1995 - 1999年法国分离的化脓性链球菌对16元大环内酯类药物麦迪霉素二醋酸酯的体外活性

In vitro activity of midecamycin diacetate, a 16-membered macrolide, against Streptococcus pyogenes isolated in France, 1995-1999.

作者信息

Schlegel L, Merad B, Rostane H, Broc V, Bouvet A

机构信息

Centre National de Référence des Streptocoques, Service de Microbiologie, Hôtel Dieu, Université Paris VI, Paris, France.

出版信息

Clin Microbiol Infect. 2001 Jul;7(7):362-6. doi: 10.1046/j.1198-743x.2001.00280.x.

DOI:10.1046/j.1198-743x.2001.00280.x

PMID:11531981

Abstract

OBJECTIVE

To compare the in vitro activity of midecamycin diacetate to that of five other macrolides (erythromycin, clarithromycin, roxithromycin, azithromycin, and josamycin) and of clindamycin against 146 clinical isolates of Streptococcus pyogenes, with regard to three different phenotypes of erythromycin resistance.

METHODS

Susceptibility pattern and resistance phenotype were determined by disk diffusion method and double disk test. Minimal inhibitory concentrations of antibiotics were obtained by the agar dilution method and evaluated according to the recommendations of the 'Comité de l'Antibiogramme de la Société Française de Microbiologie' (CA-SFM). The major determinants of erythromycin resistance in S. pyogenes (ermB, ermTR and mefA genes) were investigated by specific amplification protocols.

RESULTS

Most of the isolates of S. pyogenes collected during 1995-99 were susceptible to midecamycin (93.8%), erythromycin (90.4%), clarithromycin (93.2%), roxithromycin (91.8%), azithromycin (88.4%), josamycin (94.5%), and clindamycin (94.5%). According to the CA-SFM criteria, 132 of the 146 isolates studied were susceptible to erythromycin (MICs < or = 1 mg/L), four were intermediate (MICs 2-4 mg/L), and 10 were resistant (MICs > 4 mg/L). Only nine isolates were midecamycin resistant (MICs > 4 mg/L), and the others were susceptible. The increased activity of midecamycin (MIC90 < or = 0.06 mg/L), as compared to erythromycin (MIC90 = 0.5 mg/L) and to other 14- or 15-membered macrolides, was related to the absence of the ermB determinant in seven isolates which displayed an efflux phenotype (five isolates) or an inducible resistance phenotype due to an ermTR determinant (two isolates).

CONCLUSION

Midecamycin diacetate is active against most S. pyogenes strains isolated in France and may represent an attractive alternative to the treatment of streptococcal infections due to resistant isolates with efflux of erythromycin.

摘要

目的

比较醋酸麦迪霉素与其他五种大环内酯类抗生素（红霉素、克拉霉素、罗红霉素、阿奇霉素和交沙霉素）以及克林霉素对146株化脓性链球菌临床分离株的体外活性，涉及红霉素耐药的三种不同表型。

方法

采用纸片扩散法和双纸片试验确定药敏模式和耐药表型。通过琼脂稀释法获得抗生素的最低抑菌浓度，并根据“法国微生物学会抗菌谱委员会”（CA-SFM）的建议进行评估。通过特异性扩增方案研究化脓性链球菌中红霉素耐药的主要决定因素（ermB、ermTR和mefA基因）。

结果

1995 - 1999年期间收集的大多数化脓性链球菌分离株对麦迪霉素（93.8%）、红霉素（90.4%）、克拉霉素（93.2%）、罗红霉素（91.8%）、阿奇霉素（88.4%）、交沙霉素（94.5%）和克林霉素（94.5%）敏感。根据CA-SFM标准，146株研究分离株中132株对红霉素敏感（MICs≤1mg/L），4株为中介（MICs 2 - 4mg/L），10株耐药（MICs＞4mg/L）。只有9株分离株对麦迪霉素耐药（MICs＞4mg/L），其他均敏感。与红霉素（MIC90 = 0.5mg/L）和其他14或15元大环内酯类抗生素相比，麦迪霉素活性增强（MIC90≤0.06mg/L），这与7株表现出外排表型（5株）或因ermTR决定因素导致的诱导耐药表型（2株）的分离株中不存在ermB决定因素有关。