替加环素对414株需氧革兰阴性和革兰阳性临床分离菌株的体外抗菌活性

目的测定替加环素等15种抗菌药物对我院2004年和2005年临床分离的414株革兰阴性菌和革兰阳性需氧菌的体外抗菌活性。方法采用微量肉汤稀释法测定替加环素等15种抗菌药物对所测菌株的MIC,数据分析采用WHONET5.3软件。结果MRSA对替加环素、利奈唑胺及万古霉素的敏感率均为100%,替加环素对MRSA的MIC90是所测抗菌药物中最低者;万古霉素耐药肠球菌(VRE)对替加环素及利奈唑胺敏感率均为100%,替加环素对所有肠球菌的MIC90分别是利奈唑胺和万古霉素的MIC90的1/8和1/16;替加环素对青霉素中介肺炎链球菌(PISP)的MIC90为0.5mg/L,对青霉素耐药肺炎链球菌(PRSP)的MIC范围是0.25~1mg/L,其他抗菌药物对PISP和PRSP的MIC90是替加环素的1~32倍;替加环素对亚胺培南耐药的鲍曼不动杆菌的MIC范围是其他抗菌药物的1/2~1/64;对铜绿假单胞菌的MIC90是32mg/L;产ESBLs大肠埃希菌和肺炎克雷伯菌对替加环素、美罗培南和亚胺培南敏感率均为100%。结论替加环素对铜绿假单胞菌的抗菌活性较差,对其他需氧革兰阴性杆菌有较好的体外抗菌活性;对需氧革兰阳性球菌的抗菌活性最强。     

阿莫西林-双氯西林的体外抗菌作用研究

目的评价阿莫西林-双氯西林对常见感染临床分离菌的体外抗菌作用.方法收集临床分离菌按CLSI/NCCLS推荐的琼脂对倍稀释法测定阿莫西林-双氯西林的最低抑菌浓度（MIC）,并与相关抗菌药物进行比较.结果收集临床分离菌共513株,其中需氧革兰阳性菌248株,需氧革兰阴性菌265株.阿莫西林-双氯西林对受试的需氧革兰阳性球菌,包括肺炎链球菌、化脓性链球菌等链球菌属、甲氧西林敏感葡萄球菌、粪肠球菌具有高度抗菌活性,大多与阿莫西林-克拉维酸相仿,亦优于其他受试药,该药对卡他莫拉菌、流感嗜血杆菌抗菌作用强,其中对流感嗜血杆菌的产酶株作用略差;对伤寒沙门菌具有良好抗菌作用,对大肠埃希菌、肺炎克雷伯菌、奇异变形杆菌和志贺菌的抗菌作用较差.结论阿莫西林-双氯西林对社区获得的上、下呼吸道感染和单纯性皮肤软组织感染的常见病原菌具有良好抗菌作用,对伤寒沙门菌作用亦强,提示该药为治疗上述感染的适宜选用药物之一.     

In vitro activity of norfloxacin against Neisseria gonorrhoeae

Norfloxacin, an analogue of nalidixic acid, is a novel antibacterial compound active against both gram-negative and gram-positive pathogens. 142 Neisseria gonorrhoeae isolates proved to be remarkably sensitive to it; the MIC50 and MIC90 values for norfloxacin were 0.03 microgram/ml and 0.06 microgram/ml, respectively, for the strains resistant to the penicillins; for the strains susceptible to the penicillins, the same value of 0.03 microgram/ml was found both for the MIC50 and MIC90. 100% of the strains were inhibited by 0.125 microgram/ml of the drug: this concentration is far below the serum levels (1.5 micrograms/ml) achievable following normal dosage. Clinical trials should be performed to establish whether the activity in vivo corresponds to that found in vitro.     

6种氟喹诺酮类药物的体外抗解脲脲原体作用

目的；研究检测解脲脲原体（Uu)临床株对氟喹诺酮类药物的敏感性，为临床治疗提供参考依据。方法：应用微量肉汤稀释法检测了88株Uu对6种氟喹诺酮类药物的敏感性。结果：在6种药物中司帕沙星和加替沙星抗Uu活性最强，MIC50分别为0.25μg/ml和0.5μg/ml，MIC90均为4μg/ml。其次为左氧氟沙星和氧氟沙星，MIC50分别为1μg/ml和2μg/ml，MIC90分别为4μg/ml和8μg/ml。诺氟沙星和环丙沙星的抗Uu活性最差。结论：氟喹诺酮类抗菌药新品种司帕沙星，左氧氟沙星和加替沙量的抗Uu活性较老一代药物更强；Uu对老一代氟喹诺酮类药物存在不同程度的耐药。     

In vitro activity of six quinolone derivatives against Neisseria gonorrhoeae

The in vitro activities of six quinolone derivatives, rosoxacin, pefloxacin, ofloxacin, ciprofloxacin, A-56619 and A-56620, were compared with those of penicillin, cefotaxime, spectinomycin, chloramphenicol, tetracycline and erythromycin against 50 nonpenicillinase-producing and 15 penicillinase-producing Neisseria gonorrhoeae strains. Ciprofloxacin was the most active compound in vitro (MIC50, 0.004 mg/l) followed by ofloxacin and A-56620 (MIC50, 0.008 mg/l), A-56619 and cefotaxime (MIC50, 0.016 mg/l). The six quinolones are highly active against all the strains tested but 2, with decreased sensitivity.     

24种抗菌药对临床分离葡萄球菌的体外抗菌活性

目的 :比较 2 4种抗菌药对临床分离葡萄球菌的体外抗菌活性。方法 :受试药物为 2 4种抗菌药 ,受试菌为临床分离的2 71株金葡菌和 135株凝固酶阴性葡萄球菌。琼脂稀释法测定抗菌药对细菌的最低抑菌浓度。结果 :万古霉素、替考拉宁和利福平对甲氧西林耐药金黄色葡萄球菌 (MRSA)具有高度抗菌活性 ,抑菌率分别为 10 0 %、99.2 %和 95 .4% ;其他抗菌药的抑菌率低于 5 0 %。甲氧西林敏感金黄色葡萄球菌 (MSSA)对青霉素的敏感率仅 17.1% ,对四环素、克林霉素以及红霉素的敏感率为 70 %左右 ,对大多数 β内酰胺类抗生素的敏感率 >90 %。耐甲氧西林的凝固酶阴性葡萄球菌 (MRCNS)对万古霉素、替考拉宁和利福平的敏感率分别为 10 0 %、99.2 %和 94.9%。甲氧西林敏感的凝固酶阴性葡萄球菌 (MSCNS)对绝大多数受试药物的敏感率 >90 % ,青霉素的抑菌率低于 5 0 %。结论 :万古霉素等糖肽类抗生素为甲氧西林耐药葡萄球菌 (MRS)感染的可靠选用药物 ,重症感染者尚应联合利福平、磷霉素等抗菌药 ,不宜选用 β内酰胺类抗生素 ;由MSS所致感染则可根据药敏选用糖肽类以外的各类抗菌药。     

广州地区淋球菌耐药性的趋势分析

目的了解广州地区13年的产青霉素酶淋球菌(PPNG)和高水平耐四环素淋球菌(TRNG)的流行状况及对5种抗菌药物的耐药趋势。方法用琼脂稀释法测定最低抑菌浓度(MIC)以及用纸片碘量法检测β-内酰胺酶。结果 1 324株淋球菌中,2000~2005年度PPNG检出率占23.5%(156/665),2008~2014年度PPNG检出率占36.4%(240/659),差异有统计学意义(P0.05)。2000~2005年度TRNG检出率占33.4%(222/665),2008~2014年度TRNG检出率占42.6%(281/659),差异有统计学意义(P0.05)。青霉素耐药率从71.1%(473/665)升高至87.1%(574/659),差异有统计学意义(P0.05);环丙沙星耐药率由88.9%(591/665)升至98.0%(646/659),差异有统计学意义(P0.05);头孢曲松中度敏感率从12.3%(82/665)提升到21.5%(142/659),差异有统计学意义(P0.05);大观霉素未发现耐药菌。结论持续进行淋球菌耐药性监测非常重要,大观霉素在临床上可以作为治疗淋病的优选药物,具有良好疗效。     

13种抗生素对纹带棒状杆菌的体外活性分析

目的分析临床分离的纹带棒状杆菌的药敏试验结果及其对临床常用抗生素的最低抑菌浓度(MIC)的分布情况。方法纹带棒状杆菌由RapID CB Plus System鉴定,药敏采用琼脂平板稀释法。结果万古霉素、替考拉宁和亚胺培南对纹带棒状杆菌90%的MIC(MIC90)≤0.5μg/mL,而其他几种抗生素的MIC90≥8μg/mL。结论纹带棒状杆菌对万古霉素、替考拉宁和亚胺培南显示出较稳定的敏感性,但其他几种抗生素的敏感性不确定,药敏试验有助于临床选择最佳的抗生素治疗该类细菌的感染。     

六种氟喹诺酮类药物体外对人型支原体的抗微生物作用

目的：检测氟喹诺酮类药物对人型支原体（Mh）临床株的抗微生物作用，指导临床合理用药。方法：以微量肉汤释释法检测103株Mh对6种氟喹诺酮类药物的敏感性。结果：在6种药物中司帕沙星和加替沙星抗Mh活性最强，MIC50分别为0.031 25mg/L和0.25mg/L，MIC50均为1mg/L。其次为左氧氟沙星MIC50和MIC90分别为1mg/L和4mg/L，氧氟沙星和环丙沙星的MIC50和MIC90均分别为2mg/L和8mg/L。诺氟沙星的抗Mh活性最差，其MIC50和MIC90分别达到32mg/L和64mg/L。结论：氟喹诺酮类抗菌药新品种司帕沙星和加替沙星的抗Mh活性较临床沿用的品种强；Mh对临床沿用的氟喹诺酮类药物有不同程度的耐药性。     

肺炎链球菌对泰利霉素等抗菌药物的体外抗菌活性

目的了解本院分离的肺炎链球菌对泰利霉素等抗菌药物的体外抗菌活性。方法对本院2005--2007年从各种临床标本收集的97株肺炎链球菌，用K—B纸片法进行药敏试验，测定这些菌株对泰利霉素等3种新近上市和其他7种临床常用抗菌药物的耐药性。结果97株肺炎链球菌对泰利霉素和利奈唑胺的敏感率均为100％，对喹奴普丁-达福普汀也未发现耐药菌株，只是有18．8％的菌株表现为中介。其他抗菌药物的耐药情况如下：对红霉素、克林霉素、万古霉素、左氧氟沙星、氯霉素和四环素的耐药率分别为60．8%、58．8％、0％、2．1％、12．8%和64．5％，对青霉素的敏感率为85．6％。结论本院尚未用于临床的3种新近上市的抗菌药物泰利霉素、利奈唑胺和喹奴普丁-达福普汀，对本院分离的肺炎链球菌有良好的体外抗菌活性。而上述细菌对红霉素、林可霉素以及四环素有较高的耐药性。     

In vitro antimicrobial activity of eight new beta-lactam antibiotics against penicillin-resistant Neisseria gonorrhoeae.

Increasing numbers of cases of penicillin-resistant gonorrhea necessitate the evaluation of new antibiotics for treatment of this disease. We tested the susceptibility of 92 penicillinase-producing (PP) Neisseria gonorrhoeae isolates and 88 penicillin-susceptible (PS) isolates to eight new beta-lactam antibiotics. The minimal inhibitory concentrations of these antibiotics were determined by the agar plate method. PP and PS N. gonorrhoeae isolates were susceptible to clinically achievable levels of all antibiotics tested. There were, however, marked differences among the drugs with regard to the concentration required to inhibit growth. The PP N. gonorrhoeae isolates were extremely susceptible to ceftriaxone, ceftizoxime, and cefotaxime, highly susceptible to moxalactam and cefoperazone, and less susceptible to cefoxitin, ceforanide, and cefonicid (geometric mean minimal inhibitory concentrations were 0.002, 0.003, 0.007, 0.03, 0.07, 0.6, 2.4, and 3.1 micrograms/ml, respectively). Although this in vitro study showed PP N. gonorrhoeae isolates to be comparatively more susceptible to ceftriaxone, ceftizoxime, and cefotaxime than to the other antibiotics, these results may not correlate with clinical efficacy.     

In vitro activity of daptomycin against Staphylococcus aureus and vancomycin-resistant Enterococcus faecium isolates associated with skin and soft tissue infections: first results from India

The in vitro activity of daptomycin and selected comparator agents against Staphylococcus aureus and vancomycin-resistant Enterococcus faecium (VREF) isolates recovered from hospitalized patients with skin and soft tissue infection's was evaluated by Clinical and Laboratory Standards Institute broth microdilution method. Daptomycin was the most active agent against both S. aureus (MIC₉₀, 1 μg/mL; 100% susceptible) and VREF (MIC₉₀, 4 μg/mL; 100% susceptible), making it an excellent therapeutic option.     

In vitro activity of BRL 17421 against Haemophilus influenzae, Neisseria gonorrhoeae, and Branhamella catarrhalis

BRL 17421, a novel beta-lactam antibiotic, was tested in vitro against fastidious gram-negative bacteria and compared with amoxicillin and amoxicillin plus clavulanic acid. The compound showed good activity against Haemophilus influenzae (range of minimal inhibitory concentrations, 0.2 to 1 microgram/ml), Neisseria gonorrhoeae (0.007 to 0.5 microgram/ml), and Branhamella catarrhalis (0.03 to 0.1 microgram/ml). BRL 17421 exhibited excellent stability against the TEM-type beta-lactamase of H. influenzae and N. gonorrhoeae, and its activity was little affected by inoculum size. Minimal lethal concentrations of BRL 17421 for 10(7) colony-forming units of H. influenzae ranged between 0.5 and 4 micrograms/ml.     

In vitro activity of daptomycin against clinical isolates ofGram-positive bacteria

We determined the activity of daptomycin, a recently FDA-approved antimicrobial agent, against clinical isolates of Gram-positive bacteria, including viridans group streptococci (16 Streptococcus mitis species group, 12 S. mutans species group, 9 S. anginosus species group, 8 S. sanguinis species group, 5 S. salivarius species group) from patients with infective endocarditis, 32 methicillin-resistant Staphylococcus aureus, 32 high-level penicillin-resistant Streptococcus pneumoniae, 38 vancomycin-resistant enterococci (including 1 linezolid-resistant isolate), and thefollowing unusual Gram-positive bacteria: 3 Listeria monocytogenes, 4 Erysipelothrix rhusiopathiae, 9 Corynebacterium species, 10 Abiotrophia/Granulicatella species, 2 Rothia (Stomatococcus) mucilaginosus, and 4 Gemella morbillorum. Daptomycin minimum inhibitory concentration (MIC)₉₀ values for the viridans group streptococci, methicillin-resistant S. aureus, penicillin-resistant S. pneumoniae, and Enterococcus species were 0.5, 0.5, ≤0.125, and 4 µg/ml, respectively. The daptomycin MIC range for the unusual Gram-postitive bacteria was ≤0.125–2 µg/ml. We conclude that daptomycin has in vitro activity against viridans group streptococci associated with endocarditis as well as against several types of unusual Gram-positive bacteria that can cause endocarditis.Presented in part at the 13^th European Congress of Clinical Microbiology and Infectious Diseases, Glasgow, 2003 and at the 44^th ICAAC, Washington, DC, 2004     

In vitro activities of antimicrobial combinations against clinical isolates of Neisseria gonorrhoeae

The Centers for Disease Control and Prevention (CDC) now recommend combination therapy with ceftriaxone 250 mg plus azithromycin (AZM) 1 g as a first-line regimen for gonorrhea because the increase of Neisseria gonorrhoeae resistant to multiple antimicrobial agents. However, reports on the in vitro activity of antimicrobial combinations against clinical isolates of N. gonorrhoeae are very rare. In the present study, a checkerboard method was utilized to examine the in vitro activity of ceftriaxone (CTRX), cefodizime (CDZM), spectinomycin (SPCM), or gentamicin (GM) in combination with AZM against 25 clinical isolates of N. gonorrhoeae. The SPCM + AZM combination demonstrated the lowest mean fractional inhibitory concentration index (FICI) of 0.69, followed by the CDZM + AZM combination (mean FICI, 0.75), the CTRX + AZM combination (mean FICI, 0.81), and the GM + AZM combination (mean FICI, 0.83). Additivity/indifference effect was detected for the SPCM + AZM combination, the CDZM + AZM combination, the CTRX + AZM combination, and the GM + AZM combination, against 96 %, 72 %, 92 %, and 100 % of the isolates, respectively. There was no antagonism for any of the antimicrobial combinations against the 25 N. gonorrhoeae isolates. These results suggest that the antimicrobial combinations may be worthy of clinical evaluation as an alternative regimen for gonococcal infections caused by antimicrobial-resistant strains.     

利奈唑胺的体外抗菌作用研究

目的评价抗菌新药利奈唑胺的体外抗菌作用。方法采用琼脂对倍稀释法测定利奈唑胺对579株临床分离菌的体外抗菌活性，并与有关抗菌药进行比较；测定利奈唑胺的杀菌浓度和杀菌曲线；培养条件对利奈唑胺抗菌活性的影响。结果利奈唑胺对葡萄球菌属、肺炎链球菌等链球菌属、肠球菌属临床分离菌均具高度抗菌活性，包括对其中的甲氧西林耐药葡萄球菌、青霉素中介肺炎链球菌亦具良好的抗菌作用。对流感嗜血杆菌、淋病奈瑟菌的抗菌活性较低。对脆弱拟杆菌等厌氧菌具较高抗菌活性。利奈唑胺对耐药的革兰阳性球菌的抗菌作用与万古霉素和替考拉宁相仿或略强。最低杀菌浓度（MBC）测定及杀菌曲线试验结果显示利奈唑胺对肺炎链球菌、溶血性链球菌具有很强的杀菌作用，对大部分葡萄球菌属具杀菌作用，对肠球菌仅具抑菌作用。培养基pH值的改变、细菌接种量的改变对利奈唑胺抗菌活性有一定影响，人血清含量改变对该药抗菌活性无明显影响。结论利奈唑胺对需氧革兰阳性球菌，包括多重耐药菌具有高度抗菌活性，且与其他抗菌药问无交叉耐药。提示利奈唑胺对革兰阳性球菌，尤其是多重耐药株所致感染的控制将具有重要作用。     

In vitro antimicrobial activity of rosoxacin against Neisseria gonorrhoeae, Chlamydia trachomatis, and Ureaplasma urealyticum.

The antimicrobial activity of rosoxacin, a new quinoline antibacterial compound, was determined against the causative organisms of three sexually transmitted diseases. Rosoxacin demonstrated a high degree of activity against Neisseria gonorrhoeae clinical isolates, with the minimal inhibitory concentrations for 50% of these being 0.03 microgram/ml. The corresponding minimal inhibitory concentrations for penicillin, ampicillin, tetracycline, and spectinomycin were 0.25 U/ml, 0.125 microgram/ml, 0.25 microgram/ml, and 16 microgram/ml, respectively. Eleven strains of Chlamydia trachomatis were inhibited by 5 microgram of rosoxacin per ml, and each of seven Ureaplasma urealyticum strains was inhibited by 2 to 8 microgram of rosoxacin per ml. The results of these susceptibility studies, coupled with those of an earlier evaluation of the pharmacokinetics of rosoxacin, provide support for extending or undertaking clinical evaluations of this compound against infections with N. gonorrhoeae, C. trachomatis, and U. urealyticum.     

抗菌肽lycosin-I对铜绿假单胞菌临床分离株的体外抗菌活性分析

目的探讨lycosin-I对铜绿假单胞菌的体外抗菌活性。方法随机收集中南大学湘雅二医院铜绿假单胞菌临床分离株,其中铜绿假单胞菌的多重耐药菌10株,非耐药菌10株。应用微量肉汤稀释法检测lycosin-I对铜绿假单胞菌的体外最低抑菌浓度(MIC);选取铜绿假单胞菌的多重耐药菌的代表株Isolate 8(MIC为8μg/m L)和非耐药菌的代表株Isolate 12(MIC为8μg/m L),检测4×MIC浓度lycosin-I的杀菌动力学;体外构建适宜环境,培养代表株24 h,定点测定其600 nm处吸光度并绘制生长曲线;在培养环境中分别添加5 mmol/L钙离子或镁离子,检测lycosin-I杀菌能力的盐耐受性。结果 Lycosin-I在体外条件下对铜绿假单胞菌的多重耐药菌和非耐药菌均表现出良好的体外抗菌活性:lycosin-I抗铜绿假单胞菌多重耐药菌的MIC为12(8,32)μg/m L,非耐药菌的MIC为12(8,32)μg/m L,两组MIC差异无统计学意义(U=42,P0.05)。4×MIC浓度的lycosin-I在60 min时即可杀灭约50%的铜绿假单胞菌多重耐药菌和非耐药菌。体外培养24 h,可见在MIC以下浓度(0,2,4μg/m L)lycosin-I干预下铜绿假单胞菌多重耐药菌和非耐药菌于6~16 h快速生长,18 h后生长速度趋于平缓;在MIC浓度(8μg/m L)lycosin-I干预下,细菌均难以生长。5 mmol/L Ca2+或Mg2+可以减弱lycosin-I的体外抗菌活性,Ca2+的加入使lycosin-I抗铜绿假单胞菌的多重耐药菌和非耐药菌的MIC值均由原来的8μg/m L升高至64μg/m L,Mg2+的加入则均使MIC值由原来的8μg/m L升高至32μg/m L。但是当lycosin-I处于较高浓度状态(64μg/m L或32μg/m L)时,其仍然可以保持较好的抗铜绿假单胞菌多重耐药菌和非耐药菌活性。结论 Lycosin-I在体外条件下可以有效抑制铜绿假单胞菌浮游菌的生长,具有一定的盐耐受性,有望发展成为一种新型抗菌药物。     

脲原体属对加替沙星等9种抗菌药物的敏感性分析

目的本研究检测脲原体属对加替沙星及其他氟喹诺酮类、大环内酯类和四环素类抗菌药物的敏感性,为临床合理用药提供参考依据。方法所有菌株均为近期自泌尿生殖道临床标本中分离,采用改良的微量稀释法测定9种抗菌药物对52株脲原体属的MIC。结果改良的微量稀释法方法稳定,结果可靠。加替沙星对脲原体属具有良好抗菌活性,MIC≤4mg/L,MIC500.5mg/L;其抗脲原体活性优于环丙沙星,与左氧氟沙星及阿奇霉素相似,强于红霉素,但略弱于四环素类。克拉霉素对脲原体属抗菌活性明显高于红霉素及阿奇霉素;四环素类对脲原体属均具有良好抗菌活性。结论可采用微量稀释法测定脲原体属对抗菌药物的敏感性。加替沙星可作为治疗脲原体属感染,特别是泌尿生殖道感染的首选药物之一。