Department of Medical Microbiology, College of Medicine, University of Manitoba Diagnostic Services Manitoba, Winnipeg, Canada.
Diagnostic Services Manitoba, Winnipeg, Canada.
Clin Infect Dis. 2015 Sep 15;61 Suppl 2:S58-68. doi: 10.1093/cid/civ534.
Telavancin is a semisynthetic lipoglycopeptide derivative of vancomycin. Telavancin has a dual mechanism of antibacterial action, disrupting peptidoglycan synthesis and cell membrane function. In 2014, the Clinical and Laboratory Standards Institute (CLSI) revised the antimicrobial susceptibility testing method for telavancin, resulting in minimum inhibitory concentration (MIC) determinations that are more accurate and reproducible and demonstrate greater in vitro potency than shown with the previous testing method. The CLSI testing method changes coincided with revised telavancin MIC interpretive break point criteria for susceptibility approved by the US Food and Drug Administration for Staphylococcus aureus (≤0.12 µg/mL), Streptococcus pyogenes (≤0.12 µg/mL), Streptococcus agalactiae (≤0.12 µg/mL), Streptococcus anginosus group (≤0.06 µg/mL), and Enterococcus faecalis (vancomycin susceptible, ≤0.25 µg/mL). Telavancin is equally potent against methicillin-susceptible S. aureus (MSSA) and methicillin-resistant S. aureus (MRSA). It demonstrates activity against isolates of heterogeneous vancomycin-intermediate S. aureus and vancomycin-intermediate S. aureus but is poorly active against vancomycin-resistant S. aureus. It also demonstrates potent activity against Staphylococcus epidermidis and Streptococcus spp. (MIC90 ≤0.03 µg/mL). Thus far, it has not been possible to select for high-level telavancin resistance in the laboratory using serially passaged clinical isolates of MRSA and MSSA.
替拉万星是万古霉素的半合成糖肽衍生物。替拉万星具有双重抗菌作用机制，可破坏肽聚糖合成和细胞膜功能。2014 年，临床和实验室标准协会（CLSI）修订了替拉万星的抗菌药物敏感性检测方法，使得最低抑菌浓度（MIC）的测定结果更加准确和可重复，并且体外活性比以前的检测方法更强。CLSI 检测方法的变化与美国食品和药物管理局（FDA）批准的修订后的替拉万星 MIC 解释性断点标准相吻合，用于金黄色葡萄球菌（≤0.12μg/ml）、化脓性链球菌（≤0.12μg/ml）、无乳链球菌（≤0.12μg/ml）、咽峡炎链球菌组（≤0.06μg/ml）和粪肠球菌（对万古霉素敏感，≤0.25μg/ml）。替拉万星对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）同样有效。它对异质性万古霉素中介金黄色葡萄球菌和万古霉素中介金黄色葡萄球菌的分离株具有活性，但对万古霉素耐药的金黄色葡萄球菌活性较差。它对表皮葡萄球菌和链球菌属也具有很强的活性（MIC90≤0.03μg/ml）。迄今为止，还无法通过连续传代临床分离的 MRSA 和 MSSA 在实验室中选择高水平的替拉万星耐药性。
