比阿培南等3种碳青霉烯类抗生素的体外抗菌活性  

In vitro antimicrobial activity of three carbapenems including biapenem

作　　者：刘文静[1] 王瑶[1] 刘勇[2] 赵旺盛[3] 孙自镛[4] 倪语星[5] 孙宏莉[1] 徐英春[1] 谢秀丽[1] 王辉[1] 陈民钧[1] 

机构地区：[1]中国医学科学院北京协和医院检验科,100730 [2]中国医科大学盛京医院检验科 [3]江苏省人民医院临床检验中心 [4]华中科技大学同济医学院附属同济医院检验科 [5]上海交通大学医学院附属瑞金医院临床微生物科

出　　处：《中国感染与化疗杂志》2010年第6期468-471,共4页Chinese Journal of Infection and Chemotherapy

摘　　要：目的测定比阿培南等3种碳青霉烯类抗生素的体外抗菌活性。方法收集2008—2009年5所教学医院分离的临床非重复菌株426株。采用琼脂稀释法测定比阿培南、亚胺培南、美罗培南对上述分离菌的体外抗菌活性,用WHONET5.4软件分析结果。结果 3种抗生素对所检测的肠杆菌科细菌具有很好的抗菌活性,敏感率均>93%,其中对非产ESBLs和产ESBLs的大肠埃希菌和非产ESBLs肺炎克雷伯菌的敏感率均为100%。比阿培南对产AmpC酶阴沟肠杆菌除MIC50与几何均数介于亚胺培南和美罗培南之间,其他指标均与亚胺培南相同。铜绿假单胞菌对比阿培南耐药率仅为12.8%,低于亚胺培南(31.9%)和美罗培南(17%),但中介率较高(19.1%)。对鲍曼不动杆菌,比阿培南和亚胺培南的体外抗菌活性相似。对洋葱伯克霍尔德菌,3种抗生素的MIC90均≥256mg/L,几何均数范围为5～14mg/L。甲氧西林敏感的金葡菌对3种抗生素的敏感率均为100%,但比阿培南的MIC50、MIC90和几何均数均介于亚胺培南和美罗培南之间:小于美罗培南而大于亚胺培南。结论比阿培南与亚胺培南、美罗培南的体外抗菌活性相仿,对临床常见的革兰阳性和阴性菌具有广谱杀菌活性。Objective To determine the in vitro antimicrobial activity of three carbapenems including biapenem.Methods A total of 426 non-duplicate isolates were collected from five national teaching institutions during the year of 2008 and 2009.The activity of biapenem,imipenem and meropenem was tested by agar dilution method.All data were analyzed by WHONET 5.4 software.Results The three carbapenems showed good antibacterial activity against all the strains tested.More than 93% of the Enterobacteriaceae strains were susceptible to these antibiotics.All strains of E.coli(both ESBL negative and positive isolates)and ESBL negative Klebsiella pneumonia were susceptible to these carbapenems.Except MIC50 and geometric mean,the activity of biapenem AmpC positive E.cloacae was between imipenem and meropenem.Only 12.8% of P.aeruginosa strains were resistant to biapenem,which was lower than imipenem(31.9%)and meropenem(17%).But the proportion of biapenem-intermediate strains was higher(19.1%).The activity of biapenem against A.baumannii was much similar to imipenem,but with more intermediate strains(12.2%).The MIC90 values of the three carbapenems for B.cepacia were all higher than 256 mg/L.The geometric mean of MIC was between 5-14 mg/L.All methicillin-sensitive S.aureus(MSSA)strains were susceptible to the three carbapenems.However,the MIC50,MIC90 and geometric mean MIC of biapenem against MSSA was lower than meropenem,but higher than imipenem.Conclusions The in vitro antimicrobial activity of biapenem is comparable to imipenem and meropenem,with broad spectrum antibacterial activity against common gram-positive and-negative microorganisms.

关 键 词：比阿培南 碳青霉烯类 抗菌活性 

分 类 号：R96[医药卫生—药理学]