头孢哌酮/舒巴坦对临床常见革兰阴性杆菌抗菌活性的研究

Antibacterial activities of different concentrations of cefoperazone-sulbactam against common clinical 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抗菌活性,比较不同浓度的头孢哌酮/舒巴坦纸片药敏试验结果的差异。方法用头孢哌酮/舒巴坦含量75/75(150)和75/30(105)两种药敏纸片对临床分离的216株革兰阴性杆菌,进行K-B法检测同时用琼脂稀释法检测头孢哌酮/舒巴坦(1:1)的最低抑菌浓度(MIC),并采用SPSS统计软件对实验结果进行分析。结果头孢哌酮/舒巴坦105浓度和150浓度纸片法检测鲍氏不动杆菌、大肠埃希菌、肺炎克雷伯菌、嗜麦芽窄食单胞菌和铜绿假单胞菌,两种浓度纸片的符合率分别为30.8%,75.5%,89.4%,90.0%和79.4%;其中符合率最差的是鲍氏不动杆菌,150浓度纸片的敏感率和中介率均增加,耐药率下降,与105浓度纸片比较差异均有统计学意义(P<0.05);对2组抑菌环直径进行配对t检验,差异主要来自于鲍氏不动杆菌(P<0.05)。结论目前临床药敏实验使用的150浓度的纸片法提高了细菌的敏感性,特别是鲍氏不动杆菌的敏感性。

OBJECTIVE To understand the antibacterial activity of cefoperazone-sulbactam against common clinical gram-negative bacilli and compare the results of drug susceptibility testing for different concentrations of cefopera- zone-sulbactam disc. METHODS The drug susceptibility testings of 216 clinical gram-negative bacilli isolates to two kinds of drug susceptibility discs; 75μg/disc cefoperazone plus with 75μg/ disc sulbactam （150 disc） and 75μg/ disc cefoperazone plus with 309g/disc sulbactam （105 disc）, were conducted by using K-B method; the minimal inhibitory concentration （MIC） of cefoperazone-sulbactam （1：1） was determined by means of agar dilution meth- od, and the results of the testings were statistically analyzed with the use of SPSS software. RESULTS As for the detection of the Acinetobacter baurnannii , Escherichia coli , Klebsiella pneumoniae , Stenotrophomonas maltophilia, and Pseudornonas aeruginosa, the accordance rates of the cefoperazone-sulbactam 105 disc and cefoperazone- sulbactam 150 disc were 30.8% ,75.5% ,89.4% ,90.0%, and 79.4%, respectively; the accordance rate of detec- tion of the A. baumannii was the lowest. Both the drug susceptibility rate and intermediate rate of the 150 disc were increased, the drug resistance rates were decreased, as compared with the 105 disc, there was significant difference （P〈0. 05）. The matching t test was conducted for the inhibition zone diameters between the two groups, and the results showed that the A. baumannii varied significantly in the inhibition zone diameters （P〈0. 05）. CONCLUSION The 150 disc that is used for the clinical drug susceptibility testing at present leads to the in- crease of sensitivity of the bacteria, especially the sensitivity of the A. baumannii.