Sader Helio S, Farrell David J, Flamm Robert K, Jones Ronald N
JMI Laboratories , North Liberty, Iowa.
Surg Infect (Larchmt). 2016 Aug;17(4):443-7. doi: 10.1089/sur.2015.209. Epub 2016 Mar 18.
Ceftaroline fosamil is a novel cephalosporin approved by the United States Food and Drug Administration (US FDA) for treatment of acute bacterial skin and skin structure infection, including those caused by methicillin-resistant Staphylococcus aureus (MRSA). We evaluated the activity of ceftaroline and comparator agents tested against S. aureus isolated from surgical skin and skin structure infections (SSSI).
Clinically substantial isolates (one/patient episode) from SSSI were consecutively collected from 64 medical centers in the United States over a 6-y period (2008-2013) and tested for susceptibility by broth microdilution methods against ceftaroline and several comparator agents.
Among 794 strains tested, 50.5% were MRSA. Ceftaroline was active against all methicillin-susceptible Staphylococcus aureus (MSSA; minimal inhibitory concentration [MIC]90, 0.25 mcg/mL) and nearly all MRSA (MIC90, 1 mcg/mL). Against MSSA, ceftaroline was 16-fold more potent than ceftriaxone (MIC90, 4 mcg/mL) and the highest ceftaroline MIC was 0.5 mcg/mL. Among MRSA, 97.5% and 100.0% of strains were inhibited at ≤1 and ≤2 mcg/mL of ceftaroline. Furthermore, 27.4% and 67.5% of MRSA were resistant to clindamycin and levofloxacin, respectively. Daptomycin (MIC50/90, 0.25/0.5 mcg/mL), linezolid (MIC50/90, 1/2 mcg/mL), tigecycline (MIC50/90, 0.06/0.12 mcg/mL) and vancomycin (MIC50/90, 1/2 mcg/mL) were also highly active against S. aureus strains.
Ceftaroline exhibited potent in vitro activity against S. aureus causing SSSI in a large number of US hospitals, including MRSA. On the basis of this in vitro data, ceftaroline fosamil may represent a valuable option for treatment of surgical SSSI, and should be further evaluated as an agent for surgical prophylaxis that would cover MRSA.
头孢洛林酯是一种新型头孢菌素,已获美国食品药品监督管理局(US FDA)批准用于治疗急性细菌性皮肤及皮肤结构感染,包括由耐甲氧西林金黄色葡萄球菌(MRSA)引起的感染。我们评估了头孢洛林及对照药物对从外科皮肤及皮肤结构感染(SSSI)中分离出的金黄色葡萄球菌的活性。
在6年期间(2008 - 2013年),从美国64个医疗中心连续收集SSSI的临床重要分离株(每个患者发作期一株),并通过肉汤微量稀释法检测其对头孢洛林及几种对照药物的敏感性。
在检测的794株菌株中,50.5%为MRSA。头孢洛林对所有甲氧西林敏感金黄色葡萄球菌(MSSA;最低抑菌浓度[MIC]90,0.25μg/mL)以及几乎所有MRSA(MIC90,1μg/mL)均有活性。对于MSSA,头孢洛林的效力比头孢曲松(MIC90,4μg/mL)高16倍,头孢洛林的最高MIC为0.5μg/mL。在MRSA中,97.5%和100.0%的菌株在头孢洛林浓度≤1μg/mL和≤2μg/mL时被抑制。此外,分别有27.4%和67.5%的MRSA对克林霉素和左氧氟沙星耐药。达托霉素(MIC50/90,0.25/0.5μg/mL)、利奈唑胺(MIC50/90,1/2μg/mL)、替加环素(MIC50/90,0.06/0.12μg/mL)和万古霉素(MIC50/90,1/2μg/mL)对金黄色葡萄球菌菌株也具有高活性。
头孢洛林对美国大量医院中引起SSSI的金黄色葡萄球菌,包括MRSA,表现出强大的体外活性。基于这些体外数据,头孢洛林酯可能是治疗外科SSSI的一个有价值的选择,并且应作为一种能覆盖MRSA的外科预防药物进一步评估。