Vinayan Sneha, Sistla Sujatha, Manoharan Meerabai, Walia Kamini, Sugumar Madhan
Department of Microbiology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India.
Division of Epidemiology and Communicable Diseases, Indian Council of Medical Research, New Delhi, India.
Indian J Med Microbiol. 2025 Jan-Feb;53:100788. doi: 10.1016/j.ijmmb.2025.100788. Epub 2025 Jan 8.
Vancomycin has been the preferred treatment for MRSA infections. However, newer drugs are necessary due to the increasing prevalence of MRSA isolates that are less susceptible to vancomycin. Levonadifloxacin and its prodrug alalevonadifloxacin, novel quinolones with broad spectrum anti-MRSA activity. They are approved in India for the treatment of skin and soft-tissue infections, bacteraemia, and diabetic foot infections.
A total of 456 MRSA (Methicillin-resistant Staphylococcus aureus) isolates, including 333 isolates from JIPMER and 123 isolates from other tertiary care centers collected between January to December 2022, underwent susceptibility testing to levonadifloxacin by disc diffusion method. The study isolates included 29 h-VISA. Fifty one blood isolates were also subjected to E-test and their results were compared to the gold standard, broth micro dilution (BMD).
All 456 isolates were found to be susceptible to levonadifloxacin by disc diffusion. Levonadifloxacin demonstrated potent activity against MRSA strains isolated from blood (n = 51) with an MIC and MIC of 0.38 and 0.5 μg/mL by E-test, respectively. Similarly, it demonstrated an MIC and MIC of 0.5 & 1 μg/ml by BMD.
The present study demonstrated 100 % susceptibility to levonadifloxacin among the tested isolates of MRSA, highlighting its promising clinical potential for treating infections caused by this organism. Furthermore, the study recorded a concordance of 100 % between disc diffusion and Etest method with BMD, indicating the reliability of these methods.
万古霉素一直是耐甲氧西林金黄色葡萄球菌(MRSA)感染的首选治疗药物。然而,由于对万古霉素敏感性降低的MRSA分离株的患病率不断增加,需要更新的药物。左诺氟沙星及其前药阿拉左诺氟沙星是具有广谱抗MRSA活性的新型喹诺酮类药物。它们在印度被批准用于治疗皮肤和软组织感染、菌血症和糖尿病足感染。
2022年1月至12月期间收集的总共456株MRSA(耐甲氧西林金黄色葡萄球菌)分离株,包括来自JIPMER的333株分离株和来自其他三级护理中心的123株分离株,通过纸片扩散法对左诺氟沙星进行药敏试验。研究分离株包括29株异质性万古霉素中介金黄色葡萄球菌(h-VISA)。51株血液分离株也进行了E试验,并将其结果与金标准肉汤微量稀释法(BMD)进行比较。
通过纸片扩散法发现所有456株分离株对左诺氟沙星敏感。左诺氟沙星对从血液中分离出的MRSA菌株(n = 51)显示出强效活性,通过E试验测得的MIC和MIC分别为0.38和0.5μg/mL。同样,通过BMD测得的MIC和MIC分别为0.5和1μg/ml。
本研究表明,受试的MRSA分离株对左诺氟沙星的敏感性为100%,突出了其在治疗由该病原体引起的感染方面的潜在临床应用前景。此外,该研究记录了纸片扩散法和E试验法与BMD之间的一致性为100%,表明这些方法的可靠性。