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达托霉素及其他抗菌药物对499株引起血流感染的革兰氏阳性球菌的体外活性

[In vitro activity of daptomycin and other antimicrobial agents against 499 strains of gram-positive cocci causing bloodstream infection].

作者信息

Yang Qi-Wen, Wang Hui, Sun Hong-Li, Xu Ying-Chun, Xie Xiu-Li, Chen Min-Jun

机构信息

Department of Clinical Laboratory, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China.

出版信息

Zhonghua Nei Ke Za Zhi. 2009 Mar;48(3):220-4.

Abstract

OBJECTIVE

To evaluate the in vitro activity of daptomycin, vancomycin, teicoplanin, tigecycline, ceftobiprole and linezolid against 499 strains of blood-isolated gram-positive cocci.

METHODS

Determination of the minimal inhibitory concentration (MICs) of daptomycin with microbrothdilution method and the MICs of other 9 antimicrobial agents with agar dilution method against 499 strains of blood-isolated gram positive cocci was carried out. The data was analyzed with WHONET 5.4 software.

RESULTS

The susceptibility rates of staphylococci to daptomycin, tigecycline, linezolid, ceftobiprole, vancomycin and teicoplanin were 100%. All staphylococcus strains were inhibited by daptomycin at a MIC of 1 mg/L. The MIC(50) and MIC(90) of daptomycin were both 0.5 mg/L against methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-resistant Staphylococcus coagulase-negative (MRSCoN). Among Enterococcus spp, the highest MIC of daptomycin was 4 mg/L. The MIC(50) and MIC(90) of daptomycin were both 2 mg/L against E.faecalis, whereas they were 2 mg/L and 4 mg/L against E.faecium. One strains of linezolid-resistant E.faecalis (MIC: 8 mg/L) was susceptible to daptomycin (MIC: 1 mg/L). Three strains of E.faecium carrying vanA gene with vancomycin MICs above 32 mg/L and teicoplanin MICs also 32 mg/L were susceptible to daptomycin, tigecycline and linezolid. The MIC range of daptomycin against Streptococcus pneumoniae and Streptococcus viridans was 0.032 - 0.25 mg/L and 0.125 - 1.000 mg/L separately.

CONCLUSIONS

Daptomycin has excellent in vitro activity against common gram-positive pathogens isolated from blood. It may be a good choice for clinicians to treat drug-resistant gram-positive cocci.

摘要

目的

评估达托霉素、万古霉素、替考拉宁、替加环素、头孢比普和利奈唑胺对499株血源革兰阳性球菌的体外活性。

方法

采用微量肉汤稀释法测定达托霉素的最低抑菌浓度(MIC),采用琼脂稀释法测定其他9种抗菌药物对499株血源革兰阳性球菌的MIC。数据用WHONET 5.4软件进行分析。

结果

葡萄球菌对达托霉素、替加环素、利奈唑胺、头孢比普、万古霉素和替考拉宁的敏感率均为100%。所有葡萄球菌菌株在1mg/L的MIC时均被达托霉素抑制。达托霉素对耐甲氧西林金黄色葡萄球菌(MRSA)和耐甲氧西林凝固酶阴性葡萄球菌(MRSCoN)的MIC50和MIC90均为0.5mg/L。在肠球菌属中,达托霉素的最高MIC为4mg/L。达托霉素对粪肠球菌的MIC50和MIC90均为2mg/L,而对屎肠球菌则分别为2mg/L和4mg/L。1株耐利奈唑胺的粪肠球菌(MIC:8mg/L)对达托霉素敏感(MIC:1mg/L)。3株携带vanA基因、万古霉素MIC高于32mg/L且替考拉宁MIC也为32mg/L的屎肠球菌对达托霉素、替加环素和利奈唑胺敏感。达托霉素对肺炎链球菌和草绿色链球菌的MIC范围分别为0.032 - 0.25mg/L和0.125 - 1.000mg/L。

结论

达托霉素对从血液中分离出的常见革兰阳性病原体具有优异的体外活性。它可能是临床医生治疗耐药革兰阳性球菌的一个不错选择。

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