Widmer A F, Frei R, Rajacic Z, Zimmerli W
Department of Internal Medicine, University Hospital, Basel, Switzerland.
J Infect Dis. 1990 Jul;162(1):96-102. doi: 10.1093/infdis/162.1.96.
Implant-associated infections are often resistant to antibiotic therapy. Routine sensitivity tests fail to predict therapeutic success. Therefore experimental in vitro tests were sought that would better correlate with drug efficacy in device-related infections. The activity of six different antibiotics against methicillin-resistant Staphylococcus epidermidis was investigated. In vivo studies were performed with the guinea pig tissue-cage animal model; in vitro studies with minimum inhibiting and bactericidal concentrations, time-kill studies of growing and stationary-phase microorganisms, the killing of glass-adherent S. epidermidis. Drug efficacy on stationary and adherent microorganisms, but not minimum inhibiting concentrations, predicted the outcome of device-related infections. Rifampin cured 12 of 12 infections and was also the most efficient drug in any experimental in vitro test. Similarly, the failure of ciprofloxacin to eradicate foreign body infections correlated with its low efficacy on stationary-phase and adherent S. epidermidis.
植入物相关感染往往对抗生素治疗耐药。常规药敏试验无法预测治疗效果。因此，人们寻求能更好地与器械相关感染中的药物疗效相关联的体外试验。研究了六种不同抗生素对耐甲氧西林表皮葡萄球菌的活性。采用豚鼠组织笼动物模型进行体内研究；进行了最低抑菌浓度和杀菌浓度的体外研究、生长和稳定期微生物的时间杀菌研究、玻璃黏附表皮葡萄球菌的杀灭研究。对稳定期和黏附微生物的药物疗效而非最低抑菌浓度可预测器械相关感染的结果。利福平治愈了12例感染中的12例，并且在任何体外试验中也是最有效的药物。同样，环丙沙星未能根除异物感染与其对稳定期和黏附表皮葡萄球菌的低效相关。
