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新型胃肠外给药青霉烯类药物舒洛培南的体外抗菌活性

[In vitro antibacterial activity of a new parenteral penem, sulopenem].

作者信息

Yoshida T, Tateda E, Hiramatsu K, Yokota T

机构信息

Department of Bacteriology, School of Medicine, Juntendo University, Tokyo, Japan.

出版信息

Jpn J Antibiot. 1996 Apr;49(4):324-37.

PMID:8786624
Abstract

Eighty percent minimum inhibitory concentrations (MIC80) of sulopenem against clinically isolated 12 to 80 strains of each of different bacteria were as follows: methicillin-susceptible Staphylococcus aureus (MSSA): 0.20 micrograms/ml, methicillin-resistant S. aureus (MRSA): 50 micrograms/ml, coagulase-negative staphylococci: 3.13 micrograms/ml, Streptococcus pyogenes: < or = 0.013 microgram/ml, Streptococcus pneumoniae: < or = 0.013 microgram/ml, beta-streptococci: 0.05 microgram/ml, Enterococcus faecalis: 12.5 micrograms/ml, Enterococcus faecium: > 100 micrograms/ml, Escherichia coli CS2(R+): 0.10 microgram/ml, Klebsiella pneumoniae: 0.05 microgram/ml, Proteus mirabilis: 0.10 microgram/ml, Proteus vulgaris: 0.20 microgram/ml, Morganella morganii: 0.39 micrograms/ml, Providencia rettgeri: 3.13 micrograms/ml, Citrobacter freundii: 0.20 microgram/ml, Enterobacter cloacae: 0.39 microgram/ml, Serratia marcescens: 1.56 micrograms/ml, Pseudomonas aeruginosa: 50 micrograms/ml, Pseudomonas cepacia: 3.13 micrograms/ml, Xanthomonas maltophilia: > 100 micrograms/ml, Acinetobacter calcoaceticus: 1.56 micrograms/ml, ampicillin-resistant Haemophilus influenzae: 0.39 microgram/ml and Bacteroides fragil is: 0.20 microgram/ml, respectively. Sulopenem possesses a stronger activity than flomoxef or cefuzonam against Gram-positive bacteria, the strongest activity among the antibiotics tested against Gram-negative bacteria except P. aeruginosa. Sulopenem has stronger affinities than imipenem to all fractions of PBPs of S. aureus, E. coli, P. vulgaris, S. marcescens, even of P. aeruginosa. Affinities of sulopenem to PBPs-1 and -3 of S. aureus, PBP-2 of E. coli were much stronger than those of imipenem (IPM). Sulopenem generally has small Ki values to all types of beta-lactamases and also has stronger permanent inactivation effect to Ia and IIb types of beta-lactamases than IPM. No synergistic bactericidal activity of sulopenem was apparent with serum complement. However, synergism of sulopenem with macrophages was prominent in bactericidal activity. The cells of E. coli were well phagocytosed and rapidly digested by cultured macrophages in the presence of a higher than 1/8 MIC of sulopenem. Moreover, sulopenem was more stable than imipenem against swine and human dehydropeptidase-Is. Sulopenem is one of the antibiotics that do not induce the appearance of subclones resistant to the drug.

摘要

舒洛培南对临床分离的12至80株不同细菌的最低抑菌浓度(MIC80)如下:甲氧西林敏感金黄色葡萄球菌(MSSA):0.20微克/毫升,耐甲氧西林金黄色葡萄球菌(MRSA):50微克/毫升,凝固酶阴性葡萄球菌:3.13微克/毫升,化脓性链球菌:≤0.013微克/毫升,肺炎链球菌:≤0.013微克/毫升,β-链球菌:0.05微克/毫升,粪肠球菌:12.5微克/毫升,屎肠球菌:>100微克/毫升,大肠埃希菌CS2(R+):0.10微克/毫升,肺炎克雷伯菌:0.05微克/毫升,奇异变形杆菌:0.10微克/毫升,普通变形杆菌:0.20微克/毫升,摩根摩根菌:0.39微克/毫升,雷氏普罗威登斯菌:3.13微克/毫升,弗氏柠檬酸杆菌:0.20微克/毫升,阴沟肠杆菌:0.39微克/毫升,黏质沙雷菌:1.56微克/毫升,铜绿假单胞菌:50微克/毫升,洋葱伯克霍尔德菌:3.13微克/毫升,嗜麦芽窄食单胞菌:>100微克/毫升,醋酸钙不动杆菌:1.56微克/毫升,氨苄西林耐药流感嗜血杆菌:0.39微克/毫升和脆弱拟杆菌:0.20微克/毫升。舒洛培南对革兰氏阳性菌的活性强于氟氧头孢或头孢唑南,在测试的抗生素中,除铜绿假单胞菌外,对革兰氏阴性菌的活性最强。舒洛培南对金黄色葡萄球菌、大肠埃希菌、普通变形杆菌、黏质沙雷菌甚至铜绿假单胞菌的所有青霉素结合蛋白(PBPs)组分的亲和力均强于亚胺培南。舒洛培南对金黄色葡萄球菌的PBPs-1和-3、大肠埃希菌的PBP-2的亲和力远强于亚胺培南(IPM)。舒洛培南对所有类型的β-内酰胺酶的Ki值通常较小,对Ia和IIb型β-内酰胺酶的永久性灭活作用也比亚胺培南强。舒洛培南与血清补体无明显协同杀菌活性。然而,舒洛培南与巨噬细胞在杀菌活性方面协同作用显著。在舒洛培南浓度高于1/8 MIC时,培养的巨噬细胞能很好地吞噬并快速消化大肠埃希菌细胞。此外,舒洛培南对猪和人脱氢肽酶-I比亚胺培南更稳定。舒洛培南是不会诱导出现对该药耐药的亚克隆的抗生素之一。

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引用本文的文献

1
Sulopenem: An Intravenous and Oral Penem for the Treatment of Urinary Tract Infections Due to Multidrug-Resistant Bacteria.舒巴坦钠:一种用于治疗多重耐药菌引起的尿路感染的静脉注射和口服青霉素类药物。
Drugs. 2022 Apr;82(5):533-557. doi: 10.1007/s40265-022-01688-1. Epub 2022 Mar 16.