Division of Infectious Diseases, Universidade Federal de São Paulo (UNIFESP/EPM), São Paulo, Brazil.
J Antimicrob Chemother. 2011 Sep;66(9):2070-4. doi: 10.1093/jac/dkr239. Epub 2011 Jun 29.
To comparatively evaluate the antimicrobial activities of colistin and polymyxin B with those of other antimicrobials against a worldwide collection of 40 625 Gram-negative bacilli.
Antimicrobial susceptibility testing was performed and interpreted using the CLSI broth microdilution method except for colistin against Enterobacteriaceae.
The polymyxins showed potent in vitro activities (MIC₉₀, ≤ 0.5-1 mg/L) against this large collection of clinical isolates, with very low resistance rates (< 0.1%-1.5%). Resistance to the polymyxins remained stable among organisms tested except for Klebsiella spp. isolates collected from the Asia-Pacific and Latin American regions, where a trend towards greater resistance was observed (P ≤ 0.05). In addition, an important reduction in imipenem susceptibility among Acinetobacter spp. and Klebsiella spp. was demonstrated in most geographical regions.
Although the polymyxins showed excellent in vitro activity against the vast majority of Gram-negative bacilli evaluated, a trend to greater resistance was observed in the Asia-Pacific and Latin American regions. Therefore, the clinical use of polymyxins must be cautious and surveillance monitored.
比较黏菌素和多黏菌素 B 与其他抗菌药物对全球 40625 株革兰氏阴性杆菌的抗菌活性。
采用 CLSI 肉汤微量稀释法进行抗菌药物敏感性试验和解释，除黏菌素对肠杆菌科的抗菌活性外。
多黏菌素对这一大批临床分离株具有很强的体外活性（MIC90，≤0.5-1mg/L），耐药率非常低（<0.1%-1.5%）。除亚太地区和拉丁美洲地区分离的肺炎克雷伯菌外，多黏菌素的耐药性在检测的病原体中保持稳定，在这些地区观察到耐药性呈上升趋势（P≤0.05）。此外，在大多数地区，耐碳青霉烯类的不动杆菌属和肺炎克雷伯菌属对亚胺培南的敏感性显著降低。
虽然黏菌素对评估的绝大多数革兰氏阴性杆菌具有极好的体外活性，但在亚太地区和拉丁美洲地区观察到耐药性呈上升趋势。因此，黏菌素的临床应用必须谨慎，并进行监测。
