Ledesma Vergel, Vanbaelen Thibaut, Gestels Zina, Panis Nele, Abdellati Said, de Block Tessa, De Baetselier Irith, Van den Bossche Dorien, Manoharan-Basil Sheeba Santhini, Kenyon Chris
Department of Clinical Sciences, STI Unit, Institute of Tropical Medicine, Antwerp 2000, Belgium.
Department of Clinical Sciences, Clinical Reference Laboratory, Institute of Tropical Medicine, 2000 Antwerp, Belgium.
FEMS Microbiol Lett. 2024 Jan 9;371. doi: 10.1093/femsle/fnae104.
The ResistAZM randomized controlled trial found that the receipt of ceftriaxone/azithromycin, compared to ceftriaxone was not associated with an increase in the proportion of oral commensal Neisseria spp. and streptococci with azithromycin resistance 14 days after treatment. We repeated the analyses by measuring the minimum inhibitory concentrations (MICs) of azithromycin and ceftriaxone for individual colonies of commensal Neisseria spp. and streptococci at day 0 and day 14 in both arms. The receipt of ceftriaxone/azithromycin but not ceftriaxone was associated with an increase in azithromycin MIC for both Neisseria spp. (P < 0.0001) and streptococci (P = 0.0076). Likewise, ceftriaxone/azithromycin but not ceftriaxone monotherapy was associated with an increase in ceftriaxone MICs in Neisseria spp. (P = 0.0035). Whereas the proportion method failed to detect an association between the receipt of azithromycin and increased macrolide resistance, the MIC distribution method detected this effect. The MIC distribution method is thus a more sensitive method to assess the effect of antimicrobials on antimicrobial susceptibility.
The ResistAZM randomized controlled trial found that the receipt of ceftriaxone/azithromycin, compared to ceftriaxone was not associated with an increase in the proportion of oral commensal Neisseria spp. and streptococci with azithromycin resistance 14 days after treatment.
We repeated the analyses by measuring the minimum inhibitory concentrations (MICs) of azithromycin and ceftriaxone for individual colonies of commensal Neisseria spp. and streptococci at day 0 and day 14 in both arms.
The receipt of ceftriaxone/azithromycin but not ceftriaxone was associated with an increase in azithromycin MIC for both Neisseria spp. (P < 0.0001) and streptococci (P = 0.0076). Likewise, ceftriaxone/azithromycin but not ceftriaxone monotherapy was associated with an increase in ceftriaxone MICs in Neisseria spp. (P = 0.0035).
Whereas the proportion method failed to detect an association between the receipt of azithromycin and increased macrolide resistance, the MIC distribution method detected this effect. The MIC distribution method is thus a more sensitive method to assess the effect of antimicrobials on antimicrobial susceptibility.
“ResistAZM”随机对照试验发现，与仅接受头孢曲松治疗相比，接受头孢曲松/阿奇霉素治疗后14天，口腔共生奈瑟菌属和链球菌对阿奇霉素耐药的比例并未增加。我们通过测量双臂试验中第0天和第14天共生奈瑟菌属和链球菌单个菌落对阿奇霉素和头孢曲松的最低抑菌浓度（MIC），重复了分析。接受头孢曲松/阿奇霉素而非头孢曲松治疗与奈瑟菌属（P < 0.0001）和链球菌（P = 0.0076）的阿奇霉素MIC增加有关。同样，头孢曲松/阿奇霉素而非头孢曲松单药治疗与奈瑟菌属中头孢曲松MIC增加有关（P = 0.0035）。虽然比例法未能检测到阿奇霉素的使用与大环内酯类耐药性增加之间的关联，但MIC分布法检测到了这种效应。因此，MIC分布法是评估抗菌药物对抗菌药物敏感性影响的更敏感方法。
“ResistAZM”随机对照试验发现，与仅接受头孢曲松治疗相比，接受头孢曲松/阿奇霉素治疗后14天，口腔共生奈瑟菌属和链球菌对阿奇霉素耐药的比例并未增加。
我们通过测量双臂试验中第0天和第14天共生奈瑟菌属和链球菌单个菌落对阿奇霉素和头孢曲松的最低抑菌浓度（MIC），重复了分析。
接受头孢曲松/阿奇霉素而非头孢曲松治疗与奈瑟菌属（P < 0.0001）和链球菌（P = 0.0076）的阿奇霉素MIC增加有关。同样，头孢曲松/阿奇霉素而非头孢曲松单药治疗与奈瑟菌属中头孢曲松MIC增加有关（P = 0.0035）。
虽然比例法未能检测到阿奇霉素的使用与大环内酯类耐药性增加之间的关联，但MIC分布法检测到了这种效应。因此，MIC分布法是评估抗菌药物对抗菌药物敏感性影响的更敏感方法。
