Eur J Clin Microbiol Infect Dis. 2019;38(1):67-74.
Inoculum effect of methicillin-susceptible Staphylococcus aureus against broad-spectrum beta-lactam antibiotics.
제1저자 송경호, 정숙인 · 교신저자 이신원
소속 (11)
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.
- Department of Infectious Diseases, Chonnam National University Medical School, Gwangju, Republic of Korea.
- 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.
- 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.
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea.
- Department of Internal Medicine, Yonsei University Medical School, Wonju, Republic of Korea.
- Department of Internal Medicine, Inje University Ilsan Paik Hospital, Goyang, Republic of Korea.
- Division of Infectious Diseases, Chungnam National University Hospital, Chungnam National University School of Medicine, Daejeon, Republic of Korea.
- Department of Internal Medicine, Chonnam National University Hwasun Hospital, Hwasun, Jeollanam-do, Republic of Korea.
- Department of Internal Medicine, Inje University College of Medicine, Busan, Republic of Korea.
- 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