Department of Microbiology, P. and A. Kyriakou Children's Hospital, Thibon and Levadeias, 11527 Athens, Greece.
BMC Infect Dis. 2012 Sep 25;12:228. doi: 10.1186/1471-2334-12-228.
To investigate a possible role of Cefditoren, a recently marketed in Greece third-generation oral cephalosporin in urinary infections of outpatients.
During a multicenter survey of Enterobacteriaceae causing UTIs in outpatients during 2005-2007, Cefditoren MICs were determined by agar dilution method in a randomly selected sample of uropathogens. Susceptibility against 18 other oral/parenteral antimicrobials was determined according to Clinical and Laboratory Standards Institute methodology.
A total of 563 isolates (330 Escherichia coli, 142 Proteus mirabilis and 91 Klebsiella spp) was studied; MIC50/MIC90 of Cefditoren was 0.25/0.5 mg/L respectively, with 97.1% of the isolates being inhibited at 1 mg/L. All 12 strains producing ESBLs or AmpC enzymes were resistant to cefditoren. Susceptibility rates (%) for amoxicillin/clavulanic acid, cefuroxime axetil, cefotaxime, ciprofloxacin, trimethoprim/sulfamethoxazole and fosfomycin were 93.1- 94.1- 96.8-93.1-71.9 and 92.8% respectively. Cefditoren MIC was significantly higher in nalidixic/ciprofloxacin non-susceptible strains; resistance to cefditoren was not associated with resistance to mecillinam, fosfomycin nitrofurantoin and aminoglycosides. Multivariate analysis demonstrated history of urinary infection in the last two weeks or three months as risk factors for cefditoren resistance.
Cefditoren exhibited enhanced in vitro activity against the most common uropathogens in the outpatient setting, representing an alternative oral treatment option in patients with risk factors for resistance to first-line antibiotics.
为了研究头孢地尼在希腊新上市的第三代口服头孢菌素在门诊尿路感染中的可能作用。
在 2005-2007 年对门诊尿路感染患者的肠杆菌科进行了一项多中心调查，在随机选择的尿病原体样本中通过琼脂稀释法测定头孢地尼 MIC。根据临床和实验室标准协会的方法，确定对 18 种其他口服/注射用抗菌药物的敏感性。
共研究了 563 株分离株（330 株大肠埃希菌、142 株奇异变形杆菌和 91 株肺炎克雷伯菌）；头孢地尼的 MIC50/MIC90 分别为 0.25/0.5mg/L，97.1%的分离株在 1mg/L 时被抑制。所有 12 株产 ESBLs 或 AmpC 酶的菌株均对头孢地尼耐药。阿莫西林/克拉维酸、头孢呋辛酯、头孢噻肟、环丙沙星、复方磺胺甲噁唑和磷霉素的药敏率（%）分别为 93.1-94.1-96.8-93.1-71.9 和 92.8%。头孢地尼 MIC 在萘啶酸/环丙沙星不敏感株中显著升高；头孢地尼耐药与耐美西林、磷霉素、呋喃妥因和氨基糖苷类药物无关。多变量分析表明，过去两周或三个月内有尿路感染史是头孢地尼耐药的危险因素。
头孢地尼对门诊最常见的尿路病原体具有增强的体外活性，是对一线抗生素耐药危险因素患者的替代口服治疗选择。
