Sader Helio S, Farrell David J, Flamm Robert K, Jones Ronald N
JMI Laboratories, 345 Beaver Kreek Center, Suite A, North Liberty, IA 52317, USA.
JMI Laboratories, 345 Beaver Kreek Center, Suite A, North Liberty, IA 52317, USA.
J Glob Antimicrob Resist. 2015 Sep;3(3):161-165. doi: 10.1016/j.jgar.2015.04.003. Epub 2015 May 22.
This study evaluated daptomycin activity trends among meticillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococci (VRE) over a 5-year period (2009-2013). Consecutive, unique patient isolates of clinical significance were collected in 67 European (EU) (17 nations) and 145 US medical centres and were susceptibility tested in a central reference laboratory against daptomycin and various comparators by CLSI broth microdilution methods. MIC results were interpreted according to EUCAST and CLSI breakpoint criteria (2014). A total of (EU/USA) 14245/22967 S. aureus (26.3/49.8% MRSA), 3043/2848 Enterococcus faecalis (1.6/3.5% vancomycin-resistant) and 1827/1537 Enterococcus faecium (29.5/77.7% vancomycin-resistant) were evaluated. Isolates were mainly from complicated skin and skin-structure infections (40%) and bacteraemia (32%). The highest MRSA rates were found in Portugal (66.3%), Russia (52.2%) and the USA (49.8%), whereas the highest rates of vancomycin-resistant E. faecium (VREFM) were observed in the USA (77.7%), Poland (63.1%) and Ireland (54.5%). VREFM and vancomycin-resistant E. faecalis (VREF) were observed in 15 and 8 EU nations, respectively. Daptomycin susceptibility rates were (EU/USA) 99.94/99.97%, 100.0/99.7% and 100.0/99.96% for S. aureus, E. faecium and E. faecalis, respectively. Daptomycin was very active against MRSA (MIC, 0.25/0.5mg/L in Europe and USA), VREF (MIC of 0.5/1mg/L and 1/2mg/L in Europe and USA, respectively) and VREFM (MIC, 2/2mg/L in Europe and USA). Among MRSA, only 6/6 (0.19/0.05%) daptomycin-non-susceptible isolates were observed in Europe (six cities in four countries)/USA (six states), with no increasing trend over the study period. Only two daptomycin-non-susceptible VRE were identified, both E. faecium from the USA.
本研究评估了2009年至2013年这5年间，达托霉素对耐甲氧西林金黄色葡萄球菌（MRSA）和耐万古霉素肠球菌（VRE）的活性变化趋势。在欧洲67家（17个国家）和美国145家医疗中心收集具有临床意义的连续、独特患者分离株，并在一家中央参考实验室采用CLSI肉汤微量稀释法对达托霉素及各种对照药物进行药敏试验。MIC结果根据EUCAST和CLSI（2014年）的折点标准进行解读。共评估了（欧洲/美国）14245/22967株金黄色葡萄球菌（26.3%/49.8%为MRSA）、3043/2848株粪肠球菌（1.6%/3.5%对万古霉素耐药）和1827/1537株屎肠球菌（29.5%/77.7%对万古霉素耐药）。分离株主要来自复杂性皮肤和皮肤结构感染（40%）及菌血症（32%）。MRSA发生率最高的国家为葡萄牙（66.3%）、俄罗斯（52.2%）和美国（49.8%），而耐万古霉素屎肠球菌（VREFM）发生率最高的国家为美国（77.7%）、波兰（63.1%）和爱尔兰（54.5%）。分别在15个和8个欧洲国家观察到VREFM和耐万古霉素粪肠球菌（VREF）。达托霉素对金黄色葡萄球菌、屎肠球菌和粪肠球菌的药敏率分别为（欧洲/美国）99.94%/99.97%、100.0%/99.7%和100.0%/99.96%。达托霉素对MRSA（欧洲和美国的MIC分别为0.25/0.5mg/L）、VREF（欧洲和美国的MIC分别为0.5/1mg/L和1/2mg/L）和VREFM（欧洲和美国的MIC均为2/2mg/L）活性很强。在MRSA中，欧洲（4个国家的6个城市）/美国（6个州）仅观察到6/6（0.19%/0.05%）株对达托霉素不敏感的分离株，在研究期间无上升趋势。仅鉴定出2株对达托霉素不敏感的VRE，均为来自美国的屎肠球菌。
