JMI Laboratories, North Liberty, Iowa, USA.
Antimicrob Agents Chemother. 2012 Jun;56(6):2933-40. doi: 10.1128/AAC.00330-12. Epub 2012 Apr 2.
The Assessing Worldwide Antimicrobial Resistance Evaluation (AWARE) surveillance program is a sentinel resistance monitoring system designed to track the activity of ceftaroline and comparator agents. In the United States, a total of 8,434 isolates were collected during the 2010 surveillance program from 65 medical centers distributed across the nine census regions (5 to 10 medical centers per region). All organisms were isolated from documented infections, including 3,055 (36.2%) bloodstream infections, 2,282 (27.1%) respiratory tract infections, 1,965 (23.3%) acute bacterial skin and skin structure infections, 665 (7.9%) urinary tract infections, and 467 (5.5%) miscellaneous other infection sites. Ceftaroline was the most potent β-lactam agent tested against staphylococci. The MIC(90) values were 1 μg/ml for methicillin-resistant Staphylococcus aureus (MRSA; 98.4% susceptible) and 0.5 μg/ml for methicillin-resistant coagulase-negative staphylococci (CoNS). Ceftaroline was 16- to 32-fold more potent than ceftriaxone against methicillin-susceptible staphylococcal strains. All staphylococcus isolates (S. aureus and CoNS) were inhibited at ceftaroline MIC values of ≤ 2 μg/ml. Ceftaroline also displayed potent activity against streptococci (MIC(90), 0.015 μg/ml for beta-hemolytic streptococci; MIC(90), 0.25 μg/ml for penicillin-resistant Streptococcus pneumoniae). Potent activity was also shown against Gram-negative pathogens (Haemophilus influenzae, Haemophilus parainfluenzae, and Moraxella catarrhalis). Furthermore, wild-type strains of Enterobacteriaceae (non-extended-spectrum β-lactamase [ESBL]-producing strains and non-AmpC-hyperproducing strains) were often susceptible to ceftaroline. Continued monitoring through surveillance networks will allow for the assessment of the evolution of resistance as this new cephalosporin is used more broadly to provide clinicians with up-to-date information to assist in antibiotic stewardship and therapeutic decision making.
评估全球抗菌药物耐药性监测（AWARE）计划是一个监测系统，旨在跟踪头孢洛林和对照药物的活性。在美国，2010 年监测计划共从分布在 9 个普查区的 65 个医疗中心收集了 8434 株分离株（每个区 5 至 10 个医疗中心）。所有分离株均来自已确诊的感染，包括 3055 株（36.2%）血流感染、2282 株（27.1%）呼吸道感染、1965 株（23.3%）急性细菌性皮肤和皮肤结构感染、665 株（7.9%）尿路感染和 467 株（5.5%）其他杂项感染部位。头孢洛林是测试葡萄球菌最有效的β-内酰胺类药物。MIC（90）值为 1μg/ml，适用于耐甲氧西林金黄色葡萄球菌（MRSA；98.4%敏感）和 0.5μg/ml，适用于耐甲氧西林凝固酶阴性葡萄球菌（CoNS）。头孢洛林对甲氧西林敏感的葡萄球菌菌株的活性比头孢曲松强 16 至 32 倍。所有葡萄球菌分离株（金黄色葡萄球菌和凝固酶阴性葡萄球菌）均被抑制在头孢洛林 MIC 值≤2μg/ml。头孢洛林对链球菌也具有很强的活性（MIC（90），β-溶血性链球菌为 0.015μg/ml；青霉素耐药肺炎链球菌为 0.25μg/ml）。对革兰氏阴性病原体（流感嗜血杆菌、副流感嗜血杆菌和卡他莫拉菌）也表现出强大的活性。此外，肠杆菌科野生型菌株（非产超广谱β-内酰胺酶[ESBL]菌株和非高产 AmpC 菌株）通常对头孢洛林敏感。通过监测网络继续监测将使我们能够评估这种新头孢菌素更广泛使用时耐药性的演变，为临床医生提供最新信息，以协助抗生素管理和治疗决策。
