不同配比的阿莫西林/舒巴坦钠体外抗菌活性比较

Comparison of in vitro antibacterial activities for different ratio of amoxicillin/sulbactam

目的:研究阿莫西林(AMC)/舒巴坦(SBT)不同配比(2:1和4:1)对临床分离致病菌的体外抗菌活性。方法:采用平皿二倍稀释法测定最低抑苗浓度(MIC)。采集临床分离致病菌共620株,其中502株细菌为产β-内酰胺酶菌株(占80.97％)。结果:对产超广谱β-内酰胺酶(ESBL)大肠埃希菌和肺炎克雷伯菌、易产诱导酶的肠杆菌属及非发酵G-杆菌中铜绿假单胞菌、不动杆菌、嗜麦芽菌,AMC/SBT 4:1配比的MIC值为2:1配比时的1-2倍,但均属耐药范围。对社区感染常见菌如产酶的流感嗜血杆菌、卡他莫拉菌、甲氧西林敏感的金葡球菌(MSSA)及凝固酶阴性葡萄球菌(MSSCoN)、肺炎链球菌、β-溶血链球菌和粪肠球菌,2种配比的MIC值均相似。结论:AMC/SBT 4:1抗菌活性与2:1配比基本相同,具有进一步研制开发的价值。

Objective:To evaluate the antibacterial activities in vitro of amoxicillin/sulbactam (2:1 and 4:1). Methods:Minimal inhibitory concentrations (MIC) were determined by agar double dilution. Of 620 strains of clinical organisms, 502 cultures of organisms were found to be able to produce β-lactamases (80.97%). Results:Two combinations of amoxicillin/sulbactam (2:1 and 4:1) all showed resistant antibacterial activities with fluctuated MIC range,MIC50 and MIC90 in 1-2 times on the following organisms: Escherichia coli of ESBL, Klebsiella pneumoniae of ESBL, Enterobacter spp producing AmpC enzyme and non-fermentation gram negative rod ( Pseudomonas aeruginosa , Acineto-bacter spp, Stenophotomonas maltophilus). Two combinations of amoxicillin/sulbactam (2:1 and 4:1) also gave an equivalent titer in the MIC range,MIC50 and MIC90 on common pathogenic bacteria that cause community infection,i.e. ,Haemophilus Influenza producing β-lactamases,Moraxella catarrh , MSSA and MSSCoN, Streptococcus pneumoniae, β-haemolysis Streptococcus and Enterococcus fae-calis. Conclusion: Amoxicillin/sulbactam (4:1) was found to have the same antibacterial activity as amoxicillin/sulbactam (2:1).