[临床分离株对醋酸麦迪霉素敏感性的年度变化]

[Annual changes in susceptibility of clinical isolates to midecamycin acetate].

作者信息

Deguchi K, Yokota N, Koguchi M, Nakane Y, Fukushima Y, Fukayama S, Ishihara R, Oda S, Tanaka S, Sato K

机构信息

Section of Studies, Tokyo Clinical Research Center.

出版信息

Jpn J Antibiot. 1990 Aug;43(8):1341-52.

PMID:2283704

Abstract

To investigate annual changes in the susceptibility of clinical isolates to midecamycin acetate (MDM-AC), minimum inhibitory concentrations (MICs) of MDM-AC were determined for clinical isolates obtained from outpatients since 1985. MDM-AC-resistant strains of Staphylococcus spp. and Streptococcus spp. have shown similar degrees of resistance to midecamycin and josamycin. Regarding this as macrolide resistance, proportions of macrolide-resistant strains tended to increase for Staphylococcus aureus and Streptococcus pneumoniae but to decrease for Streptococcus pyogenes. 1. For S. aureus, 8% of the strains isolated in 1985, 20% in 1987 and 20% in 1989 were macrolide-resistant. Of these macrolide-resistant strains, 70% or more in 1987 and 80% or more in 1989 were methicillin-resistant S. aureus (MRSA). 2. For S. pneumoniae, 8% of the strains isolated in 1985, 12% in 1987 and 12% in 1989 were macrolide-resistant, indicating a tendency for resistant strains to increase annually. 3. For S. pyogenes, 8% of the strains isolated in 1985, 4% in 1987 and 0% in 1989 were macrolide-resistant, showing a decreasing tendency. 4. MDM-AC is still thought to be a clinically useful antibacterial agent because it still shows antibacterial activity against 80% or more of Gram-positive cocci clinically isolated in recent years and a low degree of induction of macrolide resistance in Staphylococcus spp.

摘要

为研究临床分离株对醋酸麦迪霉素（MDM-AC）敏感性的年度变化，对1985年以来门诊患者的临床分离株测定了MDM-AC的最低抑菌浓度（MIC）。葡萄球菌属和链球菌属的MDM-AC耐药菌株对麦迪霉素和交沙霉素显示出相似程度的耐药性。将此视为大环内酯类耐药，金黄色葡萄球菌和肺炎链球菌的大环内酯类耐药菌株比例呈上升趋势，而化脓性链球菌的比例呈下降趋势。1. 对于金黄色葡萄球菌，1985年分离的菌株中有8%、1987年有20%、1989年有20%为大环内酯类耐药。在这些大环内酯类耐药菌株中，1987年70%以上、1989年80%以上为耐甲氧西林金黄色葡萄球菌（MRSA）。2. 对于肺炎链球菌，1985年分离的菌株中有8%、1987年有12%、1989年有12%为大环内酯类耐药，表明耐药菌株有逐年增加的趋势。3. 对于化脓性链球菌，1985年分离的菌株中有8%、1987年有4%、1989年有0%为大环内酯类耐药，呈下降趋势。4. MDM-AC仍被认为是一种临床有用的抗菌剂，因为它对近年来临床分离的80%以上革兰氏阳性球菌仍显示抗菌活性，并且在葡萄球菌属中诱导大环内酯类耐药的程度较低。