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Comparative efficacy of linezolid and vancomycin for endotracheal tube MRSA biofilms from ICU patients

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dc.contributor.author Fernández-Barat, Laia
dc.contributor.author Motos, Ana
dc.contributor.author Panigada, Mauro
dc.contributor.author Álvarez Lerma, Francisco
dc.contributor.author Viña, Lucía
dc.contributor.author Lopez-Aladid, Ruben
dc.contributor.author Ceccato, Adrian
dc.contributor.author Bassi, Gianluigi Li
dc.contributor.author Nicolau, David P.
dc.contributor.author Lopez, Yuli
dc.contributor.author Muñoz, Laura
dc.contributor.author Guerrero, Laura
dc.contributor.author Soy, Dolors
dc.contributor.author Israel, Trinidad
dc.contributor.author Castro, Pedro
dc.contributor.author Torres, Antoni
dc.date.accessioned 2019-11-29T08:19:47Z
dc.date.available 2019-11-29T08:19:47Z
dc.date.issued 2019
dc.identifier.citation Fernández-Barat L, Motos A, Panigada M, Álvarez-Lerma F, Viña L, Lopez-Aladid R. et al. Comparative efficacy of linezolid and vancomycin for endotracheal tube MRSA biofilms from ICU patients. Crit Care. 2019 Jul 10;23(1):251. DOI 10.1186/s13054-019-2523-5
dc.identifier.issn 1364-8535
dc.identifier.uri http://hdl.handle.net/10230/43032
dc.description.abstract 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.
dc.format.mimetype application/pdf
dc.language.iso eng
dc.publisher BioMed Central
dc.rights Copyright © The Author(s). 2019. Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
dc.rights.uri http://creativecommons.org/licenses/by/4.0/
dc.title Comparative efficacy of linezolid and vancomycin for endotracheal tube MRSA biofilms from ICU patients
dc.type info:eu-repo/semantics/article
dc.identifier.doi http://dx.doi.org/10.1111/cod.13192
dc.subject.keyword Biofilm
dc.subject.keyword Endotracheal tube
dc.subject.keyword Linezolid
dc.subject.keyword Methicillin-resistant Staphylococcus aureus
dc.subject.keyword Respiratory infection
dc.subject.keyword Vancomycin
dc.rights.accessRights info:eu-repo/semantics/openAccess
dc.type.version info:eu-repo/semantics/publishedVersion

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