Antimicrobial susceptibilities of geographically diverse clinical human isolates of Leptospira
Antimicrobial susceptibilities of geographically diverse clinical human isolates of Leptospira
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DOI：
10.1128/aac.00044-08
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发表时间：
2008-08-01
影响因子：
4.9
通讯作者：
Murray, Clinton K.
中科院分区：
文献类型：
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作者：
Ressner, Roseanne A.;Griffith, Matthew E.;Murray, Clinton K.
尽管一些随机对照临床研究已经对钩端螺旋体病的抗菌治疗进行了研究，但这些研究仅限于世界的特定地区，并且很少有感染菌株的特征。布鲁克陆军医疗中心开发了一种用于评估抗生素敏感性的肉汤微量稀释技术。在本研究中，我们评估了来自埃及、泰国、尼加拉瓜和夏威夷的 13 种钩端螺旋体分离株（包括最近的临床分离株）对 13 种抗菌药物的敏感性。发现氨苄青霉素、头孢吡肟、阿奇霉素和克拉霉素的 MIC 低于检测下限（0.016 μg/ml）。头孢噻肟、头孢曲松、亚胺培南-西司他丁、青霉素 G、莫西沙星、环丙沙星和左氧氟沙星的 MIC(90) 介于 0.030 至 0.125 μg/ml 之间。多西环素和四环素具有最高的 MIC(90)：分别为 2 和 4 μg/ml。多西环素和四环素对来自埃及的菌株的 MIC 略高于对来自泰国或夏威夷菌株的 MIC；除此之外，敏感性模式相似。菌株之间对某些抗菌药物的敏感性似乎可能存在差异，这表明应进行更广泛的测试以寻找地理差异。
Although antimicrobial therapy of leptospirosis has been studied in a few randomized controlled clinical studies, those studies were limited to specific regions of the world and few have characterized infecting strains. A broth microdilution technique for the assessment of antibiotic susceptibility has been developed at Brooke Army Medical Center. In the present study, we assessed the susceptibilities of 13 Leptospira isolates (including recent clinical isolates) from Egypt, Thailand, Nicaragua, and Hawaii to 13 antimicrobial agents. Ampicillin, cefepime, azithromycin, and clarithromycin were found to have MICs below the lower limit of detection (0.016 mu g/ml). Cefotaxime, ceftriaxone, imipenem-cilastatin, penicillin G, moxifloxacin, ciprofloxacin, and levofloxacin had MIC(90)s between 0.030 and 0.125 mu g/ml. Doxycycline and tetracycline had the highest MIC(90)s: 2 and 4 mu g/ml, respectively. Doxycycline and tetracycline were noted to have slightly higher MICs against isolates from Egypt than against strains from Thailand or Hawaii; otherwise, the susceptibility patterns were similar. There appears to be possible variability in susceptibility to some antimicrobial agents among strains, suggesting that more extensive testing to look for geographic variability should be pursued.