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In vitro activity of tedizolid and linezolid against Staphylococcus epidermidis isolated from prosthetic joint infections.

机译:替硝唑和利奈唑胺对从假体关节感染中分离出的表皮葡萄球菌的体外活性。

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摘要

Prosthetic joint infections (PJIs) are rare but long-lasting and are serious complications without any spontaneous resolution, requiring additional surgery and long-term treatment with antibiotics. Staphylococci are the most important aetiological agents of PJIs, and among the coagulase-negative staphylococci Staphylococcus epidermidis is the most common. However, S. epidermidis often displays multidrug resistance (MDR), demanding additional treatment options. The objective was to examine the effectiveness of tedizolid and linezolid against S. epidermidis isolated from PJIs. The standard antibiotic susceptibility pattern of S. epidermidis (n = 183) obtained from PJIs was determined by disc diffusion test, and MIC was determined by Etest for tedizolid, linezolid, and vancomycin. Tedizolid displayed MIC values ranging from 0.094 to 0.5 mg/L (MIC50: 0.19 mg/L, MIC90: 0.38 mg/L), linezolid MIC values ranging from 0.25 to 2 mg/L (MIC50: 0.75 mg/L, MIC90: 1 mg/L), and vancomycin MIC values ranging from 0.5 to 3 mg/L (MIC50 and MIC90 both 2 mg/L). According to the disc diffusion test, 153/183 (84%) isolates were resistant to ≥3 antibiotic groups, indicating MDR. In conclusion, S. epidermidis isolates from PJIs were fully susceptible, and the MIC50 and MIC90 values for tedizolid were two- to four-fold dilution steps lower compared with linezolid. Tedizolid is not approved, and there are no reports of long-term treatment, but it may display better tolerability and fewer adverse effects than linezolid; it thus could be a possible treatment option for PJIs, alone or in combination with rifampicin.
机译:人工关节感染(PJI)很少见,但持续时间很长,并且是严重的并发症,没有任何自发的消退,需要进行额外的手术和长期使用抗生素进行治疗。葡萄球菌是PJI最重要的病原体,在凝固酶阴性葡萄球菌中,表皮葡萄球菌最为常见。然而,表皮葡萄球菌通常表现出耐多药性(MDR),需要其他治疗选择。目的是检查泰替唑和利奈唑胺对从PJI中分离出的表皮葡萄球菌的有效性。通过圆盘扩散试验确定从PJI获得的表皮葡萄球菌的标准药敏模式(n = 183),并通过Etest确定对替硝唑,利奈唑胺和万古霉素的MIC。 Tedizolid显示的MIC值范围为0.094至0.5 mg / L(MIC50:0.19 mg / L,MIC90:0.38 mg / L),利奈唑胺的MIC值范围为0.25至2 mg / L(MIC50:0.75mg / L,MIC90:1 mg / L),万古霉素的MIC值为0.5至3 mg / L(MIC50和MIC90均为2 mg / L)。根据椎间盘扩散试验,有153/183(84%)分离株对≥3个抗生素组有抗药性,表明存在MDR。总之,从PJI分离的表皮葡萄球菌是完全易感的,泰替唑的MIC50和MIC90值比利奈唑胺低2-4倍。替地唑烷未经批准,也没有长期治疗的报道,但与利奈唑胺相比,它可能表现出更好的耐受性和更少的不良反应。因此,单独或与利福平联用可能成为PJI的治疗选择。

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