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Abstract：
Nocardiosis typically requires a prolonged treatment duration of ≥6 months and initial combination therapy with 2-3 antibiotics. First-line regimens for nocardiosis are associated with considerable toxicity; therefore, alternative therapies are needed. Omadacycline is an aminomethylcycline with broad antimicrobial activity whose in vitro activity against Nocardia species has not been formally assessed. The in vitro potency of omadacycline was evaluated against 300 Nocardia clinical isolates by broth microdilution. The most common Nocardia species tested were N. cyriacigeorgica (21%), N. nova (20%), and N. farcinica (12%). The most common specimens were respiratory (178 isolates, 59%) and wound (57 isolates, 19%). Omadacycline minimum inhibitory concentrations (MICs) across all Nocardia species ranged from 0.06 µg/mL to 8 µg/mL, with an MIC50 of 2 µg/mL and MIC90 of 4 µg/mL. The lowest MICs were found among N. paucivorans (MIC50 = 0.25 µg/mL, MIC90 = 0.25 µg/mL), N. asiatica (MIC50 = 0.25 µg/mL, MIC90 = 1 µg/mL), N. abscessus complex (MIC50 = 0.5 µg/mL, MIC90 = 1 µg/mL), N. beijingensis (MIC50 = 0.5 µg/mL, MIC90 = 2 µg/mL), and N. otitidiscaviarum (MIC50 = 1 µg/mL, MIC90 = 2 µg/mL). The highest MICs were found among N. farcinica (MIC50 = 4 µg/mL, MIC90 = 8 µg/mL). In vitro potency differed by species among Nocardia clinical isolates. Further studies are warranted to evaluate the potential clinical utility of omadacycline for nocardiosis.
摘要：
诺卡病通常需要延长治疗时间≥6个月，并使用2-3种抗生素进行初始联合治疗。一线治疗诺卡心症的方案具有相当大的毒性；因此，需要替代疗法。Omadacycline是一种具有广泛抗菌活性的氨基甲基环素，尚未正式评估其对诺卡氏菌属物种的体外活性。通过肉汤微量稀释评估了奥马环素对300种诺卡氏菌临床分离株的体外效力。测试的最常见的诺卡氏菌物种是N.cyriacigeorgica（21％），N.新星（20%），和N.Farcinica（12%）。最常见的标本是呼吸道（178株，59%)和伤口(57个分离株，19%）。所有诺卡氏菌属物种的奥马他环素最低抑制浓度（MIC）范围为0.06µg/mL至8µg/mL，MIC50为2µg/mL，MIC90为4µg/mL。最低的MIC是在白菜中发现的（MIC50=0.25µg/mL，MIC90=0.25微克/毫升)，N.asiatica（MIC50=0.25µg/mL，MIC90=1µg/mL），N.脓肿复合物（MIC50=0.5µg/mL，MIC90=1µg/mL），北美洲（MIC50=0.5µg/mL，MIC90=2µg/mL），和耳道奈瑟菌(MIC50=1µg/mL，MIC90=2µg/mL)。最高的MIC是在土牛中发现的(MIC50=4µg/mL，MIC90=8µg/mL)。诺卡氏菌临床分离株的体外效力因物种而异。需要进一步的研究来评估omadacycline治疗诺卡心病的潜在临床应用。
