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Activity of Pulmonary Vancomycin Exposures versus Planktonic and Biofilm Methicillin-Resistant Staphylococcus aureus Isolated from Cystic Fibrosis Sputum.

肺部万古霉素暴露与从囊性纤维化痰中分离的浮游和生物膜耐甲氧西林金黄色葡萄球菌的活性。

  • 影响因子:3.59
  • DOI:10.1016/j.ijantimicag.2020.105898
  • 作者列表:"Britt NS","Hazlett DS","Horvat RT","Liesman RM","Steed ME
  • 发表时间:2020-01-10
Abstract

:Vancomycin is commonly used to treat methicillin-resistant Staphylococcus aureus (MRSA) infection in patients with cystic fibrosis (CF) lung disease; however, there are limited data to support the in vitro activity of this agent against MRSA isolated from CF sputum. The primary objective of this study was to evaluate the activity of vancomycin at pulmonary concentrations (intravenous and inhaled) against 4 clinical MRSA CF sputum isolates in planktonic and biofilm time-kill (TK) experiments. Vancomycin minimum inhibitory concentrations (MICs) were determined for these isolates at standard inoculum (SI; ∼106 colony-forming units [CFU]/mL) and high inoculum (HI; ∼108 CFU/mL), and in biofilms cultivated using physiologic media recapitulating the microenvironment of the CF lung. Vancomycin concentrations of 10, 25, 100, and 275 µg/mL were evaluated in TK experiments against planktonic MRSA at varying inocula and versus biofilm MRSA. Vancomycin MICs increased from 0.5 µg/mL at SI to 8-16 µg/mL when tested at HI. Vancomycin MICs were further increased to 16-32 µg/mL in biofilm studies. In TK experiments, vancomycin displayed bactericidal activity (≥ 3 log10 killing at 24 h) against 1/4 and 0/4 planktonic MRSA isolates at SI and HI, respectively. Against MRSA biofilms, vancomycin was bactericidal against 0/4 isolates. Based on these findings, vancomycin monotherapy appears unlikely to eradicate MRSA from the respiratory tract of patients with CF, even at high concentrations similar to those observed with inhaled therapy. Novel vancomycin formulations with enhanced biofilm penetration or combination therapy with other potentially synergistic agents should be explored.

摘要

: 万古霉素常用于治疗囊性纤维化 (CF) 肺病患者的耐甲氧西林金黄色葡萄球菌 (MRSA) 感染; 然而, 支持该药物对 CF 痰中分离的 MRSA 的体外活性的数据有限。本研究的主要目的是在浮游和生物膜时间杀伤 (TK) 实验中评价万古霉素在肺部浓度 (静脉和吸入) 下对 4 株临床 MRSA CF 痰液分离株的活性。在标准接种物 (SI; 106 菌落形成单位 [CFU]/mL) 和高接种物 (HI; 108 CFU/mL),并在使用生理培养基培养的生物膜中概括了 CF 肺的微环境。万古霉素浓度为 10 、 25 、 100 和 275 µ g/mL 在 TK 实验中对不同接种物和生物膜 MRSA 的浮游 MRSA 进行了评价。HI 测试时,万古霉素 mic 从 SI 时的 0.5 µ g/mL 增加到 8-16 µ g/mL。在生物膜研究中,万古霉素 mic 进一步增加至 16-32 µ g/mL。在 TK 实验中,万古霉素在 SI 和 HI 分别对 1/4 和 0/4 株浮游 MRSA 分离株表现出杀菌活性 (24 h 时 ≥ 3 log10 杀灭)。针对 MRSA 生物膜,万古霉素对 0/4 株分离株具有杀菌作用。基于这些发现,万古霉素单药治疗似乎不太可能从 CF 患者的呼吸道根除 MRSA,即使在与吸入治疗观察到的高浓度下也是如此。应探索生物膜渗透增强或与其他潜在增效剂联合治疗的新型万古霉素制剂。

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翻译标题与摘要 下载文献
影响因子:4.40
发表时间:2020-01-01
DOI:10.1007/s00262-019-02431-8
作者列表:["Shibaki, Ryota","Murakami, Shuji","Matsumoto, Yuji","Yoshida, Tatsuya","Goto, Yasushi","Kanda, Shintaro","Horinouchi, Hidehito","Fujiwara, Yutaka","Yamamoto, Nobuyuki","Kusumoto, Masahiko","Yamamoto, Noboru","Ohe, Yuichiro"]

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影响因子:4.04
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作者列表:["Sousa SA","Soares-Castro P","Seixas AMM","Feliciano JR","Balugas B","Barreto C","Pereira L","Santos PM","Leitão JH"]

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