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替考拉宁对全球引起菌血症(包括心内膜炎)的金黄色葡萄球菌菌株的活性更新(2011 - 2014年)

Update of the activity of telavancin against a global collection of Staphylococcus aureus causing bacteremia, including endocarditis (2011-2014).

作者信息

Mendes R E, Sader H S, Smart J I, Castanheira M, Flamm R K

机构信息

JMI Laboratories, 345 Beaver Kreek Centre, Suite A, North Liberty, IA, 52317, USA.

Theravance Biopharma US, Inc., South San Francisco, CA, USA.

出版信息

Eur J Clin Microbiol Infect Dis. 2017 Jun;36(6):1013-1017. doi: 10.1007/s10096-016-2865-8. Epub 2017 Jan 22.

Abstract

The efficacy and safety of telavancin is under evaluation for the treatment of subjects with complicated Staphylococcus aureus bacteremia and S. aureus right-sided infective endocarditis. This study evaluated the telavancin activity against a global collection of S. aureus causing bloodstream infections (BSI), including endocarditis, to support the development of bacteremia/endocarditis clinical indications. This study included a total of 4191 S. aureus [1490 methicillin-resistant S. aureus (MRSA)], which were unique (one per patient) clinical isolates recovered from blood samples collected during 2011-2014 in a global network of hospitals. All isolates were deemed responsible for BSI, including endocarditis, by local guidelines. Isolates were tested for susceptibility by broth microdilution. Telavancin (MIC, 0.03/0.06 μg/ml) inhibited all S. aureus at ≤0.12 μg/ml, the breakpoint for susceptibility. Equivalent minimum inhibitory concentration (MIC) values (MIC, 0.03/0.06 μg/ml) were obtained for telavancin against methicillin-susceptible S. aureus (MSSA) and MRSA isolates, as well as MRSA from community and healthcare origins. Similar telavancin activities (MIC, 0.03 μg/ml) were observed against MRSA subsets from North America and Europe, while isolates from the Asia-Pacific (APAC) and Latin America regions had MIC values of 0.06 μg/ml. MRSA with vancomycin MIC values of 2-4 μg/ml and the multidrug resistance (MDR) subset had telavancin MIC results of 0.06 μg/ml, although the MIC result obtained against these subsets remained identical to those of MSSA (MIC, 0.12 μg/ml, respectively). This study updates the telavancin in vitro activity, which continues to demonstrate great potency against invasive S. aureus, regardless of the susceptibility phenotype or demographic characteristics (100.0% susceptible), and supports the sought-after subsequent indications.

摘要

特拉万星治疗复杂性金黄色葡萄球菌菌血症和金黄色葡萄球菌右侧感染性心内膜炎患者的疗效和安全性正在评估中。本研究评估了特拉万星对全球范围内引起血流感染(BSI)(包括心内膜炎)的金黄色葡萄球菌菌株的活性,以支持菌血症/心内膜炎临床适应症的开发。本研究共纳入了4191株金黄色葡萄球菌[1490株耐甲氧西林金黄色葡萄球菌(MRSA)],这些菌株均为从2011年至2014年期间在全球医院网络采集的血样中分离出的独特(每位患者一株)临床分离株。根据当地指南,所有分离株均被认为是导致BSI(包括心内膜炎)的病原体。采用肉汤微量稀释法检测分离株的药敏情况。特拉万星(MIC,0.03/0.06μg/ml)对所有金黄色葡萄球菌的抑菌浓度均≤0.12μg/ml,此为药敏折点。特拉万星对甲氧西林敏感金黄色葡萄球菌(MSSA)、MRSA分离株以及社区来源和医疗保健机构来源的MRSA均获得了等效最低抑菌浓度(MIC)值(MIC,0.03/0.06μg/ml)。对来自北美和欧洲的MRSA亚组观察到相似的特拉万星活性(MIC,0.03μg/ml),而来自亚太地区(APAC)和拉丁美洲地区的分离株的MIC值为0.06μg/ml。万古霉素MIC值为2 - 4μg/ml的MRSA和多重耐药(MDR)亚组的特拉万星MIC结果为0.06μg/ml,尽管针对这些亚组获得的MIC结果与MSSA的结果相同(分别为MIC,0.12μg/ml)。本研究更新了特拉万星的体外活性,其继续显示出对侵袭性金黄色葡萄球菌具有强大的抗菌效力,无论药敏表型或人口统计学特征如何(100.0%敏感),并支持后续寻求的适应症。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fb89/5442220/39d5dced459a/10096_2016_2865_Fig1_HTML.jpg

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