Department of Internal Medicine, National Taiwan University Hospital, Hsin-Chu Branch, Hsin-Chu, Taiwan.
Antimicrob Agents Chemother. 2011 Sep;55(9):4295-301. doi: 10.1128/AAC.00349-11. Epub 2011 Jun 13.
We studied the antimicrobial activity of fosfomycin against 960 strains of commonly encountered bacteria associated with urinary tract infection using standard agar dilution and disk diffusion methods. Species studied included 3 common species of Enterobacteriaceae, Pseudomonas aeruginosa, Acinetobacter baumannii, and Stenotrophomonas maltophilia; methicillin-susceptible and -resistant Staphylococcus aureus; and vancomycin-susceptible and resistant Enterococcus faecalis and E. faecium. MICs and inhibition zone diameters were interpreted in accordance with both the currently recommended Clinical and Laboratory Standards Institute (CLSI) criteria for urinary tract isolates of Escherichia coli and Enterococcus faecalis and the European Committee on Antimicrobial Susceptibility Testing (EUCAST) criteria for Enterobacteriaceae. Tentative zone diameter interpretive criteria were developed for species not currently published by CLSI or EUCAST. Escherichia coli was uniformly susceptible to fosfomycin, as were most strains of Klebsiella pneumoniae and Enterobacter cloacae. A. baumannii was resistant to fosfomycin, while the prevalence of resistance in P. aeruginosa and S. maltophilia was greatly affected by the choice of MIC breakpoint. New tentative zone diameter criteria for K. pneumoniae, E. cloacae, S. aureus, and E. faecium were able to be set, providing some interim laboratory guidance for disk diffusion until further breakpoint evaluations are undertaken by CLSI and EUCAST.
我们使用标准琼脂稀释和纸片扩散法研究了磷霉素对 960 株常见尿路感染相关细菌的抗菌活性。研究的菌种包括 3 种常见的肠杆菌科细菌、铜绿假单胞菌、鲍曼不动杆菌和嗜麦芽窄食单胞菌；耐甲氧西林和甲氧西林敏感的金黄色葡萄球菌；以及对万古霉素敏感和耐药的粪肠球菌和屎肠球菌。MIC 和抑菌圈直径的解释均符合目前推荐的 CLSI 标准，用于解释尿路感染的大肠埃希菌和粪肠球菌分离株，以及用于肠杆菌科的欧洲抗菌药物敏感性测试委员会（EUCAST）标准。对于 CLSI 或 EUCAST 尚未公布的菌种，制定了暂定的抑菌圈直径解释标准。大肠杆菌对磷霉素普遍敏感，大多数肺炎克雷伯菌和阴沟肠杆菌菌株也是如此。鲍曼不动杆菌对磷霉素耐药，而铜绿假单胞菌和嗜麦芽窄食单胞菌的耐药率则受到 MIC 折点选择的极大影响。能够为肺炎克雷伯菌、阴沟肠杆菌、金黄色葡萄球菌和屎肠球菌设定新的暂定抑菌圈直径标准，为纸片扩散法提供了一些临时的实验室指导，直至 CLSI 和 EUCAST 进一步评估折点。
