上海市6所医院供水系统36株军团菌体外药敏结果分析  

In vitro of antimicrobial agents sensitivity against 36 strains of legionella isolated from water distribution systems of 6 hospitals in Shanghai

作　　者：黄声雷[1] 胡必杰[2] 于玲玲[1] 周春妹[1] 谢红梅[1] 高晓东[2] 

机构地区：[1]复旦大学附属中山医院呼吸科,上海200032 [2]复旦大学附属中山医院医院感染管理科,上海200032

出　　处：《中华医院感染学杂志》2011年第12期2634-2636,共3页Chinese Journal of Nosocomiology

基　　金：上海市公共卫生优秀学科带头人培养计划资助项目(08GWD10)

摘　　要：目的评估4种抗菌药物对医院环境中分离军团菌的体外抗菌活性,为临床治疗军团菌感染选择抗菌药物提供参考。方法收集2009年5-9月上海市6所医院供水系统中军团菌分离株36株,其中嗜肺军团菌血清1型(Lp-1)19株,嗜肺军团菌血清2-15型(Lp2-15)6株,其他军团菌属细菌(L.spp)11株,使用酵母琼脂培养基(BYE),采用琼脂稀释法药敏试验,孵育48h分别测定左氧氟沙星(LEV)、莫西沙星(MXF)、阿奇霉素(AZM)和红霉素(ERY)4种抗菌药物的最低抑菌浓度(MIC)。结果 4种药物的MIC范围分别为:LEV 0.015～0.06 mg/L,MXF 0.06～0.5 mg/L,ERY 0.125～1 mg/L,AZM 0.03～1 mg/L,MIC50、MIC90分别为LEV0.0150、.06 mg/L,MXF 0.06、0.06 mg/L,AZM 0.25、0.5 mg/L,ERY 0.5、1 mg/L;4种药物的抑菌商数(IQ)分别为LEV=185.13±49.98,MXF=53.61±28.03,AZM=30.40±28.94,ERY=9.83±6.52。结论氟喹诺酮类药物的体外抗军团菌的活性优于大环内酯类,同类抗菌药物比较,左氧氟沙星的体外抗军团菌活性优于莫西沙星,阿奇霉素的体外活性优于红霉素。OBJECTIVE To study the resistance of Legionella from hospital distribution water systems of Shanghai.METHODS A total of 36 legionella strains（L.pneumophila serogroup 1）（n=19）,L.pneumophila serogroup 2-15（n=6）,and Legionella spp.（n=11） were tested against levofloxacin,moxifloxacin,erythromycin,and azithromycin.The minimum inhibitory concentration（MIC） values of each antimicrobial agent for these strains were determined by a standard agar dilution procedure using buffered yearst extract agar,under 48 incubation.RESULTS Minimum inhibitory concentration values were in the following ranges： Levofloxacin 0.015-0.06mg/L,moxifloxacin 0.06-0.5 mg/L,Erythromycin 0.125-1 mg/L,and Azithromycin 0.03-1 mg/L.Under 48h incubation the MIC50 and MIC90 for levofloxacin,moxifloxacin,erythromycin,azithromycin were 0.15,0.03;0.06,0.06;0.25,0.5 and 0.5,1 mg/L,respectively.Inhibitory quotiont of LEV=185.13±49.98,MX=53.61±28.03,AZM=30.40±28.94,E=9.83±6.52.CONCLUSION It shows that fluroquinolone exhibit better in vitro activity than macrolide and that levofloxacin exhibit better in vitro activity than moxifloxacin,in vitro activity of azithromycin is superior to erythromycin.

关 键 词：军团菌 最低抑菌浓度 琼脂稀释法 医院供水系统 

分 类 号：R378[医药卫生—病原生物学]