Comparative In vitro antibacterial activity of nemonoxacin and other fluoroquinolones in correlation with resistant mechanisms in contemporary methicillin-resistant Staphylococcus aureus blood isolates in Taiwan.

IF 4.6 2区 医学 Q1 MICROBIOLOGY Annals of Clinical Microbiology and Antimicrobials Pub Date : 2025-01-17 DOI:10.1186/s12941-024-00772-6
Pao -Yu Chen, Mao-Wang Ho, Po-Liang Lu, Hung-Jen Tang, Cheng Len Sy, Jann-Tay Wang
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Abstract

Background: Nemonoxacin is a new quinolone with an antibacterial efficacy against methicillin-resistant Staphylococcus aureus (MRSA). Certain sequence types (STs) have been emerging in Taiwan, including fluoroquinolone-resistant ST8/USA300. It's an urgent need to determine nemonoxacin susceptibility against ST8/USA300 and other emerging lineages, if any. Additionally, molecular characterization of nemonoxacin resistance among different lineages has yet to be defined.

Methods: Non-duplicated MRSA blood isolates from five hospitals during 2019-2020 were collected and genotyped by pulsed-field gel electrophoresis, and further correlated to their STs. Antimicrobial susceptibility testing for all antibiotics was performing by using Sensititre standard panel, except nemonoxacin by using agar dilution method. Selected isolates with nemonoxacin MICs ≥ 0.5 mg/mL were sequenced for quinolone resistance-determining regions (QRDRs).

Results: Overall, 915 MRSA isolates belonged to four major lineages, ST8 (34.2%), ST59 (23.5%), ST239 (13.9%), and clonal complex 45 (13.7%). Two-thirds of tested isolates were non-susceptible to moxifloxacin, especially ST8/USA300 and ST239. Of them, proportions of nemonoxacin non-susceptibility by a tentative clinical breakpoint (tCBP) of 1 µg/mL among four major lineages appeared to be different (P = 0.06) and highest in ST239 (22.2%), followed by ST8/USA300 (13.5%). Among 89 isolates sequenced, 44.1% of ST8 and all ST239 isolates had ≥ 3 amino acid substitutions (AAS) in gyrA/parC (group A) or 2 AAS in gyrA/parC with additional AAS in gyrB/parE (group B). Compared to other AAS patterns, isolates in group A had the greatest non-susceptible proportions to nemonoxacin (86.9%; overall/pair-wised comparisons, P < 0.05).

Conclusions: Our study confirmed ST8/USA300 MRSA has disseminated in Taiwan. Using a tCBP defined by a higher parenteral daily dosage, nemonoxacin retained potency against moxifloxacin non-susceptible isolates. Patterns of AAS in QRDRs among different lineages may contribute to difference of nemonoxacin susceptibility.

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台湾当代耐甲氧西林金黄色葡萄球菌血液分离株奈莫沙星与其他氟喹诺酮类药物体外抑菌活性与耐药机制的比较
背景:奈蒙沙星是一种新型喹诺酮类药物,对耐甲氧西林金黄色葡萄球菌(MRSA)具有抗菌作用。某些序列类型(STs)已在台湾出现,包括氟喹诺酮耐药ST8/USA300。迫切需要确定奈蒙沙星对ST8/USA300和其他新兴谱系的敏感性,如果有的话。此外,不同谱系中耐奈蒙沙星的分子特征尚未确定。方法:收集5家医院2019-2020年非重复MRSA血分离株,采用脉冲场凝胶电泳进行基因分型,并进一步与STs进行相关性分析。除奈莫沙星采用琼脂稀释法外,其余抗生素均采用Sensititre标准板进行药敏试验。选取奈莫沙星mic≥0.5 mg/mL的分离株进行喹诺酮类药物耐药决定区(qrdr)测序。结果:915株MRSA分离株属于4个主要谱系,分别为ST8(34.2%)、ST59(23.5%)、ST239(13.9%)和克隆复合体45(13.7%)。三分之二的检测菌株对莫西沙星不敏感,尤其是ST8/USA300和ST239。其中,以1 μ g/mL为试验临床断点(tCBP)的奈莫沙星不敏感比例在4个主要谱系中存在差异(P = 0.06),其中ST239最高(22.2%),其次是ST8/USA300(13.5%)。测序的89株菌株中,44.1%的ST8和所有ST239株在gyrA/parC中有≥3个氨基酸取代(AAS) (A组),或gyrA/parC中有2个氨基酸取代(AAS), gyrB/parE中有额外的AAS (B组)。与其他AAS模式相比,A组菌株对奈蒙沙星的不敏感比例最高(86.9%;结论:本研究证实ST8/USA300 MRSA已在台湾传播。使用较高的每日外注射剂量定义的tCBP,奈莫沙星对莫西沙星不敏感的分离株保留效力。不同世系qrdr中AAS的分布模式可能导致奈莫沙星敏感性的差异。
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来源期刊
CiteScore
8.60
自引率
0.00%
发文量
49
审稿时长
>12 weeks
期刊介绍: Annals of Clinical Microbiology and Antimicrobials considers good quality, novel and international research of more than regional relevance. Research must include epidemiological and/or clinical information about isolates, and the journal covers the clinical microbiology of bacteria, viruses and fungi, as well as antimicrobial treatment of infectious diseases. Annals of Clinical Microbiology and Antimicrobials is an open access, peer-reviewed journal focusing on information concerning clinical microbiology, infectious diseases and antimicrobials. The management of infectious disease is dependent on correct diagnosis and appropriate antimicrobial treatment, and with this in mind, the journal aims to improve the communication between laboratory and clinical science in the field of clinical microbiology and antimicrobial treatment. Furthermore, the journal has no restrictions on space or access; this ensures that the journal can reach the widest possible audience.
期刊最新文献
Characteristics and spatiotemporal changes in phenotypes and genotypes of extended-spectrum β-lactamases in Escherichia coli isolated from bloodstream infections in China from 2014 to 2021. Persistent NK cell deficiency associated with pulmonary cryptococcosis. Comparative In vitro antibacterial activity of nemonoxacin and other fluoroquinolones in correlation with resistant mechanisms in contemporary methicillin-resistant Staphylococcus aureus blood isolates in Taiwan. Assessment of typing methods, virulence genes profile and antimicrobial susceptibility for clinical isolates of Proteus mirabilis. Early initiation of ceftaroline-based combination therapy for methicillin-resistant Staphylococcus aureus bacteremia.
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