Sader Helio S, Fritsche Thomas R, Jones Ronald N
JMI Laboratories, 345 Beaver Kreek Centre, Suite A, North Liberty, Iowa 52317, USA.
Int J Infect Dis. 2009 Mar;13(2):291-5. doi: 10.1016/j.ijid.2008.07.006. Epub 2008 Oct 19.
Patients on long-term hemodialysis are at a significantly higher risk for catheter-related bloodstream infections (BSI) than the general population. These infections are generally caused by gram-positive organisms, especially Staphylococcus aureus. In the present study, we evaluated the antimicrobial susceptibility patterns of S. aureus causing BSI in dialysis patients compared to those causing BSI in other patient populations.
The potencies of daptomycin and various comparator agents were evaluated by reference broth microdilution methods for S. aureus bloodstream isolates from dialysis patients (606 strains) in 43 hospitals in North America and Europe. Susceptibility patterns for the dialysis isolate set were compared to those S. aureus causing BSI in other patient populations in the same hospitals and time period.
Daptomycin was highly potent against S. aureus causing bacteremia in dialysis patients (MIC(50)/MIC(90), 0.25/0.5 microg/ml). Vancomycin (MIC(50)/MIC(90), 1/1 microg/ml) and linezolid (MIC(50)/MIC(90), 2/2 microg/ml) showed similar potency, and overall susceptibility rates for the three antibiotics were 99.8-100.0% susceptible. Linezolid and vancomycin were four- to eight-fold less potent than daptomycin.
The overall susceptibility patterns of S. aureus strains from dialysis patients were very similar to those of non-dialysis patients.
长期血液透析患者发生导管相关血流感染（BSI）的风险显著高于普通人群。这些感染通常由革兰氏阳性菌引起，尤其是金黄色葡萄球菌。在本研究中，我们评估了导致透析患者BSI的金黄色葡萄球菌与导致其他患者群体BSI的金黄色葡萄球菌的抗菌药敏模式。
采用参考肉汤微量稀释法，对北美和欧洲43家医院透析患者的金黄色葡萄球菌血流分离株（606株）评估达托霉素和各种对照药物的效力。将透析分离株的药敏模式与同一医院和同一时期导致其他患者群体BSI的金黄色葡萄球菌的药敏模式进行比较。
达托霉素对导致透析患者菌血症的金黄色葡萄球菌具有高效力（MIC50/MIC90，0.25/0.5微克/毫升）。万古霉素（MIC50/MIC90，1/1微克/毫升）和利奈唑胺（MIC50/MIC90，2/2微克/毫升）显示出相似的效力，三种抗生素的总体敏感率为99.8 - 100.0%敏感。利奈唑胺和万古霉素的效力比达托霉素低4至8倍。
透析患者金黄色葡萄球菌菌株的总体药敏模式与非透析患者非常相似。
