Tunçkanat Ferda, Saribaş Zeynep, Ercis Serpil
Hacettepe Universitesi Tip Fakültesi, Mikrobiyoloji ve Klinik Mikrobiyoloji Anabilim Dali, Ankara.
Mikrobiyol Bul. 2009 Apr;43(2):211-5.
Glycylcyclines are novel semisynthetic group of antibiotics that have been produced by substitution of glycylamido group at position 9 of tetracyclines. Tigecycline derived from minocycline is the first member of glycylcyclines. This new antibiotic has a broad spectrum of activity against variety of gram-positive and gram-negative bacteria and is not affected by known tetracycline resistance mechanisms. The aim of this study was to investigate the in-vitro activity of tigecycline as well as vancomycin, linezolid, quinupristin-dalfopristin and trimethoprim-sulphamethoxazole (TMP-SMX) against methicillin-resistant staphylococci isolated from clinical specimens of adult patients in Hacettepe University Hospital. For this purpose 127 Staphylococcus aureus (MRSA) and 42 coagulase negative staphylococci (MRCNS) which had been shown to be resistant to methicillin by disc diffusion method performed according to Clinical and Laboratory Standards Institute (CLSI) guidelines, were evaluated. In these isolates minimum inhibitory concentration (MIC) values of tigecycline were detected by E-test; susceptibilities to linezolid, quinupristin-dalfopristin, TMP-SMX were detected by disc diffusion test. All of the isolates were searched for decreased susceptibility to vancomycin by agar screening method and MIC values of vancomycin were detected by E-test for the strains that grew on vancomycin agar plates. The range of MIC values of tigecycline were 0.032-1 microg/ml for the 127 MRSA isolates (MIC50 0.25 microg/ml, MIC90 0.75 microg/ml) and were 0.047-1 microg/ml (MIC50 0.25 microg/ml, MIC90 0.5 microg/ml) for the MRCNS isolates. All staphylococcal isolates were found to be susceptible to vancomycin, linezolid and quinupristin-dalfopristin. TMP-SMX resistance was detected in 7 (5.5%) MRSA and 26 (60.5%) MRCNS isolates. The results of this study demonstrated very good in-vitro activity of tigecycline against both MRSA and MRCNS isolates in our hospital. A remarkable finding of the present study was demonstration of the quite low rate of TMP-SMX resistance among MRSA isolates whereas MRCNS isolates showed high rate of resistance.
甘氨酰环素是一类新型半合成抗生素,通过在四环素的9位上取代甘氨酰胺基而产生。源自米诺环素的替加环素是甘氨酰环素的首个成员。这种新型抗生素对多种革兰氏阳性菌和革兰氏阴性菌具有广谱活性,且不受已知四环素耐药机制的影响。本研究的目的是调查替加环素以及万古霉素、利奈唑胺、奎奴普丁-达福普汀和甲氧苄啶-磺胺甲恶唑(TMP-SMX)对从哈杰泰佩大学医院成年患者临床标本中分离出的耐甲氧西林葡萄球菌的体外活性。为此,对127株金黄色葡萄球菌(MRSA)和42株凝固酶阴性葡萄球菌(MRCNS)进行了评估,这些菌株已根据临床和实验室标准协会(CLSI)指南通过纸片扩散法证明对甲氧西林耐药。在这些分离株中,通过E试验检测替加环素的最低抑菌浓度(MIC)值;通过纸片扩散试验检测对利奈唑胺、奎奴普丁-达福普汀、TMP-SMX的敏感性。通过琼脂筛选法检测所有分离株对万古霉素的敏感性降低情况,并通过E试验检测在万古霉素琼脂平板上生长的菌株的万古霉素MIC值。127株MRSA分离株的替加环素MIC值范围为0.032-1微克/毫升(MIC50为0.25微克/毫升,MIC90为0.75微克/毫升),MRCNS分离株的MIC值范围为0.047-1微克/毫升(MIC50为0.25微克/毫升,MIC90为0.5微克/毫升)。所有葡萄球菌分离株均对万古霉素、利奈唑胺和奎奴普丁-达福普汀敏感。在7株(5.5%)MRSA和26株(60.5%)MRCNS分离株中检测到TMP-SMX耐药。本研究结果表明,替加环素对我院的MRSA和MRCNS分离株均具有非常好的体外活性。本研究的一个显著发现是,MRSA分离株中TMP-SMX耐药率相当低,而MRCNS分离株显示出高耐药率。