头孢噻利对临床常见细菌体外抗菌活性的多中心研究  

A multicenter study on the in vitro antibacterial activity of cefoselis against common clinical bacteria

作　　者：陈宏斌[1] 杨启文[1] 徐英春[1] 陈民钧[1] 赵颖[1] 王贺[1] 胡云建 倪语星[3] 孙景勇[3] 杨青[4] 孔海深[4] 何林 吴伟元 叶惠芬[6] 杨银梅[6] 季萍[7] 朱震宏[7] 任健康[8] 张利侠[8] 孙自镛[9] 朱旭慧[9] 童明庆[10] 赵旺胜[10] 梅亚宁[10] 刘勇[11] 张智洁[11] 段琼[12] 李丹[12] 刘蓬蓬[13] 王晶[14] 韩丽霞[14] 胡大春[15] 

机构地区：[1]中国医学科学院北京协和医学院北京协和医院检验科,北京100730 [2]中国医学科学院卫生部北京医院细菌室 ,北京100730 [3]上海交通大学医学院附属瑞金医院临床微生物科 [4]浙江大学医学院附属第一医院细菌室 [5]深圳市人民医院检验科 [6]广州市第一人民医院细菌室 [7]新疆医科大学附属第一医院细菌室 [8]陕西省人民医院检验科 [9]华中科技大学同济医学院附属同济医院检验科 [10]江苏省人民医院检验科 [11]中国医科大学附属第二医院检验科 [12]吉林省人民医院细菌室 [13]青岛大学医学院附属医院检验科 [14]大连医科大学第一附属医院 [15]昆明市第一人民医院检验科

出　　处：《中国感染与化疗杂志》2011年第4期256-263,共8页Chinese Journal of Infection and Chemotherapy

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ES-BLs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 MIC50 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 against 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.

关 键 词：头孢噻利 药敏试验 最低抑菌浓度 

分 类 号：R969[医药卫生—药理学]