Fluoroquinolone Therapy in Staphylococcus aureus Infections: Where Do We Stand?
Fluoroquinolone Therapy in Staphylococcus aureus Infections: Where Do We Stand?
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DOI：
10.4103/0974-2727.119862
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发表时间：
2013-07
影响因子：
1.1
通讯作者：
Qazi MS
中科院分区：
文献类型：
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作者：
Gade ND;Qazi MS
本研究旨在评价各种常用氟喹诺酮类药物对金黄色葡萄球菌分离株的效用。2009年11月至2011年12月，从血液、脓液、伤口拭子、痰、耳拭子和体液等不同临床标本中共分离出250株金黄色葡萄球菌。采用Kirby-Bauer盘片扩散法，以标准抑菌区为标准，检测各菌株对氟喹诺酮类药物及其他抗菌药物的敏感性。采用头孢西丁纸片扩散法检测耐甲氧西林金黄色葡萄球菌（MRSA）。采用e -试纸条检测MRSA分离株对万古霉素的最低抑菌浓度（MIC）。所有MRSA菌株被送往新德里Maulana Azad医学院国家葡萄球菌噬菌体分型中心进行噬菌体分型。共检出金黄色葡萄球菌107株（42.8%）为MRSA。多药耐药在MRSA菌株中比在MSSA菌株中更为常见。在氟喹诺酮类药物中，MRSA耐药最多的是环丙沙星（92.5%），其次是氧氟沙星（80.4%）。金黄色葡萄球菌分离株对万古霉素和利奈唑胺均无耐药性。万古霉素对MRSA的mic为0.5 ~ 2 μg/ml。107株MRSA噬菌体分型结果显示，37株（34.6%）不可分型，70株（65.4%）可分型。环丙沙星不能再用于抗MRSA感染的经验性治疗。氟喹诺酮类药物的其他成员的使用应仅限于那些经实验室确认其易感性的菌株。万古霉素仍然是治疗耐甲氧西林金黄色葡萄球菌感染的首选药物。
The study aimed to evaluate the utility of various commonly used fluoroquinolones against Staphylococcus aureus isolates. A total of 250 isolates of S. aureus were studied from different clinical specimens like blood, pus, wound swabs, sputum, ear swabs, and body fluids between November 2009 and December 2011. All the isolates were tested for their susceptibility to fluoroquinolones and other antimicrobial agents by Kirby-Bauer disc diffusion method using criteria of standard zone of inhibition. Methicillin-resistant S. aureus (MRSA) detection was done by cefoxitin disk diffusion method. The MRSA isolates were tested for minimum inhibitory concentration (MIC) to vancomycin by E-test strips. All the MRSA strains were sent to National Staphylococcal Phage-typing Centre, Maulana Azad Medical College, New Delhi for phage typing. A total of 107 strains of S. aureus (42.8%) were detected as MRSA. Multidrug resistance was observed among the MRSA strains more commonly than among the MSSA stains. Among the fluoroquinolones, maximum resistance in MRSA was seen to ciprofloxacin (92.5%), followed by ofloxacin (80.4%). None of the S. aureus isolates showed resistance to vancomycin and linezolid. The MICs of vancomycin for the MRSA tested ranged from 0.5 to 2 μg/ml. Phage typing pattern of 107 MRSA isolates revealed that 37 (34.6%) MRSA isolates were nontypeable and 70 (65.4%) were typeable. Ciprofloxacin can no longer be used in empirical therapy against MRSA infections. Use of other members of fluoroquinolone should be limited only to those strains that show laboratory confirmation of their susceptibility. Vancomycin remains the drug of choice to treat MRSA infections.