Picazo Juan J, Betriu Carmen, Rodríguez-Avial Iciar, Culebras Esther, López Fátima, Gómez María
Servicio de Microbiología Clínica, Hospital Clínico San Carlos, Madrid, España.
Enferm Infecc Microbiol Clin. 2010 Jan;28(1):13-6. doi: 10.1016/j.eimc.2008.09.012. Epub 2009 May 5.
The objective of this study was to determine the in vitro activity of daptomycin and other agents against methicillin-resistant Staphylococcus aureus (MRSA) isolates from several sources and coagulase-negative staphylococci (CoNS) from clinically significant blood cultures.
We tested a total of 1186 staphylococci isolates (755 MRSA and 431 CoNS) collected as part of a multicenter surveillance program for antimicrobial resistance (VIRA study) from 40 medical centers throughout Spain between 2001 and 2006. Broth microdilution tests were performed according to the Clinical and Laboratory Standards Institute guidelines.
Most MRSA isolates were resistant to ciprofloxacin (96%) and erythromycin (79.7%). Daptomycin yielded a MIC(50)/MIC(90) of 0.5/1microg/mL in MRSA, compared with 1/2microg/mL for linezolid, vancomycin, and teicoplanin. Daptomycin MICs were in the range of < or =0.125-2microg/mL. Only 1 MRSA strain had a reproducible daptomycin MIC of 2microg/mL. Among CoNS isolates, the MIC range for daptomycin was < or =0.125-1microg/mL. Daptomycin was equally active against oxacillin-susceptible and oxacillin-resistant strains.
Daptomycin was highly active against the staphylococci isolates studied. The activity of this agent was not affected by resistance to other antibiotics such as oxacillin, teicoplanin, linezolid, ciprofloxacin, or gentamicin. These data suggest that daptomycin may be useful for the treatment of severe infection caused by MRSA or CoNS.
本研究的目的是确定达托霉素及其他药物对来自多个来源的耐甲氧西林金黄色葡萄球菌(MRSA)分离株以及临床意义重大的血培养凝固酶阴性葡萄球菌(CoNS)的体外活性。
我们测试了总共1186株葡萄球菌分离株(755株MRSA和431株CoNS),这些分离株是2001年至2006年间在西班牙40个医疗中心进行的一项抗菌药物耐药性多中心监测项目(VIRA研究)的一部分。根据临床和实验室标准协会指南进行肉汤微量稀释试验。
大多数MRSA分离株对环丙沙星(96%)和红霉素(79.7%)耐药。达托霉素对MRSA的MIC(50)/MIC(90)为0.5/1μg/mL,而利奈唑胺、万古霉素和替考拉宁为1/2μg/mL。达托霉素的MIC范围为≤0.125 - 2μg/mL。只有1株MRSA菌株的达托霉素MIC可重复为2μg/mL。在CoNS分离株中,达托霉素的MIC范围为≤0.125 - 1μg/mL。达托霉素对苯唑西林敏感和耐药菌株的活性相同。
达托霉素对所研究的葡萄球菌分离株具有高度活性。该药物的活性不受对其他抗生素如苯唑西林、替考拉宁、利奈唑胺、环丙沙星或庆大霉素耐药性的影响。这些数据表明达托霉素可能对治疗由MRSA或CoNS引起的严重感染有用。