S168 17th ECCMID / 25th ICC, Posters 0.9% saline was inoculated into Mueller-Hinton agar (Oxoid, England). E test strips were placed on the culture plates and the MIC read after 24 h. Since E test strips for fosfomycin contained glucose-6-phosphate, extra supplementation of the compound in the culture medium was not done. The readings were tabulated and the MIC50 and MIC90 values determined. The breakpoint criteria to determine susceptibility were based on the CLSI. All isolates were Enterococcus faecium (89 from rectal swabs, 24 from hemoculture, 3 from tissue biopsy culture, 1 from urine culture). Results: The MIC90 and MIC50 of fosfomycin were 192 mg/L and 512 mg/L and for linezolid 1 mg/L and 2 mg/L, respectively. Overall MIC for linezolid ranged between 0.5-3 mg/dl. Conclusion: Linezolid but not fosfomycin tromethanol had good in vitro activity against 117 isolates of vancomycin resistant E. faecium. P697 In vitro activity of daptomycin and linezolid against vancomycin-resistant Gram-positive pathogens from cancer patients R. Prince, E. Coyle, K. Rolston, M. Kapadia, A. Kaur, S. McCauley (Houston, US) Objectives: To compare the in-vitro activity of daptomycin (DAP) and linezolid (LIN) to vancomycin (VAN) against Van-resistant Gram- positive (GP) organisms isolated from cancer patients. Background: GP organisms cause 40-70% of documented bacterial infections in cancer patients. VAN has been the drug of choice for the treatment of GP infections in such patients. Although uncommon, VAN- resistant organisms are being isolated with increasing frequency and alternative agents need to be evaluated in this setting. Methods: The organisms were isolated between January 2004 and September 2006 and >90% were from blood cultures. E-test TM strips (AB Biodisk, Solna, Sweden) were used for susceptibility testing. S. aureus ATC-29213 was used as the control strain. Results: MIC50, MIC90 values (if >10 strains were tested) and range of activity (in mg/mL) are shown in the Table below. Agent MIC (mg/mL) MIC 50 MIC 90 Range VAN-resistant enterococci (34) DAP 1.0 3.0 0.25-30 LIN 1.5 1.5 0.38-2.0 VAN >256 >256 >256 Leuconostoc spp. (7) DAP 0.064–0.38 LIN 2.0-8.0 VAN >256 >256 >256 Pediococcus spp. (5) DAP 0.25-1.0 LIN 4.0-8.0 VAN >256 >256 >256 Conclusions: Daptomycin appears to have excellent in-vitro activity against most VAN-resistant organisms. It also has better bactericidal activity than VAN and LIN (data not shown). LIN has excellent activity against VRE but appears to be less potent against Leuconostoc and Pediococcus spp. The clinical potential of these agents needs to be evaluated, although infections caused by some of these pathogens are rare. P698 VITEK diagnostics of Enterococcus species in urine samples V. Vuksanovic (Podgorica, ME) Objectives: Urinary infections (UTI) are common in patients with anatomically normal urinary tract, manifested as a no complicated infections, where Escherichia coli is the most frequent aetiological cause. In UTI, with structional or functional abnormality of urinary tract, the resistant enterobacteria, enterococci and Candida are more common aetiological cause. Enterococci as a opportunistic pathogens can cause severe urinary infection, infections of surgery wounds, bacteraemia and bacterial endocarditis. As the high resistance of micro organisms to antibiotics has been registered the aim of this work is to examine sensitivity of enterococci originated from patients’ urine. Methods: After isolation in blood agar, identification and sensitivity of 67 enterococci was done by using VITEK 2 system (bioM´ erieux). Out of these patients 42 were hospitalised in Clinical Centre Podgorica, and 25 samples were taken from patients visited outpatient healthcare services. Results: Out of 62 isolated enterococci, 63% (42) were from hospitalised patients, and E. faecium was identified in 50% (21) cases. This was not case with urine samples taken from patients who visited outpatient healthcare services, where E. faecium was isolated in only 4% (1) of cases. All types of E. faecalis showed sensitivity in over 95% of cases to beta lactamic antibiotics: ampicilin 95%, ampicilin sulbactam 98% and imipenem 95%, as well as to linezolid 95% and glycopeptides (teicoplanin and vancomycin 98%). Lower percentage of sensitivity was found in quinolones (73%). The highest resistance of E. faecalis was to tetracycline 72% (37), while half of the types were resistant to erythromycin 51% and gentamycin 53%. Although E. faecium is normally resistant to beta lactamic antibiotics, one urine sample had wild phenotype sensitive to ampicilin, ampicilin sulbactam and imipenem. E. faecium showed resistance to ciprofloxacin in over of 80% cases (86%), erythromycin 86% and gentamycin 82%, while sensitivity to linezolid, teicoplanin and vancomycin was registred in 90% of cases. Conclusion: This study shows that E. faecalis is the most sensitive to penicillin preparations and it is still drug of first choice in our region. Drugs of choice for E. faecium are linezolid, teicoplanin and vancomycin, in infections of hospitalised patients caused by enterococci. The final identification of enterococci and antibiogram is mandatory procedure, if it is available, in treatment of urinary infections P699 Antimicrobial effects of non-antibiotics on resistant Gram-positive bacteria O. Hendricks, T. Butterworth, J. Christensen, H. Sahly, R. Podschun, J. Kristiansen (Sønderborg, Copenhagen, DK; Kiel, DE) Objectives: Psychotropic therapeutics, especially the phenothiazines are employed for the treatment of psychosis though they exhibit the additional property of an anti-microbial activity. We defined MICs for selected compounds on clinically relevante Gram-positive bacteria. The evaluation of the combined effect of these compounds and conventional antibiotics of clinical relevance showed a significant synergistic effect. As intracellular survival of Gram positive species is another possible explanation for the insufficiency of antibiotic treatment, we investigated the influence of phenothiazines on bacterial invasion in human epithelial cell lines. The project investigates the anti-microbial activity of Non-antibiotics against clinically relevant Gram-positiv bacteria, e.g. staphylococci, streptococci and enterococci. Methods: Agardilution, Microdilution, Human ephitelcell-models A-549, HCT-8, T-24. Results: All Gram-positive bacterial strains, regardless of their susceptibility to regularly used antibiotics, were inhibited by the testsubstances at concentrations of 8–64 g/L. Combination of the antibiotics and the choosen testcompounds at subinhibitory concentration demonstrated a restored activity for the investigated antibiotics. We documented interference of our test-compounds with efflux based multidrug resistance. Furthermore, we recorded a significant reduction of the mean bacterial invasion ability in the investigated cell lines in the presence of selected agents. Overall, these results indicated a significant reduction of the mean invasion ability of the Gram-positive bacteria in all epithelial cell lines (18.9%±1.8) as compared to the invasion in absence of the substance (52.1%±4.4) (p < 0.0001). Conclusions: The present experiment shows that phenothiazine derivates, especially thioridazine, have an antimicrobial effect against the investigated strains. Our studies offer new information on the effect of phenothiazines on Resistant Gram-positive bacteria. The anti-microbial