舒巴坦与拉氧头孢配比对产酶菌的体外抗菌活性研究

目的评价拉氧头孢与舒巴坦的不同配比对143株临床分离产酶菌的体外抗菌作用。方法用平皿二倍稀释法对拉氧头孢/舒巴坦与三代头孢菌素头孢噻肟和舒巴坦复合抗生素氨苄西林/舒巴坦及头孢哌酮/舒巴坦的体外抗菌作用进行了测定。结果拉氧头孢对6种标准超广谱β内酰胺酶TEM-1、TEM-3、SHV-1、SHV-2、SHV-5、SHV-18具有高度的稳定性,MIC≤1.0μg/mL;对去遏制持续高产AmpC酶标准菌株的MIC=8.0μg/mL。对临床分离的ESBL_s菌株的MIC_(50)值拉氧头孢(0.5μg/mL)比头孢噻肟、氨苄西林/舒巴坦和头孢哌酮/舒巴坦分别低32倍、64倍和16倍、敏感率大99.1％。对临床分离产AmpC酶菌株的MIC_(50)值(8.0μg/mL)分别比头孢噻肟、氨苄西林/舒巴坦低4倍和8倍,与头孢哌酮/舒巴坦相同,敏感率为81.0％;对临床分离产SSBL菌株的MIC_(50)值(16μg/mL)比头孢噻肟、氨苄西林/舒巴坦低8倍,与头孢哌酮/舒巴坦相同,敏感率为41.7％;对临床分离高产诱导酶菌株的敏感率为100％。各种比例的舒巴坦都不能降低拉氧头孢对标准产酶株和临床产酶株的MIC值。结论拉氧头孢对临床分离的各种产酶菌耐药率极低,对包括质粒及染色体介导的各种β内酰胺酶的稳定性较高,可作为临床治疗由肠杆菌科细菌所致医院内感染的用药。

Comparative in vitro activity of Latamoxef/Sulbactam

To study the in vitro activity of Latamoxef/Sulbactam. METHODS The in vitro combination antibacterial ac- tivities were studied by using two - fold plate dilution methods. RESULTS The results showed that Latamoxef was more active including TEM - 1、TEM - 3、SHV - 1、SHV - 2、SHV - 5、SHV - 18 (MIC≤1.0mg/L), and AmpC β lactamase (MIC = 8.0mg/L). Latamoxef could decreased the MIC_(50) of cefotaxime, ampicillin/sulbactam, cefoperazone/sulbactam against produce extended ? spectrum beta - lacta- mase (ESBLs) strain 32、64、16 folds and produce AmpC β lactamase strain 4、8、0 folds and produce super _ spectrum beta lactermbses (SSBL) strain 8, 8, 0 folds. The susceptible rates of Latamoxef were 99.1%、81.0%、41、7%、100% with ESBLsstrain, AmpC β lacta- mase strain, SSBL strain, inducible β lactamase strain. CONCLUSIONS Latamoxef were the most active antibiotice against Enterobacte- riaceae, and were the most ideal antimicrobial agents for serious nosocomial infection.