Antimicrobial susceptibility of Gram-positive cocci isolated from skin and skin-structure infections in European medical centres
Antimicrobial susceptibility of Gram-positive cocci isolated from skin and skin-structure infections in European medical centres
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DOI：
10.1016/j.ijantimicag.2010.03.016
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发表时间：
2010-07-01
影响因子：
10.8
通讯作者：
Jones, Ronald N.
中科院分区：
文献类型：
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作者：
Sader, Helio S.;Farrell, David J.;Jones, Ronald N.
皮肤和皮肤结构感染（SSSI）通常涉及革兰氏阳性菌。及时开始适当的抗菌治疗对于在严重病例中取得良好的结果至关重要。经验性抗菌治疗应基于多种考虑因素，包括患者危险因素、预期病原体和局部/区域敏感性概况等。在本研究中，我们评估了从欧洲医疗中心住院的 SSSI 患者中分离出的革兰氏阳性菌的抗菌敏感性模式。在 6 年期间（2003-2008 年）从位于 13 个欧洲国家以及以色列的 33 个医疗中心收集了总共 3573 株细菌分离株，并在中心实验室通过参考肉汤微量稀释方法测试了对达托霉素和其他对照药物的敏感性。最常见的微生物是金黄色葡萄球菌（71.1%）、β-溶血性链球菌（10.5%）和肠球菌（9.3%）。总体而言，耐甲氧西林金黄色葡萄球菌（MRSA）和耐万古霉素肠球菌（VRE）的比率分别为22.5%和5.1%，但国家间差异很大。在研究期间，总体 MRSA 比率略有变化，但总体没有上升或下降的趋势，而总体 VRE 比率从 2003 年的 1.5% 持续上升到 2008 年的 11.0%。达托霉素和利奈唑胺是总体测试中最活跃的药物。所有监测的分离株均被认为对达托霉素敏感，只有一种分离株（屎肠球菌）被归类为对利奈唑胺不敏感。总之，这项当代监测研究的结果表明，达托霉素和利奈唑胺对从许多欧洲医疗中心因 SSSI 住院患者分离出的革兰氏阳性球菌保持持续的体外活性。 (C) 2010 Elsevier B.V. 和国际化疗协会。版权所有。
Skin and skin-structure infections (SSSIs) usually involve Gram-positive organisms. Prompt initiation of appropriate antimicrobial treatment is essential for achieving a favourable outcome in severe cases. Empirical antibacterial therapy should be based on several considerations, including patient risk factors, expected pathogens and local/regional susceptibility profiles, among others. In the present study, we evaluated the antimicrobial susceptibility patterns of Gram-positive bacteria isolated from patients with SSSIs hospitalised in European medical centres. A total of 3573 bacterial isolates were collected from 33 medical centres located in 13 European countries as well as Israel over a 6-year period (2003-2008) and were tested for susceptibility to daptomycin and other comparator agents by reference broth microdilution methods in a central laboratory. The most frequently isolated organisms were Staphylococcus aureus (71.1%), beta-haemolytic streptococci (10.5%) and enterococci (9.3%). Overall, rates of meticillin-resistant S. aureus (MRSA) and vancomycin-resistant enterococci (VRE) were 22.5% and 5.1%, respectively, but with great intercountry variation. The overall MRSA rate varied slightly during the study period, but with no overall tendency toward increase or decrease, whilst the overall VRE rate consistently increased from 1.5% in 2003 to 11.0% in 2008. Daptomycin and linezolid were the most active agents tested overall. All isolates monitored were considered susceptible to daptomycin, and only one isolate (Enterococcus faecium) was categorised as non-susceptible to linezolid. In conclusion, the results of this contemporary surveillance study indicate that daptomycin and linezolid retain sustained in vitro activity against Gram-positive cocci isolated from patients hospitalised with SSSI in numerous European medical centres. (C) 2010 Elsevier B.V. and the International Society of Chemotherapy. All rights reserved.