Maraki Sofia, Mavromanolaki Viktoria Eirini, Stafylaki Dimitra, Iliaki-Giannakoudaki Evangelia, Hamilos George
Department of Clinical Microbiology and Microbial Pathogenesis, University Hospital of Heraklion, PC 71110 Heraklion, Crete, Greece.
School of Medicine, University of Crete, PC 71003 Heraklion, Crete, Greece.
Antibiotics (Basel). 2023 May 12;12(5):900. doi: 10.3390/antibiotics12050900.
Skin and soft tissue infections (SSTIs) are associated with significant morbidity and healthcare costs, especially when caused by methicillin-resistant (MRSA). Vancomycin is a preferred antimicrobial therapy for the management of complicated SSTIs (cSSTIs) caused by MRSA, with linezolid and daptomycin regarded as alternative therapeutic options. Due to the increased rates of antimicrobial resistance in MRSA, several new antibiotics with activity against MRSA have been recently introduced in clinical practice, including ceftobiprole, dalbavancin, and tedizolid. We evaluated the in vitro activities of the aforementioned antibiotics against 124 clinical isolates of MRSA obtained from consecutive patients with SSTIs during the study period (2020-2022). Minimum inhibitory concentrations (MICs) for vancomycin, daptomycin, ceftobiprole, dalbavancin, linezolid and tedizolid were evaluated by the MIC Test Strip using Liofilchem strips. We found that when compared to the in vitro activity of vancomycin (MIC = 2 μg/mL), dalbavancin possessed the lowest MIC (MIC = 0.094 μg/mL), followed by tedizolid (MIC = 0.38 μg/mL), linezolid, ceftobiprole, and daptomycin (MIC = 1 μg/mL). Dalbavancin demonstrated significantly lower MIC and MIC values compared to vancomycin (0.064 vs. 1 and 0.094 vs. 2, respectively). Tedizolid exhibited an almost threefold greater level of in vitro activity than linezolid, and also had superior in vitro activity compared to ceftobiprole, daptomycin and vancomycin. Multidrug-resistant (MDR) phenotypes were detected among 71.8% of the isolates. In conclusion, ceftobiprole, dalbavancin and tedizolid exhibited potent activity against MRSA and are promising antimicrobials in the management of SSTIs caused by MRSA.
皮肤和软组织感染（SSTIs）会导致严重的发病率和医疗成本，尤其是由耐甲氧西林金黄色葡萄球菌（MRSA）引起的感染。万古霉素是治疗由MRSA引起的复杂性SSTIs（cSSTIs）的首选抗菌疗法，利奈唑胺和达托霉素被视为替代治疗选择。由于MRSA的抗菌耐药率增加，几种对MRSA有活性的新型抗生素最近已被引入临床实践，包括头孢比普、达巴万星和替加环素。我们评估了上述抗生素对研究期间（2020 - 2022年）从连续性SSTIs患者中分离出的124株MRSA临床分离株的体外活性。使用Liofilchem试纸条通过MIC测试条评估万古霉素、达托霉素、头孢比普、达巴万星、利奈唑胺和替加环素的最低抑菌浓度（MICs）。我们发现，与万古霉素的体外活性（MIC = 2μg/mL）相比，达巴万星的MIC最低（MIC = 0.094μg/mL），其次是替加环素（MIC = 0.38μg/mL）、利奈唑胺、头孢比普和达托霉素（MIC = 1μg/mL）。与万古霉素相比，达巴万星的MIC和MIC值显著更低（分别为0.064对1和0.094对2）。替加环素的体外活性比利奈唑胺高近三倍，并且与头孢比普、达托霉素和万古霉素相比也具有更强的体外活性。在71.8%的分离株中检测到多重耐药（MDR）表型。总之，头孢比普、达巴万星和替加环素对MRSA表现出强效活性，是治疗由MRSA引起的SSTIs的有前景的抗菌药物。
