Wadsworth S J, Kim K H, Satishchandran V, Axelrod P, Truant A L, Suh B
Department of Medicine, Temple University School of Medicine, Philadelphia, Pennsylvania.
J Antimicrob Chemother. 1992 Dec;30(6):821-6. doi: 10.1093/jac/30.6.821.
The frequency of infections caused by multidrug-resistant Staphylococcus aureus continues to increase while the numbers of alternative therapeutic agents remain limited. To investigate the changing patterns of in-vitro susceptibility of S. aureus to 16 antibiotics, 190 clinical isolates from two different years were studied. The MICs of methicillin-susceptible (MSSA) and methicillin-resistant (MRSA) strains isolated in 1987 were compared with those of similar numbers of strains isolated in 1989. For MRSA > or = 90% of isolates from both years were resistant to clindamycin, gentamicin and erythromycin. These strains remained highly susceptible to vancomycin (100%), minocycline (90%) and rifampicin (100%). The greatest increase in resistance was observed for ofloxacin (2% in 1987 vs 62% in 1989); cross-resistance to all of the quinolones tested was demonstrated. MSSA strains remained susceptible to vancomycin (100%), minocycline (98%), rifampicin (100%), clindamycin (90%), gentamicin (90%) and ciprofloxacin (98%). It is concluded that methicillin susceptibility is a useful marker for selecting potential agents for the treatment of infections caused by S. aureus. A combination of minocycline and rifampicin may be a useful alternative to vancomycin for treating MRSA infections.
耐多药金黄色葡萄球菌引起的感染频率持续上升，而可供选择的治疗药物数量依然有限。为研究金黄色葡萄球菌对16种抗生素的体外药敏变化模式，对来自两个不同年份的190株临床分离株进行了研究。将1987年分离的甲氧西林敏感（MSSA）和耐甲氧西林（MRSA）菌株的最低抑菌浓度（MIC）与1989年分离的数量相近的菌株进行比较。对于MRSA，这两年分离株中≥90%对克林霉素、庆大霉素和红霉素耐药。这些菌株对万古霉素（100%）、米诺环素（90%）和利福平（100%）仍高度敏感。观察到对氧氟沙星的耐药性增加最为显著（1987年为2%，1989年为62%）；对所有测试喹诺酮类药物均表现出交叉耐药。MSSA菌株对万古霉素（100%）、米诺环素（98%）、利福平（100%）、克林霉素（90%）、庆大霉素（90%）和环丙沙星（98%）仍敏感。结论是，甲氧西林敏感性是选择治疗金黄色葡萄球菌感染潜在药物的有用指标。米诺环素和利福平联合使用可能是治疗MRSA感染时替代万古霉素的有用选择。
