Comparative activities of daptomycin, linezolid, and tigecycline against catheter-related methicillin-resistant Staphylococcus bacteremic isolates embedded in biofilm
Comparative activities of daptomycin, linezolid, and tigecycline against catheter-related methicillin-resistant Staphylococcus bacteremic isolates embedded in biofilm
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DOI：
10.1128/aac.00350-06
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发表时间：
2007-05-01
影响因子：
4.9
通讯作者：
Hachem, Ray
中科院分区：
文献类型：
--
作者：
Raad, Issam;Hanna, Hend;Hachem, Ray
在导管相关血流感染的情况下，腔内抗生素封管治疗可能有助于挽救血管导管。在这项体外研究中，我们研究了新的抗生素达托霉素，利奈唑胺和替加环素的疗效，与万古霉素，米诺环素和利福平，对甲氧西林耐药金黄色葡萄球菌（MRSA）嵌入生物膜。我们还评估了在每天使用4小时进行导管锁定治疗后，MRSA菌株对这些抗生素（单独使用或与利福平联合使用）的耐药性的出现。在暴露于这些抗生素的第一天后，米诺环素、达托霉素和替加环素在抑制生物膜中MRSA方面比利奈唑胺、万古霉素和阴性对照更有效（P < 0.001），其中米诺环素最具活性，其次是达托霉素，然后是替加环素，万古霉素和利奈唑胺缺乏活性，与阴性对照相似。每天暴露4小时3天后，达托霉素从生物膜中清除MRSA最快，其次是米诺环素和替加环素，比利奈唑胺、利福平和万古霉素更快（P < 0.001）。当单独使用利福平时，每天暴露4小时5天后，从生物膜中根除MRSA的效果最差，因为它与利福平耐药MRSA的出现有关。然而，当利福平与其他抗生素联合使用时，该组合在消除生物膜中的MRSA定植方面比单独使用每种抗生素更迅速地显着有效。总之，达托霉素、米诺环素和替加环素应进一步考虑用于抗生素锁定治疗，利福平应考虑用于增强抗葡萄球菌活性，但不应作为单一药物。
In the setting of catheter-related bloodstream infections, intraluminal antibiotic lock therapy could be useful for the salvage of vascular catheters. In this in vitro study, we investigated the efficacies of the newer antibiotics daptomycin, linezolid, and tigecycline, in comparison with those of vancomycin, minocycline, and rifampin, against methicillin-resistant Staphylococcus aureus (MRSA) embedded in biofilm. We also assessed the emergence of MRSA strains resistant to these antibiotics, alone or in combination with rifampin, after 4-hour daily use for catheter lock therapy. Minocycline, daptomycin, and tigecycline were more efficacious in inhibiting MRSA in biofilm than linezolid, vancomycin, and the negative control (P < 0.001) after the first day of exposure to these antibiotics, with minocycline being the most active, followed by daptomycin and then tigecycline, and with vancomycin and linezolid lacking activity, similar to the negative control. After 3 days of 4-hour daily exposures, daptomycin was the fastest in eradicating MRSA from biofilm, followed by minocycline and tigecycline, which were faster than linezolid, rifampin, and vancomycin (P < 0.001). When rifampin was used alone, it was the least effective in eradicating MRSA from biofilm after 5 days of 4-hour daily exposures, as it was associated with the emergence of rifampin-resistant MRSA. However, when rifampin was used in combination with other antibiotics, the combination was significantly effective in eliminating MRSA colonization in biofilm more rapidly than each of the antibiotics alone. In summary, daptomycin, minocycline, and tigecycline should be considered further for antibiotic lock therapy, and rifampin should be considered for enhanced antistaphylococcal activity but not as a single agent.