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评价利奈唑胺、万古霉素、庆大霉素和环丙沙星在金黄色葡萄球菌导管相关性感染的抗生素锁定技术兔模型中的应用。

Evaluation of linezolid, vancomycin, gentamicin and ciprofloxacin in a rabbit model of antibiotic-lock technique for Staphylococcus aureus catheter-related infection.

机构信息

Infectious Diseases Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain.

出版信息

J Antimicrob Chemother. 2010 Mar;65(3):525-30. doi: 10.1093/jac/dkp499. Epub 2010 Jan 18.

DOI:10.1093/jac/dkp499
PMID:20083550
Abstract

BACKGROUND

The effectiveness of linezolid, vancomycin, ciprofloxacin and gentamicin for treating experimental Staphylococcus aureus catheter-related infection by the antibiotic-lock technique was assessed.

METHODS

Two methicillin-susceptible (MSSA) ATCC strains and two methicillin-resistant (MRSA) clinical strains were used. New Zealand white rabbits were surgically implanted with a silicone intravenous catheter. Infection was induced by filling and locking the catheter with 0.3 mL of broth culture containing S. aureus, with turbidity equivalent to that of a 0.5 McFarland standard. Eighteen hours later the antibiotic-lock technique was started and continued for 24 h. Treatment groups were: control without treatment; 2000 mg/L linezolid; 2000 mg/L vancomycin; 2000 mg/L ciprofloxacin; and 40,000 mg/L gentamicin.

RESULTS

Linezolid and vancomycin showed equivalent activity, achieving significant reductions in log(10) cfu recovered from catheter tips in one MSSA strain (>1.12) and one MRSA strain (>0.77) as compared with controls (P < 0.05). Ciprofloxacin achieved significant log(10) cfu reductions in MSSA strains relative to controls (>2.51, P < 0.01). In one MSSA strain, ciprofloxacin showed a larger reduction in log(10) cfu than linezolid or vancomycin (P < 0.01). Gentamicin was the only antibiotic achieving negative catheter tip cultures (up to 87.5% in MSSA and up to 40% in MRSA, P < 0.01), and showed the greatest log(10) cfu reduction compared with controls (>4.25 in MSSA and >2.93 in MRSA, P < 0.05) and significant differences relative to the remaining treatment groups (P < 0.05 in both MSSA and MRSA).

CONCLUSIONS

Gentamicin showed the highest activity against both MSSA and MRSA biofilms.

摘要

背景

通过抗生素锁定技术评估了利奈唑胺、万古霉素、环丙沙星和庆大霉素治疗金黄色葡萄球菌导管相关感染的效果。

方法

使用了 2 株耐甲氧西林金黄色葡萄球菌(MSSA)ATCC 株和 2 株耐甲氧西林金黄色葡萄球菌(MRSA)临床株。新西兰白兔通过手术植入硅胶静脉导管。将含有金黄色葡萄球菌的 0.3 毫升肉汤培养物填充并锁定导管,浊度相当于 0.5 McFarland 标准,从而诱导感染。18 小时后开始使用抗生素锁定技术并持续 24 小时。治疗组为:无治疗对照;2000mg/L 利奈唑胺;2000mg/L 万古霉素;2000mg/L 环丙沙星;40000mg/L 庆大霉素。

结果

利奈唑胺和万古霉素表现出相当的活性,与对照组相比,1 株 MSSA 株(>1.12)和 1 株 MRSA 株(>0.77)从导管尖端回收的对数 10 cfu 显著减少(P < 0.05)。环丙沙星与对照组相比,对 MSSA 株的对数 10 cfu 减少有显著差异(>2.51,P < 0.01)。在 1 株 MSSA 株中,与利奈唑胺或万古霉素相比,环丙沙星对 log 10 cfu 的减少更大(P < 0.01)。庆大霉素是唯一一种获得阴性导管尖端培养物的抗生素(在 MSSA 中高达 87.5%,在 MRSA 中高达 40%,P < 0.01),与对照组相比,对 log 10 cfu 的减少最大(在 MSSA 中>4.25,在 MRSA 中>2.93,P < 0.05),与其余治疗组相比差异显著(在 MSSA 和 MRSA 中均为 P < 0.05)。

结论

庆大霉素对 MSSA 和 MRSA 生物膜表现出最高的活性。

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