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Wirksamkeit neuer Fluorchinolone gegenüber der bakteriellen Normalflora der Bindehaut

The effectiveness of the new fluoroquinolones against the normal bacterial flora of the conjunctiva

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Zusammenfassung

Hintergrund

25 Antibiotika einschließlich der neuen Fluorchinolone Levofloxacin, Gatifloxacin und Moxifloxacin wurden gegenüber der bakteriellen Normalflora der Bindehaut getestet.

Patienten und Methoden

Es wurden Bindehautabstriche bei insgesamt 160 Patienten (Median: 74 Jahre, Mittelwert: 71 Jahre) der Universitätsaugenklinik Stanford/USA vor Kataraktoperation abgenommen. Die daraus kultivierten Bakterienstämme wurden auf ihre antibiotische In-vitro-Empfindlichkeit mit dem Agardiffusionstest nach Kirby-Bauer getestet.

Ergebnisse

Von 256 isolierten Bakterienstämmen waren 201 (79%) koagulasenegative Staphylokokken (KNS), 26 Staphylococcus aureus, 15 Streptokokken der Gruppe D sowie 14 gramnegative Stäbchen. 100 der 256 Stämme (39%) wurden als multiresistent (resistent gegen mehr als 5 Antibiotika) eingestuft. Die aufsteigende Reihenfolge der Resistenzrate (RR) der KNS betrug: Gatifloxacin=Moxifloxacin<Gentamycin=Tobramycin=Levofloxacin=Neomycin<Ciprofloxacin=Ofloxacin<Erythromycin. Die RR von Staphylococcus aureus und der gramnegativen Stäbchen war niedrig und wies bezüglich der getesteten Antibiotika untereinander keine signifikanten Unterschiede auf. Die Streptokokken der Gruppe D wiesen insgesamt eine hohe Resistenzrate (RR über 30%) gegenüber den Antibiotika mit Ausnahme von Gatifloxacin, Levofloxacin oder Moxifloxacin auf. Bei allen Bakterien wurden hohe Resistenzraten (50%) gegenüber Erythromycin nachgewiesen.

Schlussfolgerungen

Trotz einer hohen Prävalenz multiresistenter Bakterienstämme zeigten die Fluorchinolone der neuen Generation eine außerordentlich hohe Wirksamkeit gegenüber den koagulasenegativen Staphylokokken und den Streptokokken der Gruppe D.

Abstract

Background

Our aim was to determine the antibiotic susceptibility of the preoperative conjunctival bacterial flora against 25 commonly used antibiotics, especially the new fluoroquinolones levofloxacin, gatifloxacin, and moxifloxacin.

Patients and Methods

The Kirby-Bauer disk-diffusion technique was used to test for the in vitro antibiotic susceptibility of conjunctival bacterial strains isolated from 160 patients (median=74 years, mean=71 years) undergoing cataract surgery at the Department of Ophthalmology, Stanford University, CA, USA.

Results

Among the 256 bacteria isolated, 201 (79%) were coagulase-negative staphylococci (CNS), 26 Staphylococcus aureus, 15 Streptococcus group D and 14 gram-negative rods. A total of 100 of these 256 strains (39%) were classified as multiresitant (resistant to ≥ five antibiotics). The resistance rate (RR) of commonly used antibiotics for all CNS was: gatifloxacin=moxifloxacin<gentamycin=tobramycin=levofloxacin=neomycin<ciprofloxacin=ofloxacin<erythromycin. The RR for S. aureus and the gram-negative rods was low and insignificant in comparison to the other antibiotics tested. None of the Streptococcus group D were resistant to gatifloxacin, levofloxacin, or moxifloxacin, however, they were highly resistant (RR over 30%) to the other antibiotics. Some 50% of the bacteria were resistant to erythromycin.

Conclusion

Newer generation fluoroquinolones provide excellent efficacy against coagulase-negative staphylococci and Streptococcus group D despite a high number of multiresitant bacteria.

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Authors and Affiliations

  1. Universitätsaugenklinik der Ludwig-Maximilians-Universität München

    M. J. Koss, M. Eder, V. Klauss & H. M. de Kaspar

  2. Department of Ophthalmology, School of Medicine, Stanford University, California

    M. S. Blumenkranz, C. N. Ta & H. M. de Kaspar

  3. Zentrum für Augenheilkunde, Universitätsklinikum der Johann-Wolfgang-Goethe-Universität, Theodor-Stern-Kai 7, 60590 , Frankfurt

    M. J. Koss

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  1. M. J. Koss
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  2. M. Eder
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  3. M. S. Blumenkranz
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  4. V. Klauss
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  5. C. N. Ta
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  6. H. M. de Kaspar
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Correspondence to M. J. Koss.

Additional information

Vorgetragen als Paperbeitrag auf dem Jahreskongress der Deutschen Ophthalmologischen Gesellschaft (DOG) 2005, Berlin

Teile der Arbeit wurden bereits publiziert [23].

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Koss, M.J., Eder, M., Blumenkranz, M.S. et al. Wirksamkeit neuer Fluorchinolone gegenüber der bakteriellen Normalflora der Bindehaut. Ophthalmologe 104, 21–27 (2007). https://doi.org/10.1007/s00347-006-1453-1

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