Современные возможности терапии анаэробных инфекций | КМАХ

Современные возможности терапии анаэробных инфекций

Клиническая Микробиология и Антимикробная Химиотерапия. 2006; 8(4):298-313

​ Галкин Д.В., Кречикова О.И., Сухорукова М.В., Дехнич А.В.
анаэробы антибиотикорезистентность антианаэробная терапия
Раздел
Болезни и возбудители
Тип
Журнальная статья
Публикация
Клиническая Микробиология и Антимикробная Химиотерапия. 2006; 8(4):298-313

Аннотация

В последнее время появляется всё больше публикаций о неэффективности эмпирической терапии анаэробных инфекций в связи с устойчивостью возбудителей к применяемому режиму антибактериальной терапии. В сложившейся ситуации важно иметь достоверные локальные данные о чувствительности клинически значимых анаэробов к современным антибактериальным препаратам. В статье рассматриваются основные характеристики анаэробных инфекций, тенденции резистентности анаэробов к применяемым классам антибиотиков, а также представлены предложения по формированию стратегии выбора антибактериальной терапии анаэробных инфекций на основании результатов исследования чувствительности наиболее распространенных анаэробов, выделенных в стационарах города Смоленска у пациентов с инфекциями различной локализации. Результаты локального исследования свидетельствуют, что в настоящее время карбапенемы (имипенем, меропенем, эртапенем), нитроимидазолы (метронидазол, орнидазол), ингибиторозащищённые бета-лактамы (амоксициллин/клавуланат, амоксициллин/сульбактам, цефоперазон/сульбактам) и фторхинолоны IV поколения (моксифлоксацин) являются препаратами выбора для эмпирической антибактериальной терапии анаэробных инфекций.

  • 1. Nguyen MH, Yu VL, Morris AJ, et al. Antimicrobial resistance and clinical outcome of Bacteroides bacteremia: findings of a multicenter prospective observational trial. Clin Infect Dis 2000; 30:870-6.
  • 2. Gorbach S.L. Antimicrobial prophylaxis for appendectomy and colorectal surgery. Rev Infect Dis 1991; 13:S815-20
  • 3. Alfa M.J., Robson D., Davi M., et al. An outbreak of necrotizing enterocolitis associated with a novel Clostridium species in a neonatal intensive care unit. Clin Infect Dis 2002; 35:S101-105.
  • 4. Nord C.E., Karger L., Appelbaum P.C. Impact of antimicrobial agents on gastrointestinal microflora and the risk of infection. Am J Med 1984; 76:99-106.
  • 5. Rodloff A.C., Appelbaum P.C., Zabransky R.J. Practical anaerobic bacteriology. Cumitech 5A. 1991:1.
  • 6. Dorsher C.W., Rosenblatt J.E., Wilson W.R., et al. Anaerobic bacteremia: decreasing rate over 15-year period. Rev Infect Dis 1991; 13:633-6.
  • 7. Lombardi D.P., Enleberg N.C. Anaerobic bacteremia: incidence, patient charachteristics, and clinical significance. Am J Med 1992; 92:53-60.
  • 8. Salonen J.H. Clinical significance and outcome of anaerobic bacteremia. Clin Infect Dis 1998; 26:1413-7.
  • 9. Bouza E., Reig M., Garcia de la Torre M, et al. Retrospective analysis of two hundred and twelve cases of bacteremia due to anaerobic microorganisms. Europ J Clin Microb Infect Dis 1985; 4:262-7.
  • 10. Berne T.V., Bates T., Prior J.E. Antibiotic management of surgically treated gangrenous or perforated appendicitis. Comparison of gentamicin and clindamycin versus cefamandole versus cefoperazone. Am J Surg 1982; 144:8-13.
  • 11. Nichols R.L., Smith J.W. Anaerobes from a surgical prospective. Clin Infect Dis 1994; 18:S280-6.
  • 12. Nichols R.L., Smith J.W. Clinical aspects of anaerobic infections in the surgical patient. Am. J Med Tech 1975; 41:431-6.
  • 13. Кочеровец В.И., Михайлова В.С. Методы микробиологического анализа неспорообразных анаэробных бактерий. М.: ТОО «Лабинформ»; 1995: p. 6-7.
  • 14. NCCLS. Methods for antimicrobial susceptibility testing of anaerobic bacteria. 4th ed. Villanova, PA: NCCLS; 1997. Document no. M11-A4.
  • 15. NCCLS. Methods for antimicrobial susceptibility testing ofanaerobic bacteria. 6th ed. Villanova, PA: NCCLS; 2004. Document no. M11-A6.
  • 16. Citron D.M., Hecht D.W. Susceptibility test methods: anaerobic bacteria. In: Murray P.R., Baron E.L., Jorgensen I.H., Pfaller M.A., Yolken R.H., eds. Manual of clinical microbiology. 8th ed. Washington, DC: ASM Press; 2003. p. 1141-8.
  • 17. Hecht D.W. Prevalence of antibiotic resistance in anaerobic bacteria: worrisome developments. Clin Infect Dis 2004; 39:92-7.
  • 18. Snydman D.R., Jacobus N.V., McDermott L., et al. Multicenter study of in-vitro susceptibility of the Bacteroides fragilis group, 1995-1996, with comparison of resistance trends from 1990-1996. Antimicrob Agents Chemother 1999; 43:2417-22.
  • 19. Snydman D.R., Jacobus N.V., McDermott L.A., et al. National survey on the susceptibility of Bacteroides fragilis group: report and analysis of trends for 1997-2000. Clin Infect Dis 2002; 35:S126-34
  • 20. Solomkin J.S., Mazuski I.E., Baron E.l., et al. Guidelines for the selection of anti-infective agents for complicated intra-abdoininal infections. Clin Infect Dis 2003; 37:9971005.
  • 21. Goldstein E.L., Citron D.M., Vreni M.C., Warren Y., Tyr­rell K.L. Comparative in vitro activities of ertapenem (MK-0826) against 1001 anaerobes isolated from human intra-abdominal infections. Antimicrob Agents Chemother 2000; 44:2389-94.
  • 22. Hedberg M., Nord C.E. Antimicrobial susceptibility of Bacteroides fragilis group isolates in Europe. Clin Microbiol Infect 2003: 9:475-88.
  • 23. Appelbaum P.C., Philippon A., Jacobs M.R., Spangler S.K., Gutmann L. Characterization of b-lactamases from non-Bacderoides fragilis group Bacteroides spp. belonging to seven species and their role in b-lactam resistance. Antimicrob Agents Chemother 1990; 34:2169-76.
  • 24. Giraud-Morin С., Madinier I., Fosse Т. Sequence analysis of cfxA2-like b-lactamases in Prevotella species. J Antimicrob Chemother 2003; 51:1293-6.
  • 25. Rogers M.B., Parker A.C., Smith C.J. Cloning and characterization of the endogenous cephalosporinase gene, cepA, from Bacteroides fragilis reveals a new subgroup of Ambler class A b-lactamases. Antimicrob Agents Chemother 1993; 37:2391-400.
  • 26. Appelbaum P.C., Spangler S.K., Pankuch G.A., et al. Characterization of a b-lactamase from Clostriditim clostridioforme. J Antimicrob Chemother 1994; 33:33-40.
  • 27. Yang Y., Rasmussen B.A., Bush K. Biochemical characterization of the metallo-b-lactamase CcrA from Bacteroides fragilis TAL3636. Antimicrob Agents Chemother 1992; 36:1155-7.
  • 28. Cuchural G.J., Malamy M.H., Tally F.P. (b-lactamasemediated imipenem resistance in Bacteroides fragilis. Antimicrob Agents Chemother 1986; 30:645-8.
  • 29. Podglajen I., Breuil J., Casin I., Collatz E. Genotypic identification of two groups within the species Bacteroides fragilis by ribotyping and by analysis of PCR-generated fragment patterns and insertion sequence content. J Bacteriol 1995; 177:5270-5.
  • 30. Podglajen I., Breuil I., Bordon F., et al. A silent carbapenemase gene in strains of Bacteroides fragilis can be expressed after a one-step mutation. FEMS Microbiol Lett 1992; 70:21-9.
  • 31. Podglajen I., Breuil J., Collatz E. Insertion of a novel DNA sequence, 1S1186, upstream of the silent carbapenemase gene cfiA, promotes expression of carbapenem resistance in clinical isolates of Bacteroides fragilis. Mol Microbiol 1994; 12:105-14.
  • 32. Edwards R., Read P.N. Expression of the carbapenemase gene (cfiA) in Bacteroides fragilis. J Antimicrob Chemother 2000; 46:1009-12.
  • 33. Wexler H.M., Halebian S. Alterations to the penicillin-binding proteins in the Bacteroides fragilis group: a mechanism for non-b-lactamase mediated cefoxitin resistance. Int Antimicrob Chemother 1990; 26:7-20.
  • 34. Fang H., Ediund С., Nord C.E., Hedberg M. Selection of cefoxitin-resistant Bacteroides thetaiotaoinicron mutants and mechanisms involved in b-lactam resistance. Clin Infect Dis 2002; 35:S47-53.
  • 35. Wexler H.M. Outer-membrane pore-forming proteins in gram-negative anaerobic bacteria. Clin Infect Dis 2002; 35:S65-71.
  • 36. Breuil I., Dublanchet A., Truffaut N., Sebald M. Transferable 5-nitroim-idazole resistance in the Bacteroides fragilis group. Plasmid 1989; 21:151-4.
  • 37. Urban E., Soki I., Brazier J.S., Nagy E., Duerden B.I. Prevalence and characterization of win genes of Bacteroides sp. isolated in Hungary. Anaerobe 2002; 8:175-9.
  • 38. Haggoud A., Reysset G., Azeddoug H., Sebald M. Nucleotide sequence analysis of two 5-nitroimidazole resistance determinants from Bacteroides strains and of a new insertion sequence upstream of the two genes. Antimicrob Agents Chemother 1994; 38:1047-51.
  • 39. Carlier J.P., Sellier N., Rager M.N., Reysset G. Metabolism of a 5-nitroimidazole in susceptible and resistant isogenic strains of Bacteroides fragilis. Antimicrob Agents Chemother 1997; 41:1495-9.
  • 40. Trinh S., Haggoud A., Reysset G., Sebald M. Plasmids pIP419 and pIP421 from Bacteroides: 5-nitroimidazole resistance genes and their upstream insertion sequence elements. Microbiology 1995; 141:927-35.
  • 41. Brazier J.S., Stubbs S.L., Duerden B.I. Metronidazole resistance among clinical isolates belonging to the Bacteroides fragilis group: time to be concerned? J Antimicrob Chemother 1999; 44:580-1
  • 42. Cornick N.A., Cuchural G.I. Ir, Snydman D.R., et al. The antimicrobial susceptibility patterns of the Bacteroides fragilis group in the United States, 1987. J Antimicrob Chemother 1990; 25:1011-9.
  • 43. Snydman D.R., Jacobus N.V., McDermott L.A., et al. Multicenter study of in vitro susceptibility of the Bacteroides fragilis group, 1995 to 1996, with comparison of resistance trends from 1990 to 1996. Antimicrob Agents Chemother 1999; 43:2417-22.
  • 44. Hecht D.W., Osmolski J.R., O’Keefe J.P. Variation in the susceptibility of Bacteroides fragilis group isolates from six Chicago hospitals. Clin Infect Dis 1993; 16:S357-60.
  • 45. Drummond L.I., McCoubrey J., Smith D.G., et al. Changes in sensitivity patterns to selected antibiotics in Closlridium difficile in geriatric in-patients over an 18month period. J Med Microbiol 2003; 52:259-63.
  • 46. Aldridge K.E., Ashcraft D., Cambre K., e.a. Multicenter survey of the changing in vitro antimicrobial susceptibilities of clinical isolates of Bacteroides fragilis group, Prevotella, Fusobacterium, Porphyromonas, and Peptostreptococcus species. Antimicrob Agents Chemother 2001; 45:1238-43.
  • 47. Hecht D.W., Vedantam G. Anaerobe resistance among anaerobes: what now? Anaerobe 1999; 5:421-9.
  • 48. Jimenez-Diaz A., Reig M., Baquero F., Ballesta J.P. Antibiotic sensitivity of ribosomes from wild-type and clindamycin resistant Bacteroides vulgatus strains. J Antimicrob Chemother 1992; 30:295-301.
  • 49. Rasmussen B.A., Bush К., Tally F.P. Antimicrobial resistance in anaerobes. Clin Infect Dis 1997; 24:S110-20.
  • 50. Privitera G., Dublanchet A., Sebald M. Transfer of multiple antibiotic resistance between subspecies of Bacteroides fragilis. Infect Dis 1979; 139:97-101.
  • 51. Welch R.A., Jones K.R., Macrina F.L. Transferable lincosamide-macrolide resistance in Bacteroides. Plasmid 1979; 2:261-8.
  • 52. Tally F.P., Snydman D.R., Gorbach S.L., Malamy M.H. Plasmid-mediated, transferable resistance to clindamycin and erythromycin in Bacteroides fragilis. Infect Dis 1979; 139:83-8.
  • 53. Golan Y., McDermott L.A., Jacobus N.V., et al. Emergence of fluoroquinolone resistance among Bacteroides species. J Antimicrob Chemother 2003; 52:208-13.
  • 54. Onodera Y., Sato K. Molecular cloning of the gyrA and gyrB genes of Bacteroides fragilis encoding DNA gyrase. Antimicrob Agents Chemother 1999; 43:2423-9.
  • 55. Oh H., El Amin N., Davies T., Appelbaum P.C., Ediund C. gyrA mutations associated with quinolone resistance in Bacteroides fragilis group strains. Antimicrob Agents Chemother 2001; 45: 1977-81.
  • 56. Bachoual R., Dubreuil L., Soussy C.J., Tankovic J. Roles of gyrA mutations in resistance of clinical isolates and in vitro mutants of Bacteroides fragilis to the new fluoroquinolone trovafloxacin. Antimicrob Agents Chemother 2000; 44:1842-5.
  • 57. Oh H., Hedberg M., Ediund C. Efflux-mediated fluoroquinolone resistance in the Bacteroides fragilis group. Anaerobe 2002; 8:277-82.
  • 58. Ricci V., Piddock L. Accumulation of garenoxacin by Bacteroides fragilis compared with that of five fluoroquinolones. J Antimicrob Chemother 2003; 52:605-9.
  • 59. Goldstein E.J., Citron D.M., Hudspeth M. et al. In vitro activity of Bay 12-8039, a new 8-methoxyquinolone, compared to the activities of 11 other oral antimicrobial agents against 390 aerobic and anaerobic bacteria isolated from human and animal bite wound skin and soft tissue infections in humans. Antimicrob Agents Chemother 1997; 41:1552-7.
  • 60. Kim M-K., Nightingale C.H. Pharmacokinetics and pharmacodynamics of the fluoroquinolones. In: The Quinolones. Andriole V.T., ed. San Diego: Academic Press; 2000: 169-202.
  • 61. Oliphant C.M., Green G.M. Quinolones: a comprehensive review. Am Fam Phys 2002; 65:455-464.
  • 62. Goldstein E.J., Citron D.M., Warren Y.A., et. al. In vitro activity of moxifloxacin against 923 anaerobes isolated from human intra-abdominal infections. Antimicrob. Agents Chemother 2006; 50:148-55.
  • 63. Giordano P., Song J., Pertel P., et al. Sequential intravenous/oral moxifloxacin versus intravenous piperacillintazobactam followed by oral amoxicillin-clavulanate for the treatment of complicated skin and skin structure infection. Int J Antimicrob Agents 2005; 26:357-65.
  • 64. FDA approves moxifloxacin for treatment of complicated intra-abdominal infections. Medical News Today. [cited online 02 Dec. 2005]. Available from: URL: http://www.medicalnewstoday.com.
  • 65. Stass H., Kubitza D., Halabi A., et al. Pharmacokinetics of moxifloxacin, a novel 8-methoxyquinolone, in patients with renal dysfunction. Br J Clin Pharmacol 2002; 53:232-7.
  • 66. Ednie L.M., Jacobs M.R., Appelbaum P.C. Activities of gatifloxacin compared to those of seven other agents against anaerobic organisms. Antimicrob Agents Chemother 1998; 42:2059-62.
  • 67. Gatifloxacin information. FDA alert [3⁄2006 cited online 07 Mar. 2006]. Available from: www.fda.gov/cder/drug/infopage/gatifloxacin/default.htm
  • 68. Jousimies-Sommer H., Summanen P., Citron D.M. Overview of current susceptibility patterns. In: WadsworthKTL anaerobic bacteriology manual 6th ed. Star Publishing Company; 2002. p. 143-50.
  • 69. Козлов С.Н. Группа тетрациклинов. В кн. Практическое руководство по антиинфекционной химиотерапии. Под ред. Страчунского Л.С., Белоусова Ю.Б., Козлова С.Н. Москва: «Боргес»; 2002. p. 84-5.
  • 70. Hecker M. T., Aron D.C., Patel N.P., et al. Current patterns of misuse with an emphasis on the antianaerobic spectrum of activity. Arch Intern Med 2003; 163:972-8.
  • 71. Appelbaum P.C. Spangler S.K., Jacobs M.R. b-lactamase production and susceptibilities to amoxicillin, amoxicillin-clavulanate, ticarcillin, ticarcillin-clavulanate, cefoxitin, imipenem, and metronidazole of 320 non-Bacteroides fragilis Bacteroides isolates and 129 fusobacteria from 28 US centers. Antimicrob Agents Chemother 1990; 34:1546.
  • 72. Finegold S.M. Susceptibility testing of anaerobic bacteria. J Clin Microbiol 1998; 26:1253
  • 73. Cuchural G.J., Tally F.P., Jacobus N.V., et al. Comparative activities of newer b-lactam agents against members of the Bacteroides fragilis group. Antimicrob Agents Chemother 1990; 34:479.
  • 74. Wexler H.M., Harris B., Carter W.T., et al. Six year retrospective survey of the resistance of Bacteroides fragilis group species to clindamycin and cefoxitin. Diagn Microbiol Infect Dis 1986; 4:247.
  • 75. Cuchural G.J., Tally F.P., Jacobus N.Y., et al. Susceptibility of the Bacteroides fragilis group in the United States: Analyses by site of isolation. Antimicrob Agents Chemother 1988; 32:717.
  • 76. Edson R.S., Rosenblatt J.E., Lee D.T., et al. Recent experience with antimicrobial susceptibility of anaerobic bacteria. Mayo Clin Proc 1982; 57:737.
  • 77. Cuchural G.J., Malamy M.H., Tally F.P. b-lactamasemediated imipenem resistance in Bacteroides fragilis. Antimicrob Agents Chemother 1986; 30:645.
  • 78. Groiller G., Mory F., Quentin C., et al. Susceptibility of strict anaerobic bacteria to anaerobic bacteria to antibiotics in France: A multicenter study. Pathol Biol 1984; 42:498.
  • 79. Lamp K.C., Freeman C.D., Klutman N.E., et al. Pharmacokinetics and pharmacodynamics of the nitroimidazole antimicrobials. Clin Pharmacokinet 1999; 36:35373.
Просмотров
0 Аннотация
0 PDF
0 Цитирования
Поделились