Watanabe Shinya, Ito Teruyo, Hiramatsu Keiichi
Department of Infection Control Science, Graduate School of Medicine, Juntendo University, 2-1-1 Hongo, Bunkyo-ku, Tokyo, Japan.
J Antimicrob Chemother. 2007 Dec;60(6):1384-7. doi: 10.1093/jac/dkm361. Epub 2007 Sep 21.
The aim of the study was to test in vitro activities of the novel des-F(6)-quinolone DX-619 against methicillin-resistant staphylococci (MRS) isolated in hospitals and communities and to compare its activity with other quinolones, sitafloxacin and levofloxacin, and antibiotics used for the treatment of methicillin-resistant Staphylococcus aureus infection, including vancomycin, teicoplanin, arbekacin, linezolid and quinupristin/dalfopristin.
MICs were determined by the agar dilution method using healthcare-associated MRS (S. aureus including strains with reduced susceptibility to vancomycin, 103; coagulase-negative staphylococci, 87) and community-associated MRS (S. aureus including non-multiresistant oxacillin-resistant strains, 37; coagulase-negative staphylococci, 92). The quinolone resistance-determining regions of gyrA, gyrB, grlA and grlB genes from six strains with reduced susceptibility to DX-619 were sequenced.
DX-619 showed the lowest MIC(90) values for all categories of strains tested, irrespective of the degree of glycopeptide resistance. The six strains with MIC values of >128 mg/L of levofloxacin commonly carried two mutations in gyrA and two mutations in grlA. DX-619 showed potent activity against strains with MIC values of 2 mg/L.
DX-619 was potent against all MRS tested, suggesting that it would be a promising candidate for the treatment of methicillin-resistant S. aureus infection if sufficient in vivo concentrations were safely attained.
本研究旨在测试新型去F(6)-喹诺酮DX-619对医院和社区分离的耐甲氧西林葡萄球菌(MRS)的体外活性,并将其活性与其他喹诺酮类药物(司帕沙星和左氧氟沙星)以及用于治疗耐甲氧西林金黄色葡萄球菌感染的抗生素(包括万古霉素、替考拉宁、阿贝卡星、利奈唑胺和奎奴普丁/达福普汀)进行比较。
采用琼脂稀释法测定医疗保健相关MRS(金黄色葡萄球菌,包括对万古霉素敏感性降低的菌株,103株;凝固酶阴性葡萄球菌,87株)和社区相关MRS(金黄色葡萄球菌,包括非多重耐药的耐苯唑西林菌株,37株;凝固酶阴性葡萄球菌,92株)的最低抑菌浓度(MIC)。对6株对DX-619敏感性降低的菌株的gyrA、gyrB、grlA和grlB基因的喹诺酮耐药决定区进行测序。
无论糖肽类耐药程度如何,DX-619对所有测试菌株类别均显示出最低的MIC(90)值。6株左氧氟沙星MIC值>128mg/L的菌株通常在gyrA中有两个突变,在grlA中有两个突变。DX-619对MIC值为2mg/L的菌株显示出强大的活性。
DX-619对所有测试的MRS均具有强大活性,表明如果能安全达到足够的体内浓度,它将是治疗耐甲氧西林金黄色葡萄球菌感染的有前途的候选药物。