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抗耐甲氧西林金黄色葡萄球菌头孢菌素头孢比普对近期源自欧洲的革兰氏阳性和革兰氏阴性分离株的体外活性谱

In vitro activity profile of ceftobiprole, an anti-MRSA cephalosporin, against recent gram-positive and gram-negative isolates of European origin.

作者信息

Pillar Chris M, Aranza Mohana K, Shah Dineshchandra, Sahm Daniel F

机构信息

Eurofins Medinet, Inc., Anti-Infective Services, 13665 Dulles Technology Drive, Herndon, VA 20171, USA.

出版信息

J Antimicrob Chemother. 2008 Mar;61(3):595-602. doi: 10.1093/jac/dkm492. Epub 2008 Jan 23.

Abstract

OBJECTIVES

To determine the in vitro activity profile of ceftobiprole, a pyrrolidinone cephalosporin with activity against methicillin-resistant Staphylococcus aureus (MRSA), for use as a contemporary baseline to help detect any changes in its activity profile throughout the course of clinical development and use.

METHODS

MICs were determined by broth microdilution testing for ceftobiprole and comparators against 6680 isolates [1201 S. aureus, 460 coagulase-negative staphylococci (CoNS), 526 Streptococcus pneumoniae, 1213 Escherichia coli, 854 Klebsiella pneumoniae, 443 Proteus mirabilis, 406 Enterobacter cloacae, 387 Citrobacter spp., 291 Serratia marcescens, 621 Pseudomonas aeruginosa and 278 Acinetobacter spp.] from 31 sites in 12 countries.

RESULTS

Ceftobiprole activity against MRSA (MIC90 2 mg/L) was 4-fold less than the activity against methicillin-susceptible S. aureus (MIC90 0.5 mg/L) and a similar trend was observed for methicillin-resistant CoNS (MIC90 2 mg/L) and methicillin-susceptible CoNS (MIC90 0.25 mg/L). Activity against S. pneumoniae (MIC90s: penicillin-susceptible, 0.015 mg/L; -intermediate, 0.25 mg/L; -resistant, 0.5 mg/L) was comparable to that of ceftriaxone. Ceftobiprole activity against Enterobacteriaceae (MIC90s: ceftazidime-susceptible, 0.12 mg/L; non-susceptible, >32 mg/L), P. aeruginosa (MIC90s: ceftazidime-susceptible, 8 mg/L, non-susceptible, >32 mg/L) and Acinetobacter spp. (MIC90: >32 mg/L for imipenem-susceptible and non-susceptible) was comparable to that of cefepime. As with cefepime, ceftobiprole activity was decreased among cephalosporin-resistant isolates of gram-negative bacilli [extended-spectrum beta-lactamase (ESBL) or non-ESBL mediated].

CONCLUSIONS

Ceftobiprole demonstrated potent in vitro activity against MRSA and showed activity against key gram-negative bacilli comparable to that of cefepime. Given this broad spectrum of activity, ceftobiprole appears well suited for development and use in the treatment of a variety of healthcare-associated infections.

摘要

目的

确定头孢比普的体外活性谱,头孢比普是一种吡咯烷酮头孢菌素,对耐甲氧西林金黄色葡萄球菌(MRSA)具有活性,用作当代基线,以帮助检测其在临床开发和使用过程中活性谱的任何变化。

方法

通过肉汤微量稀释试验测定头孢比普和对照品对来自12个国家31个地点的6680株分离菌[1201株金黄色葡萄球菌、460株凝固酶阴性葡萄球菌(CoNS)、526株肺炎链球菌、1213株大肠埃希菌、854株肺炎克雷伯菌、443株奇异变形杆菌、406株阴沟肠杆菌、387株柠檬酸杆菌属、291株粘质沙雷菌、621株铜绿假单胞菌和278株不动杆菌属]的最低抑菌浓度(MIC)。

结果

头孢比普对MRSA的活性(MIC90为2mg/L)比对甲氧西林敏感金黄色葡萄球菌的活性(MIC90为0.5mg/L)低4倍,对于耐甲氧西林CoNS(MIC90为2mg/L)和甲氧西林敏感CoNS(MIC90为0.25mg/L)也观察到类似趋势。对肺炎链球菌的活性(MIC90:青霉素敏感株为0.015mg/L;中介株为0.25mg/L;耐药株为0.5mg/L)与头孢曲松相当。头孢比普对肠杆菌科细菌(MIC90:对头孢他啶敏感株为0.12mg/L;不敏感株> 32mg/L)、铜绿假单胞菌(MIC90:对头孢他啶敏感株为8mg/L,不敏感株> 32mg/L)和不动杆菌属(MIC90:对亚胺培南敏感和不敏感株均> 32mg/L)的活性与头孢吡肟相当。与头孢吡肟一样,在革兰阴性杆菌的头孢菌素耐药分离株[超广谱β-内酰胺酶(ESBL)或非ESBL介导]中,头孢比普的活性降低。

结论

头孢比普在体外对MRSA表现出强大活性,对关键革兰阴性杆菌的活性与头孢吡肟相当。鉴于这种广泛的活性谱,头孢比普似乎非常适合开发和用于治疗各种医疗保健相关感染。

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