Institute of Antibiotics, Huashan Hospital, Fudan University, Shanghai, China and Key Laboratory of Clinical Pharmacology of Antibiotics, Ministry of Health, 12 Urumqi Middle Road, Jing' an District, Shanghai, China.
Department of Clinical Laboratory, Shanghai Corps Hospital of Chinese People's Armed Police, 831 Hong Xu Road, Changning District, Shanghai, China.
J Antimicrob Chemother. 2020 Jun 1;75(6):1513-1517. doi: 10.1093/jac/dkaa027.
To assess the in vitro activities of acetylmidecamycin, a 16-membered macrolide, and 11 other antimicrobial agents against human mycoplasmas.
A total of 187 clinical isolates, Mycoplasma pneumoniae (n = 110), Mycoplasma hominis (n = 26) and Ureaplasma species (n = 51), were included in this study. The MICs of 12 antimicrobial agents, including acetylmidecamycin, thiamphenicol, chloramphenicol and some other macrolides, fluoroquinolones and tetracyclines, for these clinical isolates were determined by the broth microdilution method.
For M. pneumoniae, the MIC90 values of the tested macrolides were: acetylmidecamycin (1 mg/L)<josamycin (4 mg/L)<midecamycin (8 mg/L)<azithromycin (16 mg/L)<erythromycin (>128 mg/L). Thiamphenicol and chloramphenicol had the same MIC90 (2 mg/L). For Ureaplasma species, the MIC90 values were: acetylmidecamycin (0.25 mg/L)<josamycin (0.5 mg/L)=midecamycin<azithromycin (1 mg/L)=erythromycin. Chloramphenicol had a lower MIC90 (2 mg/L) than that of thiamphenicol (4 mg/L). For M. hominis, the MIC90 values were: acetylmidecamycin (0.25 mg/L)<josamycin (0.5 mg/L)<midecamycin (2 mg/L)<azithromycin (>128 mg/L)=erythromycin. The MIC90 values of chloramphenicol and thiamphenicol were 2 and 4 mg/L, respectively.
The results indicated that acetylmidecamycin and thiamphenicol are active in vitro against the most common mycoplasma species infecting humans, including those resistant to macrolides and fluoroquinolones. Acetylmidecamycin and thiamphenicol might be a promising option for clinicians to treat infections caused by Mycoplasma and Ureaplasma spp., particularly macrolide-resistant M. pneumoniae in paediatrics and fluoroquinolone-resistant M. hominis in adults. Further investigation of their clinical roles in treating infections caused by these organisms is warranted.
评估乙酰麦迪霉素（一种 16 元大环内酯）和其他 11 种抗菌药物对人支原体的体外活性。
本研究共纳入 187 例临床分离株，包括肺炎支原体（n=110）、人型支原体（n=26）和解脲支原体（n=51）。采用肉汤微量稀释法测定 12 种抗菌药物（包括乙酰麦迪霉素、硫霉素、氯霉素和其他一些大环内酯类、氟喹诺酮类和四环素类）对这些临床分离株的 MIC。
对于肺炎支原体，测试大环内酯类药物的 MIC90 值为：乙酰麦迪霉素（1mg/L）<交沙霉素（4mg/L）<麦迪霉素（8mg/L）<阿奇霉素（16mg/L）<红霉素（>128mg/L）。硫霉素和氯霉素的 MIC90 值相同（2mg/L）。对于解脲支原体，MIC90 值为：乙酰麦迪霉素（0.25mg/L）<交沙霉素（0.5mg/L）=麦迪霉素<阿奇霉素（1mg/L）=红霉素。氯霉素的 MIC90 值（2mg/L）低于硫霉素（4mg/L）。对于人型支原体，MIC90 值为：乙酰麦迪霉素（0.25mg/L）<交沙霉素（0.5mg/L）<麦迪霉素（2mg/L）<阿奇霉素（>128mg/L）=红霉素。氯霉素和硫霉素的 MIC90 值分别为 2mg/L 和 4mg/L。
结果表明，乙酰麦迪霉素和硫霉素对引起人类感染的最常见支原体种具有体外活性，包括对大环内酯类和氟喹诺酮类耐药的支原体。乙酰麦迪霉素和硫霉素可能是治疗支原体和脲原体属感染的临床医生的有前途的选择，特别是儿科中对大环内酯类耐药的肺炎支原体和成人中对氟喹诺酮类耐药的人型支原体感染。进一步研究它们在治疗这些病原体引起的感染中的临床作用是有必要的。
