Tavşanda metisiline dirençli Staphylococcus aureus ile oluşturulmuş deneysel menenjit modelinde daptomisin ile vankomisinin bakteriyolojik etkinliklerinin karşılaştırılması
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Tarih
2011
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Yayıncı
Ege Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Tavşanda MRSA ile oluşturulmuş menenjit modelinde daptomisin ve vankomisinin BOS'taki antibakteriyel etkinliklerinin karşılaştırılması. Yöntem: Menenjit, standart ATCC 43300 metisiline dirençli S. aureus kökeninin Yeni Zelanda tavşanlarının sisterna magnaları içine direkt inokülasyonu ile oluşturuldu. Tavsanlar 16 saatlik enkübasyon süresinin ardından kontrol, daptomisin ve vankomisin olmak üzere üç gruba ayrıldı. Daptomisin grubuna 15 mg/kg daptomisin bir kez, vankomisin grubuna 20 mg/kg 4 saat ara ile iki kez verildi, kontrol grubuna ilaç verilmedi. Tedaviye baslandıktan sonra 0. ve 8. saatlerde alınan BOS örneklerinden kantitatif kültür yapıldı. Sekizinci saatte alınan serum ve BOS örneklerinde biyolojik yöntemle ilaç seviyesi ölçümü yapıldı. Bulgular: Onaltı saatlik enkübasyon süresinin sonunda tüm tavşanlar menenjit kriterlerini sağlıyordu. Alınan BOS örneklerindeki bakteri miktarları logaritma 10 cinsinden hesaplandığında enkübasyon süresinin sonunda kontrol grubunda 3,448±0,318 kob/mL, daptomisin grubunda 3,958±0,568 kob/mL, vankomisin grubunda 3,703±0,666 kob/mL bakteri vardı (p>0,05). Tedavinin sekizinci saatinde BOS'daki bakteri miktarı tedavi gruplarında kontrol grubuna göre istatistiksel olarak anlamlı şekilde düştü (kontrol: 3.798±0.682 kob/mL, daptomisin: -3.610±0.677 kob/mL, vankomisin: -3.403±0.697 kob/mL). Daptomisin ve vankomisin grupları arasında anlamlı fark yoktu. BOS ilaç seviyesi daptomisin grubunda yeterli BOS alınamayan bir tavsan dışında tüm tavşanlarda, vankomisin grubunda ise üç tavşanda ölçülebilir seviyenin üzerinde idi. BOS'da ölçülebilir düzeyin üzerinde daptomisin saptanan tavşanlarda, BOS'a geçiş oranı %1,9-4,1 arasında değişirken vankomisin grubunda bu oran %7,1-44,4 arasında bulundu. Sonuç: Bu bulgular MRSA ile oluşturulmuş tavsan menenjit modelinde daptomisinin antibakteriyel etkinliğinin en az vankomisin kadar olduğunu düşündürmektedir.
Aim: To compare the antibacterial activity of daptomycin and vancomycin in the treatment of MRSA meningitis in experimental rabbit meningitis model. Method: Meningitis was induced by direct inoculation of ATCC 43300 MRSA strain into cisterna magna of New Zealand rabbits. After 16 hours of incubation time, rabbits were separated into three as daptomycin (D), vancomycin (V), and control groups. (C). D group received one dose of 15 mg/kg daptomycin, V group received 20 mg/kg vancomycin two times (4h apart). C group did not receive any treatment. Quantitative bacterial cultures were performed in CSF samples which were obtained at the beginning and the 8th h of treatment. CSF and serum drug levels were measured by bioassay technique in samples obtained at the 8th h of the treatment. Results: After 16 hours incubation time, all rabbits fulfilled meningitis criteria. There was no difference between number of bacteria (calculated as log10) in three groups at the beginning of the treatment (C: 3.448±0.318 cfu/mL, D: 3.958±0.568 cfu/mL, V: 3.703±0.666 cfu/mL, p>0,05). At the 8th hour of the treatment, bacterial count decreased significantly in both treatment groups compared to control group (C: +3.798±0.682 cfu/mL, D: -3.610±0.677 cfu/mL, V: -3.403±0.697 cfu/mL, p<0.05). Moreover, there was no statistically significant difference between D and V groups. Daptomycin could be measured in all but one rabbit which could not be punctured adequate CSF sample. Vancomycin drug level in CSF was higher than quantification level in three rabbits. In D group the CSF/serum ratio was 1.9-4.1% and it was 7.1-44.4% in V group. Conclusion: Our results suggest that the antibacterial activity of both daptomycin and vancomycin were similar in the treatment of MRSA meningitis in experimental rabbit model.
Aim: To compare the antibacterial activity of daptomycin and vancomycin in the treatment of MRSA meningitis in experimental rabbit meningitis model. Method: Meningitis was induced by direct inoculation of ATCC 43300 MRSA strain into cisterna magna of New Zealand rabbits. After 16 hours of incubation time, rabbits were separated into three as daptomycin (D), vancomycin (V), and control groups. (C). D group received one dose of 15 mg/kg daptomycin, V group received 20 mg/kg vancomycin two times (4h apart). C group did not receive any treatment. Quantitative bacterial cultures were performed in CSF samples which were obtained at the beginning and the 8th h of treatment. CSF and serum drug levels were measured by bioassay technique in samples obtained at the 8th h of the treatment. Results: After 16 hours incubation time, all rabbits fulfilled meningitis criteria. There was no difference between number of bacteria (calculated as log10) in three groups at the beginning of the treatment (C: 3.448±0.318 cfu/mL, D: 3.958±0.568 cfu/mL, V: 3.703±0.666 cfu/mL, p>0,05). At the 8th hour of the treatment, bacterial count decreased significantly in both treatment groups compared to control group (C: +3.798±0.682 cfu/mL, D: -3.610±0.677 cfu/mL, V: -3.403±0.697 cfu/mL, p<0.05). Moreover, there was no statistically significant difference between D and V groups. Daptomycin could be measured in all but one rabbit which could not be punctured adequate CSF sample. Vancomycin drug level in CSF was higher than quantification level in three rabbits. In D group the CSF/serum ratio was 1.9-4.1% and it was 7.1-44.4% in V group. Conclusion: Our results suggest that the antibacterial activity of both daptomycin and vancomycin were similar in the treatment of MRSA meningitis in experimental rabbit model.
Açıklama
Anahtar Kelimeler
Menenjit, Metisiline Dirençli Staphylococcus Aureus, MRSA, Daptomisin, Vankomisin, Hayvan Modeli, Tavşan, Bioassay, Meningitis, Methicillin Resistant Staphylococcus Aureus, MRSA, Daptomycin, Vancomycin, Animal Model, Rabbit, Bioassay
