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耐甲氧西林敏感和耐药金黄色葡萄球菌的抗菌药物敏感性谱:印度孟买一家三级护理中心的达托霉素最低抑菌浓度为重点。

Antimicrobial susceptibility profiles of meticillin-susceptible and -resistant Staphylococcus aureus: focus on daptomycin minimum inhibitory concentrations at a tertiary care centre in Mumbai, India.

机构信息

Research Laboratories, P.D. Hinduja National Hospital & Medical Research Centre, Mahim, Mumbai 400016, India.

出版信息

Int J Antimicrob Agents. 2010 Sep;36(3):267-70. doi: 10.1016/j.ijantimicag.2010.05.013. Epub 2010 Jul 1.

Abstract

In this study, daptomycin minimum inhibitory concentrations (MICs) for Staphylococcus aureus isolates were determined using Etest strips and were correlated with staphylococcal cassette chromosome mec (SCCmec) types and Panton-Valentine leukocidin (PVL) gene positivity. In total, 60 meticillin-resistant S. aureus (MRSA) and 60 meticillin-susceptible S. aureus (MSSA) isolates from clinical samples were subjected to antimicrobial susceptibility testing by disk diffusion according to Clinical and Laboratory Standards Institute guidelines, polymerase chain reaction (PCR) detection of PVL and mecA genes, and SCCmec typing. Daptomycin MICs were determined using Etest strips. The mecA gene was present in all MRSA isolates and was absent in 59 MSSA isolates. The PVL gene was present in 41 MRSA isolates and 25 MSSA isolates. Amongst the MRSA isolates, 10 were SCCmec type III, 27 were SCCmec IV and 23 were SCCmec V. Moreover, 26 SCCmec IV and 15 SCCmec V isolates were PVL-positive. All SCCmec III isolates were multidrug-resistant and PVL-negative. Daptomycin MICs ranged from 0.047 microg/mL to 1 microg/mL for MRSA and from 0.19 microg/mL to 1 microg/mL for MSSA. All MRSA and MSSA isolates were susceptible to daptomycin. Although SCCmec III MRSA and PVL-positive MSSA were resistant to more antimicrobial classes than SCCmec IV and V MRSA and PVL-negative MSSA, there does not appear to be a significant correlation between SCCmec types, PVL positivity and daptomycin MICs. MICs were not as low as expected for a newly introduced drug.

摘要

在这项研究中,使用 Etest 条测定了金黄色葡萄球菌分离株的达托霉素最小抑菌浓度(MIC),并将其与葡萄球菌盒式染色体 mec(SCCmec)类型和杀白细胞素(PVL)基因阳性相关联。总共从临床样本中分离出 60 株耐甲氧西林金黄色葡萄球菌(MRSA)和 60 株甲氧西林敏感金黄色葡萄球菌(MSSA),并根据临床和实验室标准协会指南进行了药敏试验,采用聚合酶链反应(PCR)检测 PVL 和 mecA 基因以及 SCCmec 分型。使用 Etest 条测定达托霉素 MIC。mecA 基因存在于所有 MRSA 分离株中,而在 59 株 MSSA 分离株中不存在。PVL 基因存在于 41 株 MRSA 分离株和 25 株 MSSA 分离株中。在 MRSA 分离株中,10 株为 SCCmec 型 III,27 株为 SCCmec 型 IV,23 株为 SCCmec 型 V。此外,26 株 SCCmec 型 IV 和 15 株 SCCmec 型 V 分离株为 PVL 阳性。所有 SCCmec 型 III 分离株均为多药耐药且 PVL 阴性。MRSA 的达托霉素 MIC 范围为 0.047μg/ml 至 1μg/ml,MSSA 的达托霉素 MIC 范围为 0.19μg/ml 至 1μg/ml。所有 MRSA 和 MSSA 分离株均对达托霉素敏感。尽管 SCCmec 型 III MRSA 和 PVL 阳性 MSSA 对多种抗菌药物的耐药性高于 SCCmec 型 IV 和 V MRSA 和 PVL 阴性 MSSA,但 SCCmec 类型、PVL 阳性和达托霉素 MIC 之间似乎没有显著相关性。MIC 并不像新引入的药物那样低。

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