Marchese A, Gualco L, Schito A M, Debbia E A, Schito G C
Sezione di Microbiologia del Di.S.C.A.T., University of Genoa, Largo R.Benzi 10, 16132 Genoa, Italy.
J Antimicrob Chemother. 2004 Nov;54(5):944-51. doi: 10.1093/jac/dkh445. Epub 2004 Oct 7.
The in vitro activity of ertapenem was evaluated in comparison to 21 selected agents against a large collection of recently isolated respiratory tract pathogens including: 180 Streptococcus pneumoniae, 100 Streptococcus pyogenes, 70 Haemophilus influenzae, 70 Moraxella catarrhalis, 100 methicillin-susceptible Staphylococcus aureus and 30 Klebsiella pneumoniae. Additional in vitro tests (time-kill curves with ertapenem alone and in combination with four other agents) for S. pneumoniae were carried out.
MIC determinations and time-kill curves were carried out following the procedures suggested by the NCCLS.
According to NCCLS susceptibility breakpoints, ertapenem was comparable to the most potent compounds tested for all pathogens studied. Ertapenem was 100% active against penicillin-susceptible and -intermediate S. pneumoniae and against 60% of penicillin-resistant strains. Time-kill tests at 4x MIC confirmed a pronounced bactericidal potency of ertapenem against these organisms. Interactions of ertapenem with several other agents against pneumococci resulted in clear synergic interactions (98.4%). Indifference was extremely rare and antagonism was not observed. All S. pyogenes strains tested were inhibited by ertapenem, irrespective of their macrolide resistance phenotypes. Ertapenem was also fully active against H. influenzae (100% susceptible) and M. catarrhalis (MIC90 0.015-0.03 mg/L) even when capable of synthesizing beta-lactamases. Methicillin-susceptible S. aureus and K. pneumoniae, including extended-spectrum beta-lactamase-producing strains, were 100% susceptible to ertapenem.
Our results indicate that ertapenem has a suitable spectrum of activity against organisms encountered in community-acquired bacterial respiratory tract infections.
将厄他培南与21种选定药物进行比较，评估其对大量近期分离出的呼吸道病原体的体外活性，这些病原体包括：180株肺炎链球菌、100株化脓性链球菌、70株流感嗜血杆菌、70株卡他莫拉菌、100株甲氧西林敏感金黄色葡萄球菌和30株肺炎克雷伯菌。针对肺炎链球菌还进行了额外的体外试验（单独使用厄他培南以及与其他四种药物联合使用的时间-杀菌曲线）。
按照美国国家临床实验室标准委员会（NCCLS）建议的程序进行最低抑菌浓度（MIC）测定和时间-杀菌曲线试验。
根据NCCLS的药敏折点，厄他培南对所研究的所有病原体的活性与测试的最有效的化合物相当。厄他培南对青霉素敏感和中介的肺炎链球菌以及60%的青霉素耐药菌株的活性为100%。在4倍MIC下进行的时间-杀菌试验证实了厄他培南对这些微生物具有显著的杀菌效力。厄他培南与其他几种抗肺炎球菌药物的相互作用产生了明显的协同作用（98.4%）。无作用情况极为罕见，未观察到拮抗作用。所有测试的化脓性链球菌菌株均被厄他培南抑制，无论其大环内酯耐药表型如何。即使能够产生β-内酰胺酶，厄他培南对流感嗜血杆菌（100%敏感）和卡他莫拉菌（MIC90为0.015 - 0.03mg/L）也具有完全活性。甲氧西林敏感金黄色葡萄球菌和肺炎克雷伯菌，包括产超广谱β-内酰胺酶的菌株，对厄他培南的敏感性为100%。
我们的结果表明，厄他培南对社区获得性细菌性呼吸道感染中遇到的病原体具有合适的活性谱。
