Department of Internal Medicine, Chung-Ho Memorial Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
J Antimicrob Chemother. 2009 Dec;64(6):1226-9. doi: 10.1093/jac/dkp370. Epub 2009 Oct 14.
The aim of this study was to assess the in vitro activities of nemonoxacin against Gram-positive cocci with various resistance phenotypes.
MICs of nemonoxacin were determined for 798 recently collected (2005-07) and non-duplicate isolates of Gram-positive cocci by the agar dilution method. These isolates included: methicillin-susceptible Staphylococcus aureus (MSSA; n = 100); methicillin-resistant S. aureus (MRSA), including ciprofloxacin-susceptible (n = 50), ciprofloxacin-resistant (n = 100), vancomycin-intermediate (n = 50) and daptomycin-non-susceptible (DNS-MRSA; n = 5) isolates, and community-acquired MRSA (CA-MRSA; n = 101); invasive Streptococcus pneumoniae isolates (n = 150); levofloxacin-non-susceptible (MICs of 4-64 mg/L) S. pneumoniae isolates (n = 30); and enterococci (n = 212), including vancomycin-resistant enterococci (VRE; n = 112).
Nemonoxacin had potent activity against MSSA (MIC(90) of < or =0.03 mg/L), ciprofloxacin-susceptible MRSA (MIC(90) of < or =0.03 mg/L) and CA-MRSA (MIC(90) of 0.06 mg/L). For all invasive S. pneumoniae isolates, the activity of nemonoxacin (MIC(90) of 0.06 mg/L) was similar to that of gemifloxacin and much better than that of levofloxacin (MIC(90) of 2 mg/L) and moxifloxacin (MIC(90) of 0.25 mg/L). Nemonoxacin had a 32- to 64-fold higher activity than levofloxacin against levofloxacin-non-susceptible isolates. Nemonoxacin exerted limited activity against ciprofloxacin-resistant MRSA (MIC(90) of 1 mg/L), vancomycin-intermediate MRSA (MIC(90) of 2 mg/L), DNS-MRSA (MIC(90) of 1 mg/L), vancomycin-susceptible enterococci (MIC(90) of 2 mg/L for Enterococcus faecalis and 4 mg/L for Enterococcus faecium) and VRE (MIC(90) of 4 mg/L for E. faecalis and 16 mg/L for E. faecium).
Our findings point to a potentially useful role for nemonoxacin in the treatment of infections caused by MSSA, ciprofloxacin-susceptible MRSA and S. pneumoniae with various resistance phenotypes.
本研究旨在评估奈莫沙星对具有不同耐药表型的革兰阳性球菌的体外活性。
采用琼脂稀释法测定了 798 株近期（2005-07 年）采集的非重复革兰阳性球菌分离株的奈莫沙星 MIC。这些分离株包括：甲氧西林敏感金黄色葡萄球菌（MSSA；n=100）；耐甲氧西林金黄色葡萄球菌（MRSA），包括环丙沙星敏感（n=50）、环丙沙星耐药（n=100）、万古霉素中介（n=50）和达托霉素不敏感（DNS-MRSA；n=5）分离株，以及社区获得性 MRSA（CA-MRSA；n=101）；侵袭性肺炎链球菌分离株（n=150）；左氧氟沙星耐药（MICs 为 4-64 mg/L）肺炎链球菌分离株（n=30）；肠球菌（n=212），包括万古霉素耐药肠球菌（VRE；n=112）。
奈莫沙星对 MSSA（MIC90<或=0.03 mg/L）、环丙沙星敏感 MRSA（MIC90<或=0.03 mg/L）和 CA-MRSA（MIC90=0.06 mg/L）具有很强的活性。对于所有侵袭性肺炎链球菌分离株，奈莫沙星的活性（MIC90=0.06 mg/L）与吉米沙星相似，明显优于左氧氟沙星（MIC90=2 mg/L）和莫西沙星（MIC90=0.25 mg/L）。奈莫沙星对左氧氟沙星耐药分离株的活性比左氧氟沙星高 32-64 倍。奈莫沙星对环丙沙星耐药 MRSA（MIC90=1 mg/L）、万古霉素中介 MRSA（MIC90=2 mg/L）、DNS-MRSA（MIC90=1 mg/L）、万古霉素敏感肠球菌（粪肠球菌 MIC90=2 mg/L，屎肠球菌 MIC90=4 mg/L）和 VRE（粪肠球菌 MIC90=4 mg/L，屎肠球菌 MIC90=16 mg/L）的活性有限。
我们的研究结果表明，奈莫沙星在治疗 MSSA、环丙沙星敏感 MRSA 和具有不同耐药表型的肺炎链球菌引起的感染方面可能具有潜在的作用。
