Nashev D, Toshkova K, Gavrilova V
Vutr Boles. 2000;32(2):35-40.
Since the emergence of the methicillin-resistant S. aureus (MRSA) in the 1960's, glycopeptides (Vancomycin and Teicoplanin) has been the drugs of choice and commonly the sole antimicrobial agents available for the treatment of serious MRSA and other Gram-positive infections. The emergence of S. aureus with intermediate vancomycin-resistance after 1997 threatens to return us to the era before the development of the antibiotics. Prevention of the further spread of S. aureus strains with intermediate and eventually with full glycopeptide resistance requires enhanced laboratory methods to detect resistance. A total of 361 S. aureus clinical isolates (177 MRSA and 184 MSSA) obtained from 1994 to 1999 in eleven Bulgarian hospitals located in geographically distinct areas of the country were enrolled in the study. Minimal inhibitory concentrations of Vancomycin and Teicoplanin were determined by agar-dilution method according to NCCLS recommendations. MIC50 and MIC90 for Vancomycin were 0.7 and 1 mg/ml, and for Teicoplanin--0.5 and 0.9 microgram/ml. All staphylococcal isolates showed sensitivity to Vancomycin and Teicoplanin. MICs of both glicopeptides against MRSA and MSSA did not differ significantly.
自20世纪60年代耐甲氧西林金黄色葡萄球菌（MRSA）出现以来，糖肽类药物（万古霉素和替考拉宁）一直是治疗严重MRSA感染及其他革兰氏阳性菌感染的首选药物，通常也是唯一可用的抗菌药物。1997年后出现的对万古霉素中度耐药的金黄色葡萄球菌，可能使我们重回抗生素研发之前的时代。为防止对糖肽类药物呈中度耐药最终呈完全耐药的金黄色葡萄球菌菌株进一步传播，需要改进实验室检测耐药性的方法。本研究纳入了1994年至1999年期间从保加利亚全国不同地理区域的11家医院获取的361株金黄色葡萄球菌临床分离株（177株MRSA和184株MSSA）。根据美国国家临床实验室标准化委员会（NCCLS）的建议，采用琼脂稀释法测定万古霉素和替考拉宁的最低抑菌浓度。万古霉素的MIC50和MIC90分别为0.7和1mg/ml，替考拉宁的MIC50和MIC90分别为0.5和0.9μg/ml。所有葡萄球菌分离株对万古霉素和替考拉宁均敏感。两种糖肽类药物对MRSA和MSSA的MIC值无显著差异。
