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美罗培南与其他广谱抗菌药物对巴西13个中心检测的2085株临床分离菌的体外活性比较

Comparative in vitro Activity of Meropenem Versus Other Extended-Spectrum Antimicrobial Agents Against 2,085 Clinical Isolates Tested in 13 Brazilian Centers.

作者信息

Gales AC, Sader HS, Dainesi SM, Mimica I, Sampaio J, Zoccoli C, Oplustil C, Mendes C

机构信息

Laboratório Especial de Microbiologia Clínica, Disciplina de Doenças Infecciosas e Parasitárias, Universidade Federal de São Paulo, São Paulo.

出版信息

Braz J Infect Dis. 1997 Dec;1(6):294-305.

Abstract

Meropenem is a parenteral carbapenem antibacterial agent with a very broad spectrum of antibacterial activity. It is the second agent of its class to become available in Brazil. The in vitro antibacterial activity of meropenem was compared with imipenem and four other antimicrobial agents in a multicenter study. This study involved 13 clinical microbiology laboratories, 10 of which came from 8 Brazilian states. A total of 2,085 clinical isolates consecutively collected between December 1995 and March 1996 were susceptibility tested using the Etest and following the NCCLS procedures. Meropenem inhibited more than 90% of isolates of Enterobacteriaceae at 0.5 µg/mL, except for Citrobacter sp. (1 µg/ml). Generally, meropenem was slightly more active than imipenem against Gram-negative organisms and its spectrum of antimicrobial activity was broader than those of all other drugs tested. Against Pseudomonas aeruginosa, meropenem (MIC50, 0.38 µg/ml) was approximately 8-fold more active than imipenem (MIC 50,3 µg/mL). Imipenem was two-to eight-fold more active than meropenem against some Gram-positive specees oxacillin, including Enterococcus faecalis (MIC 50 of 0.75 µg/mL and 2 µg/mL respectively), oxacillin-susceptible Staphylococcus aureus (MIC 50 of 0.47 &mul;g/mL and 0.094 µg/mL), oxacillin-susceptible Staphylococcus epidermidis (MIC 50 of 0.064 µg/mL and 0.5mg/mL). Against Streptococcus sp. meropenem was slightly more active than imipenem (MIC 50, 0.016 µg/mL). The results of this study may be used to guide empiric therapy in Brazil and indicates that meropenem may have an important role in the treatment of infections caused by multiresistant strains of bacteria.

摘要

美罗培南是一种具有非常广泛抗菌活性的肠胃外碳青霉烯类抗菌剂。它是该类药物中第二个在巴西上市的药物。在一项多中心研究中,对美罗培南与亚胺培南及其他四种抗菌剂的体外抗菌活性进行了比较。该研究涉及13个临床微生物实验室,其中10个来自巴西的8个州。1995年12月至1996年3月期间连续收集的2085株临床分离株,采用Etest并按照美国国家临床实验室标准化委员会(NCCLS)的程序进行药敏试验。美罗培南在0.5μg/mL时可抑制90%以上的肠杆菌科细菌分离株,但柠檬酸杆菌属(1μg/ml)除外。一般来说,美罗培南对革兰氏阴性菌的活性略高于亚胺培南,其抗菌活性谱比所有其他受试药物都更广泛。对于铜绿假单胞菌,美罗培南(MIC50,0.38μg/ml)的活性比亚胺培南(MIC50,3μg/mL)高约8倍。亚胺培南对一些革兰氏阳性菌,包括粪肠球菌(MIC50分别为0.75μg/mL和2μg/mL)、对苯唑西林敏感的金黄色葡萄球菌(MIC50分别为0.47μg/mL和0.094μg/mL)、对苯唑西林敏感的表皮葡萄球菌(MIC50分别为0.064μg/mL和0.5mg/mL)的活性比美罗培南高两到八倍。对于链球菌属,美罗培南的活性略高于亚胺培南(MIC50,0.016μg/mL)。这项研究的结果可用于指导巴西的经验性治疗,并表明美罗培南在治疗多重耐药菌株引起的感染中可能具有重要作用。

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