Institute of Antibiotics, Huashan Hospital, Fudan University, 12 M. Wulumuqi Rd., Shanghai, 200040, China.
Key Laboratory of Clinical Pharmacology of Antibiotics, Ministry of Health, Shanghai, China.
Eur J Clin Microbiol Infect Dis. 2021 Nov;40(11):2271-2283. doi: 10.1007/s10096-021-04278-3. Epub 2021 May 19.
Sitafloxacin is one of the newer generation fluoroquinolones. Considering the ever-changing antimicrobial resistance, it is necessary to monitor the activities of sitafloxacin against recent pathogenic isolates. Therefore, we determined the minimum inhibitory concentrations (MICs) of sitafloxacin and comparators by broth microdilution or agar dilution method against 1101 clinical isolates collected from 2017 to 2019 in 31 hospitals across China. Sitafloxacin was highly active against gram-positive isolates evidenced by the MICs required to inhibit the growth of 50%/90% isolates (MIC): ≤ 0.03/0.25, ≤ 0.03/0.125, ≤ 0.03/2, 0.125/0.25, 0.25/2, and 0.125/0.125 mg/L for methicillin-susceptible Staphylococcus aureus (MSSA), methicillin-susceptible coagulase-negative Staphylococcus (MSCNS), methicillin-resistant S. aureus (MRSA), methicillin-resistant CNS, Enterococcus faecalis, and Streptococcus pneumoniae, respectively. Sitafloxacin inhibited 82.8% of the MRSA strains and 97.5% of MRCNS strains. Sitafloxacin was also potent against ciprofloxacin-susceptible Escherichia coli (MIC: ≤ 0.03/0.06 mg/L) and Klebsiella pneumoniae (MIC: ≤ 0.03/0.125 mg/L), non-ESBL-producing E. coli (MIC: ≤ 0.03/1 mg/L) and K. pneumoniae (MIC: ≤ 0.03/0.5 mg/L), Haemophilus influenzae (MIC: ≤0.015/0.06 mg/L), Haemophilus parainfluenzae (MIC: 0.125/0.5 mg/L), Moraxella catarrhalis (MIC: ≤ 0.015/≤ 0.015 mg/L), Bacteroides fragilis (MIC: 0.06/2 mg/L), Peptostreptococcus (MIC: 0.125/4 mg/L), and Mycoplasma pneumoniae (≤ 0.03/≤ 0.03 mg/L). However, sitafloxacin was less active for Enterococcus faecium, ciprofloxacin-resistant and/or ESBL-producing E. coli, and K. pneumoniae strains. Sitafloxacin was superior or comparable to most of the comparators in activities against the abovementioned isolates, so sitafloxacin is still highly active against most of the clinical isolates in hospitals across China, proving its utility in treatment of the abovementioned susceptible strains.
司他沙星是新一代氟喹诺酮类药物之一。鉴于抗菌药物耐药性不断变化,有必要监测司他沙星对近期病原菌分离株的活性。因此,我们采用肉汤微量稀释法或琼脂稀释法测定了 2017 年至 2019 年期间中国 31 家医院 1101 株临床分离株对司他沙星和对照药物的最低抑菌浓度(MIC)。司他沙星对革兰阳性菌分离株具有高度活性,表现为 50%/90%抑制所需的 MIC:甲氧西林敏感金黄色葡萄球菌(MSSA)、甲氧西林敏感凝固酶阴性葡萄球菌(MSCNS)、耐甲氧西林金黄色葡萄球菌(MRSA)、耐甲氧西林凝固酶阴性葡萄球菌、屎肠球菌和肺炎链球菌分别为≤0.03/0.25、≤0.03/0.125、≤0.03/2、0.125/0.25、0.25/2 和 0.125/0.125mg/L。司他沙星抑制 82.8%的 MRSA 株和 97.5%的 MRCNS 株。司他沙星对环丙沙星敏感的大肠埃希菌(MIC:≤0.03/0.06mg/L)和肺炎克雷伯菌(MIC:≤0.03/0.125mg/L)也具有较强的活性,对非产 ESBL 的大肠埃希菌(MIC:≤0.03/1mg/L)和肺炎克雷伯菌(MIC:≤0.03/0.5mg/L)、流感嗜血杆菌(MIC:≤0.015/0.06mg/L)、副流感嗜血杆菌(MIC:0.125/0.5mg/L)、卡他莫拉菌(MIC:≤0.015/≤0.015mg/L)、脆弱拟杆菌(MIC:0.06/2mg/L)、消化链球菌(MIC:0.125/4mg/L)和肺炎支原体(≤0.03/≤0.03mg/L)也具有较强的活性。然而,司他沙星对屎肠球菌、环丙沙星耐药和/或产 ESBL 的大肠埃希菌和肺炎克雷伯菌的活性较低。司他沙星对上述分离株的活性优于或与大多数对照药物相当,因此司他沙星在中国大多数医院的临床分离株中仍然具有高度活性,证明其对上述敏感菌株的治疗具有实用性。