头孢吡肟对临床常见革兰阴性杆菌的体外抗菌活性研究

The study of in vitro antibacterial activity of cefepime against clinical isolates of Gram negative bacilli strains

目的 :了解头孢吡肟对革兰阴性杆菌的体外抗菌活性。方法 :利用K -B法测定头孢吡肟对临床分离的常见革兰阴性杆菌的耐药率并与头孢他啶、头孢噻肟和氨曲南的体外药敏实验结果相比较。结果 :共测定 376株细菌对头孢吡肟、氨曲南、头孢他啶、头孢噻肟的耐药率 :大肠埃希菌分别为 5 .8%、10 .1%、 6 .8%、 14 .1% ,铜绿假单胞菌分别为 9.7%、 10 .0 %、15 .6 %、37.8% ;阴沟肠杆菌分别为 9.0 %、4 7.3%、4 2 .9%、2 7.2 % ;鲍曼不动杆菌分别为 39.7%、4 2 .6 %、4 4 .1%、5 5 .3% ;肺炎克雷伯菌分别为 7.5 %、16 .7%、12 .8%、16 .7%。结论 :头孢吡肟对革兰阴性杆菌的抗菌活性高于三代头孢菌素和氨曲南 ,特别是对产AmpC酶的革兰阴性杆菌如阴沟肠杆菌的稳定性佳 ,具有良好的临床应用价值。

Objective: To investigate in vitro antibacterial activity of cefepime against clinical isolates of Gram negative bacilli strains.Methods: The prevalence of cefepime resistance was compared with those of the common third generation cefalosporins such as ceftazidime,cefotaxime and aztreonam. Results: Of the total 376 clinical isolate strains,the resistance for cefepime,aztreonam,ceftazidime,cefotaxime were as follows:Escherichia coli were 5.8%,10.1%,6.8% and 14.1% respectively;Pseudomonas aeruginosa were 9.7%,10.0%,15.6% and 37.8% respectively;Enterobacter cloacae were 9.0%,47.3%,42.9% and 27.2% respectively;Acinetobacter baumannii were 39.7%,42.6%,44.1% and 55.3% respectively;Klebsiella pneumoniae were 7.5%,16.7%,12.8% and 16.7% respectively.Conclusion: In vitro antibacterial activity of cefepime against Gram negative bacilli strains was significantly higher than the common third generation of cefalosporins and aztreonam especially for AmpC productive strains such as Enterobacter cloacae,cefepime,has good stability and is suitable for clinical empirical therapy.