Loza E, Morosini M I, Cantón R, Almaraz F, Reig M, Baquero F
Servicio de Microbiología, Hospital Universitario Ramon y Cajal, Madrid, Spain.
Rev Esp Quimioter. 2003 Jun;16(2):209-15.
The in vitro activity of ertapenem (MK-0826), a new carbapenem, was studied against 389 aerobic microorganisms (187 Enterobacteriaceae, 15 Aeromonas spp., 42 Staphylococcus spp., 43 Streptococcus spp., 15 Enterococcus spp., 30 Haemophilus spp., 15 Moraxella catarrhalis, 12 Neisseria gonorrhoeae, 15 Pseudomonas aeruginosa and 15 Acinetobacter spp.) and 54 anaerobic isolates (15 Clostridium spp., 12 Peptostreptococcus spp. and 27 fragilis group Bacteroides recovered from four Spanish hospitals. Ertapenem activity was compared with that of imipenem, piperacillin-tazobactam, cefoxitin, ceftriaxone, ceftazidime, cefepime, and norfloxacin. Ertapenem was the most active antibiotic against Enterobacteriaceae (MIC(90) < or =0.5 mg/l) particularly in the case of broad-spectrum, extended-spectrum and chromosomally encoded AmpC betalactamase-producing strains. Ertapenem exhibited less activity, even lower than that of imipenem, against P. aeruginosa, Acinetobacter spp. and enterococci (MIC(90) > or =16 mg/l). Ertapenem was active against methicillin-susceptible S. aureus and coagulase-negative staphylococci, beta-haemolytic streptococci, and Streptococcus pneumoniae (MIC(90) < or =1 mg/l). In the case of Haemophilus spp., M. catarrhalis and N. gonorrhoeae, ertapenem, with a MIC(90) < or =0.06 mg/l resulted the most active antibiotic tested. When considering the anaerobes, ertapenem displayed a broad spectrum of activity, similar to that of imipenem, against Clostridium spp. (MIC(90) 2 mg/l) and was slightly less active against Bacteroides fragilis (MIC(90) 0.5 mg/l). Both carbapenems were the most active among the tested compounds. Due to its activity against almost all pathogens studied, ertapenem appears to be an option for the treatment of mixed bacterial infections.
研究了新型碳青霉烯类药物厄他培南（MK-0826）对来自四家西班牙医院的389株需氧微生物（187株肠杆菌科细菌、15株气单胞菌属、42株葡萄球菌属、43株链球菌属、15株肠球菌属、30株嗜血杆菌属、15株卡他莫拉菌、12株淋病奈瑟菌、15株铜绿假单胞菌和15株不动杆菌属）和54株厌氧菌分离株（15株梭菌属、12株消化链球菌属和27株脆弱拟杆菌群）的体外活性。将厄他培南的活性与亚胺培南、哌拉西林-他唑巴坦、头孢西丁、头孢曲松、头孢他啶、头孢吡肟和诺氟沙星的活性进行了比较。厄他培南是对肠杆菌科细菌活性最强的抗生素（MIC90≤0.5mg/L），尤其对于产广谱、超广谱和染色体编码AmpCβ-内酰胺酶的菌株。厄他培南对铜绿假单胞菌、不动杆菌属和肠球菌的活性较低，甚至低于亚胺培南（MIC90≥16mg/L）。厄他培南对甲氧西林敏感的金黄色葡萄球菌、凝固酶阴性葡萄球菌、β-溶血性链球菌和肺炎链球菌有活性（MIC90≤1mg/L）。对于嗜血杆菌属、卡他莫拉菌和淋病奈瑟菌，厄他培南的MIC90≤0.06mg/L，是受试抗生素中活性最强的。在考虑厌氧菌时，厄他培南对梭菌属显示出与亚胺培南相似的广谱活性（MIC90为2mg/L），对脆弱拟杆菌的活性略低（MIC90为0.5mg/L）。两种碳青霉烯类药物在受试化合物中活性最强。由于厄他培南对几乎所有研究的病原体都有活性，它似乎是治疗混合细菌感染的一个选择。
