头孢噻利对临床常见细菌体外抗菌活性的多中心研究

摘要

目的 评价头孢噻利和其他抗菌药物对临床常见革兰阴性、阳性菌的体外抗菌活性.方法 收集2008年15所教学医院收集的849株非重复的临床分离菌株.菌株经中心实验室复核后,采用琼脂稀释法测定头孢噻利等抗菌药物的最低抑菌浓度(MICs).结果 非产ESBLs的大肠埃希菌、肺炎克雷伯菌、奇异变形杆菌以及弗劳地柠檬酸杆菌、产气肠杆菌、阴沟肠杆菌、黏质沙雷菌、普通变形杆菌对头孢噻利的敏感率为62.9%～100%,头孢噻利对这些菌的MIC50为0.016～4 mg/L;产ESBLs的大肠埃希菌、肺炎克雷伯菌、奇异变形杆菌对头孢噻利的敏感率为32.4%～54.5%,头孢噻利对这些菌的MIC50为8～32 mg/L.鲍曼不动杆菌对头孢噻利的敏感率为54.5%,本品对其的MIC50为4 mg/L,铜绿假单胞菌对本品的敏感率为45.5%,本品对其MIC50为16 mg/L,嗜麦芽窄食单胞菌和洋葱伯克霍尔德菌对本品的敏感性较差.MSSA对头孢噻利的敏感率为100%,本品对其的MIC50为1 mg/L,MRSA对本品的敏感率为17.1%,本品的MIC50为16 mg/L.PSSP、PISP和PRSP对本品的敏感率分别为87.2%、40.5%和51.6%,该药对上述菌株的MIC50分别为0.016、4和1 mg/L,优于头孢吡肟.结论头孢噻利对大部分肠杆菌科细菌保持很高的体外抗菌活性,优于头孢曲松和头孢噻肟.头孢噻利对革兰阳性球菌的体外抗菌活性优于头孢吡肟.%Objective To evaluate the in vitro antibacterial activity of cefoselis against common clinical bacteria, including gram-positive and-negative microorganisms.Methods A total of 849 nonduplicate bacterial strains were collected from 15 teaching hospitals in China during 2008.The minimum inhibitory concentrations (MICs) of cefoselis and other common antibiotics were determined by agar dilution method.Results About 62.9％ to 100％ of the non-ESBLs producing strains of E.coli, K.pneumoniae, P.mirabilis, C.freundii, E.aerogenes, E.cloacae, S.marcescens and P.vulgaris were susceptible to cefoselis.The MIC50 values ranged from 0.016 and 4 mg/L.As for the ESBLs producing strains of E.coli, K.pneumoniae and P.mirabilis , 32.4％ to 54.5％ were susceptible to cefoselis.The MIC50 values were between 8 and 32 mg/L.In addition, 54.5％ of A.baumannii strains and 45.5 ％ of P.aeruginosa strains were susceptible to cefoselis.The MIC50 of cefoselis for A.baumannii and P.aeruginosa was 4 and 16 mg/L, respectively.The antibacterial activity of cefoselis against S.maltophilia and B.cepacia was poor.The percentage of methicillin-susceptible S.aureus (MSSA) and methicillin-resistant S.aureus (MRSA) susceptible to cefoselis was 100％ and 17.1％, respectively.The corresponding MICs0 values were 1 and 16 mg/L, respectively.About 87.2％ of penicillin-susceptible S.pneumoniae (PSSP), 40.5％ of penicillin-intermediate S.pneumoniae (PISP) and 51.6％ of penicillin-resistant S.pneumoniae strains were susceptible to cefoselis, and the corresponding MIC50 value was 0.016 mg/L, 4 mg/L, and 1 mg/L, respectively.The antibacterial activity of cefoselis against S.pneumoniae was superior to cefepime.Conclusions Cefoselis demonstrates a very high antibacterial activity again.st most Enterobacteriaceae bacteria, which is superior to cefotaxime and ceftriaxone.Cefoselis is better than cefepime in terms of in vitro antibacterial activity against gram-positive coccus.