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首页> 外文OA文献 >In Vitro Activities of Cethromycin (ABT-773), a New Ketolide, against Streptococcus pneumoniae Strains That Are Not Susceptible to Penicillin or Macrolides
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In Vitro Activities of Cethromycin (ABT-773), a New Ketolide, against Streptococcus pneumoniae Strains That Are Not Susceptible to Penicillin or Macrolides

机译：新霉素酮类霉素红霉素（ABT-773）的抗青霉素或大环内酯类易感性肺炎链球菌菌株的体外活性

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Pneumococcal resistance to antimicrobials presents problems to physicians for empirical treatment of acute otitis media (AOM). Three hundred thirty-three isolates of Streptococcus pneumoniae selected for nonsusceptibility to penicillin (MIC >0.1 μg/ml) from the middle ear (n = 325) or mastoid (n = 8) of children seen between 1994 and 2000 at four children's hospitals in the United States were tested by broth microdilution for susceptibility to nine antibiotics. Using NCCLS 2002 breakpoints, resistance to the following drugs was as indicated: amoxicillin, 1%; azithromycin, 71%; cefprozil, 71%; ceftriaxone, 2%; cefdinir, 98%; erythromycin, 70%; levofloxacin, 0%; and trimethoprim-sulfamethoxazole, 93%. Of the penicillin- and erythromycin-nonsusceptible isolates, 97% were inhibited by cethromycin (ABT-773) and 83% were inhibited by telithromycin at a concentration of ≤0.125 μg/ml. Macrolide resistance among penicillin-nonsusceptible pneumococci increased from 44 to 80% in the 6 years of the study from which the isolates were selected; however, the proportion of isolates with M or MLSB phenotypes remained constant over the time period (53 and 18%, respectively). Prior treatment with a macrolide or clindamycin alone or in combination with a β-lactam resulted in 94 or 85% of isolates causing infections being macrolide and or clindamycin resistant. No prior individual macrolide (azithromycin, erythromycin, or clarithromycin) resulted in more macrolide resistance or in a more prevalent resistance phenotype. The ketolides appear to be active antimicrobials against penicillin- and macrolide-resistant pneumococci.
机译：肺炎球菌对抗菌素的耐药性给医生提供了经验性治疗急性中耳炎（AOM）的难题。在1994年至2000年期间，从1994年至2000年间在美国的四所儿童医院中发现的333株肺炎链球菌分离株对中耳（n = 325）或乳突（n = 8）的青霉素（MIC> 0.1μg/ ml）不敏感在美国，通过肉汤微稀释测试了对9种抗生素的敏感性。使用NCCLS 2002断点，表明对以下药物有耐药性：阿莫西林，1％；阿奇霉素71％;头孢吡嗪71％;头孢曲松钠2％;头孢地尼98％;红霉素70％;左氧氟沙星，0％;以及93％的甲氧苄氨嘧啶磺胺甲基恶唑。在对青霉素和红霉素不敏感的分离株中，浓度≤0.125μg/ ml的红霉素（ABT-773）抑制了97％，而telithromycin抑制了83％。在选择分离株的6年研究中，对青霉素不敏感的肺炎链球菌对大环内酯类的耐药性从44％上升至80％。但是，具有M或MLSB表型的分离株比例在这段时间内保持不变（分别为53％和18％）。事先单独使用大环内酯或克林霉素或与β-内酰胺组合治疗可导致94或85％的分离株引起大环内酯和/或克林霉素耐药。没有以前的单个大环内酯类药物（阿奇霉素，红霉素或克拉霉素）导致更大的大环内酯类药物耐药性或更普遍的耐药性表型。酮类内酯似乎是抗青霉素和大环内酯类肺炎球菌的活性抗菌剂。

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