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Int J Antimicrob Agents. 2010 Jul;36(1):28-32. doi: 10.1016/j.ijantimicag.2010.03.016. Epub 2010 May 4.
Skin and skin-structure infections (SSSIs) usually involve Gram-positive organisms. Prompt initiation of appropriate antimicrobial treatment is essential for achieving a favourable outcome in severe cases. Empirical antibacterial therapy should be based on several considerations, including patient risk factors, expected pathogens and local/regional susceptibility profiles, among others. In the present study, we evaluated the antimicrobial susceptibility patterns of Gram-positive bacteria isolated from patients with SSSIs hospitalised in European medical centres. A total of 3573 bacterial isolates were collected from 33 medical centres located in 13 European countries as well as Israel over a 6-year period (2003-2008) and were tested for susceptibility to daptomycin and other comparator agents by reference broth microdilution methods in a central laboratory. The most frequently isolated organisms were Staphylococcus aureus (71.1%), beta-haemolytic streptococci (10.5%) and enterococci (9.3%). Overall, rates of methicillin-resistant S. aureus (MRSA) and vancomycin-resistant enterococci (VRE) were 22.5% and 5.1%, respectively, but with great intercountry variation. The overall MRSA rate varied slightly during the study period, but with no overall tendency toward increase or decrease, whilst the overall VRE rate consistently increased from 1.5% in 2003 to 11.0% in 2008. Daptomycin and linezolid were the most active agents tested overall. All isolates monitored were considered susceptible to daptomycin, and only one isolate (Enterococcus faecium) was categorised as non-susceptible to linezolid. In conclusion, the results of this contemporary surveillance study indicate that daptomycin and linezolid retain sustained in vitro activity against Gram-positive cocci isolated from patients hospitalised with SSSI in numerous European medical centres.
皮肤和皮肤结构感染（SSSIs）通常涉及革兰阳性菌。在严重病例中，及时开始适当的抗菌治疗对于获得良好的结果至关重要。经验性抗菌治疗应基于多种考虑因素，包括患者的危险因素、预期病原体以及当地/区域的药敏谱等。在本研究中，我们评估了来自欧洲医疗中心住院的 SSSI 患者分离的革兰阳性菌的抗菌药敏模式。在 6 年期间（2003-2008 年），从位于 13 个欧洲国家和以色列的 33 个医疗中心收集了 3573 株细菌分离株，并在一个中央实验室中通过参考肉汤微量稀释法测试了它们对达托霉素和其他比较剂的药敏性。最常分离的病原体是金黄色葡萄球菌（71.1%）、β-溶血性链球菌（10.5%）和肠球菌（9.3%）。总的来说，耐甲氧西林金黄色葡萄球菌（MRSA）和万古霉素耐药肠球菌（VRE）的发生率分别为 22.5%和 5.1%，但存在很大的国家间差异。研究期间，MRSA 的总体发生率略有变化，但没有总体增加或减少的趋势，而 VRE 的总体发生率从 2003 年的 1.5%持续增加到 2008 年的 11.0%。达托霉素和利奈唑胺是总体上最有效的测试药物。所有监测到的分离株均被认为对达托霉素敏感，只有一个分离株（屎肠球菌）被归类为对利奈唑胺耐药。总之，这项当代监测研究的结果表明，达托霉素和利奈唑胺对来自欧洲多个医疗中心住院的 SSSI 患者分离的革兰阳性球菌保持持续的体外活性。
