硫酸异帕米星对临床常见细菌的体外抗菌作用

摘要

Objective To evaluate the vitro antibacterial activity of the isepamicin sulfate on Gram-positive and negative bacteria for clinical reference.Methods Using K-B agar diffusion method which is recommended by CLSI to investigate the antimicrobial activity of isepamicin sulfate and other antibiotics on common 420 pathogens,and the results were analyzed.Results In vitro antibacterial activity of isepamicin sulfate on the Gram-positive bacteria MRSA below vancomycin,its sensitivity rates were 30.0％,better than ampicillin/sulbactam and levofloxacin.The sensitivity rates of isepamicin sulfate to Staphylococcus haemolyticus was 93.3％,second only to vancomycin.In addition,isepamicin sulfate shows good sensitivity and anti-drug resistance on Gram-negative bacteria,particularly eco(ESBL +),eco (ESBL-),kpn (ESBL-),kpn(ESBL +),ecl,pmi and pae,its sensitivity rates were 100.0％,86.7％,100.0％,100.0％,100.0％,100.0％,96.7％ respectively.Isepamicin sulfate had a good synergistic antimicrobial activity against to Stenotrophomonas maltophilia along with enzyme production inhibitors (SCF or TZP).Conclusion Isepamicin sulfate is sensitive to most of common pathogens than other antibiotics,which can be useful for clinical reference on drug resistance bacteria infection and drug combination therapy.%目的 评价硫酸异帕米星对临床常见革兰阳性菌、革兰阴性菌的体外抗菌活性,为临床用药提供参考.方法 采用美国临床和实验室标准协会(CLSI)推荐的K-B琼脂法测定临床常见的14种致病菌(各30株)对异帕米星和其他抗菌药物的敏感性,并对结果进行分析.结果 对于革兰阳性菌甲氧西林耐药金黄色葡萄球菌(MRSA),异帕米星的体外抗菌作用低于万古霉素,MRSA对异帕米星敏感率为30.0％(9株),优于氨苄西林/舒巴坦和左氧氟沙星；异帕米星对溶血葡萄球菌的敏感率为93.3％(28株),仅次于万古霉素.对于革兰阴性菌,尤其是大肠埃希菌非产酶株、大肠埃希菌产酶株、肺炎克雷伯菌非产酶株、肺炎克雷伯菌产酶株、阴沟肠杆菌、奇异变形杆菌、铜绿假单胞菌(非痰标本),异帕米星对它们的敏感率分别为100.0％(30株)、86.7％(26株)、100.0％(30株)、100.0％(30株)、100.0％(30株)、100.0％(30株)、96.7％(29株),显示出良好的抗菌作用；对于嗜麦芽窄食单胞菌,异帕米星与产酶抑制剂(头孢哌酮舒巴坦或哌拉西林他唑巴坦)有良好的协同抗菌活性.结论 异帕米星对各种常见细菌的抗菌作用较强,在临床耐药性病细菌感染的治疗和联合用药中可供临床参考.