JMI Laboratories, North Liberty, IA, USA; University of Iowa, Iowa City, IA, USA.
JMI Laboratories, North Liberty, IA, USA.
Int J Antimicrob Agents. 2018 Apr;51(4):608-611. doi: 10.1016/j.ijantimicag.2017.12.011. Epub 2017 Dec 23.
Osteomyelitis is a difficult-to-treat infection that regularly involves prolonged use of systemic antibiotics. Dalbavancin has demonstrated activity against Gram-positive isolates, and has been considered as a candidate for the treatment of osteomyelitis in adults and children. This study evaluated the activity of dalbavancin against pathogens isolated from bone and joint infections (BJI).
Eight hundred and one Staphylococcus aureus, 160 coagulase-negative staphylococci (CoNS), 164 β-haemolytic streptococci (BHS), 82 Enterococcus faecalis and 45 viridans group streptococci (VGS) causing BJI were collected consecutively (2011-2016) and tested for susceptibility by broth microdilution methods.
S. aureus (64.0%) was the most common pathogen associated with BJI, followed by BHS (13.1%) and CoNS (12.8%). All S. aureus (33.3% meticillin-resistant) isolates were susceptible to dalbavancin, linezolid and vancomycin, while daptomycin and clindamycin showed susceptibility rates of 99.5% and 89.0%, respectively. The minimum inhibitory concentration (MIC) results for dalbavancin were at least eight-fold lower than these comparators against all S. aureus. Dalbavancin was the most potent agent against CoNS (63.1% meticillin-resistant), followed by daptomycin, linezolid and vancomycin. All E. faecalis isolates were inhibited by dalbavancin at ≤0.25 mg/L (US Food and Drug Administration susceptibility breakpoint), except for three vancomycin-resistant isolates. High susceptibility rates for ampicillin (98.8%), daptomycin (100.0%), linezolid (100.0%) and vancomycin (95.1%) were obtained against E. faecalis. Dalbavancin was very active against BHS (MIC ≤0.03 µg/mL), and was the most active agent against VGS (highest MIC ≤0.06 mg/L). Ceftriaxone, daptomycin and vancomycin were also active (93.3-100.0% susceptible) against VGS, whereas clindamycin (84.4% susceptible) had marginal activity.
Dalbavancin appears to be a viable candidate for treating BJI/osteomyelitis caused by Gram-positive cocci.
骨髓炎是一种难以治疗的感染，通常需要长期使用全身抗生素。达巴万星对革兰阳性菌具有活性，已被认为是治疗成人和儿童骨髓炎的候选药物。本研究评估了达巴万星对骨和关节感染（BJI）分离病原体的活性。
连续收集了 801 株金黄色葡萄球菌、160 株凝固酶阴性葡萄球菌（CoNS）、164 株β-溶血性链球菌（BHS）、82 株粪肠球菌和 45 株草绿色链球菌（VGS），这些菌株均为引起 BJI 的病原菌，采用肉汤微量稀释法进行药敏试验。
金黄色葡萄球菌（64.0%）是与 BJI 相关的最常见病原体，其次是 BHS（13.1%）和 CoNS（12.8%）。所有金黄色葡萄球菌（33.3%耐甲氧西林）分离株均对达巴万星、利奈唑胺和万古霉素敏感，而达托霉素和克林霉素的敏感率分别为 99.5%和 89.0%。达巴万星对所有金黄色葡萄球菌的最低抑菌浓度（MIC）结果至少比这些对照药物低 8 倍。达巴万星对 CoNS（63.1%耐甲氧西林）最有效，其次是达托霉素、利奈唑胺和万古霉素。除了 3 株万古霉素耐药株外，所有粪肠球菌分离株均被达巴万星抑制在≤0.25mg/L（美国食品和药物管理局药敏折点）。氨苄西林（98.8%）、达托霉素（100.0%）、利奈唑胺（100.0%）和万古霉素（95.1%）对粪肠球菌具有很高的敏感性。达巴万星对 BHS 非常有效（MIC≤0.03μg/mL），对草绿色链球菌最有效（最高 MIC≤0.06mg/L）。头孢曲松、达托霉素和万古霉素对草绿色链球菌也具有活性（93.3-100.0%敏感），而克林霉素（84.4%敏感）则具有边缘活性。
达巴万星似乎是治疗革兰阳性球菌引起的 BJI/骨髓炎的可行候选药物。
