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达托霉素与磷霉素联合对耐甲氧西林菌的协同抗菌活性及耐药性预防

Synergistic antibacterial activity and prevention of drug resistance of daptomycin combined with fosfomycin against methicillin-resistant .

作者信息

Ai Qin, Wang Sailan, Chen Ziyan, Zheng Shuai, Chen Zaixing, Zhang Na, Li Yaowen, Liu Huiping, Liu Yanyan, Li Jiabin, Huang Xiaohui

机构信息

Department of Basic and Clinical Pharmacology, School of Pharmaceutical Sciences, Anhui Medical University, Hefei, China.

Anhui Province Key Laboratory of Major Autoimmune Diseases, School of Pharmaceutical Sciences, Anhui Institute of Innovative Drugs, Anhui Medical University, Hefei, China.

出版信息

Antimicrob Agents Chemother. 2025 Aug 6;69(8):e0160924. doi: 10.1128/aac.01609-24. Epub 2025 Jun 18.

Abstract

The combination of daptomycin and fosfomycin is attracting attention due to the rising resistance observed in methicillin-resistant (MRSA). Most studies indicate that this combination exhibits synergistic or additive antimicrobial activity against MRSA. However, its capacity to prevent resistance remains uncertain. In this study, we first investigated the antibacterial effect of daptomycin and fosfomycin on MRSA, followed by predicting MRSA resistance under the influence of different drugs using a resistance mutation selection window. Subsequently, we conducted preliminary analyses of drug resistance gene mutations in resistance mutants through gene sequencing technology. Additionally, we established an biofilm infection model to explore the internal tolerance associated with phenotypic alterations in biofilms and assess the combination's ability to prevent drug resistance. Combination drug sensitivity experiments demonstrated that daptomycin and fosfomycin synergistically enhanced antimicrobial effects against the tested strains. This combination reduced the mutant prevention concentration of each drug and narrowed the selection window for drug-resistant mutations. Sequencing results indicated that specific resistance genes were mutated in the single-drug mutants, while no mutations were detected in the combination. Furthermore, the combination exhibited stronger inhibition and removal of biofilm compared to single agents. In conclusion, the daptomycin-fosfomycin combination displays a synergistic antibacterial effect against MRSA and shows enhanced capacity to prevent bacterial resistance, likely attributed to its ability to inhibit resistance gene mutations and exhibit superior anti-biofilm activity.

摘要

由于耐甲氧西林金黄色葡萄球菌(MRSA)中观察到的耐药性不断上升,达托霉素和磷霉素的联合使用正受到关注。大多数研究表明,这种联合用药对MRSA表现出协同或相加的抗菌活性。然而,其预防耐药性的能力仍不确定。在本研究中,我们首先研究了达托霉素和磷霉素对MRSA的抗菌作用,然后使用耐药突变选择窗口预测不同药物影响下的MRSA耐药性。随后,我们通过基因测序技术对耐药突变体中的耐药基因突变进行了初步分析。此外,我们建立了一个生物膜感染模型,以探索与生物膜表型改变相关的内在耐受性,并评估该联合用药预防耐药性的能力。联合药敏实验表明,达托霉素和磷霉素协同增强了对受试菌株的抗菌作用。这种联合用药降低了每种药物的突变预防浓度,并缩小了耐药突变的选择窗口。测序结果表明,单药突变体中有特定的耐药基因突变,而联合用药组未检测到突变。此外,与单一药物相比,联合用药对生物膜的抑制和清除作用更强。总之,达托霉素-磷霉素联合用药对MRSA显示出协同抗菌作用,并表现出增强的预防细菌耐药性的能力,这可能归因于其抑制耐药基因突变的能力和卓越的抗生物膜活性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/77f6/12327001/3953da44e61a/aac.01609-24.f001.jpg

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