利奈唑胺耐药粪肠球菌感染患者临床分离株与定植株同源性分析

目的研究1例患者体内利奈唑胺(LZD)耐药粪肠球菌临床分离株与定植株同源性特点。方法对1例肺部感染患者分离的10株粪肠球菌(其中2株分离自尿标本,8株分离自粪便标本)进行细菌耐药分析,并通过脉冲场凝胶电泳(PFGE)确定粪肠球菌之间的同源性。结果患者进行LZD治疗前后,尿标本分离出的2株粪肠球菌均为LZD耐药株(MIC值分别为8 mg/mL,16 mg/mL),粪便中培养挑取的8株(治疗前6株,治疗后2株),其中LZD敏感4株,中介2株,耐药2株(MIC值波动在0.25~12 mg/mL)。通过PFGE分型检测提示10株粪肠球菌具有同源性。结论该例患者泌尿道和肠道检出的粪肠球菌具有同源性,提示LZD耐药肠球菌可能长期定植于患者体内,并可能发生移位导致耐药细菌感染。     

Pharmacokinetic drug evaluation of tedizolid for the treatment of skin infections

Introduction: Tedizolid is indicated for the treatment of acute bacterial skin and skin structure infections (ABSSSI). Although tedizolid shares many similar properties with linezolid, another oxazolidinone used to treat ABSSSI, the two antibiotics have several key differences.

Areas covered: This review provides a detailed summary of the overall pharmacodynamics, pharmacokinetics, clinical efficacy, and safety of tedizolid for the treatment of ABSSSI.

Expert opinion: Compared to other antibiotics used for ABSSSI, tedizolid has several advantages. Tedizolid has a long half-life, allowing for once daily dosing. Tedizolid also has broad spectrum of activity against Gram-positive pathogens, including methicillin-resistant Staphylococcus aureus, Coagulase-negative Staphylococci, and Enterococci – including isolates demonstrating resistance to linezolid. It is available in both oral and intravenous formulations, and, has outstanding oral bioavailability, allowing for oral-step down therapy. There is also some evidence that, tedizolid has fewer significant interactions with serotonin reuptake inhibitors or monoamine oxidase inhibitors than linezolid. Finally, thrombocytopenia may occur less often with tedizolid than linezolid. However, these benefits must be weighed against the financial cost of tedizolid and the availability of alternative antibiotic choices.     

利奈唑胺治疗耐药结核的研究进展

利奈唑胺是一种新型恶唑烷酮类抗菌药物,在体外对耐多药结核菌有抗菌作用,其临床疗效已得到一系列临床研究证明.本文综述其抗菌作用、临床疗效及不良反应等研究进展.     

The safety and efficacy of linezolid in orthopaedic practice for the treatment of infection due to antibiotic-resistant organisms

Linezolid is the first of a new class of antibacterial agents, the oxazolidinones. It is particularly effective against Gram-positive infections and little resistance has been reported, even amongst methicillin- and vancomycin-resistant bacteria. The compound’s excellent oral bioavailability and reasonable safety profile, along with the increasing incidence of resistant infections, means that linezolid offers a valuable alternative to more traditional therapies such as vancomycin. Although no large randomised trials have been carried out in patients with orthopaedic infections such as osteomyelitis and septic arthritis, early results are encouraging. However, the apparent increase in observed adverse events, particularly bone marrow suppression, seen with prolonged administration, means that treatment of such patients must be undertaken with careful surveillance, at least until these complications are better understood.     

HPLC测定利奈唑胺的血药浓度

目的建立人血浆中利奈唑胺浓度测定的高效液相色谱法。方法以苯巴比妥为内标,血浆样品用乙腈沉淀蛋白,采用LunaC18柱（250mm×4．6mm,5μm）分析。流动相为乙腈-水（25：75）,流速为1．0mL·min^-1,检测波长251nm,柱温35℃。结果本法在0．1～40mg·L^-1内线性关系良好（r=0．9999）,检测限为0．05mg·L^-1,日内、日间RSD均小于4％。结论本方法简单、灵敏、准确,适用于利奈唑胺临床血药浓度监测及人体药动学研究。     

噁唑烷酮类抗菌剂构效关系及结构改造研究进展

噁唑烷酮类抗菌药是一类结构类型与作用机制完全不同于目前其他所有抗菌药物的新型合成抗菌药,自首个该类药物利奈唑胺上市后,以获得抗菌谱更广、抗菌活性更高的新型噁唑烷酮类化合物为目标的结构改造方案及有关细菌对化合物耐药机制的研究便全面展开。综述噁唑烷酮类抗菌药的作用机制、构效关系、细菌对其的耐药机制和相关的化合物结构改造的研究进展。     

Successful salvage therapy with daptomycin after linezolid and vancomycin failure in a liver transplant recipient with methicillin-resistant Staphylococcus aureus endocarditis

Abstract: Infective endocarditis is a rare complication affecting solid organ transplant recipients. Staphylococcus aureus is a common cause of infective endocarditis accounting for about 30% of cases. We present a case of nosocomial methicillin-resistant S. aureus endocarditis with persistent bacteremia, in a patient following orthotopic liver transplantation. We were unable to eradicate this infection with primary linezolid therapy or with secondary treatment with combined vancomycin and rifampicin, but successfully treated it with daptomycin, in addition to tricuspid and aortic valve replacement.