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肺炎链球菌、流感嗜血杆菌和卡他莫拉菌的体外药敏试验:2000 - 2001年欧洲多中心研究

In vitro susceptibility of Streptococcus pneumoniae, Haemophilus influenzae and Moraxella catarrhalis: a European multicenter study during 2000-2001.

作者信息

Jones M E, Blosser-Middleton R S, Critchley I A, Karlowsky J A, Thornsberry C, Sahm D F

机构信息

Focus Technologies, Inc., Hilversum, The Netherlands.

出版信息

Clin Microbiol Infect. 2003 Jul;9(7):590-9. doi: 10.1046/j.1469-0691.2003.00573.x.

Abstract

OBJECTIVE

To assess the current (2001) activity of respiratory fluoroquinolones and comparator agents against respiratory pathogens isolated in European countries.

METHODS

During 2000-2001, we prospectively collected 1995 isolates of Haemophilus influenzae, 1870 isolates of Streptococcus pneumoniae and 649 isolates of Moraxella catarrhalis from hospital laboratories in France, Germany, Greece, Italy, Spain and the UK. National Committee for Clinical Laboratory Standards (NCCLS)-approved broth microdilution antimicrobial susceptibility testing methods and interpretive criteria were used throughout.

RESULTS

Of the S. pneumoniae isolates, 99.6% were susceptible to moxifloxacin, gatifloxacin and levofloxacin; the corresponding figure for H. influenzae was 100%. All M. catarrhalis isolates had moxifloxacin MICs </= 0.12 mg/L. For all three pathogens, fluoroquinolone susceptibility remained unchanged from the previous 1997-98 study. The incidence of penicillin non-susceptibility in the S. pneumoniae isolates tested remained similar to or higher than that recorded in previous studies: France, 165/291 (56.7%); Germany, 46/506 (9.1%); Greece, 20/55 (36.4%); Italy, 45/364 (12.4%); Spain, 146/268 (54.5%); and the UK, 26/386 (6.7%). Significant levels of resistance to oral compounds (cefuroxime, cefaclor, cefdinir, clarithromycin, azithromycin, tetracycline, and trimethoprim-sulfamethoxazole) were detected among S. pneumoniae isolates. beta-Lactamase production among H. influenzae isolates ranged from 6.2% to 33.1% per country, and ampicillin, clarithromycin or trimethoprim-sulfamethoxazole resistance were the most common phenotypes detected. beta-Lactamase production among M. catarrhalis isolates ranged from 94.1% to 100% per country.

CONCLUSIONS

With the exception of a few localized reports, resistance to moxifloxacin and other new fluoroquinolones in common respiratory pathogens is a rare occurrence, despite significant resistance to other compound classes. Surveillance will play a key role in tracking changes in fluoroquinolone susceptibility in European countries.

摘要

目的

评估目前(2001年)呼吸喹诺酮类药物及对照药物对欧洲国家分离出的呼吸道病原体的抗菌活性。

方法

在2000 - 2001年期间,我们前瞻性地从法国、德国、希腊、意大利、西班牙和英国的医院实验室收集了1995株流感嗜血杆菌、1870株肺炎链球菌和649株卡他莫拉菌。始终采用美国国家临床实验室标准委员会(NCCLS)批准的肉汤微量稀释抗菌药敏试验方法及判读标准。

结果

在肺炎链球菌分离株中,99.6%对莫西沙星、加替沙星和左氧氟沙星敏感;流感嗜血杆菌的相应比例为100%。所有卡他莫拉菌分离株的莫西沙星最低抑菌浓度(MIC)≤0.12mg/L。对于所有这三种病原体,喹诺酮类药物的敏感性与1997 - 1998年的上一项研究相比没有变化。所检测的肺炎链球菌分离株中青霉素不敏感的发生率与之前研究记录的相似或更高:法国,165/291(56.7%);德国,46/506(9.1%);希腊,20/55(36.4%);意大利,45/364(12.4%);西班牙,146/268(54.5%);英国,26/386(6.7%)。在肺炎链球菌分离株中检测到对口服化合物(头孢呋辛、头孢克洛、头孢地尼、克拉霉素、阿奇霉素、四环素和甲氧苄啶 - 磺胺甲恶唑)的显著耐药水平。每个国家流感嗜血杆菌分离株中β - 内酰胺酶的产生率在6.2%至33.1%之间,氨苄西林耐药、克拉霉素耐药或甲氧苄啶 - 磺胺甲恶唑耐药是检测到的最常见表型。每个国家卡他莫拉菌分离株中β - 内酰胺酶的产生率在94.1%至100%之间。

结论

除了一些局部报告外,尽管对其他类化合物有显著耐药性,但常见呼吸道病原体对莫西沙星和其他新型喹诺酮类药物耐药的情况很少见。监测将在追踪欧洲国家喹诺酮类药物敏感性变化方面发挥关键作用。

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