In vitro activities of 15 antimicrobial agents against 110 toxigenic Clostridium difficile clinical isolates collected from 1983 to 2004
In vitro activities of 15 antimicrobial agents against 110 toxigenic Clostridium difficile clinical isolates collected from 1983 to 2004
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DOI：
10.1128/aac.01623-06
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发表时间：
2007-08-01
影响因子：
4.9
通讯作者：
Gerding, Dale N.
中科院分区：
文献类型：
--
作者：
Hecht, David W.;Galang, Minerva A.;Gerding, Dale N.
艰难梭菌相关疾病（CDAD）的发病率和严重程度正在增加，标准治疗并不总是有效的。因此，需要更有效的抗菌药物和治疗策略。我们使用琼脂稀释法测定了1983年至2004年期间主要来自美国的110株艰难梭菌致突变性临床分离株对以下抗菌药物的体外敏感性：多利培南、美罗培南、加替沙星、左氧氟沙星、阿替沙星、OPT-80、雷莫拉宁、利福拉齐、利福昔明、硝唑尼特、替唑尼特、替加环素、万古霉素、替硝唑和甲硝唑。在测试的分离株中包括毒素型III的六种菌株，NAP 1/BI/027组涉及最近的美国，加拿大和欧洲的疫情。体外活性最强的药物是利福昔明、利福拉齐、替唑尼特、硝唑尼特和OPT-80，其MIC（MIC 50）和MIC 90值分别为0.0075和0.015 μ g/ml、0.0075和0.03 μ g/ml、0.06和0.125 μ g/ml、0.06和0.125 μ g/ml，0.125和0.125 μ g/ml。然而，对于三个分离株，利福拉齐和利福昔明的MIC非常高（MIC>256 μ g/ml）。雷莫拉宁、万古霉素、多利培南和美罗培南在体外也非常活跃，MIC 50和MIC 90范围较窄。没有一个分离株对甲硝唑耐药，甲硝唑是唯一有断点的药物，替硝唑显示出几乎相同的结果。这些体外敏感性结果令人鼓舞，并支持在CDAD治疗的临床试验中继续评价选定的抗菌药物。
The incidence and severity of Clostridium difficile-associated disease (CDAD) is increasing, and standard treatment is not always effective. Therefore, more-effective antimicrobial agents and treatment strategies are needed. We used the agar dilution method to determine the in vitro susceptibility of the following antimicrobials against 110 toxigenic clinical isolates of C difficile from 1983 to 2004, primarily from the United States: doripenem, meropenem, gatifloxacin, levofloxacin, moxifloxacin, OPT-80, ramoplanin, rifalazil, rifaximin, nitazoxanide, tizoxanide, tigecycline, vancomycin, tinidazole, and metronidazole. Included among the isolates tested were six strains of the toxinotype III, NAP1/BI/027 group implicated in recent U.S., Canadian, and European outbreaks. The most active agents in vitro were rifaximin, rifalazil, tizoxanide, nitazoxanide, and OPT-80 with MICs at which 50% of the isolates are inhibited (MIC50) and MIC90 values of 0.0075 and 0.015 mu g/ml, 0.0075 and 0.03 mu g/ml, 0.06 and 0.125 mu g/ml, 0.06 and 0.125 mu g/ml, 0.125 and 0.125 mu g/ml, respectively. However, for three isolates the rifalazil and rifaximin MICs were very high (MIC of >256 mu g/ml). Ramoplanin, vancomycin, doripenem, and meropenem were also very active in vitro with narrow MIC50 and MIC90 ranges. None of the isolates were resistant to metronidazole, the only agent for which there are breakpoints, with tinidazole showing nearly identical results. These in vitro susceptibility results are encouraging and support continued evaluation of selected antimicrobials in clinical trials of treatment for CDAD.