常用抗菌药物对外伤后细菌性致死性肉芽肿病原菌的体外抗菌活性研究

目的了解常用抗菌药物对外伤后细菌性致死性肉芽肿(FBGT)病原菌的体外抗菌活性,为该病的诊治提供实验室依据。方法应用改良的新鲜兔脑厌氧肉汤分离培养病原菌,用API鉴定系统20A鉴定细菌,最低抑菌浓度(MIC)测定采用肉汤稀释法。结果从4例FBGT患者中分离到5株疮疱丙酸杆菌,其对青霉素、氨苄西林、替卡西林/克拉维酸、氨苄西林/舒巴坦、头孢哌酮、克林霉素、亚胺培南/西司他丁的MIC值均在0.125~1.0 mg/L,对甲硝唑的MIC为64~128 mg/L。结论FBGT病原菌生长缓慢,需在营养丰富的厌氧肉汤中生长增殖,增殖成功后可在厌氧血平板中生长,该病原菌对甲硝唑全部耐药,不能应用该类药物治疗;青霉素、氨苄西林、克林霉素等常用抗菌药物体外抗菌活性较高,临床可选择这些不同种类的药物联合治疗。

In vitro Antibacterial Activity of Routine Antimicrobial Agents to Pathogens of Fatal Bacterial Granuloma after Trauma

OBJECTIVE To study the in vitro antibacterial activity of the routine antimicrobial agents to the pathogens of fatal bacterial granuloma after trauma(FBGT)in order to provide laboratory basis for its clinical diagnosis and treatment.METHODS Using reformed rabbit-brain anaerobic enriched broth to isolate and culture the pathogens that identified by API 20A system.The minimum inhibiting concentration(MIC) test used anaerobic broth dilution method.RESULTS There were 5 Propionibacterium acnes strains isolated from 4 patients with FBGT.The MIC of penicillin,ampicillin,ticarcillin/clavulanic acid,ampicillin/sulbactam,cefoperazone,lincomycin and imipenem/cilastain was 0.125-1.0 mg/L.But the MIC of metronidazole was 64-128 mg/L.CONCLUSIONS The pathogens of FBGT grow slowly,needing nutritious anaerobic broth.But after successfully culturing,they can grow on the normal anaerobic blood flat.The pathogens are all resistant to metronidazole,but susceptive to the other routine antimicrobial agents,so FBGT should not be treated by metronidazole.The clinic should combine to use penicillin,ampicillin,lincomycin and other antimicrobial agents for treatment.