Instituto de Biomedicina de Sevilla, Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, 41013 Seville, Spain.
Eur J Clin Microbiol Infect Dis. 2010 May;29(5):527-31. doi: 10.1007/s10096-010-0890-6. Epub 2010 Feb 25.
The in vivo activity of tigecycline was evaluated in an experimental pneumonia model (C57BL/6 mice) by Acinetobacter baumannii. Two clinical strains were used: minimum inhibitory concentrations (MICs) of imipenem and tigecycline 1 and 2 microg/mL (imipenem-susceptible, IPM-S), and 8 and 2 microg/mL (imipenem-intermediate, IPM-I), respectively. For imipenem (30 mg/Kg), T/CMI (h) were 1.04 and 0.51 for IPM-S and IPM-I, respectively. For tigecycline (5 mg/Kg), the area under the concentration-time curve (AUC)/MIC(0-24 h) (serum and lung) were 9.24 and 4.37 (for the two strains), respectively. In the efficacy experiments with the IPM-S, imipenem (log CFU/g 3.59 +/- 0.78, p = 0.006) and tigecycline (2.82 +/- 1.2, p = 0.054) decreased the bacterial counts in lungs with respect to its controls; with the IPM-I, both imipenem (1.21 +/- 0.52, p = 0.002) and tigecycline (3.21 +/- 0.28, p = 0.035) decreased the bacterial counts with respect to the controls. In the survival experiments, with the IPM-S, the mortality was the same in the control (67%) and in the tigecycline (77%) groups, and imipenem reduced it (21%, p = 0.025); with the IPM-I, the mortality was the same in the control (87%) and in the tigecycline (85%) groups, and imipenem (0%) reduced it (p < 0.001). In summary, the present study shows that tigecycline is less efficacious than imipenem in the treatment of experimental A. baumannii pneumonia caused by IPM-S and IPM-I strains.
本研究采用鲍曼不动杆菌建立实验性肺炎模型(C57BL/6 小鼠)评估替加环素的体内活性。使用了两株临床分离株:亚胺培南和替加环素的最低抑菌浓度(MIC)分别为 1 和 2μg/mL(亚胺培南敏感株,IPM-S)和 8 和 2μg/mL(亚胺培南中介株,IPM-I)。对于亚胺培南(30mg/kg),IPM-S 和 IPM-I 的 T/CMI(h)分别为 1.04 和 0.51。对于替加环素(5mg/kg),血清和肺组织中的浓度-时间曲线下面积(AUC)/MIC(0-24h)分别为 9.24 和 4.37(两株菌)。在 IPM-S 的疗效实验中,与对照组相比,亚胺培南(log CFU/g 3.59 +/- 0.78,p = 0.006)和替加环素(2.82 +/- 1.2,p = 0.054)降低了肺部细菌载量;在 IPM-I 中,亚胺培南(1.21 +/- 0.52,p = 0.002)和替加环素(3.21 +/- 0.28,p = 0.035)均降低了肺部细菌载量,与对照组相比。在生存实验中,在 IPM-S 中,对照组(67%)和替加环素组(77%)的死亡率相同,亚胺培南降低了死亡率(21%,p = 0.025);在 IPM-I 中,对照组(87%)和替加环素组(85%)的死亡率相同,亚胺培南(0%)降低了死亡率(p < 0.001)。综上所述,本研究表明替加环素在治疗由 IPM-S 和 IPM-I 菌株引起的实验性鲍曼不动杆菌肺炎方面不如亚胺培南有效。