Cremades R, Santos A, Rodríguez J C, García-Pachón E, Ruiz M, Escribano I, Royo G
Section of Microbiology, Hospital General Universitario and Universidad Miguel Hernandez, Elche, Spain.
Chemotherapy. 2009;55(2):114-8. doi: 10.1159/000194973. Epub 2009 Jan 21.
In view of the problems of correlation between the data provided by classical microbiological studies and clinical response, we designed an in vitro method to screen for the sterilizing activity of various antibiotics, individually or in combinations, against clinical isolates of various rapidly growing mycobacteria in the stationary phase.
We screened a large number of antibiotic combinations (4-16 microg/ml) for their sterilizing capacity in 26 Mycobacterium fortuitum clinical isolates, 7 Mycobacterium chelonae and 2 Mycobacterium abscessus clinical isolates (10(5) CFU).
The best results against M. fortuitum were obtained with moxifloxacin, both on its own (13/26 strains) and in combination. This drug is also very active against M. chelonae (3/7 strains), and in combination with clarithromycin and amikacin exhibits sterilizing activity against all the strains studied. Combinations of clarithromycin with moxifloxacin or linezolid at high doses (16 microg/ml) exhibit activity against M. abscessus.
The most relevant finding of our study is the good activity of moxifloxacin against these microorganisms in the stationary phase. This indicates the need to confirm these data in animal models or clinical trials in order to determine their true clinical importance.
鉴于经典微生物学研究提供的数据与临床反应之间的相关性问题,我们设计了一种体外方法,以筛选各种抗生素单独或联合对处于稳定期的各种快速生长分枝杆菌临床分离株的杀菌活性。
我们筛选了大量抗生素组合(4 - 16微克/毫升)对26株偶然分枝杆菌临床分离株、7株龟分枝杆菌和2株脓肿分枝杆菌临床分离株(10⁵ 菌落形成单位)的杀菌能力。
莫西沙星单独使用(13/26株)及其联合使用时对偶然分枝杆菌取得了最佳效果。该药物对龟分枝杆菌也非常有效(3/7株),并且与克拉霉素和阿米卡星联合使用时对所有研究菌株均表现出杀菌活性。高剂量(16微克/毫升)的克拉霉素与莫西沙星或利奈唑胺联合使用对脓肿分枝杆菌有活性。
我们研究中最相关的发现是莫西沙星对处于稳定期的这些微生物具有良好活性。这表明需要在动物模型或临床试验中确认这些数据,以确定它们真正的临床重要性。