Department of Ophthalmology, Royal Liverpool University Hospital, School of Infection and Host Defence, University of Liverpool, Liverpool, United Kingdom.
Invest Ophthalmol Vis Sci. 2010 May;51(5):2519-24. doi: 10.1167/iovs.09-4638. Epub 2009 Dec 17.
To determine the minimum inhibitory concentrations (MICs) of 12 antimicrobials in current ophthalmic use and 4 potentially new alternatives against isolates from bacterial keratitis.
Bacteria were collected from cases of bacterial keratitis in six centers in the United Kingdom between 2003 and 2006. MICs were measured by using susceptibility strips containing a concentration gradient of the antimicrobials penicillin, cefuroxime, ceftazidime, chloramphenicol, gentamicin, amikacin, vancomycin, teicoplanin, ciprofloxacin, ofloxacin, levofloxacin, moxifloxacin, meropenem, linezolid, tigecycline, and daptomycin.
Isolates (n = 772) were collected including coagulase negative Staphylococcus (CNS) (30%), Pseudomonas aeruginosa (23%), Staphylococcus aureus (14%), Enterobacteriaceae (14%), and streptococci (13%). Meropenem had low MICs for most isolates. All isolates except P. aeruginosa were susceptible to tigecycline. Linezolid was active against the majority of Gram-positive pathogens. Ten percent of S. aureus and 20% of CNS isolates were methicillin resistant. When systemic breakpoints were used, 84% of S. aureus isolates were susceptible to ciprofloxacin and 98% to moxifloxacin. Of the P. aeruginosa isolates, 99% were susceptible to ceftazidime, 96% to gentamicin, 99% to ciprofloxacin and 100% to moxifloxacin. More than 97% of Enterobacteriaceae isolates were susceptible to ceftazidime, gentamicin, ciprofloxacin, and moxifloxacin.
Based on systemic breakpoint data, resistance to commonly used antimicrobials was apparent. Meropenem is a potentially effective agent for ophthalmic use, with low MICs throughout all the bacterial subgroups. Tigecycline and linezolid showed good activity against particular groups and may be useful for treating bacterial keratitis resistant to current antimicrobials. Of the fluoroquinolones, moxifloxacin showed the lowest MICs and resistance for both Gram-positive and -negative bacteria.
测定当前眼科使用的 12 种抗菌药物和 4 种潜在新替代品对来自细菌性角膜炎分离株的最低抑菌浓度（MICs）。
2003 年至 2006 年期间，从英国六个中心的细菌性角膜炎病例中收集细菌。通过使用含有抗菌药物青霉素、头孢呋辛、头孢他啶、氯霉素、庆大霉素、阿米卡星、万古霉素、替考拉宁、环丙沙星、氧氟沙星、左氧氟沙星、莫西沙星、美罗培南、利奈唑胺、替加环素和达托霉素浓度梯度的药敏条测量 MICs。
共收集了 772 株分离株，包括凝固酶阴性葡萄球菌（CNS）（30%）、铜绿假单胞菌（23%）、金黄色葡萄球菌（14%）、肠杆菌科（14%）和链球菌（13%）。大多数分离株对美罗培南的 MICs 较低。除铜绿假单胞菌外，所有分离株均对替加环素敏感。利奈唑胺对大多数革兰氏阳性病原体均具有活性。10%的金黄色葡萄球菌和 20%的 CNS 分离株对甲氧西林耐药。当使用全身药敏折点时，84%的金黄色葡萄球菌分离株对环丙沙星和 98%对莫西沙星敏感。在铜绿假单胞菌分离株中，99%对头孢他啶、96%对庆大霉素、99%对环丙沙星和 100%对莫西沙星敏感。超过 97%的肠杆菌科分离株对头孢他啶、庆大霉素、环丙沙星和莫西沙星敏感。
根据全身药敏折点数据，对常用抗菌药物的耐药性明显。美罗培南是一种具有潜在疗效的眼科药物，在所有细菌亚群中的 MICs 均较低。替加环素和利奈唑胺对特定群体表现出良好的活性，可能对治疗对当前抗菌药物耐药的细菌性角膜炎有用。在氟喹诺酮类药物中，莫西沙星对革兰氏阳性和阴性细菌的 MICs 和耐药性均最低。
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