不同配比头孢呋辛/三唑巴坦的体外抗菌活性研究

In vitro antibacterial activities of cefuroxime/tazobactam

目的评价不同配比头孢呋辛/三唑巴坦(CXM/TB)的体外抗菌活性。方法采用平皿琼脂二倍稀释法测定不同配比CXM/TB对1436株临床分离致病菌的最低抑菌浓度(MIC)。结果不同配比CXM/TB(1:1、2:1、3:1、4:1、8:1和16:1)对1436株临床分离菌具有广谱抗菌作用,CXM/TB 1:1、2:1、3:1的抗菌活性相近,稍强于CXM/TB 4:1、8:1、16:1。不同配比CXM/TB对1109株产β-内酰胺酶菌株中的金葡菌、表皮葡萄球菌、大肠埃希菌、肺炎克雷伯菌、醋酸钙不动杆菌、普通变形菌、奇异变形菌、雷氏普罗威登斯菌、摩氏摩根菌、阴沟肠杆菌、产气肠杆菌、异型柠檬酸杆菌和黏质沙雷菌的MIC90值分别为CXM的1/4～1/32,对产ESBLs大肠埃希菌、肺炎克雷伯菌的MIC90值分别为CXM的1/8～1/16,但对产β-内酰胺酶的铜绿假单胞菌、假单胞菌属(除铜绿假单胞菌)的MIC90值与CXM相近;对不产β-内酰胺酶的金葡菌、表皮葡萄球菌、化脓链球菌、肺炎链球菌、流感嗜血菌、副流感嗜血菌的抗菌活性与CXM相近。不同配比CXM/TB对612株产酶耐药临床分离菌中的金葡菌、表皮葡萄球菌、大肠埃希菌、肺炎克雷伯菌、醋酸钙不动杆菌、普通变形菌、奇异变形菌、产气肠杆菌的MIC90分别为CXM的1/8～1/64。不同配比CXM/TB对MRSA、MRSE、粪肠球菌、假单胞菌属的抗菌活性差。结论不同配比CXM/TB均有较强的体外抗菌活性,CXM/TB 1:1、2:1、3:1的抗菌活性相近,稍优于CXM/TB 4:1、8:1、16:1,TB增强了CXM抗产β-内酰胺酶细菌的活性。

Objective To evaluate the in vitro antibacterial activities of cefuroxime/tazobactam （CXM/TB） 1：1, 2：1, 3：1, 4：1, 8：1 and 16：1. Methods The minimal inhibitory concentrations （MICs） of CXM/TB against 1436 clinical isolates of bacteria were tested by standard agar dilution method. Results CXM/TB 1：1, 2：1, 3：1, 4：1, 8：1 and 16：1 had broad antibacterial activities against 1436 clinical isolates, and the activities of CXM/TB 1：1, 2：1 and 3：1 were similar but a little stronger than those of CXM/TB 4：1, 8：1 and 16：1. The MIC90 values of CXM/TB 1：1, 2：1, 3：1, 4：1, 8：1 and 16：1 were 4-32 times lower than those of CXM against β-1actamase-producing S. aureus, S. epidermidis, E. coli, K. pneumoniae, A. calcoacetius, P vulgaris, P mirabilis, P. rettgeri, ill. morganii, E. cloacae, E. aerogenes, C. diversus and S. marcescens, 8-16 times lower than those of CXM against ESBLs-producing E. coli and K. pneumoniae. The antibacterial activities of CXM/TAZ 1：1, 2：1, 3：1, 4：1, 8：1 and 16：1 were similar to that of CXM against β-lactamase-producing P aeruginosa and Pseudomonas spp., and against non-β-lactamase- producing S. aureus, S. epidermidis, S. pyogenes, S. pneumoniae, H. influenzae and H. parainfluenzae. The MIC90 values of CXM/TB 1：1, 2：1, 3：1, 4：1, 8：1 and 16：1 against both β-lactamase-producing and cefuroxime-resistant S. aureus, S. epidermidis, E. coli, K. pneumoniae, A. calcoacetius, P vulgaris, P mirabilis and E. aerogenes were 8-64 times lower than those of CXM. CXM/TB 1：1, 2：1, 3：1, 4：1, 8：1 and 16：1 showed poor antibacterial activities against MRSA, MRSE, E. faecalis, P. aeruginosa and Pseudomonas spp. Conclusions CXM/TB 1：1, 2：1, 3：1, 4：1, 8：1 and 16：1 had potent in vitro antibacterial activities, and tazobactam could enhance the antibacterial activity of cefuroxime against β-1actamase-producing and cefuroxime-resistant strains. The activities of CXM/TB 1：1, 2：1 and 3：1 were similar but a little stronger than those of CXM/TB 4：1, 8：1 and 16：1.