替加环素对临床常见多重耐药菌的体外抗菌活性研究

In-vitro activity of tigecycline against clinically common multiple-drug-resistant pathogens

目的研究替加环素对临床常见多重耐药菌的体外抗菌活性。方法2009至2010年回顾性收集11个城市15家医院分离到的临床常见多重耐药菌（不含铜绿假单胞菌），采用琼脂稀释法检测替加环素的MIC值，数据分析采用WHONET5．6软件。结果收集到的938株临床常见多重耐药菌中，革兰阳性球菌521株（55．5％），革兰阴性杆菌417株（44．5％）。根据FDA和EUCAST中替加环素的折点判定标准，替加环素对ESBL阳性大肠埃希菌和肺炎克雷伯菌的敏感率分别为99．1％／99．1％和97．1％／68．6％，对碳青霉烯类药物不敏感大肠埃希菌、肺炎克雷伯菌、鲍曼不动杆菌及其他肠杆菌科细菌的敏感率依次为：100％／95．7％、100％／79．2％、80．2％／一和94．9％／56．4％。替加环素对多重耐药革兰阳性球菌、肠杆菌科细菌和鲍曼不动杆菌的MIc50/90范围分别为（0．125～0．25）／（0．125～0．5）mg／L、（0．5～1）／（1～2）mg／L和2／4mg／L。96．8％（121／125）厄他培南不敏感肠杆菌科细菌、80．2％（93／116）亚胺培南不敏感鲍曼不动杆菌和98．3％（173／176）头孢噻肟不敏感的肠杆菌科细菌对替加环素敏感。结论替加环素对铜绿假单胞菌以外的临床常见多重耐药菌具有很好的体外抗菌活性，可作为今后临床抗感染治疗的新选择。（中华检验医学杂舌，2013，36：308-312）

Objective To investigate in-vitro activity of tigecycline against common clinical muhi- drug resistant （MDR） bacteria. Methods The MDR bacteria （except Pseudomonas aeruginosa） were collected retrospectively from 2009 to 2010 in 15 hospitals from ll cities. The MIC of tigecycline was measured by agar dilution method, WHONETS. 6 software was used for data analysis. Results A total of 938 clinical MDR bacteria were collected, which consisted of 521 gram-positive cocci （ 55.5% ） and 417 gram-negative bacilli （44. 5% ）. According to the interpretative criteria recommended by FDA and EUCAST, the sensitive rates of ESBLs-producing Escherichia coli and Klebsiella pneumoniae to tigecycline were 99. 1%/99. 1% , 97.1%/68. 6% respectively. The sensitive rates of the carbapenems insensitive Escherichia coli, KlebsieUa pneumoniae, Acinetobacter baumanii and other enterobacteriaceae were 100%/95.7%, 100%/79. 2% ,80. 2%/- and 94. 9%/56. 4% respectively. The range of MICs0/90 were as follows： （0. 125 - 0. 25）/（0. 125 - 0. 5 ） mg/L （ gram-positive cocci）, （0. 5 - 1 ）/（ 1 - 2 ） mg/L （enterobacteriaceae） and 2/4 mg/L （Acinetobacter baumanii）. 96. 8% （121/125）ertapenem insensitive enterobacteriaceae, 80. 2% （93/116） imipenem insensitive Acinetobacter baumanii and 98.3% （173/176）cefotaxime insensitive enterohacteriaceae were all sensitive to tigecycline. Conclusion Tigecycline maintained a good in vitro antibacterial activity against clinical MDR bacteria （except Pseudomonas aeruginosa）, which can be used as a new choice for future clinical anti-infective therapy. （Chin J Lab Med,2013,36：308-312 ）