Zou Peng, Chen Zhiquan, Tu Jijun, Chen Xinfeng, Liu Xuejian
The Department of Orthopedics, Zhengzhou Seventh People's Hospital, Zhengzhou, China.
Microb Drug Resist. 2024 Sep;30(9):391-397. doi: 10.1089/mdr.2024.0023. Epub 2024 Jul 17.
The majority of isolates possess the extended-spectrum beta-lactamase (ESBL) enzymes. Therefore, can easily develop drug resistance. How to effectively overcome the problem of drug resistance in is still a research hotspot. This study aimed to compare the mutant prevention concentration (MPC) of ESBL-positive and ESBL-negative isolated from orthopedic patients, which may provide a basis for the effective use of drugs to control the enrichment of resistance mutants of . The MPC values of 55 isolates of ESBL-positive against 4 fluoroquinolones were 32 µg/mL for levofloxacin and gatifloxacin, 16 µg/mL for ciprofloxacin, and 4 µg/mL for gemifloxacin. The selection index value was 8 for levofloxacin and ciprofloxacin and 2 for gemifloxacin and gatifloxacin, respectively. For ESBL-negative isolates, the MPC values were 16 µg/mL for levofloxacin and ciprofloxacin, 4 µg/mL for gemifloxacin, and 32 µg/mL for gatifloxacin. The selection index value was 8 for levofloxacin and ciprofloxacin, 2 for gemifloxacin, and 4 for gatifloxacin. For the ESBL-positive , the %T>MIC order was gemifloxacin > levofloxacin > ciprofloxacin > gatifloxacin. For the ESBL-negative the %T>MIC order was levofloxacin > gemifloxacin > ciprofloxacin > gatifloxacin. The mutant-preventing ability of gatifloxacin and gemifloxacin was the strongest among the 4 fluoroquinolones. So gemifloxacin may be the first choice of drug to treat infection.
大多数分离株都具有超广谱β-内酰胺酶（ESBL）。因此，其很容易产生耐药性。如何有效克服其耐药性问题仍是一个研究热点。本研究旨在比较从骨科患者中分离出的ESBL阳性和ESBL阴性菌株的突变预防浓度（MPC），这可能为有效使用药物控制菌株耐药突变体的富集提供依据。55株ESBL阳性菌株对4种氟喹诺酮类药物的MPC值，左氧氟沙星和加替沙星为32μg/mL，环丙沙星为16μg/mL，吉米沙星为4μg/mL。左氧氟沙星和环丙沙星的选择指数值分别为8，吉米沙星和加替沙星的选择指数值分别为2。对于ESBL阴性菌株，左氧氟沙星和环丙沙星的MPC值为16μg/mL，吉米沙星为4μg/mL，加替沙星为32μg/mL。左氧氟沙星和环丙沙星的选择指数值为8，吉米沙星为2，加替沙星为4。对于ESBL阳性菌株，%T>MIC顺序为吉米沙星>左氧氟沙星>环丙沙星>加替沙星。对于ESBL阴性菌株，%T>MIC顺序为左氧氟沙星>吉米沙星>环丙沙星>加替沙星。加替沙星和吉米沙星在4种氟喹诺酮类药物中的突变预防能力最强。所以吉米沙星可能是治疗菌株感染的首选药物。
