Department of Clinical Microbiology, Health Sciences Centre, MS673-820 Sherbrook St., Winnipeg, Manitoba R3A1R9, Canada.
Antimicrob Agents Chemother. 2011 Jun;55(6):2837-46. doi: 10.1128/AAC.01787-10. Epub 2011 Mar 14.
The in vitro activities of ceftaroline and comparative agents were determined for a collection of the most frequently isolated bacterial pathogens from hospital-associated patients across Canada in 2009 as part of the ongoing CANWARD surveillance study. In total, 4,546 isolates from 15 sentinel Canadian hospital laboratories were tested using the Clinical and Laboratory Standards Institute (CLSI) broth microdilution method. Compared with other cephalosporins, including ceftobiprole, cefepime, and ceftriaxone, ceftaroline exhibited the greatest potency against methicillin-susceptible Staphylococcus aureus (MSSA), with a MIC₉₀ of 0.25 μg/ml. Ceftaroline also demonstrated greater potency than ceftobiprole against community-associated methicillin-resistant S. aureus (MRSA) (MIC₉₀, 0.5 μg/ml) and health care-associated MRSA (MIC₉₀, 1 μg/ml) and was at least 4-fold more active than other cephalosporins against Staphylococcus epidermidis; all isolates of MSSA and MRSA tested were susceptible to ceftaroline (MIC, ≤1 μg/ml). Against streptococci, including Streptococcus pneumoniae, ceftaroline MICs (MIC₉₀, ≤0.03 μg/ml) were comparable to those of ceftobiprole; however, against penicillin-nonsusceptible, macrolide-nonsusceptible, and multidrug-nonsusceptible isolates of S. pneumoniae, ceftaroline demonstrated 2- to 4-fold and 4- to 16-fold more potent activities than those of ceftobiprole and ceftriaxone, respectively. All isolates of S. pneumoniae tested were susceptible to ceftaroline (MIC, ≤0.25 μg/ml). Among Gram-negative isolates, ceftaroline demonstrated potent activity (MIC₉₀, ≤0.5 μg/ml) against Escherichia coli (92.2% of isolates were susceptible), Klebsiella pneumoniae (94.1% of isolates were susceptible), Proteus mirabilis (97.7% of isolates were susceptible), and Haemophilus influenzae (100% of isolates were susceptible). Ceftaroline demonstrated less potent activity (MIC₉₀, ≥4 μg/ml) against Enterobacter spp., Acinetobacter baumannii, Pseudomonas aeruginosa, Klebsiella oxytoca, Serratia marcescens, and Stenotrophomonas maltophilia. Overall, ceftaroline demonstrated potent in vitro activity against a recent collection of the most frequently encountered Gram-positive and Gram-negative isolates from patients attending hospitals across Canada in 2009.
2009 年,作为正在进行的 CANWARD 监测研究的一部分,对来自加拿大 15 家监测医院的最常分离的医院相关病原体进行了体外研究,评估头孢洛林的活性及其与其他比较药物的活性。使用临床和实验室标准协会(CLSI)肉汤微量稀释法,共检测了 4546 株来自 15 家加拿大监测医院实验室的分离株。与其他头孢菌素类药物(包括头孢托罗、头孢吡肟和头孢曲松)相比,头孢洛林对甲氧西林敏感金黄色葡萄球菌(MSSA)的活性最强,MIC90 为 0.25μg/ml。头孢洛林对社区获得性耐甲氧西林金黄色葡萄球菌(CA-MRSA)(MIC90 为 0.5μg/ml)和医源性耐甲氧西林金黄色葡萄球菌(HA-MRSA)(MIC90 为 1μg/ml)的活性也强于头孢托罗,对表皮葡萄球菌的活性至少比其他头孢菌素类药物强 4 倍;所有测试的 MSSA 和 MRSA 分离株均对头孢洛林敏感(MIC≤1μg/ml)。对链球菌属,包括肺炎链球菌,头孢洛林的 MIC90(≤0.03μg/ml)与头孢托罗相当;然而,对于青霉素不敏感、大环内酯类不敏感和多药不敏感的肺炎链球菌分离株,头孢洛林的活性分别比头孢托罗和头孢曲松强 2-4 倍和 4-16 倍。所有测试的肺炎链球菌分离株均对头孢洛林敏感(MIC≤0.25μg/ml)。在革兰氏阴性菌分离株中,头孢洛林对大肠埃希菌(92.2%的分离株敏感)、肺炎克雷伯菌(94.1%的分离株敏感)、奇异变形杆菌(97.7%的分离株敏感)和流感嗜血杆菌(100%的分离株敏感)具有很强的活性(MIC90,≤0.5μg/ml)。头孢洛林对肠杆菌科、鲍曼不动杆菌、铜绿假单胞菌、催产克雷伯菌、粘质沙雷菌和嗜麦芽窄食单胞菌的活性较弱(MIC90,≥4μg/ml)。总的来说,头孢洛林对 2009 年来自加拿大各地医院患者的最常见革兰氏阳性和革兰氏阴性分离株的最近一次采集显示出很强的体外活性。