Diekema D J, Jones R N, Rolston K V
Department of Pathology, University of Iowa College of Medicine, Iowa City 52242, USA.
Diagn Microbiol Infect Dis. 1999 May;34(1):37-43. doi: 10.1016/s0732-8893(99)00010-3.
Gram-positive bacterial pathogens are important causes of disease in cancer patients and are becoming increasingly resistant to available antimicrobial agents. We examined the in vitro activity of gatifloxacin, a new fluoroquinolone, compared with other quinolones, ceftazidime, and traditional Gram-positive-active agents tested against pathogens isolated from patients at 10 cancer treatment hospitals in the United States. A total of 1,128 Gram-positive isolates were tested by the E-test method (AB BIODISK, Solna, Sweden) with results validated by concurrent quality control strain analysis. Gatifloxacin was more potent than either ciprofloxacin or levofloxacin against all Gram-positive species. Vancomycin was the most active agent tested against all species except Bacillus spp., which were more susceptible to the fluoroquinolones. When tested against these Gram-positive pathogens from patients with cancer, the spectrum of gatifloxacin was also greater than that of levofloxacin and ciprofloxacin. Gatifloxacin may have a role as part of prophylactic or therapeutic antimicrobial regimens for selected cancer patients with Gram-positive infections.
革兰氏阳性菌病原体是癌症患者发病的重要原因，并且对现有的抗菌药物耐药性日益增强。我们在美国10家癌症治疗医院，检测了新型氟喹诺酮类药物加替沙星与其他喹诺酮类药物、头孢他啶以及传统革兰氏阳性菌活性药物相比，对从患者身上分离出的病原体的体外活性。采用E-test法（AB BIODISK，瑞典索尔纳）对总共1128株革兰氏阳性菌分离株进行检测，同时通过质量控制菌株分析验证结果。加替沙星对所有革兰氏阳性菌种的活性均强于环丙沙星或左氧氟沙星。万古霉素是除芽孢杆菌属外对所有菌种活性最强的药物，芽孢杆菌属对氟喹诺酮类药物更敏感。在检测这些来自癌症患者的革兰氏阳性病原体时，加替沙星的抗菌谱也比左氧氟沙星和环丙沙星更广。对于某些患有革兰氏阳性菌感染的癌症患者，加替沙星可能作为预防性或治疗性抗菌方案的一部分发挥作用。
