氟喹诺酮类药物对临床分离金黄色葡萄球菌的防耐药变异浓度  

Mutant Prevention Concentrations of Fluoroquinolones for Clinical Isolates of Staphylococcus aureus

作　　者：崔俊昌[1] 刘又宁[1] 王睿[1] 梁蓓蓓[1] 郑专杰[1] 

机构地区：[1]解放军总医院,北京100853

出　　处：《中华医院感染学杂志》2005年第6期611-614,共4页Chinese Journal of Nosocomiology

基　　金：国家自然科学基金资助项目(30370615)

摘　　要：目的测定氟喹诺酮类(FQ)药物对金黄色葡萄球菌临床分离菌的防耐药变异浓度(mutant preventionconcentration,MPC)。方法肉汤法富集1010CFU/ml金黄色葡萄球菌临床分离菌54 株,采用琼脂平板稀释法分别测定莫西沙星、加替沙星、帕珠沙星和环丙沙星对金黄色葡萄球菌的MIC及MPC,并计算MIC90、MPC90。结果莫西沙星、加替沙星、帕珠沙星和环丙沙星对42株环丙沙星敏感的金黄色葡萄球菌临床分离菌的MPC90值,分别为0.5μg/ml、0.5μg/ml、4μg/ml 和8μg/ml,细菌耐药选择指数(MPC90/MIC90比值)分别为4、4、16 和16;对12株环丙沙星耐药而莫西沙星和加替沙星敏感的金黄色葡萄球菌临床分离菌,莫西沙星和加替沙星的MPC90值均为16μg/ml,MPC90/MIC90比值均为8。结论对环丙沙星敏感的金黄色葡萄球菌,莫西沙星和加替沙星限制耐药突变株选择的能力优于帕珠沙星和环丙沙星;结合药代动力学参数,莫西沙星和加替沙星单药能有效限制耐药突变株的选择,而环丙沙星则容易选择出耐药突变株;而对环丙沙星耐药但莫西沙星和加替沙星敏感的金黄色葡萄球菌,莫西沙星和加替沙星单药则不能限制耐药突变株的选择。OBJECTIVE To measure mutant prevention concentration (MPC) of fluoroquinolones for clinical isolates of Staphylococcus aureus. METHODS The clinical isolates of S.aureus were enriched in broth,and the bacterial concentrations were adjusted to 10 10 colony forming units per milliliter. The minimal inhibitory concentration (MIC) and MPC of moxifloxacin, gatifloxacin, pazufloxacin and ciprofloxacin for S.aureus were determined by agar plates dilution method. RESULTS The MPC_ 90 (μg/ml) of moxifloxacin,gatifloxacin,pazufloxacin and ciprofloxacin for ciprofloxacin-susceptible S.aureus were 0.5, 0.5, 4 and 8, and the selective index (MPC_ 90 /MIC_ 90 ) were 4, 4, 16 and 16, respectively. The MPC_ 90 of moxifloxacin and gatifloxacin for ciprofloxacin-resistant S.aureus were 16 μg/ml and 16 μg/ml,and the MPC_ 90 /MIC_ 90 were 8 and 8. CONCLUSIONS The ability of moxifloxacin and gatifloxacin for restricting the selection of ciprofloxacin-susceptible S.aureus resistant mutants were stronger than that of pazufloxacin and ciprofloxacin. Combined with pharmacokinetic parameters, moxifloxacin and gatifloxacin may restrict the selective enrichment of resistant mutants among ciprofloxacin-susceptible S.aureus whenever they are administered as monotherapy, and ciprofloxacin is expected to selectively enrich mutants easily. But for ciprofloxacin-resistant S.aureus, moxifloxacin and gatifloxacin will select resistant mutants whenever they are administered as monotherapy.

关 键 词：防耐药变异浓度 氟喹诺酮 金黄色葡萄球菌 

分 类 号：R969.3[医药卫生—药理学]