耐甲氧西林金黄色葡萄球菌对抗生素和噬菌体制剂的敏感性研究

L. V. Lagun, Ya. A. Kulvinsky, N. A. Kulvinskaya
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摘要

目的评估耐甲氧西林金黄色葡萄球菌菌株对抗生素以及噬菌体治疗和预防制剂的敏感性。 材料和方法。耐甲氧西林金黄色葡萄球菌菌株的抗生素敏感性研究采用了盘扩散法,万古霉素和利奈唑胺的最小抑菌浓度测定采用了肉汤微稀释法,头孢他啶的最小抑菌浓度测定采用了 E 试验。还研究了耐甲氧西林金黄色葡萄球菌对噬菌体制剂的敏感性。 研究结果已证实利奈唑胺和万古霉素是对耐甲氧西林金黄色葡萄球菌(MRSA)相当有效的药物,但耐药性也开始产生。在所有测试过的抗生素中,MRSA 对氟喹诺酮类和头孢西丁的耐药性最高;头孢西丁的耐药性结果可以解释为对其他头孢菌素类(头孢他啶除外)和所有青霉素类的耐药性。只有 67.9% 的 MRSA 菌株保留了对头孢他啶的敏感性,但头孢他啶耐药菌株的最小抑菌浓度较低。噬菌体 "Sextaphage "和 "Piobacteriophage Phagio "制剂分别只对 35.8% 和 18.9% 的 MRSA 分离物具有溶菌活性。 结论监测耐甲氧西林金黄色葡萄球菌的抗生素耐药性发展是葡萄球菌感染合理抗生素治疗策略的重要组成部分。只有考虑到初步逐步确定致病菌的噬菌体敏感性,才能将噬菌体制剂视为治疗由 MRSA 引起的化脓性炎症疾病的一种完全可能的抗生素替代品。
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Study of the sensitivity of methicillin-resistant Staphylococcus aureus to antibiotics and bacteriophage preparations
   Objective. To evaluate the sensitivity of methicillin-resistant Staphylococcus aureus strains to antibiotics and therapeutic and prophylactic preparations of bacteriophages.   Materials and methods. The antibiotic sensitivity of strains of methicillin-resistant S.aureus was studied by the disco-diffusion method, the determination of the minimum inhibitory concentrations of vancomycin and linezolid by broth microdilution method, and ceftaroline by E-tests. The sensitivity of methicillin-resistant S.aureus to bacteriophage preparations was studied.   Results. It has been established that linezolid and vancomycin are quite active drugs against methicillin-resistant S.aureus (MRSA), however, resistance to them begins to develop. MRSA resistance to fluoroquinolones and cefoxitin was the highest of all antibiotics tested; the results obtained with cefoxitin can be interpreted for other cephalosporins (except ceftaroline) and all penicillins. Only 67.9% of MRSA strains retained sensitivity to ceftaroline, but ceftaroline-resistant strains had low levels of minimal inhibitory concentration. The preparations of the bacteriophages “Sextaphage” and “Piobacteriophage Phagio” showed their lytic activity only in relation to 35.8% and 18.9% of MRSA isolates, respectively.   Conclusion. Monitoring the development of antibiotic resistance in methicillin-resistant S.aureus is an important part of the strategy of rational antibiotic therapy for staphylococcal infections. Only taking into account the preliminary step-by-step determination of the phage sensitivity of the causative agent of the disease, bacteriophage preparations can be considered as a completely possible alternative to antibiotics for the treatment of purulent inflammatory diseases caused by MRSA.
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