Spectrum of Gram-positive bacteraemia and in vitro activities of daptomycin, linezolid and vancomycin against organisms isolated from cancer patients

Gram-positive organisms are the predominant bacterial pathogens in cancer patients. A survey indicated that coagulase-negative staphylococci (CoNS) (29.5%), Staphylococcus aureus (18.0%), Enterococcus spp. (12.1%) and viridans group streptococci (VGS) (9.1%) are isolated most often. The rate of reduced susceptibility to vancomycin (minimum inhibitory concentration ≥1.0 μg/mL) was 100% for meticillin-susceptible S. aureus and 99% for meticillin-resistant S. aureus, and 100% for meticillin-susceptible CoNS and 98% for meticillin-resistant CoNS. More than 98% of these isolates were susceptible to daptomycin and linezolid. Daptomycin and linezolid had comparable in vitro activity to vancomycin against Bacillus spp., Corynebacterium spp., Rhodococcus spp., Micrococcus spp., Stomatococcus mucilaginosus and VGS. Both agents were active against the majority (95%) of vancomycin-resistant organisms, including vancomycin-resistant enterococci, Pediococcus spp. and Leuconostoc spp. These data suggest that daptomycin and linezolid have an adequate antimicrobial spectrum and potent in vitro activity against Gram-positive isolates from cancer patients and may be considered as alternatives to vancomycin for empirical or targeted therapy in this setting.