °C until use. Colonies isolated from these samples that showed antimicrobial activity against Lactobacillus del- brueckii ssp. bulgaricus in the overlaid assays were selected. Well diffusion assays were carried out with the cell-free supernatant (CFS) from these colonies neutralized to pH and inhibition zones were recorded. The activity against eight common bacterial pathogens was evaluated. A total of 32 colo- nies with potential antimicrobial activity were isolated. The neutralized CFS of 10 strains showed antimicrobial activity against at least one pathogen tested in the well diffusion assays.
    [Show full text]
  • Streptococci
    STREPTOCOCCI Streptococci are Gram-positive, nonmotile, nonsporeforming, catalase-negative cocci that occur in pairs or chains. Older cultures may lose their Gram-positive character. Most streptococci are facultative anaerobes, and some are obligate (strict) anaerobes. Most require enriched media (blood agar). Streptococci are subdivided into groups by antibodies that recognize surface antigens (Fig. 11). These groups may include one or more species. Serologic grouping is based on antigenic differences in cell wall carbohydrates (groups A to V), in cell wall pili-associated protein, and in the polysaccharide capsule in group B streptococci. Rebecca Lancefield developed the serologic classification scheme in 1933. β-hemolytic strains possess group-specific cell wall antigens, most of which are carbohydrates. These antigens can be detected by immunologic assays and have been useful for the rapid identification of some important streptococcal pathogens. The most important groupable streptococci are A, B and D. Among the groupable streptococci, infectious disease (particularly pharyngitis) is caused by group A. Group A streptococci have a hyaluronic acid capsule. Streptococcus pneumoniae (a major cause of human pneumonia) and Streptococcus mutans and other so-called viridans streptococci (among the causes of dental caries) do not possess group antigen. Streptococcus pneumoniae has a polysaccharide capsule that acts as a virulence factor for the organism; more than 90 different serotypes are known, and these types differ in virulence. Fig. 1 Streptococci - clasiffication. Group A streptococci causes: Strep throat - a sore, red throat, sometimes with white spots on the tonsils Scarlet fever - an illness that follows strep throat. It causes a red rash on the body.
    [Show full text]
  • Differential Diagnosis Between Streptococcus Agalactiae and Listeria Monocytogenes in the Clinical Laboratory
    ANNALS OF CLINICAL AND LABORATORY SCIENCE, Vol. 7, No. 3 Copyright © 1977, Institute for Clinical Science Differential Diagnosis between Streptococcus Agalactiae and Listeria Monocytogenes in the Clinical Laboratory CHRISTINE KONTNICK, M.T., ALEXANDER von GRAEVENITZ, M.D., and VINCENT PISCITELLI, M.T. Clinical Microbiology Laboratories, Yale-New Haven Hospital, and Department of Laboratory Medicine, Yale University School of Medicine, New Haven, CT 06504 ABSTRACT Streptococci of the group B (S. agalactiae) and Listeria monocytogenes resemble each other in many morphological and biochemical characteris­ tics. Ten beta-hemolytic strains of each species were subjected to 26 tests commonly and easily performed in the clinical laboratory. Macroscopic and microscopic morphology on solid media showed differences only in the size of the colonies and in the length of the individual organisms. Among many other tests, hippurate hydrolysis and the CAMP reaction were pos­ itive in both species. In the presence of these two reactions, a negative catalase test and chaining in broth would make a presumptive diagnosis of S. agalactiae, while motility at 25 C, the presence of the Henry effect, and resistance to furadantin would be indicative of L. monocytogenes. Introduction in Gram-stained smears; (3) a negative bacitracin test and (4) a positive test for The high incidence of Streptococcus either (a) hippurate hydrolysis, (b) the agalactiae (group B) in human speci­ CAMP reaction or (c) the formation of an mens, which has been recognized only in orange-red pigment. However, if one of the past decade, calls for a rapid pre­ these conditions for the diagnosis is not sumptive diagnosis of the species.
    [Show full text]
  • Identification of Clinically Relevant Streptococcus and Enterococcus
    pathogens Article Identification of Clinically Relevant Streptococcus and Enterococcus Species Based on Biochemical Methods and 16S rRNA, sodA, tuf, rpoB, and recA Gene Sequencing Maja Kosecka-Strojek 1,* , Mariola Wolska 1, Dorota Zabicka˙ 2 , Ewa Sadowy 3 and Jacek Mi˛edzobrodzki 1 1 Department of Microbiology, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University, 30-387 Krakow, Poland; [email protected] (M.W.); [email protected] (J.M.) 2 Department of Molecular Microbiology, National Medicines Institute, 00-725 Warsaw, Poland; [email protected] 3 Department of Epidemiology and Clinical Microbiology, National Medicines Institute, 00-725 Warsaw, Poland; [email protected] * Correspondence: [email protected]; Tel.: +48-12-664-6365 Received: 13 October 2020; Accepted: 9 November 2020; Published: 11 November 2020 Abstract: Streptococci and enterococci are significant opportunistic pathogens in epidemiology and infectious medicine. High genetic and taxonomic similarities and several reclassifications within genera are the most challenging in species identification. The aim of this study was to identify Streptococcus and Enterococcus species using genetic and phenotypic methods and to determine the most discriminatory identification method. Thirty strains recovered from clinical samples representing 15 streptococcal species, five enterococcal species, and four nonstreptococcal species were subjected to bacterial identification by the Vitek® 2 system and Sanger-based sequencing methods targeting the 16S rRNA, sodA, tuf, rpoB, and recA genes. Phenotypic methods allowed the identification of 10 streptococcal strains, five enterococcal strains, and four nonstreptococcal strains (Leuconostoc, Granulicatella, and Globicatella genera). The combination of sequencing methods allowed the identification of 21 streptococcal strains, five enterococcal strains, and four nonstreptococcal strains.
    [Show full text]
  • Streptococcus Agalactiae, Arcanobacterium Haemolyticum과 Finegoldia Magna에 의한 괴사성 근막염 1예
    대한진단검사의학회지 제 28권제3호 2008 � 증례∙임상미생물학 � Korean J Lab Med 2008;28:191-5 DOI 10.3343/kjlm.2008.28.3.191 개에게 물린 당뇨환자의 Streptococcus agalactiae, Arcanobacterium haemolyticum과 Finegoldia magna에 의한 괴사성 근막염 1예 이성실1∙노경호2∙김창기1∙용동은1,3∙최준용 4∙이진우∙이경원1,3∙정윤섭1 연세대학교 의과대학 진단검사의학교실 세균내성연구소1, BK21 의과학사업단 3, 내과학교실4, 정형외과학교실5, 고려대학교 의과대학 진단검사의학교실2 A Case of Necrotizing Fasciitis Due to Streptococcus agalactiae, Arcanobacterium haemolyticum, and Finegoldia magna in a Dog-bitten Patient with Diabetes Sungsil Lee, M.D.1, Kyoung Ho Roh, M.D.2, Chang Ki Kim, M.D.1, Dongeun Yong, M.D.1,3, Jun Yong Choi, M.D.4, Jin Woo Lee, M.D.5, Kyungwon Lee, M.D.1,3, and Yunsop Chong, Ph.D.1 Departments of Laboratory Medicine and Research Institute of Bacterial Resistance1; BK21 Project for Medical Sciences3, Internal Medicine4, and Orthopedic Surgery5, Yonsei University College of Medicine, Seoul; Department of Laboratory Medicine2, Korea University College of Medicine, Seoul, Korea We report a case of necrotizing fasciitis involving Streptococcus agalactiae, Arcanobacterium haemolyticum, and Finegoldia magna in a 36-yr-old female diabetic patient, which started after a minor dog bite to the toe of the patient. This case suggested that a trivial infection after a minor dog bite in an immunocompromised patient such as diabetes patient could result in a significant compli- cation such as necrotizing fasciitis. The life-threatening infection was cured by timely above-the-knee amputation, as well as penicillin G and clindamycin therapy. (Korean J Lab Med 2008;28:191-5) Key Words : Necrotizing fasciitis, Streptococcus agalactiae, Arcanobacterium haemolyticum, Finegoldia magna, Diabetic patient INTRODUCTION tions[1-3].
    [Show full text]
  • HIGHLIGHTS of PRESCRIBING INFORMATION These Highlights Do
    HIGHLIGHTS OF PRESCRIBING INFORMATION • Dosage in Pediatric Patients (1 Month of Age to 16 Years): 20 to 40 These highlights do not include all the information needed to use mg/kg/day in 3 or 4 equal doses by intravenous infusion. (2.3) • Alternative Pediatric Patients Dosing: 350 mg/m2/day for serious CLINDAMYCIN IN 0.9% SODIUM CHLORIDE injection safely and 2 effectively. See full prescribing information for CLINDAMYCIN IN infections and 450 mg/m /day for more severe infections. (2.3) 0.9% SODIUM CHLORIDE injection. • Dosage in Neonates (Less than 1 Month of Age): 15 to 20 mg/kg/day in 3 to 4 equal doses by intravenous infusion. (2.3) CLINDAMYCIN IN 0.9% SODIUM CHLORIDE injection, for --------------------- DOSAGE FORMS AND STRENGTHS --------------------- intravenous use Each 50 mL of Clindamycin in 0.9% Sodium Chloride Injection, Initial U.S. Approval: 1989 300 mg/50 mL (6 mg/mL), 600 mg/50 mL (12 mg/mL), and 900 mg/50 mL (18 mg/mL) contains 300 mg, 600 mg, or 900 mg clindamycin, respectively WARNING: CLOSTRIDIOIDES DIFFICILE-ASSOCIATED (as clindamycin phosphate, USP), in a single-dose GALAXY container. (3) DIARRHEA (CDAD) and COLITIS ------------------------------ CONTRAINDICATIONS ----------------------------- See full prescribing information for complete boxed warning. Individuals with a history of hypersensitivity to preparations containing clindamycin or lincomycin. (4) Clostridioides difficile-associated diarrhea (CDAD) has been reported with use of nearly all antibacterial agents, including Clindamycin in ----------------------- WARNINGS AND PRECAUTIONS ----------------------- 0.9% Sodium Chloride Injection and may range in severity from mild • Anaphylactic shock and anaphylactic reactions have been reported. (5.2) diarrhea to fatal colitis.
    [Show full text]