氨苄西林预报粪肠球菌和屎肠球菌亚胺培南敏感性的可行性研究

目的 评价氨苄西林预报粪肠球菌和屎肠球菌亚胺培南敏感性的可行性。方法 收集23家医院的127株粪肠球菌和124株屎肠球菌非重复临床分离株。采用微量肉汤稀释法和纸片扩散法测定粪肠球菌和屎肠球菌对青霉素、氨苄西林、亚胺培南的敏感性。结果 纸片扩散法青霉素和氨苄西林均敏感或均耐药的粪肠球菌，微量肉汤稀释法氨苄西林-亚胺培南的分类一致率（CA）均为100.0%，未出现非常重大误差（VME）和重大误差（ME）；纸片扩散法青霉素和氨苄西林均耐药的粪肠球菌，微量肉汤稀释法氨苄西林-亚胺培南的CA为77.8%,ME占22.2%；青霉素耐药、氨苄西林敏感的粪肠球菌，微量肉汤稀释法氨苄西林-亚胺培南的CA为57.1%，纸片扩散法的CA为81.8%。结论 氨苄西林预报粪肠球菌和屎肠球菌亚胺培南敏感性的可靠性优于青霉素，但氨苄西林的敏感性不能用于预报青霉素耐药、氨苄西林敏感表型粪肠球菌和屎肠球菌的亚胺培南敏感性；青霉素敏感可预报粪肠球菌和屎肠球菌对氨苄西林敏感。

Using ampicillin to predict imipenem susceptibilities of Enterococcus faecalis and Enterococcus faecium

Objective To evaluate the feasibility of ampicillin to predict the imipenem susceptibilities of Enterococcus faecalis and Enterococcus faecium.Methods Totally,127 non-duplicated isolates of Enterococcus faecalis and 124 isolates of Enterococcus faecium were collected from 23 hospitals.The susceptibilities of Enterococcus faecalis and Enterococcus faecium to penicillin,ampicillin and imipenem were determined by broth microdilution and disk diffusion methods.Results For Enterococcus faecalis,which were both sensitive or resistant to penicillin and ampicillin,the categorical agreement(CA)of ampicillin-imipenem by broth microdilution was 100.0%,and there was no very major error(VME)and major error(ME).For Enterococcus faecalis,which were resistant to both penicillin and ampicillin,the CA of ampicillin-imipenem by disk diffusion was 77.8%,and the ME accounted for 22.2%.For penicillin-resistant but ampicillin-sensitive Enterococcus faecalis,the CA of ampicillin-imipenem were 57.1%and 81.8%by broth microdilution and disk diffusion.Conclusions Ampicillin is better than penicillin to predict the susceptibilities of Enterococcus faecalis and Enterococcus faecium to imipenem.The susceptibilities to ampicillin can not be used to predict the susceptibilities of penicillin-resistant but ampicillin-sensitive Enterococcus faecalis and Enterococcus faecium to imipenem.Enterococcus faecalis and Enterococcus faecium isolates being sensitive to penicillin are predictably susceptible to ampicillin.