毒理性
阿伏帕星是一种广泛用于家禽、猪、小牛、育肥牛和羔羊饲料中的抗微生物抗生素，因其对动物生长的积极影响而得到应用。在万古霉素尚未广泛使用的时候，人们对于人类耐药问题并没有太多的担忧。然而，当万古霉素在人类医学中变得至关重要，用于治疗耐甲氧西林金黄色葡萄球菌（MRSA）和其他严重感染时，情况发生了变化。对万古霉素的耐药性，特别是在肠球菌（VRE）中，成为许多国家重要的公共卫生问题。研究人员在接触阿伏帕星的动物中发现了VRE，而在未使用阿伏帕星作为生长促进剂的国家中的动物中并未发现。此外，使用阿伏帕星的国家中社区非住院人群VRE的流行率要高得多。有证据表明，食用动物中的VRE可能是人类耐药性的储库，可能是通过动物和人类菌株之间的遗传物质交换，或者通过动物菌株暂时定植人类肠道。阿伏帕星在美国从未获得使用批准，自1997年以来，其使用已被欧盟禁止。
人类暴露和毒性：一名50岁女性因接触阿伏帕星而患上了接触性皮炎。
动物研究：研究表明，将糖肽类抗生素阿伏帕星作为生长促进剂与家禽和猪场出现对万古霉素高度耐药的粪肠球菌（VREF）之间存在关联。这些调查作为回顾性队列研究进行，比较了接触或不接触阿伏帕星的农场组。在家禽中，阿伏帕星的使用与VREF的发生之间的关联被广谱抗生素的使用混淆了。在猪中，这种关联具有相似的幅度。两项研究的相似发现为阿伏帕星的使用与农场VREF的发生之间的因果关系提供了证据，并表明食用动物构成了人类VREF感染的可能储库。
IDENTIFICATION AND USE: Avoparcin is an antimicrobial antibiotic that has been widely used in feed for poultry, pigs, calves, cattle for fattening and lambs, due to its positive effects on animal growth. At the time since vancomycin was not widely used, there was little reason to be concerned about resistance problems in humans. Things changed, however, when vancomycin became critical in human medicine for treatment of methicillin-resistant Staphylococcus aureus (MRSA) and other serious infections. Resistance to vancomycin, especially among enterococci (VRE) became an important public health problem in many countries. Researchers identified VRE in animals exposed to avoparcin, where they were not found in animals in countries where avoparcin was not used as a growth promoter. Furthermore, the prevalence of VRE among non-hospitalized people in the community was much higher in countries that used avoparcin. There is evidence that VRE in food animals may have been a reservoir for resistance in humans, perhaps through exchange of genetic material between animal and human strains, or through transient colonization of the human gut by animal strains. Avoparcin was never approved for use in the United States and its use has been banned in the European Union since 1997.HUMAN EXPOSURE AND TOXICITY: A case of contact dermatitis in a 50 year old woman resulted from exposure to avoparcin. ANIMAL STUDIES: Studies have shown an association between the use of the glycopeptide antibiotic avoparcin as a growth promoter and the occurrence of Enterococcus faecium (VREF) with high-level resistance to vancomycin on poultry and pig farms. The investigations were conducted as retrospective cohort studies, where groups of farms exposed or not exposed to avoparcin were compared. In poultry, the association between the use of avoparcin and the occurrence of VREF was confounded by the use of broad-spectrum antibiotics. In pigs, the association had a similar magnitude. The similar findings in the two studies provide evidence in favor of a causal association between the use of avoparcin and the occurrence of VREF on farms, and suggest that food animals constitute a potential reservoir of infection for VREF in humans.
来源:Hazardous Substances Data Bank (HSDB)
