High in vitro activity of fidaxomicin against Clostridium difficile isolates from a university teaching hospital in China
High in vitro activity of fidaxomicin against Clostridium difficile isolates from a university teaching hospital in China
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非达霉素对中国某大学教学医院分离的艰难梭菌具有高体外活性。
DOI：
10.1016/j.jmii.2017.06.007
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发表时间：
2018-06-01
影响因子：
7.4
通讯作者：
Xu, Ying-Chun
中科院分区：
文献类型：
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作者：
Cheng, Jing-Wei;Yang, Qi-Wen;Xu, Ying-Chun
背景：艰难梭菌感染（CDI）是急性护理环境和更广泛的医疗保健系统中发病和死亡的重要原因。本研究的目的是评估非达霉素对来自中国一所大学教学医院的艰难梭菌分离株的体外活性。
方法：收集101株艰难梭菌分离株，通过多重聚合酶链反应（PCR）分析毒素基因。毒素基因阳性菌株还通过多位点序列分型（MLST）和PCR - 核糖分型进行分型。采用琼脂稀释法测定分离株对非达霉素、甲硝唑、万古霉素、替加环素和莫西沙星的最低抑菌浓度（MICs）。
结果：所有101株分离株对非达霉素（0.032 - 1mg/L）、甲硝唑（0.125 - 1mg/L）、万古霉素（0.25 - 2mg/L）和替加环素（0.016 - 0.5mg/L）均显示出较低的MICs。替加环素的几何平均MIC值最低（0.041mg/L），其次是非达霉素（0.227mg/L）、甲硝唑（0.345mg/L）和万古霉素（0.579mg/L）。约35%的菌株（n = 35）对莫西沙星耐药，A - B⁺CDT⁻分离株对莫西沙星的耐药率（85.0%）远高于A⁺B⁺CDT⁻（15.7%）和A - B - CDT⁻（29.2%）分离株（P < 0.001）。非达霉素、甲硝唑、万古霉素和莫西沙星对3株ST1分离株的MIC值高于其他序列型（STs）。所有28株莫西沙星耐药的产毒分离株在gyrA或/和gyrB基因上均存在突变。
结论：非达霉素对所有测试的艰难梭菌分离株均表现出较高的抗菌活性，有望成为治疗中国CDI患者的一种新药。版权所有（C）2017，台湾微生物学会。由爱思唯尔台湾有限责任公司出版。
Background: Clostridium difficile infection (CDI) is a significant cause of morbidity and mortality in both the acute care setting and the wider healthcare system. The purpose of this study was to evaluate the in vitro activity of fidaxomicin against C. difficile isolates from a university teaching hospital in China.Methods: One hundred and one C. difficile isolates were collected and analyzed for toxin genes by multiplex PCR. The toxin gene positive strains were also typed by multilocus sequence typing (MLST) and PCR-ribotyping. The MICs of the isolates were determined against fidaxomicin, metronidazole, vancomycin, tigecycline and moxifloxacin, by the agar dilution method.Results: All the 101 isolates exhibited low MICs to fidaxomicin (0.032-1 mg/L), metronidazole (0.125-1 mg/L), vancomycin (0.25-2 mg/L) and tigecycline (0.016-0.5 mg/L). Tigecycline showed the lowest geometric mean MIC value (0.041 mg/L), followed by fidaxomicin (0.227 mg/L), metronidazole (0.345 mg/L), and vancomycin (0.579 mg/L). About 35% of the strains (n = 35) were resistant to moxifloxacin, and the resistance rate to moxifloxacin for A-B+CDT- isolates (85.0%) was much higher than that of A+B+CDT- (15.7%) and A-B-CDT- (29.2%) isolates (P < 0.001). The MIC values of fidaxomicin, metronidazole, vancomycin and moxifloxacin against the 3 ST1 isolates were higher than for other STs. All the 28 moxifloxacin-resistant toxigenic isolates carried a mutation either in gyrA or/and gyrB.Conclusion: Fidaxomicin exhibited high antimicrobial activity against all C. difficile isolates tested, which shows promise as a new drug for treating Chinese CDI patients. Copyright (C) 2017, Taiwan Society of Microbiology. Published by Elsevier Taiwan LLC.