头孢菌素对产ESBLs肺炎克雷白杆菌的抗菌活性研究  

Antibacterial Effect of Cephalothin on ESBLs-producing K.Pneunmoniae

作　　者：余道军[1] 李荣群[2] 范建中[1] 周田美[1] 董晓勤[1] 汪涛[1] 

机构地区：[1]杭州市第一人民医院检验科,310006 [2]浙江中医学院基础医学系,杭州310009

出　　处：《医药导报》2006年第5期392-395,共4页Herald of Medicine

摘　　要：目的探讨头孢他啶和头孢噻肟钠体内外抗产超广谱β-内酰胺酶(ESBLs)肺炎克雷白杆菌的效果。方法采用K-B法和仪器法对确认为产ESBLs的肺炎克雷白杆菌进行药敏试验,并选择两株体外药敏结果不同的产ESBLs的肺炎克雷白杆菌建立小鼠腹腔感染模型,同时用头孢他啶和头孢噻肟钠对感染小鼠进行治疗。结果产ESBLs的肺炎克雷白杆菌对头孢他啶的耐药率明显低于其他头孢菌素类药物(均P<0.05),头孢他啶对药敏试验敏感的产ESBLs肺炎克雷白杆菌腹腔感染小鼠保护率为90.0%,头孢他啶和头孢噻肟钠对药敏试验耐药的产ESBLs的肺炎克雷白杆菌腹腔感染小鼠保护率为0。结论头孢菌素类抗菌药物的体内外抗产ESBLs肺炎克雷白杆菌作用基本一致,头孢他啶可以作为亚胺培南/西司他丁钠的替代品治疗产ESBLs肺炎克雷白杆菌感染。Objective To investigate the antibacterial effect of cefiazidime and cefotaxime on ESBLs-producing K. pneunmoniae in vitro and in vivo. Methods Antimicrobial susceptibilities test of ESBL-positive K. pneunmoniae was done using the methods of K-B and instrument. The infected celiac model of mice was established by 2 strains of ESBLs-producing K. pneunmoniae with different results in antimicrobial susceptibilities test in vitro and the infected mice were treated by ceftazidime and cefotaxime respectively. Results The Ceftazidime＇s reisistant rate to ESBLs-producing K. pneunmoniae was lower than other cephalothin （P 〈 0.05 ）. The protection rate of ceftazidime was 90.0% to mice infected with the ceftazidime-sensitive ESBLs-producing strain, while the protection rate of ceftazidime and cefotaxime was 0.0 to mice infected with the ceftazidimeresistant and cefotaxime-resistant strain. Conclusion The antibacterial effect of cephalothin on ESBLs- producing K. pneunmoniae was consistent both in vitro and in vivo. Ceftazidime could be used as the substitute of imipenem to treat ceftazidime-sensitive ESBLs- producing K. Pneunmoniae infection.

关 键 词：头孢他啶 头孢噻肟钠 肺炎克雷白杆菌 超广谱Β-内酰胺酶 

分 类 号：R978.1[医药卫生—药品] R969.4[医药卫生—药学]