β-内酰胺/β-内酰胺酶抑制剂对双歧杆菌和乳酸杆菌敏感性分析

Analysis on sensitivity of β-lactam/β-lactamase inhibitors to bifidobacteria and lactobacilli

目的分析儿童肠道双歧杆菌和乳酸杆菌对β-内酰胺/β-内酰胺酶抑制剂复合物(β-lactam/β-lactamase inhibitors)的药敏情况。方法按照伯杰细菌鉴定手册的方法从36例健康儿童大便标本中分离出45株双歧杆菌和39株乳酸杆菌,依据2015年临床和实验室标准协会(CLSI)的标准,采用E-test方法实施双歧杆菌和乳酸杆菌对氨苄西林、阿莫西林/克拉维酸、氨苄西林/舒巴坦、哌拉西林、哌拉西林/他唑巴坦、替卡西林、替卡西林/克拉维酸、头孢哌酮、头孢哌酮/舒巴坦的药敏试验,并进行统计分析。结果 45株双歧杆菌对氨苄西林、阿莫西林/克拉维酸、氨苄西林/舒巴坦、哌拉西林、哌拉西林/他唑巴坦、替卡西林、替卡西林/克拉维酸、头孢哌酮敏感百分率分别为77.78%、95.56%、88.89%、73.33%、91.11%、68.89%、84.44%、82.22%,39株乳酸杆菌对上述抗生素敏感百分率分别为74.36%、94.87%、92.31%、71.79%、92.31%、69.23%、89.74%、79.49%。除头孢哌酮/舒巴坦没有CLSI药敏MIC解释标准而无法判断外,其他β-lactam/β-lactamase inhibitor均比单一β-lactam抗生素敏感百分率升高,双歧杆菌氨苄西林与阿莫西林/克拉维酸、哌拉西林与哌拉西林/他唑巴坦的敏感数P值分别为0.01、0.03,乳酸杆菌氨苄西林与阿莫西林/克拉维酸、氨苄西林与氨苄西林/舒巴坦、哌拉西林与哌拉西林/他唑巴坦、替卡西林与替卡西林/克拉维酸的敏感数P值分别为0.01、0.03、0.02、0.03。结论β-lactam/β-lactamase inhibitor比单一β-lactam抗生素抑制儿童肠道双歧杆菌和乳酸杆菌作用更强。

Objective To analyze the susceptibility situation of bifidobacteria and lactobacilli from child intestinal tract on β-lactam/β-lactamase inhibitor complex. Methods According to the method of the Bergey Bacterial Identification Manual,45 strains of bifidobacteria and 39 strains of lactobacilli were isolated from the stool specimens of 36 healthy children.The susceptibility tests of bifidobacteria and lactobacilli to ampicillin, amoxicillin/clavulanate, ampicillin/sulbactam, piperacillin, piperacillin/tazobactam, ticarcillin,ticarcillin/clavulanate,cefoperazone and cefoperazone/sulbactam were performed by adopting the E-test method.Then the statistical analysis was conducted. Results The sensitivity percentages of 45 strains of bifidobacteria to ampicillin, amoxicillin/clavulanate, ampicillin/sulbactam, piperacillin, piperacillin/tazobactam, ticarcillin,ticarcillin/clavulanate and cefoperazone were 77.78%,95.56%,88.89%,73.33%,91.11%,68.89%,84.44% and 82.22 % respectively,which of 39 strains of lactobacilli to above antibiotic drugs were 74.36%,94.87%, 92.31 %,71.79%,92.31%,69.23%,89.74% and79.49%,respectively.Except having no judgment due to without the CLSI drug susceptibility MIC interpretation criteria of cefoperazone/sulbactam,the sensitivity percentages of other β-lactam/β-lactamase inhibitor complex were higher than those of single β-lactam antibiotics,the sensitive number P values of bifidobacteria in ampicillin with amoxicillin/clavulanate and piperacillin with piperacillin/tazobactam were 0.01 and 0.03 respectively,which of lactobacilli in ampicillin with amoxicillin/clavulanate,ampicillin with ampicillin/sulbactam,piperacillin with piperacillin/tazobactam,ticarcillin with ticarcillin/clavulanate were 0.01,0.03,0.02 and 0.03 respectively. Conclusion β-lactam/β-lactamase inhibitors complex has stronger effect for inhibiting child intestinal tract bifidobacteria and lactobacilli than single β-lactam antibiotics.