协同作用但在临床上是不可实现的:阿莫西西林/塞夫特里亚克松组合对抗对安比西林敏感的Enterococcus faecium
Ahmed Ashrin1, Clémence Hagenimana1,2, Hervé Jacquier1,2
1Unité de Bactériologie, Département de Prévention, Diagnostic et Traitement des Infections, Hôpitaux Universitaires Henri Mondor-Albert Chenevier, Assistance Publique-Hôpitaux de Paris (AP-HP), Créteil 94010, France.
The Journal of antimicrobial chemotherapy
|November 17, 2025
概括
阿莫西西林/塞夫特里亚克森组合在实验室中显示出对安比西林敏感的Enterococcus faecium (EFM-S) 的协同作用,但对传染性内心炎 (IE) 临床上无关紧要. 这表明,由于无法达到药物度,因此排除了E. faecium感染的治疗方案.
科学领域:
- 传染性疾病 传染性疾病
- 微生物学 微生物学
- 药理学 药理学是指药理学的学科.
背景情况:
- 传染性内心炎 (IE) 需要有效的抗生素策略,通常涉及组合治疗.
- 虽然推使用阿莫西西林/塞夫特里亚克松治疗β-乳酸盐敏感的菌 (EFS),但对安培西林敏感的菌 (EFM-S) 的数据有限.
研究的目的:
- 调查阿莫西西林/塞夫特里亚克松与临床EFM-S分离物的体外协同作用.
- 评估这种抗生素组合对EFM-SIE的临床相关性.
主要方法:
- 查克板测试用于确定阿莫西西林/塞夫特里亚与26个EFM-S和10个EFS分离物的最小抑制度 (MIC) 和协同作用 (ΣFIC ≤0.5).
- 以前进行了全基因组测序,以确定EFM-S类.
主要成果:
- 在21/26 EFM-S菌株和所有EFS菌株中观察到协同作用.
- 与EFS相比,EFM-S的最小协同度更高.
- 五种非协同效应的EFM-S菌株表现出低的triaxone MIC,可能限制了协同效应的检测.
结论:
- 尽管观察到体外协同作用,但阿莫西西林/塞夫特里亚克松组合在临床上对EFM-S IE无关.
- 在体内无法达到的药物度使这种疗法对E. faecium感染无效.
- 需要更明确的指导方针来排除这种组合E. faecium,无论β-lactam的敏感性.
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