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新型头孢菌素头孢洛林对社区获得性肺炎患者血培养分离菌的活性

Activity of the new cephalosporin ceftaroline against bacteraemia isolates from patients with community-acquired pneumonia.

作者信息

Morrissey Ian, Ge Yigong, Janes Regina

机构信息

Quotient Bioresearch Limited, Microbiology, Newmarket Road, Fordham, Cambridgeshire CB75WW, UK.

出版信息

Int J Antimicrob Agents. 2009 Jun;33(6):515-9. doi: 10.1016/j.ijantimicag.2008.12.005. Epub 2009 Feb 8.

Abstract

The activity of ceftaroline, a novel cephalosporin, was evaluated against 1337 isolates from patients with bacteraemic community-acquired pneumonia (CAP) requiring hospitalisation (including 119 Haemophilus influenzae, 9 Moraxella catarrhalis, 164 Staphylococcus aureus, 1007 Streptococcus pneumoniae and 38 Streptococcus pyogenes). Minimum inhibitory concentrations (MICs) were determined by broth microdilution according to Clinical and Laboratory Standards Institute (CLSI) guidelines, and susceptibility category assessments were made using CLSI or US Food and Drug Administration (FDA) breakpoints. Ceftaroline MICs were < or = 0.008-0.06 mg/L against H. influenzae, 0.25-2mg/L against methicillin-resistant S. aureus (MRSA), 0.06-1mg/L against methicillin-susceptible S. aureus, 0.015-0.5mg/L against M. catarrhalis and < or = 0.008-0.5mg/L against S. pneumoniae, and all S. pyogenes isolates had ceftaroline MICs < or = 0.008mg/L. Ceftaroline was more active than ceftriaxone or cefepime both against MRSA and penicillin-resistant pneumococci. More than 90% of MRSA isolates were resistant to clarithromycin and levofloxacin but were susceptible to linezolid or tigecycline. A high rate of clarithromycin resistance was also observed in the pneumococci. Ceftaroline was very active in vitro against all CAP isolates, including MRSA and penicillin-non-susceptible pneumococci, in contrast to the other beta-lactams tested. These data confirm ceftaroline as a new cephalosporin with enhanced anti-Gram-positive activity and suggest that ceftaroline has the potential to be a useful new agent in the treatment of CAP-associated bacteraemic infections.

摘要

对一种新型头孢菌素头孢洛林的活性进行了评估,受试菌株为1337株来自因社区获得性肺炎(CAP)菌血症而需住院治疗的患者(包括119株流感嗜血杆菌、9株卡他莫拉菌、164株金黄色葡萄球菌、1007株肺炎链球菌和38株化脓性链球菌)。根据临床和实验室标准协会(CLSI)指南,采用肉汤微量稀释法测定最低抑菌浓度(MIC),并使用CLSI或美国食品药品监督管理局(FDA)的折点进行药敏类别评估。头孢洛林对流感嗜血杆菌的MIC≤0.008~0.06mg/L,对耐甲氧西林金黄色葡萄球菌(MRSA)为0.25~2mg/L,对甲氧西林敏感金黄色葡萄球菌为0.06~1mg/L,对卡他莫拉菌为0.015~0.5mg/L,对肺炎链球菌≤0.008~0.5mg/L,所有化脓性链球菌菌株的头孢洛林MIC≤0.008mg/L。头孢洛林对MRSA和耐青霉素肺炎球菌的活性均高于头孢曲松或头孢吡肟。超过90%的MRSA菌株对克拉霉素和左氧氟沙星耐药,但对利奈唑胺或替加环素敏感。在肺炎球菌中也观察到较高的克拉霉素耐药率。与其他受试β-内酰胺类药物相比,头孢洛林在体外对所有CAP分离株,包括MRSA和耐青霉素肺炎球菌均具有很高的活性。这些数据证实头孢洛林是一种具有增强抗革兰氏阳性菌活性的新型头孢菌素,并表明头孢洛林有潜力成为治疗CAP相关菌血症感染的有效新药。

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