目的:Lefamulin是美国食品和药物管理局于2019年批准用于治疗社区获得性细菌性肺炎(CABP)的新型抗生素。在这项研究中,我们评估了lefamulin的体外抗菌活性,以更好地了解其抗菌作用。
方法:试验菌株来自2017年至2019年中国各地的患者,其中呼吸道病原体菌株634株。通过肉汤微量稀释法测定lefamulin和比较剂的最低抑制浓度(MIC)。
结果:Lefamulin对肺炎链球菌和葡萄球菌表现出有效的活性,在0.25mg/L时具有100%的抑制作用,和对肺炎链球菌有利的MIC50/90(0.125/0.125mg/L)(青霉素MIC≥2mg/L),MIC50/90(≤0.015/0.125mg/L)对耐甲氧西林金黄色葡萄球菌,和MIC50/90(≤0.015/0.06mg/L)对耐甲氧西林表皮葡萄球菌。Lefamulin还对化脓性链球菌和无乳链球菌具有良好的活性(MIC50/90:≤0.015/≤0.015mg/L),产β-内酰胺酶的流感嗜血杆菌(MIC50/90:0.5/1mg/L),β-内酰胺酶阴性流感嗜血杆菌(MIC50/90:1/1mg/L),粘膜炎莫拉菌(MIC50/90:0.25/0.25mg/L),和肺炎支原体(MIC50/90:0.03/0.03mg/L),无论对阿奇霉素的耐药性如何。Lefamulin通常比对比剂对测试菌株更有活性。
结论:总之,lefamulin对呼吸道病原体(甲氧西林敏感和耐药葡萄球菌,肺炎链球菌,β-溶血性链球菌,流感嗜血杆菌,粘膜炎支原体和肺炎支原体)。体外活性支持在中国使用lefamulin治疗CABP。
OBJECTIVE: Lefamulin is a novel antibiotic approved by the U.S. Food and Drug Administration in 2019 for the treatment of community-acquired bacterial pneumonia (CABP). In this study we evaluated the in vitro antimicrobial activity of lefamulin in order to better understand its antibiogram.
METHODS: The test strains were isolated from patients across
China during the period from 2017 to 2019, including 634 strains of respiratory pathogens. The minimum inhibitory concentrations (MICs) of lefamulin and comparators were determined by broth microdilution method.
RESULTS: Lefamulin showed potent activity against Streptococcus pneumoniae and Staphylococcus evidenced by 100% inhibition at 0.25 mg/L, and favorable MIC50/90 (0.125/0.125 mg/L) against S. pneumoniae (penicillin MIC ≥ 2 mg/L), MIC50/90 (≤0.015/0.125 mg/L) against methicillin-resistant S. aureus, and MIC50/90 (≤0.015/0.06 mg/L) against methicillin-resistant S. epidermidis. Lefamulin also had good activity against Streptococcus pyogenes and Streptococcus agalactia (MIC50/90: ≤0.015/≤0.015 mg/L), β-lactamase-producing Haemophilus influenzae (MIC50/90: 0.5/1 mg/L), β-lactamase-negative H. influenzae (MIC50/90: 1/1 mg/L), Moraxella catarrhalis (MIC50/90: 0.25/0.25 mg/L), and Mycoplasma pneumoniae (MIC50/90: 0.03/0.03 mg/L) regardless of resistance to azithromycin. Lefamulin was generally more active than the comparators against the test strains.
CONCLUSIONS: In summary, lefamulin has good and broad-spectrum coverage of respiratory pathogens (methicillin-sensitive and -resistant Staphylococcus, S. pneumoniae, β-hemolytic Streptococcus, H. influenzae, M. catarrhalis and M. pneumoniae). In vitro activity supports the use of lefamulin in the treatment of CABP in
China.