In Vitro Activity of Ceftaroline Against Multidrug-Resistant Staphylococcus aureus and Streptococcus pneumoniae: A Review of Published Studies and the AWARE Surveillance Program (2008-2010)
In Vitro Activity of Ceftaroline Against Multidrug-Resistant Staphylococcus aureus and Streptococcus pneumoniae: A Review of Published Studies and the AWARE Surveillance Program (2008-2010)
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DOI：
10.1093/cid/cis563
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发表时间：
2012-09-15
影响因子：
11.8
通讯作者：
Jones, Ronald N.
中科院分区：
文献类型：
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作者：
Farrell, David J.;Castanheira, Mariana;Jones, Ronald N.
头孢他林是一种新的广谱注射用头孢菌素，对引起急性细菌性皮肤和皮肤结构感染(ABSSSI)和社区获得性细菌性肺炎(CABP)的流行病原体具有抗菌活性。2008至2010年间，美国开展了评估全球抗菌素耐药性评估监测计划，以评估头孢他林和对照抗菌剂对ABSSSI和CABP病原体的体外活性。从代表所有美国人口普查地区的72个医疗中心收集的8469株金黄色葡萄球菌和3593株肺炎链球菌被提交给中央参考实验室(JMI实验室，North Liberty，IA)，以参考方法进行肉汤微量稀释试验。金黄色葡萄球菌对甲氧西林的总耐药率为52.6%，虽然头孢他林对甲氧西林敏感的金黄色葡萄球菌显示出更强的活性(对50%[MIC50]和90%[MIC90]的最低抑菌浓度，均为0.25mU g/mL)，但对所有8469株金黄色葡萄球菌(MIC50和MIC90，分别为0.5和1mU g/mL)表现出良好的活性。有8296株(98.0%)的菌株在美国食品和药物管理局(FDA)的<；1微克/毫升，无一株MIC为2微克/毫升。头孢他林对肺炎链球菌的最低抑菌浓度为0.25mU/m L(MIC50和MIC90分别为0.015和0.12mU/m L)，抑制率为98.7%，是头孢曲松的16倍(MIC90为2m U/m L)。肺炎链球菌分离株的多重耐药率总体为30.1%，并在监测的3年中每年保持稳定。头孢他林对多重耐药肺炎链球菌表现出较高的抗菌活性(MIC50和MIC90分别为0.12和0.25mU/m L)，1001株非敏感株中只有44株(4.4%)不敏感，所有44株不敏感株的MIC仅为0.5mU g/m L。肺炎链球菌对头孢曲松的耐药率为2.1%(10.9%为不敏感)，中等敏感率为8.8%，总敏感率仅为89.1%。2008-2010年在美国进行的头孢他林监测记录了对已知引起ABSSSI和CABP的多药耐药金黄色葡萄球菌和多药耐药肺炎金黄色葡萄球菌的持续效力和谱。
Ceftaroline is a new broad-spectrum parenteral cephalosporin with antibacterial activity against the prevalent pathogens causing both acute bacterial skin and skin structure infections (ABSSSIs) and community-acquired bacterial pneumonia (CABP). The Assessing Worldwide Antimicrobial Resistance Evaluation Surveillance Program was conducted in the United States between 2008 and 2010 to assess the in vitro activity of ceftaroline and comparator antibacterial agents against ABSSSI and CABP pathogens. A total of 8469 Staphylococcus aureus isolates and 3593 Streptococcus pneumoniae isolates collected from 72 medical centers representing all US Census regions were submitted to a central reference laboratory (JMI Laboratories, North Liberty, IA) for broth microdilution testing by reference methods. The overall prevalence of methicillin resistance among S. aureus isolates was 52.6%, and although ceftaroline showed more potent activity against methicillin-susceptible S. aureus (minimum inhibitory concentration for 50% [MIC50] and 90% [MIC90] of organisms, both 0.25 mu g/mL) than against methicillin-resistant S. aureus (MIC50 and MIC90, both 1 mu g/mL), it showed good activity against all 8469 S. aureus isolates (MIC50 and MIC90, 0.5 and 1 mu g/mL, respectively), with 8296 isolates (98.0%) testing susceptible at the US Food and Drug Administration (FDA) break point of < 1 mu g/mL and no isolates having MICs of > 2 mu g/mL. Against S. pneumoniae, ceftaroline inhibited 98.7% of tested isolates at the FDA susceptible break point of < 0.25 mu g/mL (MIC50 and MIC90, 0.015 and 0.12 mu g/mL, respectively) and was 16-fold more active than ceftriaxone (MIC90, 2 mu g/mL). The prevalence of multidrug resistance among S. pneumoniae isolates was 30.1% overall and remained stable over each of the 3 monitored years. Ceftaroline demonstrated high activity (MIC50 and MIC90, 0.12 and 0.25 mu g/mL, respectively) against multidrug-resistant S. pneumoniae, with only 44 of 1001 strains (4.4%) testing nonsusceptible and all 44 nonsusceptible strains having a ceftaroline MIC of only 0.5 mu g/mL. Ceftriaxone resistance among S. pneumoniae was 2.1% (10.9% were nonsusceptible), with an intermediate susceptibility rate of 8.8%, resulting in an overall susceptibility rate of only 89.1%. Ceftaroline surveillance in the United States during 2008-2010 documented sustained potency and spectrum against multidrug-resistant S. aureus and multidrug-resistant S. pneumoniae known to cause ABSSSI and CABP.