头孢哌酮/舒巴坦对临床常见革兰阴性杆菌体外抗菌活性的分析

Prevalence of Antimicrobial-resistance to Cefoperazone/sulbactam in Gram-negative bacilli

目的了解头孢哌酮/舒巴坦对临床常见革兰阴性杆菌的体外抗菌活性。方法收集2003年1月-2007年12月从住院患者各种临床标本中分离的革兰阴性杆菌,经革兰染色、氧化酶试验等初筛,然后采用VITEK-32全自动微生物分析仪进行菌种的鉴定,药敏试验采用纸片扩散法,对结果进行回顾性调查。结果肠杆菌科菌对头孢哌酮/舒巴坦的耐药率较低,大肠埃希菌、肺炎克雷伯菌和阴沟肠杆菌对头孢哌酮/舒巴坦的耐药率分别为6.9%、9.2%和12.9%;非发酵菌中鲍氏不动杆菌、脑膜脓毒金黄杆菌、铜绿假单胞菌、嗜麦芽寡养单胞菌、洋葱伯克霍尔德菌对头孢哌酮/舒巴坦的耐药率分别为7.7%、8.1%、20.4%、21.5%和34.1%。结论头孢哌酮/舒巴坦对肠杆菌科菌及非发酵菌中的鲍氏不动杆菌和脑膜脓毒金黄杆菌具有非常强的体外抗菌活性,对其他革兰阴性杆菌的耐药率也均<40.0%,头孢哌酮/舒巴坦对治疗革兰阴性杆菌引起的感染有非常好的应用前景。

OBJECTIVE To investigate the antibacterial activity of cefoperazone/sulbactam to Gram-negative bacilli in vitro. METHODS Gram-negative bacilli were isolated from various clinical specimens in our hospital from Jan 2004 to Dec 2007, screened by Gram-staining and oxidase test. The strain identification and the antimicrobial susceptibility test were determined by VITEK-60 Full Automated Microbiology Analyzer and slip diffusion method, respectively. The results of the survey were retrospectively reviewed. RESULTS The resistance rates of Enterobacteriaceae to cefoperazone / sulbactam were very low, the rates of Escherichia coli, Klebsiella pneumoniae and Enterobacter cloacae were 6.9%, 9.2%and 12.9%, respectively; and the rates of Acinetobacter baumannii, Chryseobacterium meningosepticum, Pseudomonas aeruginosa, Stenotrophornonas rnaltophilia and Burkholderia cepacia were 7. 7%, 8. 1%, 20. 4%, 21. 5% and 34. 1%, respectively. CONCLUSIONS The antimicrobial activity of cefoperazone/sulbactam to Enterobacteriaceae and non-fermentation bacteria （A. baumannil, Ch. meningosepticum） is strong. The resistant rate of other Gram-negative bacteria to cefoperazone/ sulbactam is less than 40 percent. In the treatment of infection caused by Gram-negative bacilli, cefoperazone/ sulbactam has a very good prospect.