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在美国医疗中心针对手术皮肤及皮肤结构感染分离出的金黄色葡萄球菌测试头孢洛林的抗菌活性。

Antimicrobial Activity of Ceftaroline Tested against Staphylococcus aureus from Surgical Skin and Skin Structure Infections in US Medical Centers.

作者信息

Sader Helio S, Farrell David J, Flamm Robert K, Jones Ronald N

机构信息

JMI Laboratories , North Liberty, Iowa.

出版信息

Surg Infect (Larchmt). 2016 Aug;17(4):443-7. doi: 10.1089/sur.2015.209. Epub 2016 Mar 18.

Abstract

BACKGROUND

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).

METHODS

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.

RESULTS

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.

CONCLUSIONS

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.

摘要

背景

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。

方法

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。

结果

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。

结论

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。

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