Lee Jonghan, Kim Chang Ki, Roh Kyoung Ho, Lee Hyukmin, Yum Jong Hwa, Yong Dongeun, Lee Kyungwon, Chong Yunsop
Department of Laboratory Medicine, Yonsei University College of Medicine, Seoul, Korea.
Korean J Lab Med. 2007 Aug;27(4):292-7. doi: 10.3343/kjlm.2007.27.4.292.
Methicillin-resistant Staphylococcus aureus (MRSA) and some gram-negative bacilli are very prevalent nosocomial pathogens, commonly causing mixed infections, and are often resistant to multiple drugs. Arbekacin is an aminoglycoside used for the treatment of MRSA infections, but is also active against some gram-negative bacilli. The aim of this study was to determine in vitro activity of arbekacin against recent clinical isolates of staphylococci and gram-negative bacilli.
The strains were isolated from clinical specimens of patients at Severance Hospital in 2003. Antimicrobial susceptibility was tested by the Clinical and Laboratory Standards Institute agar dilution method. The following arbekacin breakpoints were used: susceptible, </=4 microg/mL; and resistant, >/=16 microg/mL .
All isolates of staphylococci tested were inhibited by </=4 microg/mL of arbekacin, regardless of their methicillin susceptibility. The MIC90s of arbekacin, 1-4 microg/mL, were 8->32-fold and >32-128-fold lower than those of amikacin and gentamicin, respectively. The resistance rates of MRSA, methicillin-susceptible S. aureus, methicillin-resistant coagulase-negative staphylococci (CNS) and methicillin-susceptible CNS were 0% to arbekacin, 0-54% to amikacin, and 24-79% to gentamicin. The MIC90s of arbekacin for Escherichia coli and Citrobacter freundii, 1 microg/mL and 16 microg/mL, were 2-4-fold and 8-16-fold lower than those of amikacin and gentamicin, respectively. However, The MIC90s of arbekacin for other species of gram-negative bacilli, 64->128 microg/mL, were similar to those of other aminoglycosides.
Arbekacin may be a useful alternative to glycopeptides for the treatment of monomicrobial methicillin-resistant staphylococcal infections, as well as mixed infections with gram-negative bacilli, as most isolates of E. coli, C. freundii and some other gram-negative bacilli were also susceptible to arbekacin.
耐甲氧西林金黄色葡萄球菌(MRSA)和一些革兰氏阴性杆菌是非常常见的医院病原体,常引起混合感染,且往往对多种药物耐药。阿贝卡星是一种用于治疗MRSA感染的氨基糖苷类药物,但对一些革兰氏阴性杆菌也有活性。本研究的目的是确定阿贝卡星对近期葡萄球菌和革兰氏阴性杆菌临床分离株的体外活性。
菌株于2003年从首尔延世大学Severance医院患者的临床标本中分离得到。采用美国临床和实验室标准协会琼脂稀释法检测抗菌药物敏感性。使用以下阿贝卡星折点:敏感,≤4μg/mL;耐药,≥16μg/mL。
所有测试的葡萄球菌分离株均被≤4μg/mL的阿贝卡星抑制,无论其对甲氧西林的敏感性如何。阿贝卡星的MIC90为1 - 4μg/mL,分别比阿米卡星和庆大霉素低8至32倍和32至128倍。MRSA、甲氧西林敏感金黄色葡萄球菌、耐甲氧西林凝固酶阴性葡萄球菌(CNS)和甲氧西林敏感CNS对阿贝卡星的耐药率为0%,对阿米卡星的耐药率为0 - 54%,对庆大霉素的耐药率为24 - 79%。阿贝卡星对大肠杆菌和弗氏柠檬酸杆菌的MIC90分别为1μg/mL和16μg/mL,分别比阿米卡星和庆大霉素低2至4倍和8至16倍。然而,阿贝卡星对其他革兰氏阴性杆菌的MIC90为64至>128μg/mL,与其他氨基糖苷类药物相似。
阿贝卡星可能是糖肽类药物治疗单一耐甲氧西林葡萄球菌感染以及与革兰氏阴性杆菌混合感染的有用替代药物,因为大多数大肠杆菌、弗氏柠檬酸杆菌和其他一些革兰氏阴性杆菌分离株也对阿贝卡星敏感。