Department of Internal Medicine, University Hospital of Heraklion, Heraklion, Crete, Greece.
Eur J Clin Microbiol Infect Dis. 2012 Nov;31(11):3191-8. doi: 10.1007/s10096-012-1684-9. Epub 2012 Jul 1.
The alarmingly increasing resistance rates among non-fermenting Gram-negative species, particularly Pseudomonas aeruginosa and Acinetobacter baumannii, intensified the interest in alternative antibiotic treatment options. Isepamicin, an old aminoglycoside, may play a role in the treatment of patients with infections caused by those multi-drug resistant pathogens. We evaluated the antimicrobial activity of isepamicin against non-fermenting Gram-negative isolates collected of the microbiological laboratory at the University Hospital of Heraklion, Crete, Greece from 2004 to the first trimester of 2011. We tested a total of 4,219 isolates (66.2 % Pseudomonas spp., 30 % Acinetobacter spp., 3.8 % other non-fermenters). The lower respiratory tract, pus, and urine were the most frequent sites of isolation (29.7 %, 19.9 %, and 12.9 %, respectively). Overall, 2768 (65.6 %) of the evaluated isolates were susceptible to isepamicin (including 79.9 % of Pseudomonas spp, 37.2 % of Acinetobacter spp, 43.1 % of other non-fermenters). Isepamicin exhibited higher antimicrobial activity compared to broad spectrum penicillins, cephalosporins, other aminoglycosides, carbapenems, and fluoroquinolones. Only colistin was more active than isepamicin. Additionally, 41.7 % of carbapenem-resistant and 53.2 % of colistin-resistant P. aeruginosa isolates were susceptible to isepamicin. The susceptibility rates for the respective types of A. baumannii isolates were 12 % and 6.2 %. Yet, isepamicin was active against 29.2 % of A. baumannii that were resistant to all other tested aminoglycosides. Isepamicin exhibits considerable antimicrobial activity against Gram-negative non-fermenters in a region with high antimicrobial resistance. Particularly, isepamicin may provide a therapeutic option for infections from carbapenem- and colistin-resistant P. aeruginosa and other aminoglycoside-resistant A. baumannii. Further modifications in the aminoglycoside molecule may provide formulations with enhanced antimicrobial activity.
非发酵革兰氏阴性菌（尤其是铜绿假单胞菌和鲍曼不动杆菌）的耐药率令人震惊地不断上升，这使得人们对替代抗生素治疗方案产生了浓厚的兴趣。异帕米星，一种古老的氨基糖苷类药物，可能在治疗由这些多药耐药病原体引起的感染患者方面发挥作用。我们评估了异帕米星对希腊克里特岛伊拉克利翁大学医院微生物实验室在 2004 年至 2011 年初期间收集的非发酵革兰氏阴性菌分离株的抗菌活性。我们共检测了 4219 株分离株（66.2%为铜绿假单胞菌，30%为鲍曼不动杆菌，3.8%为其他非发酵菌）。下呼吸道、脓液和尿液是最常见的分离部位（分别为 29.7%、19.9%和 12.9%）。总体而言，2768 株（65.6%）被评估的分离株对异帕米星敏感（包括 79.9%的铜绿假单胞菌、37.2%的鲍曼不动杆菌和 43.1%的其他非发酵菌）。与广谱青霉素类、头孢菌素类、其他氨基糖苷类、碳青霉烯类和氟喹诺酮类药物相比，异帕米星表现出更高的抗菌活性。只有黏菌素比异帕米星更活跃。此外，41.7%的耐碳青霉烯类和 53.2%的耐黏菌素类铜绿假单胞菌分离株对异帕米星敏感。相应类型的鲍曼不动杆菌分离株的敏感性分别为 12%和 6.2%。然而，异帕米星对 29.2%的所有其他测试氨基糖苷类耐药的鲍曼不动杆菌分离株仍具有活性。异帕米星在一个具有高抗菌耐药性的地区对革兰氏阴性非发酵菌具有相当大的抗菌活性。特别是，异帕米星可能为耐碳青霉烯类和黏菌素类的铜绿假单胞菌和其他耐氨基糖苷类的鲍曼不动杆菌引起的感染提供治疗选择。对氨基糖苷类分子的进一步修饰可能会提供具有增强抗菌活性的制剂。
