JMI Laboratories, North Liberty, Iowa, USA.
JMI Laboratories, North Liberty, Iowa, USA.
J Glob Antimicrob Resist. 2021 Mar;24:48-52. doi: 10.1016/j.jgar.2020.11.020. Epub 2020 Dec 4.
To evaluate the in vitro activity of dalbavancin compared with vancomycin, daptomycin and other agents against a large collection of coagulase-negative staphylococci (CoNS) isolates.
A total of 5088 CoNS causing clinically significant infection were consecutively collected from 122 medical centres in the USA and Europe over 6 years (2014-2019). Isolates were tested for susceptibility by the reference broth microdilution method. Species identification was confirmed by MALDI-TOF. Most isolates were from bloodstream infections (BSIs) (53.5%) or skin/skin structure infections (28.5%).
Staphylococcus epidermidis was the most common species overall (54.6%) and for BSI (61.3%). The second most common species were Staphylococcus lugdunensis overall (12.3%) and Staphylococcus hominis for BSI (14.7%). Dalbavancin (MIC, 0.03/0.06 mg/L) inhibited >99.9% of CoNS isolates at ≤0.25 mg/L (susceptible breakpoint for Staphylococcus aureus per CLSI). All species were inhibited at ≤0.25 mg/L dalbavancin, except some S. epidermidis (>99.9%) and Staphylococcus warneri (98.9%) isolates. Staphylococcus capitis and Staphylococcus simulans exhibited the lowest dalbavancin MIC values (0.015/0.03 mg/L) and Staphylococcus haemolyticus and Staphylococcus saprophyticus the highest (MIC, 0.06/0.12 mg/L); 47.8% of S. epidermidis and 34.7% of S. haemolyticus exhibited decreased susceptibility to vancomycin (MIC ≥ 2 mg/L) and 23.2% of S. capitis and 28.4% of S. warneri showed decreased susceptibility to daptomycin (MIC ≥ 1 mg/L).
Antimicrobial susceptibility varied widely among CoNS species. Dalbavancin inhibited >99.9% and 99.1% of isolates at the US-FDA and EUCAST breakpoints, respectively. Clinical studies of dalbavancin for treatment of CoNS infections should be considered based on these in vitro data.
评估达巴万星与万古霉素、达托霉素和其他药物对大量凝固酶阴性葡萄球菌（CoNS）分离株的体外活性。
6 年间（2014-2019 年），连续从美国和欧洲的 122 个医学中心收集了 5088 株引起临床显著感染的 CoNS。采用参考肉汤微量稀释法检测药敏性。通过 MALDI-TOF 确认种属鉴定。大多数分离株来自血流感染（BSI）（53.5%）或皮肤/皮肤结构感染（28.5%）。
表皮葡萄球菌总体（54.6%）和 BSI（61.3%）最为常见。第二常见的是路邓葡萄球菌（总体 12.3%）和人葡萄球菌（BSI 中 14.7%）。达巴万星（MIC，0.03/0.06 mg/L）在≤0.25mg/L 时抑制了>99.9%的 CoNS 分离株（CLSI 规定的金黄色葡萄球菌的敏感折点）。除了一些表皮葡萄球菌（>99.9%）和华纳葡萄球菌（98.9%）分离株外，所有分离株在≤0.25mg/L 达巴万星时均被抑制。头状葡萄球菌和中间葡萄球菌的达巴万星 MIC 值最低（0.015/0.03 mg/L），溶血葡萄球菌和腐生葡萄球菌的 MIC 值最高（MIC，0.06/0.12 mg/L）；47.8%的表皮葡萄球菌和 34.7%的溶血葡萄球菌对万古霉素表现出低敏感性（MIC≥2mg/L），23.2%的头状葡萄球菌和 28.4%的华纳葡萄球菌对达托霉素表现出低敏感性（MIC≥1mg/L）。
凝固酶阴性葡萄球菌种间的抗菌药物敏感性差异很大。达巴万星在美国食品和药物管理局（US-FDA）和欧盟药敏试验委员会（EUCAST）的折点处分别抑制了>99.9%和 99.1%的分离株。应根据这些体外数据考虑开展达巴万星治疗凝固酶阴性葡萄球菌感染的临床研究。
