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Eur J Clin Microbiol Infect Dis. 2019;38(1):67-74.

Inoculum effect of methicillin-susceptible Staphylococcus aureus against broad-spectrum beta-lactam antibiotics.

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제1저자 송경호, 정숙인 · 교신저자 이신원

소속 (11)
  1. Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.
  2. Department of Infectious Diseases, Chonnam National University Medical School, Gwangju, Republic of Korea.
  3. Department of Internal Medicine, Pusan National University School of Medicine and Medical Research Institute, Pusan National University Hospital, 179 Gudeok-ro, Seo-gu, Busan, 49241, Republic of Korea. ebenezere.lee@gmail.com.
  4. Department of Internal Medicine, Pusan National University School of Medicine and Medical Research Institute, Pusan National University Hospital, 179 Gudeok-ro, Seo-gu, Busan, 49241, Republic of Korea.
  5. Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea.
  6. Department of Internal Medicine, Yonsei University Medical School, Wonju, Republic of Korea.
  7. Department of Internal Medicine, Inje University Ilsan Paik Hospital, Goyang, Republic of Korea.
  8. Division of Infectious Diseases, Chungnam National University Hospital, Chungnam National University School of Medicine, Daejeon, Republic of Korea.
  9. Department of Internal Medicine, Chonnam National University Hwasun Hospital, Hwasun, Jeollanam-do, Republic of Korea.
  10. Department of Internal Medicine, Inje University College of Medicine, Busan, Republic of Korea.
  11. Department of Internal Medicine, Daegu Fatima Hospital, Daegu, Republic of Korea.

Abstract

Scarce information concerning the inoculum effect (InE) of methicillin-susceptible Staphylococcus aureus (MSSA) against broad-spectrum β-lactam antibiotics is available. We investigated the InE of MSSA against ceftriaxone, cefepime, meropenem, ampicillin/sulbactam and piperacillin/tazobactam. The bacteraemic MSSA isolates were collected at ten Korean general hospitals from Sep 2013 to Mar 2015. The InE was defined if MICs of antibiotics at high inoculum (HI, ~5 × 107 CFU/ml) increased beyond the susceptible range compared to those at standard inoculum (SI, ~5 × 105 CFU/ml). All isolates were sequenced for blaZ gene typing. Among 302 MSSA isolates, 254 (84.1%) were positive for blaZ; types A, B, C and D were 13.6%, 26.8%, 43.4% and 0.3%, respectively. Mean HI MICs of all tested antibiotics were significantly increased and increases in HI MIC of piperacillin/tazobactam (HI, 48.14 ± 4.08 vs. SI, 2.04 ± 0.08 mg/L, p < 0.001) and ampicillin/sulbactam (HI, 24.15 ± 1.27 vs. SI, 2.79 ± 0.11 mg/L, p < 0.001) were most prominent. No MSSA isolates exhibited meropenem InE, and few isolates exhibited cefepime (0.3%) and ceftriaxone (2.3%) InE, whereas 43.0% and 65.9% of MSSA isolates exhibited piperacillin/tazobactam and ampicillin/sulbactam InE, respectively. About 93% of type C blaZ versus 45% of non-type C exhibited ampicillin/sulbactam InE (p < 0.001) and 88% of type C blaZ versus 9% of non-type C exhibited piperacillin/tazobactam InE (p < 0.001). A large proportion of MSSA clinical isolates, especially those positive for type C blaZ, showed marked ampicillin/sulbactam InE and piperacillin/tazobactam.

Keywords

Ampicillin-sulbactamBeta-lactamaseInhibitorInoculum effectStaphylococcus aureusblaZ

그 밖의 정보
출판 형태
Journal Article
저널
European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · eISSN 1435-4373
전자 출판
2018-09-30
MeSH
Anti-Bacterial Agents* / pharmacology / therapeutic use · Bacteremia / drug therapy / microbiology / mortality · Humans · Korea · Microbial Sensitivity Tests · Staphylococcal Infections* / drug therapy / microbiology / mortality · Staphylococcus aureus / drug effects / enzymology / genetics · beta-Lactamases / genetics · beta-Lactams* / pharmacology / therapeutic use
Substances
Anti-Bacterial Agents · beta-Lactams · beta-Lactamases
연구비
National research foundation of Korea NRF-2015R1C1A1A01054293
참고문헌
27편