Hoban D J, Bouchillon S K, Karlowsky J A, Johnson J L, Butler D L, Miller L A, Poupard J A
Laboratories International for Microbiology Studies, Rolling Meadows, Illinois, USA.
Antimicrob Agents Chemother. 2000 Nov;44(11):3008-11. doi: 10.1128/AAC.44.11.3008-3011.2000.
From 1997 to 1999, 94 study centers in 15 European, 3 North American, and 2 South American countries contributed 2,632 isolates of Streptococcus pneumoniae to an international antimicrobial susceptibility testing study. Only 62.0% of isolates were susceptible to penicillin, while 22.3% were penicillin intermediate and 15.6% were penicillin resistant. Resistance to trimethoprim-sulfamethoxazole (24.4%), azithromycin (26.0%), and clarithromycin (27.1%) was also highly prevalent. For the penicillin-resistant isolates (n = 411), the MICs at which 90% of isolates are inhibited (MIC(90)s) for gemifloxacin, levofloxacin, ofloxacin, clarithromycin, and azithromycin were 0.03, 1, 2, >16, and >64 microgram/ml, respectively. Similarly, for isolates resistant to both azithromycin and clarithromycin (n = 649), gemifloxacin, levofloxacin, ofloxacin, and penicillin MIC(90)s were 0.03, 1, 2, and 4 microgram/ml, respectively. Overall rates of resistance to trovafloxacin (0.3%), levofloxacin (0.3%), grepafloxacin (0.6%), and ofloxacin (0.7%) were low. For ofloxacin-intermediate and -resistant isolates (n = 142), gemifloxacin had the lowest MIC(90) (0.12 microgram/ml) compared to the MIC(90)s of trovafloxacin (0.5 microgram/ml), grepafloxacin (1 microgram/ml), and levofloxacin (2 microgram/ml). For all S. pneumoniae isolates tested, gemifloxacin MICs were </=0.5 microgram/ml, suggesting that gemifloxacin has the potential to be used as a treatment for pneumococcal infections, including those arising from isolates resistant to beta-lactams and macrolides.
1997年至1999年期间,来自欧洲15个国家、北美3个国家和南美2个国家的94个研究中心为一项国际抗菌药物敏感性测试研究提供了2632株肺炎链球菌分离株。只有62.0%的分离株对青霉素敏感,而22.3%为青霉素中介型,15.6%为青霉素耐药型。对甲氧苄啶-磺胺甲恶唑(24.4%)、阿奇霉素(26.0%)和克拉霉素(27.1%)的耐药性也非常普遍。对于青霉素耐药分离株(n = 411),吉米沙星、左氧氟沙星、氧氟沙星、克拉霉素和阿奇霉素抑制90%分离株的最低抑菌浓度(MIC90s)分别为0.03、1、2、>16和>64微克/毫升。同样,对于对阿奇霉素和克拉霉素均耐药的分离株(n = 649),吉米沙星、左氧氟沙星、氧氟沙星和青霉素的MIC90s分别为0.03、1、2和4微克/毫升。对曲伐沙星(0.3%)、左氧氟沙星(0.3%)、格帕沙星(0.6%)和氧氟沙星(0.7%)的总体耐药率较低。对于氧氟沙星中介型和耐药型分离株(n = 142),与曲伐沙星(0.5微克/毫升)、格帕沙星(1微克/毫升)和左氧氟沙星(2微克/毫升)的MIC90s相比,吉米沙星的MIC90最低(0.12微克/毫升)。对于所有测试的肺炎链球菌分离株,吉米沙星的MICs≤0.5微克/毫升,这表明吉米沙星有潜力用于治疗肺炎球菌感染,包括由对β-内酰胺类和大环内酯类耐药的分离株引起的感染。