Baseline study to determine in vitro activities of daptomycin against gram-positive pathogens isolated in the United States in 2000-2001
Baseline study to determine in vitro activities of daptomycin against gram-positive pathogens isolated in the United States in 2000-2001
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DOI：
10.1128/aac.47.5.1689-1693.2003
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发表时间：
2003-05-01
影响因子：
4.9
通讯作者：
Karlowsky, JA
中科院分区：
文献类型：
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作者：
Critchley, IA;Blosser-Middleton, RS;Karlowsky, JA
利用2000年和2001年在美国50家医院分离的6,973种革兰氏阳性细菌对达托霉素的活性进行了评估。收集到的肺炎链球菌1163株中，青霉素耐药率为16.1%；金黄色葡萄球菌（1018株）和屎肠球菌（368株）对oxacillin和万古霉素的耐药率分别为30.0%和59.5%。多药耐药（MDR）表型（对三种或三种以上化学类抗菌药物耐药的分离株）占肺炎链球菌分离株的14.2%，金黄色葡萄球菌分离株的27.1%和粪肠杆菌分离株的58.4%。对于所有测试的革兰氏阳性菌株，90%的测试分离株被抑制的MIC（MIC(90)s）和定向谱药物（达托霉素、奎奴普司汀-达福普司汀和利奈唑胺）的MIC范围与对其他药物或耐多药敏感或耐药的分离株相同或高度相似。达托霉素对肺炎链球菌青霉素敏感株和耐药株的MIC90均为0.12马克/毫升。达托霉素对耐氧西林金黄色葡萄球菌的MIC90均为0.5 mug/ml，对万古霉素敏感和耐药的粪肠杆菌的MIC90均为4 mug/ml。达托霉素和其他定向谱药物的MIC（90）不受分离株的区域或解剖学来源或患者人口统计学参数（患者年龄、性别、住院或门诊）的影响。我们的结果证实了达托霉素的革兰氏阳性活性谱，并且其活性独立于对常用处方和测试的抗菌药物的敏感性或耐药性。该研究可作为监测革兰氏阳性物种在引入临床使用后对达托霉素敏感性变化的基线。
The activity of daptomycin was assessed by using 6,973 gram-positive bacteria isolated at 50 United States hospitals in 2000 and 2001. Among the isolates of Streptococcus pneumoniae (n=1,163) collected, the rate of penicillin resistance was 16.1%; rates of oxacillin resistance among Staphylococcus aureus isolates (n=1,018) and vancomycin resistance among Enterococcus faecium isolates (n=368) were 30.0 and 59.5%, respectively. Multidrug-resistant (MDR) phenotypes (isolates resistant to three or more different chemical classes of antimicrobial agents) accounted for 14.2% of S. pneumoniae isolates, 27.1% of S. aureus isolates, and 58.4% of E. faecium isolates. For all gram-positive species tested, MICs at which 90% of the isolates tested were inhibited (MIC(90)s) and MIC ranges for directed-spectrum agents (daptomycin, quinupristin-dalfopristin, and linezolid) were identical or highly similar for isolates susceptible or resistant to other agents or MDR. Daptomycin had a MIC90 of 0.12 mug/ml for both penicillin-susceptible and -resistant isolates of S. pneumoniae. Against oxacillin-resistant S. aureus daptomycin had a MIC90 of 0.5 mug/ml, and it had a MIC90 of 4 mug/ml against both vancomycin-susceptible and -resistant E. faecium. The MIC(90)s for daptomycin and other directed-spectrum agents were unaffected by the regional or anatomical origin of isolates or patient demographic parameters (patient age, gender, and inpatient or outpatient care). Our results confirm the gram-positive spectrum of activity of daptomycin and that its activity is independent of susceptibility or resistance to commonly prescribed and tested antimicrobial agents. This study may serve as a baseline to monitor future changes in the susceptibility of gram-positive species to daptomycin following its introduction into clinical use.