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单独使用和联合使用头孢噻肟治疗头孢噻肟不敏感的侵袭性肺炎链球菌分离株的疗效。

Efficacy of delafloxacin alone and in combination with cefotaxime against cefotaxime non-susceptible invasive isolates of Streptococcus pneumoniae.

机构信息

Esther Ríos Dueñas, Departamento de Medicina, Facultad de Medicina, Universidad Complutense de Madrid. Plaza Ramón y Cajal, s/n 28040 Madrid, Spain.

出版信息

Rev Esp Quimioter. 2024 Apr;37(2):158-162. doi: 10.37201/req/107.2023. Epub 2024 Jan 16.

DOI:10.37201/req/107.2023
PMID:38226580
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10945109/
Abstract

OBJECTIVE

We assessed the in vitro activity of delafloxacin and the synergy between cefotaxime and delafloxacin among cefotaxime non-susceptible invasive isolates of Streptococcus pneumoniae (CNSSP).

METHODS

A total of 30 CNSSP (cefotaxime MIC > 0.5 mg/L) were studied. Serotyping was performed by the Pneumotest-Latex and Quellung reaction. Minimum inhibitory concentrations (MICs) of delafloxacin, levofloxacin, penicillin, cefotaxime, erythromycin and vancomycin were determined by gradient diffusion strips (GDS). Synergistic activity of delafloxacin plus cefotaxime against clinical S. pneumoniae isolates was evaluated by the GDS cross method.

RESULTS

Delafloxacin showed a higher pneumococcal activity than its comparator levofloxacin (MIC50, 0.004 versus 0.75 mg/L and MIC90, 0.047 versus >32 mg/L). Resistance to delafloxacin was identified in 7/30 (23.3%) isolates, belonging to serotypes 14 and 9V. Synergy between delafloxacin and cefotaxime was detected in 2 strains (serotypes 19A and 9V). Antagonism was not observed. Addition of delafloxacin increased the activity of cefotaxime in all isolates. Delafloxacin susceptibility was restored in 5/7 (71.4%) strains.

CONCLUSIONS

CNSSP showed a susceptibility to delafloxacin of 76.7%. Synergistic interactions between delafloxacin and cefotaxime were observed in vitro among CNSSP by GDS cross method.

摘要

目的

评估达拉非沙星对头孢噻肟不敏感的侵袭性肺炎链球菌（CNSSP）的体外活性及其与头孢噻肟的协同作用。

方法

共研究了 30 株 CNSSP（头孢噻肟 MIC>0.5mg/L）。采用 Pneumotest-Latex 和 Quellung 反应进行血清分型。采用梯度扩散条（GDS）测定达拉非沙星、左氧氟沙星、青霉素、头孢噻肟、红霉素和万古霉素的最小抑菌浓度（MIC）。采用 GDS 交叉法评价达拉非沙星联合头孢噻肟对临床肺炎链球菌分离株的协同活性。

结果

达拉非沙星对肺炎链球菌的活性高于其对照左氧氟沙星（MIC50，0.004 与 0.75mg/L 和 MIC90，0.047 与>32mg/L）。30 株分离株中有 7 株（14 型和 9V 型）对达拉非沙星耐药。在 2 株（19A 型和 9V 型）分离株中检测到达拉非沙星与头孢噻肟之间的协同作用。未观察到拮抗作用。添加达拉非沙星增加了所有分离株中头孢噻肟的活性。5/7（71.4%）株的达拉非沙星敏感性得到恢复。

结论

CNSSP 对达拉非沙星的敏感性为 76.7%。通过 GDS 交叉法，体外观察到达拉非沙星与头孢噻肟对 CNSSP 具有协同作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bf64/10945109/d3cc60835d53/revespquimioter-37-158-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bf64/10945109/d3cc60835d53/revespquimioter-37-158-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bf64/10945109/d3cc60835d53/revespquimioter-37-158-g001.jpg

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