Department of Microbiology, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India.
Department of Microbiology, S. L. Raheja (A Fortis Associate) Hospital, Mahim, Mumbai, Maharashtra, India.
Indian J Med Microbiol. 2020 Jul-Dec;38(3 & 4):307-312. doi: 10.4103/ijmm.IJMM_20_307.
Levonadifloxacin is a novel benzoquinolizine subclass of quinolone with broad-spectrum activities against problematic pathogens such as methicillin-resistant Staphylococcus aureus, quinolone-resistant S. aureus, vancomycin intermediate S. aureus, and vancomycin-resistant S. aureus. Levonadifloxacin and its oral prodrug, alalevonadifloxacin, have been recently approved in India for the treatment of acute bacterial skin and skin structure infections, including concurrent bacteraemia and diabetic foot infections. The aim of the study is to assess the activity of levonadifloxacin against Gram-positive clinical isolates collected from various Indian hospitals using the disc-diffusion method.
Nonduplicate isolates of S. aureus and other Gram-positive isolates collected from June 2019 to March 2020 were subjected to levonadifloxacin susceptibility testing (disk diffusion method) as per the Clinical and Laboratory Standards Institute guidelines (Year 2019). Levonadifloxacin 10 μg impregnated disks were used during the testing.
A total of 664 diverse Gram-positive clinical isolates collected from six different hospitals in India were analyzed. Majority (65.5%) of the isolates were S. aureus. All the S. aureus and other Gram-positive isolates were found to be susceptible to levonadifloxacin as per the prespecified interpretive criteria identified based on population pharmacokinetic model and Monte Carlo simulation enabled probability of pharmacodynamic target attainment analysis.
The present study showed that levonadifloxacin was highly active against contemporary Gram-positive pathogens and furthermore demonstrated that levonadifloxacin susceptibilities can be reliably determined using the disc-diffusion method.
左氧氟沙星是一种新型苯并喹啉类喹诺酮类药物，对耐甲氧西林金黄色葡萄球菌、耐喹诺酮类金黄色葡萄球菌、万古霉素中介金黄色葡萄球菌和万古霉素耐药金黄色葡萄球菌等问题病原体具有广泛的活性。左氧氟沙星及其口服前药阿拉左氧氟沙星最近在印度获得批准，用于治疗急性细菌性皮肤和皮肤结构感染，包括合并菌血症和糖尿病足感染。本研究旨在使用纸片扩散法评估左氧氟沙星对从印度各医院收集的革兰氏阳性临床分离株的活性。
从 2019 年 6 月至 2020 年 3 月收集的非重复金黄色葡萄球菌和其他革兰氏阳性分离株进行左氧氟沙星药敏试验（纸片扩散法），按照临床和实验室标准协会指南（2019 年）进行。在测试过程中使用了 10μg 左氧氟沙星浸渍的纸片。
共分析了来自印度六家不同医院的 664 种不同的革兰氏阳性临床分离株。分离株中，大多数（65.5%）为金黄色葡萄球菌。根据基于群体药代动力学模型和蒙特卡罗模拟的药效学目标达成概率分析确定的预设解释标准，所有金黄色葡萄球菌和其他革兰氏阳性分离株均对左氧氟沙星敏感。
本研究表明，左氧氟沙星对当代革兰氏阳性病原体具有高度活性，并且进一步表明，可以使用纸片扩散法可靠地确定左氧氟沙星的敏感性。
