拉氧头孢对肠杆菌科细菌及厌氧菌的体外抗菌活性观察

The activity of moxalactam against Enterobacteriaceae and anaerobia in vitro

目的观察拉氧头孢对肠杆菌科细菌及厌氧菌的体外抗菌活性，并与其他抗菌药物进行比较，为临床合理应用拉氧头孢提供实验依据。方法根据美国临床和实验室标准协会（CLSI）（2014版）标准，采用琼脂稀释法和Etest法测定拉氧头孢及其他抗菌药物对491株临床分离的肠杆菌科细菌和厌氧菌的最低抑菌浓度（MICs值）。结果拉氧头孢对大肠埃希菌、肺炎克雷伯菌、变形杆菌、肠杆菌属及其他肠杆菌科细菌均具有较好的抗菌活性（包括ESBLs大肠埃希菌、肺炎克雷伯菌及变形杆菌），其MIC50范围均在0．25—4mg／L之间，MIC90范围均在0．5～8mg／L之间，敏感率均在90％以上；产ESBLs与非产ESBLs的肠杆菌科细菌对亚胺培南及美罗培南的敏感率均在90％以上；产ESBLs的大肠埃希菌、肺炎克雷伯菌、变形杆菌对哌拉西林／他唑巴坦和头孢哌酮／舒巴坦的敏感率分别为90％、68％、53％和76％、66％、76．6％；而非产ESBLs细菌对哌拉西彬他唑巴坦和头孢哌酮／舒巴坦的敏感率在均95％以上；肠杆菌属细菌及其他肠杆菌科细菌对哌拉西林／他唑巴坦的敏感率分别为80％、80％，对头孢哌酮／舒巴坦的敏感率分别为80％、76．7％。拉氧头孢对厌氧菌的MICs范围为≤0．064-〉256mg／L，MIC50为2mg／L，MIC90为64mg／L。结论拉氧头孢对产与不产ESBLs的肠杆菌科细菌以及厌氧菌均具有较好的体外抗菌活性。

Objective To observe the antibacterial activity of moxalactam against Enterobacteriaceae bacteria and anaerobic bacteria in vitro, and to compare with other antibacterial drugs, for providing experimental basis for the clinical application of moxalactam. Methods Minimum inhibitory concentrations （MICs） of moxalactam and other antibacterial agents against 491 Enterobacteriaceae spp. and anaerobic spp. collecting from clinical settings were determined by agar dilution methods and E-test strips according to the Clinical and Laboratory Standards Institute （CLSI） （2014）. Results Moxalactam showed great antibacterial activity to Enterobacteriaceae spp. , including ESBLs-producing Escherichia coli, Klebsiella pneumoniae, and Proteus spp. , with the MIC50, MIC90, and susceptibility rates of 0. 25 - 4 mg/L, 0. 5 - 8 rag/L, and 〉 90%, respectively. The susceptibility rates of Enterobacteriaceae with ESBLs-producing or non-ESBLs-producing to imipenem and meropenem were both higher than 90%. The susceptibility rates of ESBLs-producing Escherichia coli, Klebsiella pneumoniae, and Proteus spp. to piperacillin/tazobactam and cefoperazone/sulbactam were 90%, 68%, 53% and 76%, 66%, 76. 6%, respectively, while the susceptibility rates of non-ESBLs-producing Escherichia coli,Klebsiella pneumoniae, and Proteus spp. were all more than 95% . The susceptibility rates of Enterobacter spp. and other Enterobacter to piperacillin/ tazobactam were 80% , 80% and that to cefoperazone/sulbactam were 80% , 76. 7% , respectively. The MICs range of moxalactam on anaerobic spp. was from ≤0. 064 to 〉256 mg/L,while MIC50 was 2 mg/L and MIC90 was 64 mg/L. Conclusions Moxalactam showed well activity against ESBLs-producing and non-ESBLs- producing Enterobacteriaceae and anaerobia.