Moya-Salazar Jeel, Terán-Vásquez Alfonso, Salazar-Hernandez Richard, Rojas-Zumaran Víctor, Goicochea-Palomino Eliane A, Moya-Salazar Marcia M, Contreras-Pulache Hans
Faculty of Medicine, Universidad Señor de Sipán, Chiclayo 14002, Peru.
Department of Pathology, Hospital Nacional Docente Madre-Niño San Bartolomé, Lima 51001, Peru.
Antibiotics (Basel). 2025 Jun 22;14(7):636. doi: 10.3390/antibiotics14070636.
causes gastroenteritis worldwide with increasing antimicrobial resistance. Furazolidone (FZD) shows potential in resource-poor areas but needs further study. We aimed to assess the in vitro susceptibility of spp. to FZD, ciprofloxacin (CIP), and erythromycin (ERY) in a high-risk pediatric cohort and to evaluate the clinical relevance of resistance patterns using inhibitory quotient (IQ) pharmacodynamics. A two-phase prospective study (2012-2013, 2014-2015) was conducted at a tertiary pediatric hospital in Lima, Peru. Stool samples from children ≤24 months were cultured on selective media, with isolates identified via conventional bacteriological methods. Antimicrobial susceptibility was determined using Kirby-Bauer disk diffusion and regression-derived minimum inhibitory concentrations (MICs). IQ analysis correlated inhibition zones with therapeutic outcomes. Among 194 isolates (: 28%; : 72%), resistance to CIP declined from 97.7% (2012-2013) to 83% (2014-2015), while ERY resistance rose from 2.3% to 9.4% (= 0.002). No FZD resistance was observed, with mean inhibition zones of 52 ± 8 mm (2012-2013) and 43 ± 10.5 mm (2014-2015). MICs for FZD were predominantly <0.125 μg/mL, and all susceptible isolates demonstrated favorable IQ outcomes. Multidrug resistance (≥2 drugs) increased to 6.2% (2014-2015), though all MDR strains retained FZD susceptibility. CLSI and EUCAST breakpoints showed concordance for ERY ( = 0.724) but discordance for CIP ( = 0.022 vs. 0.008). FZD exhibits sustained in vitro efficacy against spp., even among MDR strains, contrasting with escalating fluoroquinolone and macrolide resistance.
在全球范围内引发肠胃炎且抗菌药物耐药性不断增加。呋喃唑酮(FZD)在资源匮乏地区显示出潜力,但仍需进一步研究。我们旨在评估高危儿科队列中某菌属对FZD、环丙沙星(CIP)和红霉素(ERY)的体外敏感性,并使用抑制商(IQ)药效学评估耐药模式的临床相关性。在秘鲁利马的一家三级儿科医院进行了一项两阶段前瞻性研究(2012 - 2013年,2014 - 2015年)。对24个月及以下儿童的粪便样本在选择性培养基上进行培养,通过传统细菌学方法鉴定分离株。使用 Kirby - Bauer 纸片扩散法和回归推导的最低抑菌浓度(MIC)来确定抗菌药物敏感性。IQ 分析将抑菌圈与治疗结果相关联。在194株分离株中(某菌属:28%;另一菌属:72%),对CIP的耐药率从97.7%(2012 - 2013年)降至83%(2014 - 2015年),而ERY耐药率从2.3%升至9.4%(P = 0.002)。未观察到对FZD的耐药情况,2012 - 2013年平均抑菌圈为52±8毫米,2014 - 2015年为43±10.5毫米。FZD的MIC主要<0.125μg/mL,所有敏感分离株均显示出良好的IQ结果。多重耐药(≥2种药物)增加到6.2%(2014 - 2015年),尽管所有多重耐药菌株对FZD仍敏感。CLSI和EUCAST断点对ERY显示出一致性(P = 0.724),但对CIP显示出不一致性(P = 0.022对0.008)。FZD对某菌属表现出持续的体外疗效,即使在多重耐药菌株中也是如此,这与氟喹诺酮和大环内酯类耐药性的不断上升形成对比。