von Eiff C, Reinert R R, Kresken M, Brauers J, Hafner D, Peters G
Institute of Medical Microbiology, Westfälische Wilhelms-Universität, D-48149 Münster, Germany.
J Clin Microbiol. 2000 Aug;38(8):2819-23. doi: 10.1128/JCM.38.8.2819-2823.2000.
Antibiotic-resistant gram-positive bacteria have become an increasing problem in the last two decades. In order to evaluate the prevalence of antibiotic resistance in staphylococcal bloodstream isolates in Germany, 2,042 staphylococci collected in 21 tertiary-care hospitals were investigated during a 3-year period (March 1996 to March 1999). Altogether, 1,448 S. aureus isolates and 594 coagulase-negative staphylococci (CoNS) that comprised 13 different species were included. Furthermore, the antistaphylococcal activities of quinupristin-dalfopristin were compared with those of eight other compounds by the broth microdilution method. The rates of oxacillin resistance in Staphylococcus aureus, S. epidermidis, S. haemolyticus, and other CoNS were 13.5, 69, 90, and 34%, respectively. In oxacillin-resistant strains high rates of resistance (up to 100%) to erythromycin, clindamycin, ciprofloxacin, and gentamicin were also observed. However, no strain appeared to be resistant to vancomycin or quinupristin-dalfopristin. The streptogramin combination exhibited excellent in vitro activity against all staphylococcal species tested, regardless of the patterns of resistance to other drug classes. In terms of MICs at which 90% of the isolates are inhibited, quinupristin-dalfopristin was 2 times more active against S. aureus isolates, 4 to 16 times more active against S. haemolyticus, and 8 to 32 times more active against S. epidermidis than vancomycin or teicoplanin.
在过去二十年中，耐抗生素革兰氏阳性菌已成为一个日益严重的问题。为了评估德国葡萄球菌血流分离株中抗生素耐药性的流行情况，在三年期间（1996年3月至1999年3月）对21家三级护理医院收集的2042株葡萄球菌进行了调查。总共纳入了1448株金黄色葡萄球菌分离株和594株凝固酶阴性葡萄球菌（CoNS），后者包含13个不同物种。此外，采用肉汤微量稀释法将奎奴普丁-达福普汀的抗葡萄球菌活性与其他八种化合物的活性进行了比较。金黄色葡萄球菌、表皮葡萄球菌、溶血葡萄球菌和其他CoNS的苯唑西林耐药率分别为13.5%、69%、90%和34%。在苯唑西林耐药菌株中，还观察到对红霉素、克林霉素、环丙沙星和庆大霉素的高耐药率（高达100%）。然而，没有菌株对万古霉素或奎奴普丁-达福普汀耐药。链阳霉素组合对所有测试的葡萄球菌物种均表现出优异的体外活性，无论其对其他药物类别的耐药模式如何。就抑制90%分离株的最低抑菌浓度（MIC）而言，与万古霉素或替考拉宁相比，奎奴普丁-达福普汀对金黄色葡萄球菌分离株的活性高2倍，对溶血葡萄球菌的活性高4至16倍，对表皮葡萄球菌的活性高8至32倍。
