CAJ | 학술논문

目的研究达托霉素等抗菌药物对2679株革兰阳球菌的体外抗菌活性.方法收集2010年1月-2011年12月9个城市17家教学医院临床分离的2679株非重复革兰阳性球菌.采用微量肉汤稀释法测定的达托霉素最低抑菌浓度(MIC),用琼脂稀释法测定其他抗菌药物的MIC值,用WHONET5.6软件进行药敏数据统计分析.结果耐甲氧西林金黄色葡萄球菌(MRSA)和耐甲氧西林凝固酶阴性葡萄球菌(MRSCoN)检出率分别为45.8％和84.2％,MRSA对复方磺胺甲(噁)唑和氯霉素的敏感率分别为93.1％和85.5％,对红霉素、四环素、克林霉素和利福平的敏感率分别为13.8％、26.6％、63.2％、50.0％,对达托霉素、万古霉素和利奈唑胺的敏感率均为100.0％,MRSCoN对达托霉素、万古霉素和利奈唑胺的敏感率均为100.0％,达托霉素对于MRSA和MRSCoN的MIC50和MIC90均为0.5 mg/L.513株肠球菌对于高水平庆大霉素耐药率为56.9％,氯霉素和四环素的敏感率分别为76.0％和44.1％,对替加环素和达托霉素敏感率均达100.0％,达托霉素对于其中17株耐万古霉素肠球菌(V RE)的MIC50和MIC90均为2 mg/L.肺炎链球菌和β-溶血链球菌对于达托霉素的敏感率均为100.0％,按口服青霉素折点判读,青霉素不敏感的肺炎链球菌(PNSSP)的比例为63.1％.达托霉素对于PNSSP的MIC50和MIC90分别是0.125 mg/L和0.25 mg/L.达托霉素对于β-溶血链球菌MIC50和MIC90分别是0.008 mg/L和0.032 mg/L.结论达托霉素对临床常见革兰阳性球菌具有较好的抗菌活性,包括多重耐药菌,是治疗革兰阳性菌特别是耐药菌感染的很好选择.
목적 연구체탁매소등항균약물대2679주혁란양구균적체외항균활성.방법 수집2010년1월-2011년12월9개성시17가교학의원림상분리적2679주비중복혁란양성구균.채용미량육탕희석법측정적체탁매소최저억균농도(MIC),용경지희석법측정기타항균약물적MIC치,용WHONET5.6연건진행약민수거통계분석.결과 내갑양서림금황색포도구균(MRSA)화내갑양서림응고매음성포도구균(MRSCoN)검출솔분별위45.8％화84.2％,MRSA대복방광알갑(오)서화록매소적민감솔분별위93.1％화85.5％,대홍매소、사배소、극림매소화리복평적민감솔분별위13.8％、26.6％、63.2％、50.0％,대체탁매소、만고매소화리내서알적민감솔균위100.0％,MRSCoN대체탁매소、만고매소화리내서알적민감솔균위100.0％,체탁매소대우MRSA화MRSCoN적MIC50화MIC90균위0.5 mg/L.513주장구균대우고수평경대매소내약솔위56.9％,록매소화사배소적민감솔분별위76.0％화44.1％,대체가배소화체탁매소민감솔균체100.0％,체탁매소대우기중17주내만고매소장구균(V RE)적MIC50화MIC90균위2 mg/L.폐염련구균화β-용혈련구균대우체탁매소적민감솔균위100.0％,안구복청매소절점판독,청매소불민감적폐염련구균(PNSSP)적비례위63.1％.체탁매소대우PNSSP적MIC50화MIC90분별시0.125 mg/L화0.25 mg/L.체탁매소대우β-용혈련구균MIC50화MIC90분별시0.008 mg/L화0.032 mg/L.결론 체탁매소대림상상견혁란양성구균구유교호적항균활성,포괄다중내약균,시치료혁란양성균특별시내약균감염적흔호선택.
Objective To evaluate the in vitro activity of daptomycin against 2679 Gram-positive cocci.Methods A total of 2679 non-duplicate Gram-positive cocci isolates were collected from 17 teaching hospitals during January,2010 and December,2011.The minimal inhibitory concentrations (MICs) of daptomycin and other anti-microbial agents against 4 Gram-positive cocci were determined by micro-broth dilution method and agar dilution respectively.The data of drug susceptibility were analyzed by WHONET5.6 software.Results Methicillin-resistant Staphylococcus aureus (MRSA) and methicillinresistant coagulase-negative Staphylococci (MRSCoN) detection rates were 45.8％ and 84.2％,respectively.The susceptibility rates of sulfamethoxazole,chloramphenicol,erythromycin,tetracycline,clindamycin and rifampicin against MRSA were 93.1％,85.5％,13.8％,26.6％,63.2％ and 50.0％,respectively.The susceptibility rates of daptomycin,vancomycin and linezolid against MRSA and MRSCoN were all 100.0％.The daptomycin MIC50 and MIC90 of MRSCoN and MRSA were 0.5 mg/L.The high level gentamicin resistance rate of 513 Enterococci isolates was 56.9％.The susceptibility rates of chloramphenicol and tetracycline were 76.0％ and 44.1％,respectively.The susceptibility rates of tigecycline and daptomycin reached 100.0％.The MIC50 and MIC90 of daptomycin against 17 vancomycin-resistant Enterococci (VRE) were both 2 mg/L.The susceptibility rates of daptomycin against Streptococcus pneumoniae and β-hemolytic Streptococcus were 100.0％.The prevalence of penicillin-nonsusceptible Streptococcus pneumoniae (PNSSP) was 63.1％.The MIC50 and MIC90 of daptomycin against PNSSP were 0.125 mg/L and 0.25 mg/L,respectively according to the breakpoint of oral penicillin.The MIC50 and MIC90 daptomycin against β-hemolytic Streptococci were 0.008 mg/L and 0.032 mg/L.Conclusions Daptomycin have excellent in vitro activity against common Gram-positive cocci,including multi-drug resistant bacteria.It may be a good choice for clinicians to treat drug-resistant Gram-positive cocci.