Schurek Kristen N, Adam Heather J, Hoban Daryl J, Zhanel George G
Department of Medical Microbiology, Faculty of Medicine, University of Manitoba, 5th Floor Basic Medical Sciences Building, 730 William Avenue, Winnipeg, Manitoba, Canada R3E 0W3.
Int J Antimicrob Agents. 2006 Sep;28(3):266-9. doi: 10.1016/j.ijantimicag.2006.04.007. Epub 2006 Aug 9.
The use of current Clinical and Laboratory Standards Institute levofloxacin breakpoints for assessing fluoroquinolone resistance in Streptococcus pneumoniae is inadequate for detecting isolates possessing first-step parC mutations. Consequently, the risk for development of fluoroquinolone resistance is greatly underestimated. Adopting microbiological breakpoints for fluoroquinolones and S. pneumoniae, where parC mutations are rare in susceptible isolates, more accurately describes the emergence of resistance and may help to prevent a number of future fluoroquinolone treatment failures. Additionally, we propose that the use of a second fluoroquinolone marker, such as ciprofloxacin, offers the best prediction for detecting an isolate possessing a first-step parC mutation.
使用临床和实验室标准协会当前的左氧氟沙星断点来评估肺炎链球菌对氟喹诺酮类药物的耐药性，不足以检测出具有第一步parC突变的分离株。因此，氟喹诺酮类耐药性发展的风险被大大低估。采用针对氟喹诺酮类药物和肺炎链球菌的微生物学断点，在敏感分离株中parC突变很少见，能更准确地描述耐药性的出现，并可能有助于预防未来一些氟喹诺酮类药物治疗失败的情况。此外，我们建议使用第二种氟喹诺酮类标记物，如环丙沙星，能为检测具有第一步parC突变的分离株提供最佳预测。
