夫西地酸对常见革兰染色阳性细菌的药物敏感性实验研究

目的 探讨夫两地酸、万古霉素、妥布霉素及氧氟沙星对8种常见革兰染色阳性细菌的体外药物敏感性.方法 实验研究.选用首都医科大学附属北京同仁医院、北京同仁眼科中心、北京市眼科研究所微生物室保存的眼部100株革兰染色阳性细菌,按照眼部微生物标本常规方法收集并进行细菌培养和菌种鉴定,采用纸片扩散法观察100株细菌对夫西地酸、万古霉素、妥布霉素及氧氟沙星的药物敏感性.应用SPSS 11.5软件包中的四格表卡方检验进行统计分析.结果 体外培养阳性的革兰染色阳性细菌对妥布霉素、氧氟沙星、万古霉素及夫西地酸的总体敏感性百分比分别是55.0%、65.0%、98.0%及53.0%.万古霉素总体敏感性百分比高于妥布霉素、氧氟沙星及夫西地酸,差异有统计学意义(x2=51.425、36.113、54.737,P<0.05).常见葡萄球菌对夫西地酸的敏感性(85.5%)仅低于万古霉素(100.0%),差异有统计学意义(x2=6.605,P<0.05);但高于妥布霉素(58.2%)和氧氟沙星(54.5%),差异有统计学意义(x2=10.106、12.511,P<0.05).常见的链球菌对夫西地酸的敏感性(0.0%)低于万古霉素(100.0%)和氧氟沙星(85.0%),差异有统计学意义(x2=40.000、29.565,P<0.05);而和妥布霉素(15.0%)之间比较差异无统计学意义(x2=1.441,P>0.05).而革兰阳性杆菌和奴卡菌属对夫西地酸的敏感性百分比(24.0%)则低于另外3种抗生素(妥布霉素80.0%,氧氟沙星72.0%,万古霉素92.0%),差异有统计学意义(x2=23.727、22.430、11.538,P<0.05).结论 夫西地酸对葡萄球菌的抗菌作用较强,面对链球菌和革兰阳性杆菌的作用则明显较弱.

Analysis on the susceptibility of fusidic acid for common gram positive bacteria

Objective To assess in vitro susceptibility of the fusidic acid, vancomycin, tobramycin and ofloxacin for 8 kinds of ocular gram-positive bacteria. Methods It was an experimental study. One hundred strains of ocular gram-positive bacterial isolates selected from Beijing Institute of Ophthalmology, cultivated and identified by the routine, were tested for their susceptibilities to fusidic acid, vancomycin, tobramycin and ofloxacin, with in vitro by the Kirby-Bauer disk diffusion method. Significant differences between groups were evaluated by SPSS 11.5 chi-square test of four-fold table. Results In the study, the percentage of susceptibility for in vitro gram-pesitive bacterial isolates to tobramycin, ofloxacin, vancornycin and fusidic acid was 55. 0%, 65. 0%, 98.0% and 53. 0%. The susceptibility to vancomycin was significantly higher than to tobramycin, ofloxacin and fusidic acid (x2 = 51. 425,36. 113,54. 737 ;P < 0. 05). The susceptibility of common staphylococci to fusidic acid (85.5%) was just lower than to vancomycin ( 100. 0% ) ( x2 = 6. 605, P < 0. 05 ), but was significantly higher than to tobramycin ( 58. 2% ) and ofloxacin (54. 5% )( x2 = 10. 106,12. 511 ;P < 0. 05 ). The susceptibility of common streptococcus to fusidic acid (0.0%) was lower than to vancomycin(100.0%) and ofloxacin (85.0%) (x2 =40.000, 29. 565;P <0. 05 ), but the susceptibility to fusidic acid and tobramycin (15. 0%) were equivalent( x2 = 1. 441 ,P >0. 05). The gram-positive bacilli and nocadia showed significantly lower susceptibility to fusidic acid (24. 0% ) than that to the other three antibiotics ( tobramycin 80. 0%, ofloxacin 72. 0%, vancomycin 92.0%)(x2 =23.727, 22.430, 11.538;P<0.05). Conclusion The in vitro susceptibility of fusidic acid to staphylococci is higher, while to streptococcus and gram-positive bacilli is obviously lower than other three kinds of antibiotics.