摘要
目的比较不同β内酰胺类/β内酰胺酶抑制剂对肠杆菌科细菌的体外抗菌活性。方法收集临床分离肠杆菌科细菌,用平皿二倍稀释法测定抗菌药最低抑菌浓度(MIC),根据2014版美国临床实验室标准化委员会(CLSI)折点判读结果,用SPSS17.0统计软件处理数据。结果共收集到2166株肠杆菌科细菌。哌拉西林对大肠埃希菌的MIC50和MIC90分别是256,512μg·m L-1,加用他唑巴坦后MIC50和MIC90则分别为2,8μg·m L-1。对产超广谱β内酰胺酶(ESBLs)大肠埃希菌和肺炎克雷伯菌,哌拉西林/他唑巴坦敏感率最高为93.7%和86.1%,头孢哌酮/他唑巴坦为91.59%和82.59%,头孢哌酮/舒巴坦为74.4%和58.37%。复方制剂对非产ESBLs大肠埃希菌和肺炎克雷伯菌的敏感率与单用β内酰胺类相差不大。β内酰胺类抗菌药对普通变形杆菌的敏感率比奇异变形杆菌高,但加用β内酰胺酶抑制剂后两者敏感率差不多。美洛西林/舒巴坦对摩根菌属敏感率为97.4%,明显高于单用美洛西林的76.3%。头孢噻肟/他唑巴坦和头孢曲松/他唑巴坦对肠杆菌科细菌的MIC90比单用头孢噻肟和头孢曲松低。结论β内酰胺类/β内酰胺酶抑制剂对肠杆菌科细菌的抗菌活性比单用β内酰胺类抗菌药强,尤其对产ESBLs大肠埃希菌和肺炎克雷伯菌差异更为明显,其中以哌拉西林/他唑巴坦的抗菌活性最强。
Objective To evaluate the antibacterial activities of severalβ-lactam/β-lactam inhibitor combinations in vitro.Methods All the clinical isolates were Enterobacteriaceae collected from hospitals and the susceptibility tests were performed using agar dilution method recom-mended by CLSI.The minimum inhibitory concentration （ MIC ） results were interpreted according to the breakpoints of CLSI （2014） guideline.The data was analyzed by software SPSS17.0.Results A total of 2166 Enterobacteriaceae were collected and were performed MIC tests.Based on the MIC results, the MIC50 and MIC90 of piperacillin to Escherichia coli were 256 , 512 μg·mL^-1 , while piperacillin/tazobactam were 2 , 8μg· mL^-1 , respectively.The sensitive rates of piperacillin/tazobactam to ESBLs -producing Escherichia coli and Klebsiella pneumoniae were 93.7% and 86.1%, cefoperazone/tazobactam were 91.5% and 82.5%, while cefoperazone /sulbactam were 74.4% and 58.39%. Among ESBLs -non -producing Escherichia coli and Klebsiella pneumoniae, there is not much difference between using β-lactam/β-lactam inhibitor combinations and β-lactams alone.β-lactam antibiotics have higher sensitive rates to Proteus vulgaris than Proteus mirabilis, butβ-lactam/β-lactam inhibitor combinations have no difference against them.The sensitive rate of mezlocillin/sulbactam to Morganella spp.was 97.4%, significantly higher than mezlocillin alone with sensitive rate 76.3%.The MIC90 of cefotaxime/tazobactam and ceftriaxone/tazobactam were lower than using cefotaxime and ceftriaxone alone.Conclusion β-lactam/β-lactam inhibitor combinations have greater antimicrobial activity to Enterobacteriaceae than β-lactams alone, especially for ESBLs-producing Escherichia coli and Klebsiella pneumoniae.Among them, piperacillin/tazobactam has the greatest antimicrobial activity.
出处
《中国临床药理学杂志》
CAS
CSCD
北大核心
2015年第11期916-920,共5页
The Chinese Journal of Clinical Pharmacology
