头孢丙烯对5种儿童感染常见病原菌的抗菌活性

Antibacterial activity of cefprozil against five common pathogens isolated from pediatric patients

目的观察头孢丙烯等口服抗生素对5种儿童社区获得性感染常见致病菌的体外抗菌活性。方法选取近年北京儿童医院临床分离的金葡菌、化脓性链球菌、肺炎链球菌、流感嗜血杆菌和卡他莫拉菌菌株,采用E试验法检测其对头孢丙烯、头孢克洛、头孢地尼等抗生素的敏感性。结果头孢丙烯对所检测菌株的MIC90值分别是:甲氧西林敏感金葡菌0.75mg/L;化脓性链球菌0.023mg/L;肺炎链球菌青霉素敏感株0.094mg/L,青霉素耐药株12mg/L;β内酰胺酶阴性流感嗜血杆菌2mg/L,β内酰胺酶阳性16mg/L;β内酰胺酶阴性卡他莫拉菌0.75mg/L,β内酰胺酶阳性2mg/L。PRSP株对头孢丙烯耐药率为61.9%,流感嗜血杆菌β内酰胺酶阳性株中占15.8%。结论头孢丙烯对金葡菌、化脓性链球菌、青霉素敏感肺炎链球菌、β内酰胺酶阴性卡他莫拉菌有良好抗菌作用;对β内酰胺酶阳性流感嗜血杆菌的抗菌活性低于头孢地尼;青霉素耐药肺炎链球菌株对头孢丙烯有较高的耐药率。

Objective To study the in vitro antimicrobial activity of cefprozil against five common bacterial pathogens causing community-acquired pediatric infections. Methods The tested bacterial strains isolated from patients in Beijing Children＇s Hospital included Staphylococcus aureus （77 = 50）, Streptococcus pneumoniae （n = 74）, Streptococcus pyogenes （ n = 30）, Haemophilus influenzae （n=30） and Moraxella catarrhalis （n=30）. Minimum inhibitory concentrations （MICs） of cefprozil, cefaclor and several other antimicrobials against these strains were determined using E test method. Results MICro of cefprozil was 0.75 mg/L against methicillin-sensitive S. aureus, 0. 023 mg/L against S. pyogenes, 0. 094 （penicillin-susceptible S. pneumaniae, PSSP） to 12 mg/L （penicillin-resistant S. pneumoniae, PRSP） against S. pneumoniae, 2 （beta-lactamase negative strain） to 16 mg/L （beta-lactamase positive strain） against H. influenzae and 0.75 （beta-lactamase-negative strain） to 16 mg/L （beta-lactamase positive strain） against M. catarrhalis isolates respectively. About 61.9%of PRSP isolates and 15.8% of beta-lactamase positive H. influenzae strains were resistant to cefprozil respectively. Conclusions Our results suggest that cefprozil has good in vitro activity against methieillin-sensitive S. aureus, S. pyogenes, PSSP, and beta-lactamase negative M. catarrhalis isolates. But it is not as active as cefdinir against beta-lactamase positive H. influenzae. Relatively higher proportion of PRSP isolates is resistant to cefprozil.