22株脑膜炎奈瑟菌对治疗和预防用抗菌药的体外敏感性

目的了解22株脑膜炎奈瑟菌对常用的治疗和预防用抗菌药的体外敏感性。方法采用2005年美国CLSI推荐的琼脂稀释法测试12种抗菌药物对22株脑膜炎柰瑟球菌的MIC。结果22株脑膜炎奈瑟菌对青霉素、氨苄西林、美罗培南、头孢曲松、头孢噻肟和氯霉素的敏感率均为100%;对米诺环素、阿奇霉素和利福平敏感率也为100%;对环丙沙星和左氧氟沙星的敏感率仅为27.3%;对复方磺胺甲噁唑无敏感菌株。结论可以首选窄谱的抗菌药青霉素或氨苄西林治疗脑膜炎奈瑟菌感染;利福平可以作为密切接触人群预防用药。而环丙沙星、左氧氟沙星、复方磺胺甲噁唑有较高的耐药率,建议不作为当前流行菌株的预防用药。

In vitro susceptibility of 22 strains of N. meningitidis to therapeutic and prophylactic agents

Objective To investigate the in vitro susceptibility of 22 strains of N. meningitidis to therapeutic and prophylactic agents. Methods MICs of 12 antimicrobial agents were determined by agar dilution method according to CLIS guidelines (2005) against 22 strains of N. meningitidis. Results All the 22 strains were susceptible to the therapeutic antimicrobial agent penicillin, ampicillin, meropenem, ceftriaxone, cefotaxime and chloramphenicol. Prophylactic agent including minocycline, azithromycin and rifampin inhibited 100% of the 22 strains. However, only 27.3% of the strains were susceptible to ciprofloxacin and levofloxacin. None was susceptible to trimethoprim-sulfamethoxazole. Conclusions Penicillin or ampicillin is still the drug of choice for treatment of meningococcal meningitis. Minocycline, azithromycin and rifampin can be used as prophylactic agents for individuals with close contact. Chemoprophylaxis with ciprofloxacin, levofloxacin or trimethoprim-sulfamethoxazole is not recommended for prevalent N. meningitidis.