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替加环素对来自欧洲和美国的路邓葡萄球菌及溶血葡萄球菌临床分离株的体外活性。

In vitro activity of tedizolid against clinical isolates of Staphylococcus lugdunensis and Staphylococcus haemolyticus from Europe and the United States.

作者信息

Farrell David J, Mendes Rodrigo E, Bensaci Mekki

机构信息

JMI Laboratories, 345 Beaver Kreek Center, North Liberty, IA, USA.

Merck & Co., Inc., 2000 Galloping Hill Road, Kenilworth, NJ, USA.

出版信息

Diagn Microbiol Infect Dis. 2019 Jan;93(1):85-88. doi: 10.1016/j.diagmicrobio.2018.08.006. Epub 2018 Aug 23.

DOI:10.1016/j.diagmicrobio.2018.08.006
PMID:30314652
Abstract

Staphylococcus lugdunensis and Staphylococcus haemolyticus are unique among CoNS in that the former often causes aggressive disease, while the latter consistently exhibits high rates of multidrug resistance. We evaluated the in vitro susceptibility of contemporary (2012-2013) isolates from both pathogens to tedizolid and comparators, using standard methodology. Results were interpreted using CLSI and EUCAST breakpoints. Overall, 106 S. lugdunensis and 103 S. haemolyticus isolates were collected from 51 medical centers in the United States and 30 centers in 18 European countries. Tedizolid showed good activity against S. lugdunensis (MIC/MIC: 0.12/0.12 mg/L) and S. haemolyticus (MIC/MIC: 0.12/0.12 mg/L), inhibiting all isolates at MIC ≤0.25 mg/L. Based on the EUCAST breakpoint for staphylococci and when substituting the CLSI breakpoint for Staphylococcus aureus, all isolates were tedizolid susceptible. All isolates were also susceptible to linezolid, but the in vitro potency of tedizolid was 4-fold greater than that of linezolid against both S. lugdunensis and S. haemolyticus, based on MIC values. S. lugdunensis exhibited ≥99% susceptibility to vancomycin, teicoplanin, gentamicin, levofloxacin, and trimethoprim-sulfamethoxazole; 7% of isolates were resistant to tetracycline, 11% to clindamycin, and 2% were methicillin-resistant. S. haemolyticus exhibited high rates of resistance to commonly used anti-staphylococcal agents: 71% of isolates were resistant to methicillin, 36%-37% to clindamycin, and 30%-50% to gentamicin. These in vitro findings suggest that tedizolid could be an alternative treatment option for infections due to these medically important CoNS pathogens. Additional clinical evaluation and continued surveillance of tedizolid in vitro activity against S. lugdunensis and S. haemolyticus are warranted.

摘要

路邓葡萄球菌和溶血葡萄球菌在凝固酶阴性葡萄球菌中较为独特,前者常引起侵袭性疾病,而后者始终表现出较高的多重耐药率。我们采用标准方法评估了这两种病原菌当代(2012 - 2013年)分离株对特地唑胺及对照药物的体外敏感性。结果依据美国临床和实验室标准协会(CLSI)及欧洲抗菌药物敏感性试验委员会(EUCAST)的断点进行解读。总体而言,从美国的51个医疗中心和18个欧洲国家的30个中心收集了106株路邓葡萄球菌和103株溶血葡萄球菌分离株。特地唑胺对路邓葡萄球菌(MIC/MIC:0.12/0.12 mg/L)和溶血葡萄球菌(MIC/MIC:0.12/0.12 mg/L)显示出良好活性,在MIC≤0.25 mg/L时抑制了所有分离株。基于EUCAST针对葡萄球菌的断点,以及用CLSI针对金黄色葡萄球菌的断点进行替代时,所有分离株对特地唑胺敏感。所有分离株对利奈唑胺也敏感,但基于MIC值,特地唑胺对路邓葡萄球菌和溶血葡萄球菌的体外效力比利奈唑胺高4倍。路邓葡萄球菌对万古霉素、替考拉宁、庆大霉素、左氧氟沙星和复方磺胺甲恶唑的敏感性≥99%;7%的分离株对四环素耐药,11%对克林霉素耐药,2%为耐甲氧西林菌株。溶血葡萄球菌对常用抗葡萄球菌药物表现出高耐药率:71%的分离株耐甲氧西林,36% - 37%耐克林霉素,30% - 50%耐庆大霉素。这些体外研究结果表明,特地唑胺可能是治疗这些具有医学重要性的凝固酶阴性葡萄球菌病原体所致感染的替代治疗选择。有必要对特地唑胺针对路邓葡萄球菌和溶血葡萄球菌的体外活性进行进一步的临床评估和持续监测。

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