Tsai Tung-Yuan, Chang Shan-Chwen, Hsueh Po-Ren, Feng Nan-Hsiung, Wang Jann-Tay
Department of Internal Medicine, Kaohsiung Military General Hospital, Kaohsiung, Taiwan.
J Microbiol Immunol Infect. 2007 Dec;40(6):481-6.
Isepamicin is a newly introduced aminoglycoside in Taiwan. Since in vitro data for isepamicin against nosocomial Gram-negative bloodstream infection from Taiwan are limited, we compared the activity of isepamicin, amikacin, gentamicin and tobramycin against nosocomial Gram-negative blood isolates.
A total of 247 non-duplicate nosocomial blood isolates of Gram-negative bacteria collected between January 2003 and December 2003 in a major teaching hospital in Taiwan were tested for their in vitro susceptibilities to gentamicin, tobramycin, amikacin, and isepamicin using the agar dilution method. The isolates included Escherichia coli (31 isolates), Klebsiella pneumoniae (31), Enterobacter cloacae (30), Serratia marcescens (31), Morganella morganii (21), Citrobacter freundii (10), Pseudomonas aeruginosa (31), Acinetobacter baumannii (31), and Stenotrophomonas maltophilia (31).
Overall, isepamicin had high antibacterial activity against the tested Gram-negative bacteria. For the 154 Enterobacteriaceae isolates, isepamicin had the lowest minimum concentration inhibiting 90% of isolates (MIC90) among the tested drugs, while its resistance rate (3.9%) was equal to that of amikacin (3.9%) and lower than those of tobramycin (18.2%) and gentamicin (21.4%). For the 93 of non-fermentative Gram-negative bacilli isolates, isepamicin had the lowest MIC90, and a resistance rate (23.7%) lower than those of amikacin (27.9%), tobramycin (38.7%) and gentamicin (40.9%).
The in vitro activity of isepamicin against Gram-negative bacteria isolates was equal or similar to amikacin and superior to other tested aminoglycosides. In view of its potential for less nephrotoxicity and ototoxicity than other aminoglycosides, isepamicin is a drug of choice for the empirical treatment of nosocomial infections caused by Gram-negative bacteria.
异帕米星是台湾地区新引入的一种氨基糖苷类抗生素。由于台湾地区关于异帕米星针对医院革兰阴性菌血流感染的体外数据有限，我们比较了异帕米星、阿米卡星、庆大霉素和妥布霉素对医院革兰阴性血源分离菌的活性。
采用琼脂稀释法，对2003年1月至2003年12月期间在台湾一家大型教学医院收集的247株非重复的医院革兰阴性菌血源分离株进行体外药敏试验，检测其对庆大霉素、妥布霉素、阿米卡星和异帕米星的敏感性。分离株包括大肠埃希菌（31株）、肺炎克雷伯菌（31株）、阴沟肠杆菌（30株）、黏质沙雷菌（31株）、摩根摩根菌（21株）、弗劳地枸橼酸菌（10株）、铜绿假单胞菌（31株）、鲍曼不动杆菌（31株）和嗜麦芽窄食单胞菌（31株）。
总体而言，异帕米星对受试革兰阴性菌具有较高的抗菌活性。对于154株肠杆菌科分离株，异帕米星在受试药物中对90%分离株的最低抑菌浓度（MIC90）最低，而其耐药率（3.9%）与阿米卡星（3.9%）相当，低于妥布霉素（18.2%）和庆大霉素（21.4%）。对于93株非发酵革兰阴性杆菌分离株，异帕米星的MIC90最低，耐药率（23.7%）低于阿米卡星（27.9%）、妥布霉素（38.7%）和庆大霉素（40.9%）。
异帕米星对革兰阴性菌分离株的体外活性与阿米卡星相当或相似，优于其他受试氨基糖苷类抗生素。鉴于其肾毒性和耳毒性可能低于其他氨基糖苷类抗生素，异帕米星是经验性治疗革兰阴性菌引起的医院感染的首选药物。
