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[近期临床分离株对异帕米星、其他氨基糖苷类及注射用β-内酰胺类药物的耐药性]

[The resistance of recent clinical isolates against isepamycin, other aminoglycosides and injectable beta-lactams].

作者信息

O'Hara K, Nakamura A, Sawai T, Hosino K, Iwai Y, Nakamura S, Seto I

机构信息

Division of Microbial Chemistry, Faculty of Pharmaceutical Sciences, Chiba University.

出版信息

Jpn J Antibiot. 2000 Jan;53(1):46-59.

PMID:10709145
Abstract

Clinical isolates collected from clinical facilities across Japan in 1998 were tested against five aminoglycosides and three beta-lactams. The resistance of 50 strains each of methicillin sensitive Staphylococcus aureus, methicillin resistant Staphylococcus aureus (MRSA), Staphylococcus epidermidis, Escherichia coli, Citrobacter freundii, Klebsiella pneumoniae, Enterobacter sp., Serratia sp., Pseudomonas aeruginosa and Proteus sp. (P. mirabilis 25 strains and P. vulgaris 25 strains) to the aminoglycosides isepamicin (ISP), amikacin (AMK), gentamicin, tobramycin and dibekacin, and to the beta-lactams imipenem, ceftazidime and piperacillin (all three known to be effective against P. aeruginosa) were investigated using a micro liquid dilution method with the following results: 1. ISP was effective against all strains except for 14% of MRSA, 2% of Proteus sp., and 4% of P. aeruginosa. 2. Six strains of MRSA were resistant to all eight drugs; however, in these cases ISP exhibited a relatively low minimum inhibitory concentration (MIC) compared to the other compounds. 3. Four strains of MRSA were resistant to all drugs except ISP. MRSA was the only isolate to demonstrate a resistance to seven or more drugs. 4. Twenty-one strains of MRSA and 1 strain of P. aeruginosa were resistant to six drugs; however, all of these were susceptible to both ISP and AMK. 5. Against all strains tested, ISP generally exhibited a lower MIC compared to AMK. These results suggest that, even ten years after its entering the market, ISP is still an aminoglycoside having a high anti-bacterial activity against a wide range of clinical isolates.

摘要

对1998年从日本各地临床机构收集的临床分离株进行了5种氨基糖苷类药物和3种β-内酰胺类药物的测试。采用微量液体稀释法,分别检测了50株甲氧西林敏感金黄色葡萄球菌、50株耐甲氧西林金黄色葡萄球菌(MRSA)、50株表皮葡萄球菌、50株大肠埃希菌、50株弗氏柠檬酸杆菌、50株肺炎克雷伯菌、50株肠杆菌属、50株沙雷菌属、50株铜绿假单胞菌以及25株奇异变形杆菌和25株普通变形杆菌对氨基糖苷类药物异帕米星(ISP)、阿米卡星(AMK)、庆大霉素、妥布霉素和地贝卡星,以及对β-内酰胺类药物亚胺培南、头孢他啶和哌拉西林(已知这三种药物对铜绿假单胞菌均有效)的耐药性,结果如下:1. 除14%的MRSA、2%的变形杆菌属和4%的铜绿假单胞菌外,ISP对所有菌株均有效。2. 有6株MRSA对所有8种药物耐药;然而,在这些情况下,与其他化合物相比,ISP的最低抑菌浓度(MIC)相对较低。3. 有4株MRSA对除ISP外的所有药物耐药。MRSA是唯一对7种或更多药物耐药的分离株。4. 有21株MRSA和1株铜绿假单胞菌对6种药物耐药;然而,所有这些菌株对ISP和AMK均敏感。5. 对于所有测试菌株,ISP的MIC通常低于AMK。这些结果表明,即使在上市十年后,ISP仍然是一种对多种临床分离株具有高抗菌活性的氨基糖苷类药物。

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