Mamtora Dhruv, Saseedharan Sanjith, Rampal Ritika, Joshi Prashant, Bhalekar Pallavi, Ahdal Jaishid, Jain Rishi
Department of Microbiology, S.L. Raheja Hospital, Mumbai, Maharashtra, India.
Department of Critical Care Medicine, S.L. Raheja Hospital, Mumbai, Maharashtra, India.
J Lab Physicians. 2020 Dec;12(3):230-232. doi: 10.1055/s-0040-1720944. Epub 2020 Nov 23.
Blood stream infections (BSIs) due to Gram-positive pathogens such as methicillin-resistant (MRSA) are associated with high mortality ranging from 10 to 60%. The current anti-MRSA agents have limitations with regards to safety and tolerability profile which limits their prolonged usage. Levonadifloxacin and its oral prodrug alalevonadifloxacin, a novel benzoquinolizine antibiotic, have recently been approved for acute bacterial skin and skin structure infections including diabetic foot infections and concurrent bacteremia in India. The present study assessed the potency of levonadifloxacin, a novel benzoquinolizine antibiotic, against Gram-positive blood stream clinical isolates ( = 31) collected from January to June 2019 at a tertiary care hospital in Mumbai, India. The susceptibility of isolates to antibacterial agents was defined following the Clinical and Laboratory Standard Institute interpretive criteria (M100 E29). High prevalence of MRSA (62.5%), quinolone-resistant (QRSA) (87.5%), and methicillin-resistant coagulase-negative staphylococci (MR-CoNS) (82.35%) were observed among bacteremic isolates. Levonadifloxacin demonstrated potent activity against MRSA, QRSA, and MR-CoNS strains with significantly lower minimum inhibitory concentration MIC values of 0.5/1 mg/L as compared with levofloxacin (8/32 mg/L) and moxifloxacin (2/8 mg/L). Potent bactericidal activity coupled with low MICs support usage of levonadifloxacin for the management of BSIs caused by multidrug resistant Gram-positive bacteria.
由革兰氏阳性病原体如耐甲氧西林金黄色葡萄球菌（MRSA）引起的血流感染（BSIs）与10%至60%的高死亡率相关。目前的抗MRSA药物在安全性和耐受性方面存在局限性，这限制了它们的长期使用。左诺氟沙星及其口服前药阿拉左诺氟沙星是一种新型苯并喹嗪类抗生素，最近在印度已被批准用于治疗急性细菌性皮肤和皮肤结构感染，包括糖尿病足感染和并发菌血症。 本研究评估了新型苯并喹嗪类抗生素左诺氟沙星对2019年1月至6月在印度孟买一家三级护理医院收集的革兰氏阳性血流临床分离株（n = 31）的抗菌效力。根据临床和实验室标准协会的解释标准（M100 E29）确定分离株对抗菌剂的敏感性。 在血行感染分离株中观察到MRSA（62.5%）、耐喹诺酮金黄色葡萄球菌（QRSA）（87.5%）和耐甲氧西林凝固酶阴性葡萄球菌（MR-CoNS）（82.35%）的高流行率。左诺氟沙星对MRSA、QRSA和MR-CoNS菌株表现出强效活性，与左氧氟沙星（8/32 mg/L）和莫西沙星（2/8 mg/L）相比，其最低抑菌浓度MIC值显著更低，为0.5/1 mg/L。 强效杀菌活性加上低MIC值支持使用左诺氟沙星来治疗由多重耐药革兰氏阳性菌引起的BSIs。
