급성단순성방광염 여성 환자에서 분리된 요로감염균에 대한 Tosufloxacin과 Ofloxacin, Levofloxacin의 항균력 비교
In-Vitro Activity of Tosufloxacin Compared with Levofloxacin and Ofloxacin against Uropathogens, Isolated from Acute Uncomplicated Cystitis in Female Outpatients
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목 적 : Tosufloxacin은 기존의 퀴놀론계 항생제보다 높은 항균력을 가진 퀴놀론계 항생제이다. 그러나 요로감염의 원인균에 대한 tosufloxacin의 감수성은 잘 알려져 있지 않다. 급성단순성방광염 여성 외래환자의 소변에서 분리된 원인균에 대한 tosufloxacin의 최소억제농도(minimum inhibitory concentration, MIC)를 levofloxacin과 ofloxacin의 그것과 비교분석하고자 본 연구를 실시하였다. 재료 및 방법 : 2006년 8월부터 2006년 11월까지 수도권 4개의 병원에서 수거한 소변검체에 대하여 배양검사와 항생제 감수성검사를 실시하였다. 분리된 총 89개 균주의 tosufloxacin, levofloxacin 그리고 ofloxacin에 대한 MIC를 한천희석방법을 통해 측정하였다. 결 과 : 원인 균주 중 E. coli가 70.8%로 가장 흔한 원인균이었다. Tosufloxacin과 levofloxacin의 MIC는 대체적으로 2개의 최다값을 갖는 bimodal 양상을 보였는데, tosufloxacin은 0.03과 32 µg/mL, levofloxacin은 0.03과 16 µg/ mL에서 최다값을 가졌다. 반면에 ofloxacin은 0.5 µg/mL에서 또 하나의 최다값을 가지는 분포를 나타냈다. E. coli에 대한 tosufloxacin, levofloxacin 그리고 ofloxacin MIC50 값은 각각 0.03 µg/mL, 0.06 µg/mL, 0.125 µg/mL로 나타나 tosufloxacin의 MIC50 값이 가장 우수함을 알 수 있었다. 새로운 퀴놀론계 항생제인 tosufloxacin은 기존의 퀴놀론계 항생제에 비해 상대적으로 더 우수한 항균력을 보이고 있음을 알 수 있었다. 결 론 : 본 연구결과 tosufloxacin은 levofloxacin과 ofloxacin에 비해 요로감염 원인균들에 대한 더 낮은 MIC 값을 나타냈으며, 이는 요로감염의 치료에 있어 기존의 퀴놀론계 항생제와 더불어 효과적인 약물이 될 수 있음을 시사하는 바이다.
Abstract
Background : Tosufloxacin is one of the fluoroquinolones with higher antibacterial activity against many organisms than other fluoroquinolones developed previously. However, the antimicrobial susceptibilities of tosufloxacin against uropathogens are not well known. The objective of this study was to compare minimum inhibitory concentrations (MICs) of tosufloxacin with those of levofloxacin and ofloxacin for uropathogens cultured from the urine of female outpatients with acute uncomplicated cystitis. Materials and Methods : We collected and cultured urine samples from four metropolitan hospitals between August 2006 and November 2006. The MICs of tosufloxacin, levofloxacin and ofloxacin were determined for 89 isolates using an agar dilution method. Results : The most prevalent causative organism was Escherichia coli (70.8%). The MIC distribution of tosufloxacin and levofloxacin showed a bimodal distribution for E. coli. The two modes for E. coli were 0.03 and 32 µg/mL for tosufloxacin and 0.03 and 16 µg/mL for levofloxacin. However, ofloxacin had one more peak at MIC 0.5 µg/mL. MIC50s of tosufloxacin, levofloxacin and ofloxacin for E. coli were 0.03 µg/mL, 0.06 µg/mL and 0.125 µg/mL, respectively. Tosufloxacin, the newer fluoroquinolone, was more active than levofloxacin and ofloxacin against both E. coli and Gram-positive bacteria. Conclusion : Of the studied fluoroquinolones tosufloxacin had the lowest MICs against uropathogens and could be considered a promising alternative fluoroquinolone agent for the treatment of urinary tract infection.
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