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多西环素、替加环素、头孢唑林和万古霉素对金黄色葡萄球菌多个克隆株的比较时间杀菌研究。

Comparative time-kill study of doxycycline, tigecycline, cefazolin and vancomycin against several clones of Staphylococcus aureus.

作者信息

Herrera Melina, Mobilia Liliana, Posse Graciela, Limansky Adriana, Ballerini Viviana, Bantar Carlos

机构信息

Hospital San Martín, Perón 450, (3100) Paraná, Entre Ríos, Argentina..

出版信息

Curr Clin Pharmacol. 2013 Nov;8(4):332-9. doi: 10.2174/15748847113089990063.


DOI:10.2174/15748847113089990063
PMID:23590512
Abstract

BACKGROUND: We present herein, a comparative study assessing the bactericidal kinetics of tigecycline, doxycycline, cefazolin and vancomycin against several methicllin-susceptible (MSSA) and -resistant (MRSA) Staphylococcus aureus isolates recovered from patients of 24 different cities in Argentina. METHODS: After genotypic characterization, 20 strains (10 MRSA and 10 MSSA) were selected for time-kill studies. RESULTS: Vancomycin showed bactericidal effect (i.e. ≥3-log(10) CFU/mL decrease) against 50% and 10% of the MRSA strains at 4 x Minimal Inhibitory Concentration (MIC) and 2xMIC, respectively, after 24 h of incubation and displayed bactericidal activity against all MSSA isolates at 4xMIC. Cefazolin was bactericidal against 30% of MSSA strains at the higher concentration (4xMIC) and against 10% at 2 x MIC and MIC dose concentrations. The bactericidal magnitude of cefazolin observed after 24 h of incubation was lower than the vancomycin one. Albeit bacteriostactic, tigecycline at 2xMIC exerted a -1 to2-log decrease in the viable cell counts after 24-h incubation against 19 of the 20 S. aureus strains. Doxycycline was the least inhibitory of the antibiotics tested against both MRSA and MSSA, displaying no bactericidal activity in any of the cases and showing regrowth after 24 h of incubation at MIC level. CONCLUSION: Vancomycin at high concentrations showed the best activity. Cefazolin did not show the activity expected for a beta-lactam antibiotic against MSSA. Tigecycline may be a useful option in infections caused by MRSA, where bactericidal activity is not an exclusive requirement and doxycycline does not seem an attractive alternative in serious infections.

摘要

背景:我们在此展示一项比较研究,评估替加环素、强力霉素、头孢唑林和万古霉素对从阿根廷24个不同城市的患者中分离出的几种甲氧西林敏感(MSSA)和耐药(MRSA)金黄色葡萄球菌菌株的杀菌动力学。 方法:在进行基因型鉴定后,选择20株菌株(10株MRSA和10株MSSA)进行时间杀灭研究。 结果:万古霉素在4倍最低抑菌浓度(MIC)和2倍MIC时,分别在孵育24小时后对50%和10%的MRSA菌株显示出杀菌作用(即≥3个对数(10)CFU/mL减少),并在4倍MIC时对所有MSSA分离株显示出杀菌活性。头孢唑林在较高浓度(4倍MIC)时对30%的MSSA菌株有杀菌作用,在2倍MIC和MIC剂量浓度时对10%的菌株有杀菌作用。孵育24小时后观察到的头孢唑林的杀菌幅度低于万古霉素。尽管替加环素具有抑菌作用,但在2倍MIC时,孵育24小时后对20株金黄色葡萄球菌菌株中的19株活菌数减少了1至2个对数。强力霉素是所测试的抗生素中对MRSA和MSSA抑制作用最小的,在任何情况下均无杀菌活性,并且在MIC水平孵育24小时后出现再生长。 结论:高浓度的万古霉素显示出最佳活性。头孢唑林对MSSA并未显示出β-内酰胺类抗生素预期的活性。在由MRSA引起的感染中,替加环素可能是一种有用的选择,在这种感染中杀菌活性并非唯一要求,而强力霉素在严重感染中似乎不是一个有吸引力的替代选择。

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