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替加环素对拉丁美洲医学中心临床分离细菌的抗菌活性检测:来自 SENTRY 抗菌监测计划(2011-2014 年)的结果。

Tigecycline antimicrobial activity tested against clinical bacteria from Latin American medical centres: results from SENTRY Antimicrobial Surveillance Program (2011-2014).

机构信息

JMI Laboratories, 345 Beaver Kreek Centre, Ste A, North Liberty, IA 52317, USA.

JMI Laboratories, 345 Beaver Kreek Centre, Ste A, North Liberty, IA 52317, USA.

出版信息

Int J Antimicrob Agents. 2016 Aug;48(2):144-50. doi: 10.1016/j.ijantimicag.2016.04.021. Epub 2016 May 24.

Abstract

Bacterial organisms (n = 13,494) were consecutively collected in 2011-2014 from 21 Latin American medical centres (11 nations). Antimicrobial susceptibility was determined by broth microdilution at a central laboratory. Tigecycline was very active against Gram-positive organisms, with MIC50/90 values of 0.06/0.06 µg/mL for Staphylococcus aureus (n = 2878), 0.06/0.12 µg/mL for coagulase-negative staphylococci (n = 880), 0.06/0.06 µg/mL for enterococci (n = 708) and ≤0.03/≤0.03-0.06 µg/mL for streptococci (n = 1352). All Gram-positive species exhibited 100.0% susceptibility (FDA and/or EUCAST criteria), except for Streptococcus pneumoniae (99.8% susceptible). The S. aureus oxacillin resistance rate varied from 28.0% (Brazil) to 55.0% (Argentina), and the overall vancomycin resistance rate was 15.5% (Enterococcus faecium, 50.3%; and Enterococcus faecalis, 2.3%). The E. faecium vancomycin resistance rate varied from a low (26.3%) in Argentina to a high (71.7%) in Brazil. Against Enterobacteriaceae (n = 4543), tigecycline MIC50/90 values were 0.25/1 µg/mL; 98.3% and 94.2% of strains were considered susceptible according to FDA and EUCAST breakpoints, respectively. Overall, 37.7% and 57.3% of Escherichia coli and Klebsiella pneumoniae exhibited the CLSI ESBL screening phenotype. The highest CLSI ESBL screening phenotype rates among E. coli and Klebsiella spp. strains were observed for isolates collected from Mexico (69.9%) and Chile (69.9%), respectively. Occurrence of carbapenem-resistant Enterobacteriaceae was substantially higher in Brazil (9.0%) and Argentina (6.3%) compared with Chile and Mexico (0.4-0.7%). Tigecycline was also active against Acinetobacter spp. (MIC50/90, 1/2 µg/mL; 92.3/72.1% inhibited at ≤2/≤1 µg/mL) and Stenotrophomonas maltophilia (MIC50/90, 0.5/2 µg/mL; 91.5/83.0% inhibited at ≤2/≤1 µg/mL).

摘要

细菌生物体(n=13494)于 2011-2014 年连续从 21 个拉丁美洲医疗中心(11 个国家)采集。在一个中心实验室通过肉汤微量稀释法测定抗微生物药物敏感性。替加环素对革兰氏阳性菌非常有效,金黄色葡萄球菌(n=2878)、凝固酶阴性葡萄球菌(n=880)、肠球菌(n=708)和链球菌(n=1352)的 MIC50/90 值分别为 0.06/0.06μg/mL、0.06/0.12μg/mL、0.06/0.06μg/mL 和≤0.03/≤0.03-0.06μg/mL。所有革兰氏阳性菌均表现出 100.0%的敏感性(FDA 和/或 EUCAST 标准),除肺炎链球菌(99.8%敏感)外。金黄色葡萄球菌的苯唑西林耐药率从 28.0%(巴西)到 55.0%(阿根廷)不等,万古霉素总耐药率为 15.5%(屎肠球菌,50.3%;粪肠球菌,2.3%)。粪肠球菌的万古霉素耐药率从阿根廷的低(26.3%)到巴西的高(71.7%)不等。对于肠杆菌科(n=4543),替加环素的 MIC50/90 值为 0.25/1μg/mL;根据 FDA 和 EUCAST 折点,分别有 98.3%和 94.2%的菌株被认为敏感。总体而言,37.7%和 57.3%的大肠埃希菌和肺炎克雷伯菌表现出 CLSI ESBL 筛选表型。在从墨西哥(69.9%)和智利(69.9%)收集的大肠杆菌和克雷伯菌分离株中观察到最高的 CLSI ESBL 筛选表型率。与智利和墨西哥(0.4-0.7%)相比,巴西(9.0%)和阿根廷(6.3%)的耐碳青霉烯肠杆菌科的发生率明显更高。替加环素对不动杆菌属(MIC50/90,1/2μg/mL;92.3/72.1%在≤2/≤1μg/mL时被抑制)和嗜麦芽窄食单胞菌(MIC50/90,0.5/2μg/mL;91.5/83.0%在≤2/≤1μg/mL时被抑制)也有活性。

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