RAPID DEVELOPMENT OF CIPROFLOXACIN RESISTANCE IN METHICILLIN-SUSCEPTIBLE AND METHICILLIN-RESISTANT STAPHYLOCOCCUS-AUREUS
RAPID DEVELOPMENT OF CIPROFLOXACIN RESISTANCE IN METHICILLIN-SUSCEPTIBLE AND METHICILLIN-RESISTANT STAPHYLOCOCCUS-AUREUS
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DOI：
10.1093/infdis/163.6.1279
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发表时间：
1991-06-01
影响因子：
6.4
通讯作者：
WACHSMUTH, IK
中科院分区：
文献类型：
--
作者：
BLUMBERG, HM;RIMLAND, D;WACHSMUTH, IK
氟喹诺酮类药物，特别是环丙沙星，已被建议用于治疗耐甲氧西林金黄色葡萄球菌（MRSA）感染和定植以及甲氧西林敏感的S。金黄色葡萄球菌（MSSA）感染。 对MRSA和MSSA中环丙沙星耐药性的发展进行了前瞻性评价。 使用环丙沙星3个月后，MRSA产生了高水平的耐药性（MIC 90，64 μ g/ml），并以惊人的速度增加，在1年内从无到79%。 MSSA中也出现了高水平的环丙沙星耐药性，同期增加到13.6%。 抗生素谱、噬菌体分型和质粒谱分析表明，MRSA的不止一个克隆产生了耐药性，并且环丙沙星耐药性与获得新质粒无关。 大多数患者有院内获得，约一半有既往使用环丙沙星的历史。 环丙沙星耐药在沙门氏菌中发展迅速。因此，环丙沙星似乎在治疗葡萄球菌感染和定植，特别是由于MRSA引起的感染和定植中具有有限的用途。
The fluoroquinolones, particularly ciprofloxacin, have been suggested to treat methicillin-resistant Staphylococcus aureus (MRSA) infections and colonization and methicillin-susceptible S. aureus (MSSA) infections. The development of ciprofloxacin resistance in MRSA and MSSA was prospectively evaluated. After 3 months of ciprofloxacin use, high-level resistance (MIC90, 64-mu-g/ml) developed in MRSA and increased at an alarming rate, from none to 79% over a 1-year period. High-level ciprofloxacin resistance also developed in MSSA, increasing to 13.6% over the same period. Antibiograms, phage typing, and plasmid profile analysis suggest that more than one clone of MRSA developed resistance and that ciprofloxacin resistance is not associated with the acquisition of a new plasmid. Most patients had nosocomial acquisition and about one-half had a history of previous ciprofloxacin use. Ciprofloxacin resistance can develop rapidly in S. aureus; thus, ciprofloxacin appears to have limited usefulness in treating staphylococcal infections and colonization, especially those due to MRSA.