Hodille E, Delouere L, Bouveyron C, Meugnier H, Bes M, Tristan A, Laurent F, Vandenesch F, Lina G, Dumitrescu O
Centre de référence des staphylocoques, institut des agents infectieux, hospices civils de Lyon, 69495 Lyon, France; International Center for Infectiology Research, 69007 Lyon, France; CNRS UMR5308, Inserm U1111, École normale supérieure de Lyon, université Lyon 1, 69495 Lyon, France.
Centre de référence des staphylocoques, institut des agents infectieux, hospices civils de Lyon, 69495 Lyon, France.
Med Mal Infect. 2017 Mar;47(2):152-157. doi: 10.1016/j.medmal.2016.10.004. Epub 2016 Nov 14.
We assessed the in vitro activity of ceftobiprole on 440 Staphylococcus aureus clinical strains isolated from bronchopulmonary infections (2010-2014).
S. aureus isolates were characterized for methicillin resistance, PVL status, and clonal complex. All isolates were tested for minimal inhibitory concentrations (MIC) determination by broth microdilution method for ceftobiprole, ceftaroline fosamil, and comparator antibiotics (linezolid, tigecycline, vancomycin, and daptomycin).
A total of 325 (74%) strains were methicillin-susceptible S. aureus (MSSA) and 115 (26%) were methicillin-resistant S. aureus (MRSA); 105 (24%) S. aureus strains were PVL-positive, including 35.2% (37/105) MRSA and 64.8% (68/105) MSSA. Ceftobiprole was highly active against S. aureus with MIC of 1 mg/L, MICs ranging between 0.12 and 4mg/L (only one resistant strain, MIC of 4 mg/L). MIC and MIC were twice lower in MSSA than MRSA. Moreover, PVL MRSA were slightly more susceptible to ceftobiprole (MIC of 0.5 mg/L and MIC of 1 mg/L) than PVL MRSA (MIC and MIC of 1 mg/L). The ceftobiprole-resistant strain was also resistant to ceftaroline fosamil and presented the D239L mutation in PBP2A. The comparator antibiotics were equally active on the strains tested, with MIC of 0.5 mg/L for ceftaroline fosamil, tigecycline, and daptomycin; 1 mg/L for vancomycin; and 2 mg/L for linezolid.
Our results suggest that ceftobiprole is highly active against S. aureus and is an effective alternative to vancomycin or linezolid in the management of staphylococcal pneumonia. However, close monitoring of isolates should be maintained to prevent resistant strain diffusion.
我们评估了头孢比普对2010 - 2014年从支气管肺部感染中分离出的440株金黄色葡萄球菌临床菌株的体外活性。
对金黄色葡萄球菌分离株进行甲氧西林耐药性、杀白细胞素（PVL）状态和克隆复合体特征分析。所有分离株均采用肉汤微量稀释法测定头孢比普、头孢洛林酯和对照抗生素（利奈唑胺、替加环素、万古霉素和达托霉素）的最低抑菌浓度（MIC）。
共有325株（74%）为甲氧西林敏感金黄色葡萄球菌（MSSA），115株（26%）为甲氧西林耐药金黄色葡萄球菌（MRSA）；105株（24%）金黄色葡萄球菌菌株为PVL阳性，其中包括35.2%（37/105）的MRSA和64.8%（68/105）的MSSA。头孢比普对金黄色葡萄球菌具有高活性，MIC为1mg/L，MIC范围在0.12至4mg/L之间（仅1株耐药菌株，MIC为4mg/L）。MSSA的MIC和MIC值比MRSA低两倍。此外，PVL MRSA对头孢比普（MIC为0.5mg/L，MIC为1mg/L）的敏感性略高于非PVL MRSA（MIC和MIC均为1mg/L）。耐头孢比普菌株也对头孢洛林酯耐药，并在青霉素结合蛋白2A（PBP2A）中出现D239L突变。对照抗生素对受试菌株的活性相当，头孢洛林酯、替加环素和达托霉素的MIC为0.5mg/L；万古霉素为1mg/L；利奈唑胺为2mg/L。
我们的结果表明，头孢比普对金黄色葡萄球菌具有高活性，在治疗葡萄球菌肺炎方面是万古霉素或利奈唑胺的有效替代药物。然而，应持续密切监测分离株，以防止耐药菌株传播。
