Department of Anatomy and Physiology, Institute of Computational Comparative Medicine, College of Veterinary Medicine, Kansas State University, 1800 Denison avenue, Manhattan, KS, 66506, USA.
Department of Diagnostic Medicine/Pathobiology, College of Veterinary Medicine, Kansas State University, 1800 Denison avenue, Manhattan, KS, 66506, USA.
Sci Rep. 2018 Jul 12;8(1):10553. doi: 10.1038/s41598-018-28602-8.
To design an antimicrobial treatment regimen for a bacterial disease, data on the drug pharmacodynamics (PD) against selected drug-susceptible strains of the pathogen are used. The regimen is applied across such strains in the field, assuming the PD parameter values remain the same. We used time-kill experiments and PD modeling to investigate the fluoroquinolone enrofloxacin PD against different isolates of two bovine respiratory disease pathogens: four Mannheimia haemolytica and three Pasteurella multocida isolates. The models were fitted as mixed-effects non-linear regression; the fixed-effects PD parameter values were estimated after accounting for random variation among experimental replicates. There was both inter- and intra- bacterial species variability in the PD parameters Hill-coefficient and E (maximal decline of bacterial growth rate), with more variable PD responses among M. haemolytica than among P. multocida isolates. Moreover, the Hill-coefficient was correlated to the isolate's maximal population growth rate in the absence of antimicrobial exposure (a.k.a. specific growth rate; Spearman's ρ = 0.98, p-value = 0.003, n = 6 isolates excluding one outlier). Thus, the strain's properties such as growth potential may impact its PD responses. This variability can have clinical implications. Modifying the treatment regimen depending on phenotypic properties of the pathogen strain causing disease may be a precision medicine approach.
为了设计针对细菌疾病的抗菌治疗方案,需要使用针对病原体选定药敏菌株的药物药效学(PD)数据。该方案在野外应用于这些菌株,假设 PD 参数值保持不变。我们使用时间杀菌实验和 PD 建模来研究氟喹诺酮恩诺沙星对两种牛呼吸道疾病病原体的不同分离株的 PD:四种溶血曼海姆菌和三种多杀巴斯德菌分离株。模型拟合为混合效应非线性回归;在考虑实验重复之间的随机变异后,估计固定效应 PD 参数值。PD 参数 Hill 系数和 E(细菌生长率最大下降)在细菌种内和种间均存在变异性,与多杀巴斯德菌分离株相比,溶血曼海姆菌的 PD 反应更具变异性。此外,Hill 系数与分离株在没有抗菌暴露(也称为特定生长率)下的最大种群增长率相关(Spearman ρ=0.98,p 值=0.003,n=6 个分离株,不包括一个异常值)。因此,菌株的特性,如生长潜力,可能会影响其 PD 反应。这种变异性可能具有临床意义。根据引起疾病的病原体菌株的表型特性修改治疗方案可能是一种精准医学方法。