20种抗菌药物对肺炎链球菌的体外抗菌活性研究  

Study on antibacterial activity of 20 antimicrobial agents against S. pneumoniae in vitro

作　　者：宋秀杰[1] 刘又宁[1] 梁蓓蓓[2] 白楠[2] 蔡芸[2] 刘浩[2] 陈桂云[2] 王睿[2] 

机构地区：[1]解放军总医院呼吸科,北京100853 [2]解放军总医院临床药理研究室,北京100853

出　　处：《中国药物应用与监测》2010年第1期20-23,共4页Chinese Journal of Drug Application and Monitoring

基　　金：国家科技部支撑计划重点课题(2007BAI04B00)

摘　　要：目的:评价莫西沙星等20种常用抗菌药物对临床分离的60株肺炎链球菌的体外抗菌活性。方法:采用微量肉汤稀释法测定20种抗菌药物对肺炎链球菌的最低抑菌浓度(MIC)。结果:60株肺炎链球菌中有青霉素敏感的肺炎链球菌(PSSP)42株(71.7%),青霉素不敏感肺炎链球菌(PNSSP)18株(28.3%);其中,青霉素耐药的肺炎链球菌(PRSP)有2株(3.3%)。对PSSP菌株,20种抗菌药物中敏感率较高的药物有头孢曲松、头孢噻肟、加替沙星、莫西沙星、左氧氟沙星、阿莫西林/克拉维酸,敏感率均为100%;耐药率较高的药物有红霉素、罗红霉素、克拉霉素、阿奇霉素,耐药率分别为83.3%,83.3%,74.7%,74.7%。对PNSSP菌株,敏感率较高的药物有阿莫西林/克拉维酸、莫西沙星、头孢噻肟、加替沙星、左氧氟沙星,敏感率分别为100%,100%,88.8%,94.4%,94.4%;耐药率较高的药物有红霉素、克拉霉素、阿奇霉素,耐药率均为66.7%。20种抗菌药物对60株肺炎链球菌的累积抑菌百分率曲线显示莫西沙星和阿莫西林/克拉维酸的抑菌能力最强。结论:肺炎链球菌对大环内酯类、复方新诺明、磷霉素等抗菌药物的耐药率较高,第三、四代氟喹诺酮类药物(左氧氟沙星、莫西沙星、加替沙星)和阿莫西林/克拉维酸及第三代头孢菌素中的头孢噻肟、头孢曲松等对肺炎链球菌(包括PNSSP)有很好的抗菌活性,提示其可作为高度耐药肺炎链球菌感染的首选药物。Objective： To investigate the antibacterial activity of 20 antimicrobial agents in vitro against 60 strains S. pneumoniae isolated from clinical samples. Methods： Minimum inhibitory concentration （MIC） of 20 antimicrobial agents against S. pneumoniae was performed by broth diffusion method. Results： Among 60 strains S. pneumoniae, there were 42 strains （71.7%） penicillin-susceptible S. pneumoniae （PSSP）, 18 strains （28.3%） penicillin non-susceptible S, pneumoniae （PNSSP）, among of them, 2 strains （3.3%） were penicillin-resistant S. pneumoniae （PRSP）. For PSSP, ceftriaxone, cefotaxime, gatifloxacin, moxifloxaein, levofloxacin and amoxicillin-clavulanic acid were the most sensitive antimicrobial agents, and the sensitive rates were all 100%. In contrast, erythromycin, roxithromycin, clarithromycin, azithromycin were the most resistant antimicrobial agents, and the resistant rates were 83.3%, 83.3%, 74.7% and 74.7%, respectively. For PNSSP, the most sensitive antimicrobial agents were amoxicillinclavulanic acid, moxifloxacin, cefotaxime, gatifloxacin and levofloxacin, and the sensitive rates were 100%, 100%, 88,8%, 94.4% and 94.4%, respectively. The most resistant antimicrobial agents were erythromycin, clarithromycin, azithromycin, and the resistant rates were all 66.7%. Moxifloxacin and amoxicillin-clavulanic acid had the strongest antibacterial activity according to the accumulative inhibition percentage curves. Conclusion： A high frequency of resistance to macrolides including erythromycin, clarithromyein, roxithromcin, azithromycin and trimethoprim-sulfamethoxazole and fosfomycin was found. Levofloxacin, moxifloxacin, gatifloxacin, amoxicillin-clavulanic acid, cefotaxime and ceftriaxone were susceptible to S. pneurnoniae, which could be the first choice for high resistant S. pneumoniae in clinic.

关 键 词：肺炎链球菌 最低抑菌浓度 抗菌活性 

分 类 号：R96[医药卫生—药理学]