磷霉素对尿标本中分离细菌的药物抗菌活性分析

目的分析尿标本中常见分离细菌的磷霉素药物抗菌活性及其特点,为临床用药提供参考。方法对610株中段尿标本分离的细菌进行鉴定及耐药表型分析,同时应用标准琼脂稀释法进行磷霉素药物敏感性检测,包括大肠埃希菌150株、肺炎克雷伯菌150株、阴沟肠杆菌100株、鲍曼不动杆菌50株、金黄色葡萄球菌60株、屎肠球菌50株和粪肠球菌50株。结果不同细菌及其耐药表型之间磷霉素敏感性及最小抑菌浓度（MIC）折点存在差异。磷霉素对大肠埃希菌有很高的抗菌活性,敏感率达98%,但对肺炎克雷伯菌与阴沟肠杆菌的敏感率（分别为90%、85%）均低于大肠埃希菌;屎肠球菌MIC值分布略高于粪肠球菌;磷霉素对金黄色葡萄菌也有很好的抗菌活性,敏感率达90%,其中耐甲氧西林金黄色葡萄球菌（MRSA）MIC值分布水平更高;而所有鲍曼不动杆菌的磷霉素MIC值均维持在高水平。结论磷霉素对常见泌尿系统感染细菌有较好的抗菌活性,但临床使用时要考虑不同细菌及耐药表型之间的差异。

Antimicrobial activity analysis of fosfomycin against pathogens isolated from urine specimens

Objective To analyze the antimicrobial activity and characteristics of fosfomycin against commonly pathogens isolated from urine specimens and to provide laboratory evidence for clinical application of fosfomycin.Methods Standard agar dilution was used to study the antimicrobial activity of fosfomycin against 610 pathogens associated with urinary tract infection, including Escherichia coli 150 strains, Klebsiella pneumonia 150 strains, Enterobacter cloacae 100 strains, Acinetobacter baumannii 50 strains, Staphylococcus aureus 60 strains, Enterococcus faecalis 50 strains and Enterococcus faecium 50 strains. Results There were different susceptibility phenotypes and break points of minimum inhibitory concentration（MIC） to fosfomycin between different pathogens. Fosfomycin was highly active against Escherichia coli, the durg sensitive rate was 98%, the sensitive rate against Klebsiella pneumonia（90%） and Enterobacter cloacae（85%） was lower than that against Escherichia coli; Enterococcus faecium MIC value was slightly higher than Enterococcus faecalis; fosfomycin showed good activity against Staphylococcus aureus（90%）, and the MIC values of methicillin-resistant isolated was higher than that of methicillin-susceptible strains; and the modal MICs for Acinetobacter baumannii were high concentration. Conclusion Fosfomycin has good antibacterial activity against common urinary system infection bacteria, but to consider the differences between different bacteria and drug resistance phenotype in clinical application.