Kaku Norihito, Morinaga Yoshitomo, Takeda Kazuaki, Kosai Kosuke, Uno Naoki, Hasegawa Hiroo, Miyazaki Taiga, Izumikawa Koichi, Mukae Hiroshi, Yanagihara Katsunori
Department of Laboratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, Japan.
Department of Laboratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, Japan.
Int J Med Microbiol. 2016 Sep;306(6):421-8. doi: 10.1016/j.ijmm.2016.05.010. Epub 2016 May 19.
Tedizolid (TZD) is a second-generation oxazolidinone and demonstrates potent in-vitro activity against multidrug-resistant Gram-positive bacteria. Phase III studies in patients with acute bacterial skin and skin structure infections (ABSSSI) have demonstrated the non-inferiority of TZD to linezolid (LZD). However, there are only a few studies that show the effect of TZD in pulmonary infections. In this study, we investigated the effect of TZD in a murine model of hematogenous pulmonary infection caused by methicillin-resistant Staphylococcus aureus (MRSA). The mice were treated either twice daily with saline (control), 25mg/kg of vancomycin (low-VAN), 110mg/kg of vancomycin (high-VAN), 120mg/kg of LZD or once daily with 20mg/kg of TZD. As compared to the control, the low- and high-VAN treatment groups, LZD and TZD significantly improved the survival rate, reduced the bacterial count in the lungs. Furthermore, TZD decreased the area of central bacterial colony zone (CBCZ) at 36h post-inoculation, compared with the control. In addition, we investigated the immunomodulatory effect of TZD by evaluating the plasma concentrations of the inflammatory cytokines. Although there were no significant differences in the bacterial count in the lungs amongst the drugs at 26h post-inoculation, TZD and LZD significantly improved the plasma concentrations of TNF-alpha, IL-6 and MIP-2, in comparison with the control. In this study, both TZD and LZD demonstrated antimicrobial and immunomodulatory efficacy in a murine model of hematogenous pulmonary infection caused by MRSA.
替加环素(TZD)是第二代恶唑烷酮类药物,对多重耐药革兰氏阳性菌具有强大的体外活性。针对急性细菌性皮肤及皮肤结构感染(ABSSSI)患者的III期研究已证明TZD不劣于利奈唑胺(LZD)。然而,仅有少数研究显示TZD在肺部感染中的作用。在本研究中,我们调查了TZD在耐甲氧西林金黄色葡萄球菌(MRSA)引起的血源性肺部感染小鼠模型中的作用。小鼠分别每日两次接受生理盐水治疗(对照组)、25mg/kg万古霉素(低剂量万古霉素组)、110mg/kg万古霉素(高剂量万古霉素组)、120mg/kg利奈唑胺治疗,或每日一次接受20mg/kg替加环素治疗。与对照组相比,低剂量和高剂量万古霉素治疗组、利奈唑胺组和替加环素组显著提高了生存率,降低了肺部细菌数量。此外,与对照组相比接种后36小时替加环素组减少了中央细菌菌落区(CBCZ)面积。另外,我们通过评估炎性细胞因子的血浆浓度来研究替加环素的免疫调节作用。虽然接种后26小时各药物组肺部细菌数量无显著差异,但与对照组相比,替加环素组和利奈唑胺组显著提高了肿瘤坏死因子-α、白细胞介素-6和巨噬细胞炎性蛋白-2的血浆浓度。在本研究中,替加环素和利奈唑胺在MRSA引起的血源性肺部感染小鼠模型中均显示出抗菌和免疫调节功效。