Mercier Renee-Claude, Kennedy Christine, Meadows Christina
College of Pharmacy, University of New Mexico, Albuquerque 87131, USA.
Pharmacotherapy. 2002 Dec;22(12):1517-23. doi: 10.1592/phco.22.17.1517.34117.
To evaluate the antimicrobial properties of tigecycline, both alone and in combination with other antibiotics, against multidrug-resistant strains of Enterococcus faecium and Staphylococcus aureus.
In vitro study.
University laboratory.
Tigecycline, both alone and in combination with other antimicrobial agents, was evaluated against two strains of vancomycin-resistant E. faecium (VREF), three glycopeptide-intermediately resistant S. aureus strains, and one methicillin-resistant S. aureus strain. Tigecycline's activity was compared with that of vancomycin, gentamicin, rifampin, and doxycycline, using time-kill studies and analysis of minimum inhibitory concentrations and minimum bactericidal concentrations. Tigecycline also was evaluated in combination with vancomycin, gentamicin, rifampin, and doxycycline in time-kill studies. The number of log10 colony-forming units/ml at 24 hours was compared among treatment groups and growth control by analysis of variance. All isolates were susceptible to tigecycline, regardless of their susceptibilities to vancomycin or doxycycline. In time-kill studies, tigecycline significantly inhibited the bacterial inoculum of all isolates (p < 0.05). Although none of the tigecycline combinations studied had enhanced killing activity against VREF, when gentamicin was combined with tigecycline, improved effects were found against both strains. Against three of the S. aureus strains tested, the combination of gentamicin and tigecycline demonstrated enhanced or improved activity independently of each strain's susceptibility to gentamicin.
The multidrug-resistant, gram-positive bacteria tested, including doxycycline-resistant isolates, were susceptible to tigecycline. The combination of tigecycline and gentamicin may have improved or enhanced activity against strains of vancomycin-resistant enterococci and S. aureus.
评估替加环素单独及与其他抗生素联合使用时，对耐多药粪肠球菌和金黄色葡萄球菌菌株的抗菌特性。
体外研究。
大学实验室。
对两株耐万古霉素粪肠球菌（VREF）、三株糖肽中介耐药金黄色葡萄球菌菌株和一株耐甲氧西林金黄色葡萄球菌菌株，评估了替加环素单独及与其他抗菌药物联合使用的情况。通过时间杀菌研究以及最低抑菌浓度和最低杀菌浓度分析，将替加环素的活性与万古霉素、庆大霉素、利福平及多西环素进行比较。在时间杀菌研究中，还评估了替加环素与万古霉素、庆大霉素、利福平及多西环素联合使用的情况。通过方差分析比较各治疗组与生长对照组在24小时时每毫升log10集落形成单位的数量。所有分离株对替加环素均敏感，无论它们对万古霉素或多西环素的敏感性如何。在时间杀菌研究中，替加环素显著抑制了所有分离株的细菌接种量（p < 0.05）。虽然所研究的替加环素联合用药中，没有一种对VREF具有增强的杀菌活性，但当庆大霉素与替加环素联合使用时，对两种菌株均发现有改善效果。对于所测试的三株金黄色葡萄球菌菌株，庆大霉素与替加环素联合使用显示出增强或改善的活性，且与各菌株对庆大霉素敏感性无关。
所测试的耐多药革兰氏阳性菌，包括耐多西环素分离株，对替加环素敏感。替加环素与庆大霉素联合使用，可能对耐万古霉素肠球菌和金黄色葡萄球菌菌株具有改善或增强的活性。
