Susceptibility of 228 Non-Fermenting Gram-Negative Rods to Tigecycline and Six Other Antimicrobial Drugs
Susceptibility of 228 Non-Fermenting Gram-Negative Rods to Tigecycline and Six Other Antimicrobial Drugs
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DOI：
10.1179/joc.2009.21.3.267
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发表时间：
2009-06-01
影响因子：
1.8
通讯作者：
Burillo, A.
中科院分区：
文献类型：
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作者：
Gomez-Garces, J. L.;Aracil, B.;Burillo, A.
本研究的目的是测定替加环素和其他6种临床常用抗菌药物对228株临床分离的非发酵革兰氏阴性棒菌（nfgnr）的体外活性，包括不动杆菌、嗜麦芽窄养单胞菌和铜绿假单胞菌。根据临床和实验室标准协会的建议确定最低抑制浓度（mic）。对于替加环素，我们使用了FDA批准的标准。近50%的临床分离不动杆菌对哌拉西林/他唑巴坦、环丙沙星、庆大霉素和头孢他啶耐药。该微生物对亚胺培南更敏感，对粘菌素和替加环素更敏感；没有菌株对替加环素耐药。嗜麦芽窄养单胞菌对所测试的药物表现出更大的耐药性。所有菌株均对亚胺培南耐药，对哌拉西林/他唑巴坦耐药的比例较大（82.6%）。除替加环素外，对其他药物的耐药性也较高，仅有3株耐药菌株（MIC >= 8 μ g/ml）。另一方面，替加环素对铜绿假单胞菌几乎没有活性，而铜绿假单胞菌具有MexXY-OprM等外排泵系统。近90%的菌株对环丙沙星耐药；只有8%的人对庆大霉素耐药；超过一半的菌株具有粘菌素中间或耐药，最后，大约一半的菌株对所研究的3种β -内酰胺敏感。总之，nfgnr呈现出可变的敏感性模式，尽管它们通常对抗菌素具有高度耐药性，包括那些被认为更具特异性的抗菌素。替加环素对大多数检测的菌株显示出良好的活性，拓宽了用于治疗这些复杂微生物引起的感染的药物范围。
The aim of the study was to determine the in vitro activity of tigecycline and 6 other antimicrobial drugs used in clinical practice against 228 clinical isolates of non-fermenting Gram-negative rods (NFGNRs) including Acinetobacter spp., Stenotrophomonas maltophilia, and Pseudomonas aeruginosa. Minimum inhibitory concentrations (MICs) were determined according to the recommendations of the Clinical and Laboratory Standards Institute. For tigecycline, we used the criteria approved by the FDA. Almost 50% of the clinical isolates of Acinetobacter spp. were resistant to piperacillin/tazobactam, ciprofloxacin, gentamicin, and ceftazidime. Strains of this microorganism were more susceptible to imipenem, and even more susceptible to colistin and tigecycline; no strains were resistant to tigecycline. Stenotrophomonas maltophilia showed even greater resistance to the drugs tested. Thus, all strains were resistant to imipenem and a large percentage (82.6%) were resistant to piperacillin/tazobactam. Resistance to the other agents tested was also high, with the exception of tigecycline, with only 3 resistant strains (MIC >= 8 mu g/ml). Tigecycline, on the other hand, was scarcely active against Pseudomonas aeruginosa, which bears efflux pump systems such as MexXY-OprM. Almost 90% of strains were resistant to ciprofloxacin; only 8% were resistant to gentamicin; over half were colistin-intermediate or -resistant, and finally, approximately half of the strains were susceptible to the 3 beta-lactams studied. In conclusion, NFGNRs present variable susceptibility patterns, although they are generally highly resistant to antimicrobial agents including those considered more specific. Tigecycline, which showed good activity against most of the strains examined, broadens the spectrum of drugs available for the treatment of infections caused by these complex microorganisms.