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[罗他霉素对临床新鲜分离株的抗菌活性]

[Antibacterial activity of rokitamycin against fresh clinical isolates].

作者信息

Deguchi K, Yokota N, Koguchi M, Suzuki Y, Suzuki K, Fukayama S, Ishihara R, Oda S

机构信息

Section of Studies, Tokyo Clinical Research Center.

出版信息

Jpn J Antibiot. 1992 Dec;45(12):1609-21.

PMID:1289579
Abstract

We obtained bacterial strains which were clinically isolated and identified from outpatients with various infections in medical institutions throughout Japan. Possible antibacterial activities of rokitamycin (RKM) were examined against these isolates. Minimum inhibitory concentrations (MICs) were determined through a comparative study with reference drugs. The results of the study are summarized as follows. 1. Resistance patterns of 400 isolates which were highly resistant to macrolides (MLs) with MIC values > 100 micrograms/ml were classified into 55 patterns. Staphylococcus spp. showed cross resistance to 14-membered ring MLs with 100% cross resistance observed between erythromycin (EM) and clarithromycin (CAM), and 85.2% between EM and oleandomycin (OL). Fewer isolates showed strong resistance to 16-membered ring MLs than to 14-membered ring MLs. Cross resistances observed among the Staphylococcus isolates were 100% between acetylmidecamycin (MDM-AC) and kitasamycin (leucomycin (LM)), 93.9% between MDM-AC and josamycin (JM), and 53.3% between MDM-AC and RKM. Streptococcus spp. and Peptococcus spp. showed very similar resistance patterns to both 14- and 16-membered ring MLs, but resistance patterns to RKM were quite different. Most of anaerobic streptococci and Bacteroides fragilis group had similar resistance patterns to 14- and 16-membered ring MLs, but in some cases a pattern similar to that of Staphylococcus spp. was observed. 2. When ML-resistant bacteria isolated during 1975 to 1980 were compared to those isolated in 1986 and 1989, it was observed that resistance of Staphylococcus aureus remained almost unchanged, that of Streptococcus pyogenes was lower in the later years than during 1975 to 1980, but that of Streptococcus pneumoniae increased. 3. Most of ML-resistances of the resistant isolates were inducible, but extents of induction varied depending on drugs tested. Strong inductions were observed when 14-membered ring MLs were used, but inductions were minimal with 16-membered ring MLs. RKM appeared to induce resistance to the least extent. From these results, it appears that the RKM is quite useful clinically even in the 1990s.

摘要

我们获取了从日本各地医疗机构的各类感染门诊患者中临床分离并鉴定出的细菌菌株。检测了罗他霉素(RKM)对这些分离菌株可能具有的抗菌活性。通过与参考药物进行比较研究来确定最低抑菌浓度(MIC)。研究结果总结如下。1. 对大环内酯类(MLs)高度耐药(MIC值>100微克/毫升)的400株分离菌株的耐药模式被分为55种类型。葡萄球菌属对14元环MLs表现出交叉耐药性,红霉素(EM)和克拉霉素(CAM)之间的交叉耐药率为100%,EM与竹桃霉素(OL)之间为85.2%。对16元环MLs表现出强耐药性的分离菌株比14元环MLs的少。在葡萄球菌分离菌株中观察到的交叉耐药情况为:乙酰麦迪霉素(MDM-AC)与吉他霉素(柱晶白霉素(LM))之间为100%,MDM-AC与交沙霉素(JM)之间为93.9%,MDM-AC与RKM之间为53.3%。链球菌属和消化球菌属对14元和16元环MLs的耐药模式非常相似,但对RKM的耐药模式却大不相同。大多数厌氧链球菌和脆弱拟杆菌组对14元和16元环MLs的耐药模式相似,但在某些情况下观察到与葡萄球菌属相似的模式。2. 将1975年至1980年期间分离出的ML耐药菌与1986年和1989年分离出的进行比较,发现金黄色葡萄球菌的耐药性几乎没有变化,化脓性链球菌在后期比1975年至1980年期间更低,但肺炎链球菌的耐药性增加了。3. 大多数耐药分离菌株的ML耐药性是可诱导的,但诱导程度因所测试的药物而异。使用14元环MLs时观察到强诱导作用,但16元环MLs的诱导作用最小。RKM似乎诱导耐药的程度最小。从这些结果来看,即使在20世纪90年代,RKM在临床上似乎也相当有用。

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