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替加环素及对照药物对常见病原体的体外活性:印度的经验

In-vitro activity of tigecycline and comparator agents against common pathogens: Indian experience.

作者信息

Veeraraghavan Balaji, Poojary Aruna, Shankar Chaitra, Bari Anurag Kumar, Kukreja Seema, Thukkaram Bhuvaneswari, Neethimohan Ramya Gajaraj, Bakhtavachalam Yamuna Devi, Kamat Shweta

机构信息

Department of Clinical Microbiology, Christian Medical College, Vellore, Tamil Nadu, India.

Breach Candy Hospital Trust, Mumbai, Maharashtra, India.

出版信息

J Infect Dev Ctries. 2019 Mar 31;13(3):245-250. doi: 10.3855/jidc.10376.

Abstract

INTRODUCTION

Tigecycline Evaluation and Surveillance Trail (TEST) study is an on-going global surveillance. The study was performed to determine the susceptibility of common pathogens to tigecycline and comparator antibiotics by broth microdilution (BMD) at two tertiary care centres in India from 2015 to 2017.

METHODOLOGY

Total of 989 isolates collected from various clinical specimens between January 2015 and September 2017 from two centres in India were included. BMD was performed to determine the minimum inhibitory concentration (MIC) for tigecycline and comparator antibiotics.

RESULTS

Among Gram-negative bacteria, susceptibility to tigecycline was lowest among Klebsiella spp. being 84% while others such as E. coli, Enterobacter spp., Serratia spp. and H. influenzae showed susceptibility of 98%, 95%, 98% and 100% respectively. Overall, 99 isolates among Enterobacteriaceae (E. coli, Klebsiella spp. and Enterobacter spp.) were ESBL producers, susceptible to tigecycline. Among the 101 meropenem resistant Enterobacteriaceae, 85 were susceptible to tigecycline (84%). Among the Gram-positive bacteria, S. aureus and Enterococcus spp. were 99% and 98% susceptible to tigecycline respectively. Among 68 MRSA isolates in the study, 66 (97%) were susceptible to tigecycline. Seven vancomycin resistant E. faecalis were isolated and all were susceptible to tigecycline.

CONCLUSION

Tigecycline has retained activity over both Gram-positive and Gram-negative organisms with MIC values comparable to global reports. About 98% of the MDR Gram-positive and Gram-negative bacteria in the study are susceptible to tigecycline. With increased incidence of extensively drug resistant organisms, tigecycline is a potential reserve drug.

摘要

引言

替加环素评估与监测试验(TEST)研究是一项正在进行的全球监测。该研究旨在通过肉汤微量稀释法(BMD),于2015年至2017年在印度的两个三级医疗中心确定常见病原体对替加环素及对照抗生素的敏感性。

方法

纳入了2015年1月至2017年9月期间从印度两个中心的各种临床标本中收集的989株分离菌。采用BMD法测定替加环素及对照抗生素的最低抑菌浓度(MIC)。

结果

在革兰氏阴性菌中,克雷伯菌属对替加环素的敏感性最低,为84%,而其他菌如大肠杆菌、肠杆菌属、沙雷菌属和流感嗜血杆菌的敏感性分别为98%、95%、98%和100%。总体而言,肠杆菌科(大肠杆菌、克雷伯菌属和肠杆菌属)中的99株分离菌为超广谱β-内酰胺酶(ESBL)产生菌,对替加环素敏感。在101株耐美罗培南的肠杆菌科细菌中,85株对替加环素敏感(84%)。在革兰氏阳性菌中,金黄色葡萄球菌和肠球菌属对替加环素的敏感性分别为99%和98%。在该研究的68株耐甲氧西林金黄色葡萄球菌(MRSA)分离菌中,66株(97%)对替加环素敏感。分离出7株耐万古霉素的粪肠球菌,均对替加环素敏感。

结论

替加环素对革兰氏阳性菌和革兰氏阴性菌均保持活性,其MIC值与全球报告相当。该研究中约98%的多重耐药革兰氏阳性菌和革兰氏阴性菌对替加环素敏感。随着广泛耐药菌的发病率增加,替加环素是一种潜在的储备药物。

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