Zimmerli W, Frei R, Widmer A F, Rajacic Z
Department of Internal Medicine and Research, University Hospital, Basle, Switzerland.
J Antimicrob Chemother. 1994 May;33(5):959-67. doi: 10.1093/jac/33.5.959.
Treatment outcome of experimental device-related infections cannot be predicted by the results of standard susceptibility tests such as MIC. Microorganisms involved in such infections have a slow growth rate and adhere to surfaces. Therefore, laboratory tests were developed taking into account these properties and compared with the treatment outcome in an animal model. Vancomycin, teicoplanin, ciprofloxacin and fleroxacin were tested alone, or in combination with rifampicin for their ability to cure experimental device-related infections in guinea pigs due to Staphylococcus aureus ATCC 29213. Rifampicin alone or in combination was significantly more effective than the other four drugs (P < 0.001). Combined treatment with rifampicin had a higher cure rate than rifampicin alone. Treatment success was not predicted by an antibiotic trough level exceeding the MIC at site of infection. In contrast, drug efficacy was predicted if the stationary-phase MBC was in the sensitive range, and if glass-adherent S. aureus was killed by low drug concentrations.
实验性装置相关感染的治疗结果无法通过诸如 MIC 等标准药敏试验的结果来预测。此类感染中涉及的微生物生长速度缓慢且会黏附于表面。因此，考虑到这些特性开发了实验室检测方法，并在动物模型中与治疗结果进行比较。对万古霉素、替考拉宁、环丙沙星和氟罗沙星单独或与利福平联合使用时治愈由金黄色葡萄球菌 ATCC 29213 引起的豚鼠实验性装置相关感染的能力进行了检测。单独使用利福平或联合使用利福平时比其他四种药物显著更有效（P < 0.001）。利福平联合治疗的治愈率高于单独使用利福平。感染部位抗生素谷浓度超过 MIC 并不能预测治疗成功。相反，如果稳定期最低杀菌浓度处于敏感范围内，并且低药物浓度能杀死黏附于玻璃的金黄色葡萄球菌，则可预测药物疗效。
