Cheng Nai-Cheng, Hsueh Po-Ren, Liu Yung-Ching, Shyr Jainn-Ming, Huang Wen-Kuei, Teng Lee-Jene, Liu Cheng-Yi
Department of Internal Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
Microb Drug Resist. 2005 Winter;11(4):330-41. doi: 10.1089/mdr.2005.11.330.
This study evaluated the in vitro activities of tigecycline, ertapenem, isepamicin, and other comparators against 861 bacterial isolates recovered from patients treated in three major teaching hospitals in 2003. MICs to antimicrobial agents were determined by the agar dilution method. High rates of oxacillin resistance (58%) in Staphylococcus aureus (60 isolates), and vancomycin resistance (21%) and quinupristin-dalfopristin non-susceptibility (39%) in Enterococcus faecium (34 isolates) were found. Carbapenems had excellent in vitro activities (>or=98% susceptibility) against the 419 isolates of Enterobacteriaceae, with the MIC(50) and MIC(90) of imipenem, meropenem, and ertapenem being 0.25 and 4 mg/L, 0.03 and 0.12 mg/L, and 0.03 and 0.5 mg/L, respectively. For, Pseudomonas aeruginosa (74 isolates) and Burkholderia cepacia (21 isolates), meropenem (MIC(90), 0.25, 2, and 4 mg/L, respectively) had better in vitro activities than imipenem (MIC(90), 8, 4, and 32 mg/L, respectively) and ertapenem (MIC(90), 0.5, >32, and 32 mg/L, respectively). Isepamicin had a similar activity with amikacin against all Enterobacteriaceae, Pseudomonas aeruginosa, B. cepacia, and Acinetobacter baumannii, except for C. freundii isolates in which isepamicin had an eight-fold activity better than amikacin. Tigecycline had excellent in vitro activities against all isolates tested (MIC(90), <or=1 mg/L) including 14 pandrugresistant A. baumannii isolates (MICs, 1-4 mg/L), except for Proteus mirabilis (59 isolates; MIC(90), 8 mg/L), Bacteroides fragilis (60 isolates; MIC(90), 8 mg/L), P. aeruginosa (MIC(90), 16 mg/L), and B. cepacia (21 isolates; MIC(90), 16 mg/L). Tigecycline, carbapenems, and isepamicin exhibited better or comparable in vitro activities against a wide spectrum of commonly encountered bacteria than other comparator antimicrobials and may represent therapeutic options for infections due to multidrug-resistant pathogens.
本研究评估了替加环素、厄他培南、异帕米星及其他对照药物对2003年从三家主要教学医院接受治疗的患者中分离出的861株细菌的体外活性。采用琼脂稀释法测定抗菌药物的最低抑菌浓度（MIC）。结果发现，金黄色葡萄球菌（60株）对苯唑西林的耐药率较高（58%），粪肠球菌（34株）对万古霉素的耐药率为21%，对奎奴普丁/达福普汀不敏感率为39%。碳青霉烯类药物对419株肠杆菌科细菌具有优异的体外活性（敏感性≥98%），亚胺培南、美罗培南和厄他培南的MIC50和MIC90分别为0.25和4mg/L、0.03和0.12mg/L、0.03和0.5mg/L。对于铜绿假单胞菌（74株）和洋葱伯克霍尔德菌（21株），美罗培南（MIC90分别为0.25、2和4mg/L）的体外活性优于亚胺培南（MIC90分别为8、4和32mg/L）和厄他培南（MIC90分别为0.5、>32和32mg/L）。除弗氏柠檬酸杆菌分离株中亚胺培南的活性比阿米卡星高8倍外，异帕米星对所有肠杆菌科细菌、铜绿假单胞菌、洋葱伯克霍尔德菌和鲍曼不动杆菌的活性与阿米卡星相似。替加环素对所有测试分离株均具有优异的体外活性（MIC90≤1mg/L），包括14株泛耐药鲍曼不动杆菌分离株（MIC为1 - 4mg/L），但奇异变形杆菌（59株；MIC90为8mg/L）、脆弱拟杆菌（60株；MIC90为8mg/L）、铜绿假单胞菌（MIC90为16mg/L）和洋葱伯克霍尔德菌（21株；MIC90为16mg/L）除外。与其他对照抗菌药物相比，替加环素、碳青霉烯类药物和异帕米星对多种常见细菌表现出更好或相当的体外活性，可能是耐多药病原体所致感染的治疗选择。
