达托霉素在金黄色葡萄球菌导管相关性感染模型中作为抗生素锁治疗是有效的。
Daptomycin is effective as antibiotic-lock therapy in a model of Staphylococcus aureus catheter-related infection.
机构信息
Infectious Diseases Research Laboratory, Infectious Diseases Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain.
Infectious Disease Division, Internal Medicine Department, Clínica Universitaria de Navarra, Navarra, Spain.
出版信息
J Infect. 2014 Jun;68(6):548-52. doi: 10.1016/j.jinf.2014.01.001. Epub 2014 Jan 8.
BACKGROUND
The effectiveness of daptomycin versus vancomycin for treating experimental methicillin-susceptible (MSSA) and methicillin-resistant Staphylococcus aureus (MRSA) catheter-related infection by antibiotic-lock technique was assessed.
METHODS
One MSSA strain and one clinical MRSA isolate were used. A preliminary in vitro study determined the minimum biofilm eradication concentration (MBEC) of vancomycin and daptomycin. An intravenous catheter was implanted in New Zealand white rabbits. Infection was induced by 24 h locking the catheter with 0.3 mL of broth culture containing MSSA or MRSA. The 24 h of antibiotic-lock treatment groups were: control, vancomycin 10 mg/mL, daptomycin 5 mg/mL and daptomycin 50 mg/mL.
RESULTS
Daptomycin showed greater in vitro activity than vancomycin against biofilm bacteria (MBECs of vancomycin and daptomycin for MSSA, >2000 mg/L and 7 mg/L; MRSA, >2000 mg/L and 15 mg/L). Daptomycin 5 mg/mL achieved significant reductions relative to vancomycin 10 mg/mL in log10 cfu recovered from catheter tips for both strains (P < 0.05). Only daptomycin 50 mg/mL achieved negative catheter tip cultures (up to 75% in MSSA and 85% in MRSA, P < 0.05), showing the greatest median log10 cfu reduction compared to controls (6.07 in MSSA and 6.59 in MRSA, P < 0.05).
CONCLUSIONS
Daptomycin 50 mg/mL showed the highest activity against both strains biofilms.
背景
评估了抗生素锁定技术治疗实验性耐甲氧西林金黄色葡萄球菌（MSSA）和耐甲氧西林金黄色葡萄球菌（MRSA）导管相关感染时，达托霉素与万古霉素的疗效。
方法
使用了一株 MSSA 菌株和一株临床分离的 MRSA 菌株。初步的体外研究确定了万古霉素和达托霉素的最低生物膜清除浓度（MBEC）。将静脉导管植入新西兰白兔体内。通过将含有 MSSA 或 MRSA 的 0.3ml 肉汤培养物锁定导管 24 小时来诱导感染。抗生素锁定治疗组的 24 小时为：对照组、万古霉素 10mg/ml、达托霉素 5mg/ml 和达托霉素 50mg/ml。
结果
达托霉素对生物膜细菌的体外活性大于万古霉素（万古霉素和达托霉素对 MSSA 的 MBECs，>2000mg/L 和 7mg/L；MRSA，>2000mg/L 和 15mg/L）。与万古霉素 10mg/ml 相比，达托霉素 5mg/ml 使两种菌株从导管尖端回收的 log10cfu 显著减少（P<0.05）。只有达托霉素 50mg/ml 才能获得阴性导管尖端培养物（MSSA 中达 75%，MRSA 中达 85%，P<0.05），与对照组相比，中位 log10cfu 减少最多（MSSA 中减少 6.07，MRSA 中减少 6.59，P<0.05）。
结论
达托霉素 50mg/ml 对两种菌株的生物膜表现出最高的活性。
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