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首页> 外文期刊>Antimicrobial agents and chemotherapy. >Efficacies of Vancomycin, Arbekacin, and Gentamicin Alone or in Combination against Methicillin-Resistant Staphylococcus aureus in an In Vitro Infective Endocarditis Model.
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Efficacies of Vancomycin, Arbekacin, and Gentamicin Alone or in Combination against Methicillin-Resistant Staphylococcus aureus in an In Vitro Infective Endocarditis Model.

机译：在体外感染性心内膜炎模型中，单独使用万古霉素，阿贝卡星和庆大霉素或与耐甲氧西林金黄色葡萄球菌联用的疗效。

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摘要

We adopted an in vitro infective endocarditis model (IVIEM) to compare the efficacy of vancomycin (VAN), arbekacin (ABK), and gentamicin (GEN) alone or in combination. Using two strains of clinically isolated methicillin-resistant Staphylococcus aureus, one GEN susceptible (GS171) and one GEN resistant (GR153), fibrin clots were prepared and suspended in the IVIEM. Antibiotics were given as boluses every 6 h (q6h), q12h, or q24h or by continuous infusion with VAN, q12h or q24h with ABK, and q8h or q24h with GEN. For combination treatment, VAN q12h plus ABK q24h and VAN q12h plus GEN q24h were given. Fibrin clots were removed from each model at 0, 8, 24, 32, 48, and 72 h, and the bacterial densities were determined. The number of colonies within the fibrin clot was significantly decreased in all study groups compared with control groups (P < 0.001). When VAN and ABK were administered alone, the number of colonies was significantly lower in GS171 than in GR153 by 8 h after administration (P = 0.02) and was lowest in GS171 when ABK was administered q12h (P = 0.01). At 72 h, ABK or VAN alone produced equivalent bacterial reductions regardless of dosing frequency and GEN resistance. In GR153, VAN plus ABK showed an additive effect till 24 h, although VAN plus GEN showed indifference. Our data suggest that ABK could be used as an alternative to VAN in GEN-resistant staphylococcal endocarditis. An additive effect was seen when VAN and ABK were used together in GEN-resistant strains until 24 h; however, further studies are warranted for the clinical application of this combination.
机译：我们采用体外感染性心内膜炎模型（IVIEM）来比较单独使用或组合使用的万古霉素（VAN），阿贝卡星（ABK）和庆大霉素（GEN）的疗效。使用两种临床分离的耐甲氧西林金黄色葡萄球菌菌株，一种GEN易感性（GS171）和一种GEN抵抗性（GR153），制备纤维蛋白凝块并将其悬浮在IVIEM中。抗生素每6小时（q6h），q12h或q24h推注一次，或与VAN，qbh或q24h与ABK连续输注，q8h或q24h与GEN连续输注。对于组合治疗，给出VAN q12h加ABK q24h和VAN q12h加GEN q24h。在0、8、24、32、48和72小时时，从每个模型中除去血纤蛋白凝块，并测定细菌密度。与对照组相比，所有研究组的纤维蛋白凝块内的菌落数量均显着减少（P <0.001）。当单独施用VAN和ABK时，GS171的菌落数在施用后8 h显着低于GR153（P = 0.02），而在AB171 q12h施用时，其菌落数最低（P = 0.01）。在72 h时，无论给药频率和GEN耐药性如何，单独使用ABK或VAN都能产生同等程度的细菌减少。在GR153中，VAN + ABK表现出累加效应，直到VAN GEN + GEN表现出冷漠，直到24 h。我们的数据表明，ABK可以替代GEN耐药葡萄球菌性心内膜炎的VAN。当VAN和ABK在GEN抗性菌株中一起使用到24小时时，可以看到加性效应;但是，需要对该组合的临床应用进行进一步研究。

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