Basilea Pharmaceutica International Ltd., Grenzacherstrasse 487, 4005, Basel, Switzerland.
Eur J Clin Microbiol Infect Dis. 2018 Sep;37(9):1653-1659. doi: 10.1007/s10096-018-3295-6. Epub 2018 Jun 6.
Coagulase-negative staphylococci (CoNS) are a significant cause of bacteraemia, the treatment of which is becoming increasingly complex due to the emergence of multidrug-resistant strains. This study aimed to evaluate the in vitro activity of ceftobiprole, an advanced-generation cephalosporin, as compared with other antimicrobial agents against CoNS from patients with bacteraemia. As part of the British Society for Antimicrobial Chemotherapy (BSAC) Bacteraemia Surveillance Programme, 650 blood isolates of CoNS were obtained from patients with bacteraemia at 74 centres throughout the UK and Ireland for the years 2013-2015. Minimum inhibitory concentrations (MICs) of ceftobiprole and other antimicrobial agents were determined using the BSAC agar dilution method. Susceptibility was assessed by European Committee on Antimicrobial Susceptibility Testing (EUCAST) criteria. The majority of the isolates (63.2%) were Staphylococcus epidermidis. Overall, methicillin resistance, as determined by oxacillin susceptibility testing, was observed in 64.2% of isolates. The MIC of ceftobiprole was 1/2 mg/L, and 100% of CoNS isolates were inhibited at the EUCAST ceftobiprole non-species-specific pharmacokinetic/pharmacodynamic breakpoint of 4 mg/L. Only one isolate was resistant to vancomycin. Overall rates of resistance to ciprofloxacin, clindamycin, erythromycin and teicoplanin were 50.5, 25.1, 68.2 and 20.9%, respectively. In S. epidermidis, resistance to oxacillin was associated with increased resistance to other antimicrobials. Ceftobiprole demonstrated in vitro activity against all CoNS species isolated from patients with bacteraemia and was active against species resistant to other antistaphylococcal antimicrobials. The collection of clinical data regarding the efficacy of ceftobiprole in treating CoNS bacteraemia is warranted.
凝固酶阴性葡萄球菌（CoNS）是菌血症的重要原因，由于多药耐药株的出现，其治疗变得越来越复杂。本研究旨在评估头孢洛林这一新型头孢菌素与其他抗菌药物相比对菌血症患者凝固酶阴性葡萄球菌的体外活性。作为英国抗菌化疗学会（BSAC）菌血症监测计划的一部分，从英国和爱尔兰的 74 个中心的菌血症患者中获得了 2013-2015 年 650 株凝固酶阴性葡萄球菌血培养分离株。使用 BSAC 琼脂稀释法测定头孢洛林和其他抗菌药物的最低抑菌浓度（MIC）。采用欧洲抗菌药物敏感性试验委员会（EUCAST）标准评估药敏性。大多数分离株（63.2%）为表皮葡萄球菌。总的来说，通过苯唑西林药敏试验，64.2%的分离株表现为耐甲氧西林。头孢洛林的 MIC 为 1/2mg/L，100%的凝固酶阴性葡萄球菌分离株在 EUCAST 头孢洛林非种特异性药代动力学/药效学 4mg/L 折点以下被抑制。仅有 1 株分离株对万古霉素耐药。对环丙沙星、克林霉素、红霉素和替考拉宁的总体耐药率分别为 50.5%、25.1%、68.2%和 20.9%。在表皮葡萄球菌中，对苯唑西林的耐药性与对其他抗菌药物的耐药性增加相关。头孢洛林对从菌血症患者中分离的所有凝固酶阴性葡萄球菌均具有体外活性，且对其他抗葡萄球菌抗菌药物耐药的菌株也具有活性。需要收集关于头孢洛林治疗凝固酶阴性葡萄球菌菌血症疗效的临床数据。
