头孢哌酮/舒巴坦对4种革兰阴性杆菌体外抗菌活性的研究

Antibacterial Activity of Cefotaxime/sulbactam Against 4 Kinds of Gram-negative Bacilli in vitro

目的了解头孢哌酮/舒巴坦对4种临床常见的革兰阴性杆菌体外抗菌活性。方法用纸片协同试验分别检测大肠埃希菌和肺炎克雷伯菌的ESBLs,检测铜绿假单胞菌和鲍氏不动杆菌的金属酶,同时用K-B法对所有试验菌株进行14种常用抗菌药物的敏感试验。结果164株肠杆菌科细菌中有51株ESBLs阳性,包括:大肠埃希菌23株,阳性率26.3%;肺炎克雷伯菌28株,阳性率35.9%;85株铜绿假单胞菌检出产金属酶33株,阳性率38.8%;鲍氏不动杆菌未检出产金属酶菌株;头孢哌酮/舒巴坦对产酶与否的肠杆菌科细菌均具稳定的高敏感率,尤其是对产ESBLs菌株大肠埃希菌和肺炎克雷伯菌的敏感率分别达87.0%和89.3%;对产金属酶和非产酶的铜绿假单胞菌,其敏感率分别为57.6%和92.3%。结论头孢哌酮/舒巴坦对4种临床常见的革兰阴性杆菌具强大的体外抗菌活性,尤其是对于产ESBLs菌或产金属酶细菌引起的感染,可作为首选药物使用。

OBJECTIVE To know the antibacterial activity of cefotaxime/sulbactam against 4 kinds of Gramnegative bacilli in vitro in general clinics. METHODS By double-disk test to detect the ESBLs of Escherichia coli and Klebsiella pneumoniae and the metallo-β-1actamase of Pseudomonas aeruginosa and Acinetobacter baumannii. And all the tested bacilli were tested by 14 kinds of general antibacterial drugs through K-B experiment. RESULTS Fifty one of 164 Enterobacteriaceae strains were ESBLs positive, including 23 E. coli strains with positive rate of 26.3% and 28 K. pneumoniae strains with positive rate of 35.9%. The metallo-β-lactamase was produced in 33 of 85 P. aeruginosa strains and the positive rate was 38. 8%, and none in A. baumannii. The result showed cefotaxime/sulbactam was very sensitive to Enterobacteriaceae, no matter it had enzyme or not. These drugs had a special high sensitivity to ESBLs producing E. coli and K. pneumoniae, and their sensitivity rate was 87.0% and 89.3%. The sensitivity rate to P. aeruginosa, produced enzyme or not was 56.7% and 92.3%. CONCLUSIONS Cefotaxime/sulbactam has a powerful antibacterial activity against 4 kinds of Gram-negative bacilli in vitro in general clinics, especially to the infection caused by ESBLs-producing or metallo-β-1actamase-producing bacteria, and can be taken as the preferred drugs.