Surveillance of the Activity of Aminoglycosides and Fluoroquinolones Against Ophthalmic Pathogens from Europe in 2010–2011
Surveillance of the Activity of Aminoglycosides and Fluoroquinolones Against Ophthalmic Pathogens from Europe in 2010–2011
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DOI：
10.3109/02713683.2015.1045084
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发表时间：
2015-07
影响因子：
2
通讯作者：
Christine M. Sanfilippo;I. Morrissey;R. Janes;T. Morris
中科院分区：
文献类型：
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作者：
Christine M. Sanfilippo;I. Morrissey;R. Janes;T. Morris
摘要目的：眼表细菌感染通常用广谱抗生素经验性治疗。由于对抗生素耐药性增加的担忧，我们评估了欧洲目前眼部细菌病原体的敏感性模式。材料与方法：2011年从法国、德国、意大利、波兰、斯洛伐克共和国、西班牙和英国的研究中心收集了金黄色葡萄球菌、凝固酶阴性葡萄球菌（CoNS）、肺炎链球菌、流感嗜血杆菌和铜绿假单胞菌的非连续眼部分离株。要求各中心提供相似数量的甲氧西林敏感和耐药葡萄球菌分离株。测定了氟喹诺酮类（贝西氟哌酸、环丙氟哌酸、莫西氟哌酸）、氨基糖苷类（妥布霉素、庆大霉素、奈替米星）、苯唑西林、氯霉素和红霉素的最小抑制浓度。根据欧洲抗菌药物敏感性试验委员会（EUCAST）标准，将分离株分类为敏感、中间或耐药。结果：共获得741株眼部分离株。抗生素耐药率不仅取决于抗生素和物种，而且因原产国而异。对环丙沙星、妥布霉素、红霉素以及较小程度上对氯霉素的耐药性是所有葡萄球菌关注的问题。耐甲氧西林链球菌普遍存在多重耐药。金黄色葡萄球菌（MRSA）和MRCoNS以及S. pneumoniae，H.流感病毒和铜绿假单胞菌通常分别对红霉素、β-内酰胺类药物和环丙沙星/妥布霉素不敏感。耐药率在接受测试的七个国家之间显示出很大差异。氟喹诺酮类和氨基糖苷类在抗菌效力和对抗生素耐药机制的恢复力方面存在差异。结论：耐甲氧西林葡萄球菌分离株通常对多种其他抗生素不敏感，使MRSA和MRCoNS成为潜在的重大问题。本研究中在整个欧洲观察到的广泛耐药率证实了在选择抗菌药物用于眼部感染的经验性管理时考虑当前局部耐药模式的重要性。
Abstract Purpose/Aim: Bacterial infections of the ocular surface are commonly treated empirically with broad spectrum antibiotics. Due to concerns over increasing antibiotic resistance, we evaluated current susceptibility patterns of the ocular bacterial pathogens in Europe. Materials and methods: Non-consecutive ocular isolates of Staphylococcus aureus, coagulase-negative staphylococci (CoNS), Streptococcus pneumoniae, Haemophilus influenzae, and Pseudomonas aeruginosa were collected in 2011 from centers in France, Germany, Italy, Poland, Slovak Republic, Spain, and the United Kingdom. Centers were asked to provide similar numbers of methicillin-susceptible and -resistant staphylococcal isolates. Minimum inhibitory concentrations were determined for fluoroquinolones (besifloxacin, ciprofloxacin, moxifloxacin), aminoglycosides (tobramycin, gentamicin, netilmicin), oxacillin, chloramphenicol and erythromycin. Isolates were categorized as susceptible, intermediate, or resistant according to European Committee on Antimicrobial Susceptibility Testing (EUCAST) criteria. Results: A total of 741 ocular isolates were obtained. Antibiotic resistance rates depended not only on the antibiotic and species, but also varied greatly by the country of origin. Resistance to ciprofloxacin, tobramycin, erythromycin, and to a lesser extent, chloramphenicol, was a concern for all staphylococci. Multidrug resistance was common among methicillin-resistant S. aureus (MRSA) and MRCoNS and isolates of S. pneumoniae, H. influenzae, and P. aeruginosa were frequently non-susceptible to erythromycin, beta-lactams, and ciprofloxacin/tobramycin, respectively. Resistance rates showed substantial differences among the seven countries tested. Fluoroquinolones and aminoglycosides showed differences in antibacterial potency and resilience toward the antibiotic resistance mechanisms. Conclusions: Methicillin-resistant staphylococcal isolates were frequently non-susceptible to a multitude of other antibiotics, making MRSA and MRCoNS a potentially significant concern. The broad range of resistance rates observed across Europe in this study confirms the importance of considering current local resistance patterns when antibacterial agents are chosen for empiric management of ocular infections.