头孢米诺的体外抗菌作用研究  

In vitro antibacterial activity of cefminox

作　　者：郭燕[1] 朱德妹[1] 叶信予[1] 杨洋[1] 吴湜[1] 吴卫红[1] 吴培澄[1] 胡付品[1] 张婴元[1] 

机构地区：[1]复旦大学附属华山医院抗生素研究所,卫生部抗生素临床药理重点实验室,上海200040

出　　处：《中国感染与化疗杂志》2013年第3期201-213,共13页Chinese Journal of Infection and Chemotherapy

基　　金：国家科技部"国家科技重大新药创制专项"资助(20122X09303004-001)

摘　　要：目的评价头孢米诺对近期临床分离的肠杆菌科细菌、不发酵糖革兰阴性杆菌和厌氧菌的体外抗菌作用。方法采用琼脂稀释法测定头孢米诺对884株临床分离的大肠埃希菌、肺炎克雷伯菌、铜绿假单胞菌和厌氧菌等的体外抗菌作用。结果 316株大肠埃希菌和肺炎克雷伯菌中不产酶株96株(30.4%),单产ESBLs菌173株(54.7%),单产AmpC酶菌6株(1.9%)和产ESBLs+AmpC酶菌41株(13.0%)。头孢米诺对上述大肠埃希菌和肺炎克雷伯菌中不产酶和单产ESBLs菌株,以及变形杆菌属和摩根菌属细菌均具有良好的抗菌活性,MIC50和MIC90值大多≤2 mg/L;抗菌活性优于头孢美唑和头孢西丁;头孢米诺对不产酶大肠埃希菌和肺炎克雷伯菌的抗菌活性亦优于测试的头孢硫脒、头孢呋辛、头孢哌酮-舒巴坦和哌拉西林-他唑巴坦2种酶抑制剂复方,但抗菌活性均不及亚胺培南和美罗培南。头孢米诺对大肠埃希菌和肺炎克雷伯菌中产AmpC酶菌株的抗菌活性和肠杆菌属、沙雷菌属、枸橼酸杆菌属细菌和铜绿假单胞菌、鲍曼不动杆菌等不发酵糖革兰阴性杆菌的抗菌活性差;但头孢米诺对梭杆菌属细菌有高度抗菌活性,MIC50和MIC90分别为≤0.06 mg/L和1 mg/L,对其他受试的厌氧菌亦具有良好的抗菌活性。结论头孢米诺对不产酶和单产ESBLs的大肠埃希菌和肺炎克雷伯菌,以及变形杆菌属细菌、摩根摩根菌和厌氧菌等均具有良好的抗菌活性。提示头孢米诺可用于上述敏感菌以及厌氧菌所致感染的治疗。Objective To evaluate the in vitro activity of cefminox against gram-negative and anaerobic clinical isolates. Methods The minimum inhibitory concentrations （MICs） of cefminox against 884 strains of bacterial isolates recently collected from clinical setting. Results were analyzed according to CLSI 2012 breakpoints. Results Of the 316 E. coli and K. pneumoniae strains tested, 96 （30.4%） produced neither ESBLs nor AmpC, 173 （54.7%） produced ESBLs, 6 （1.9%） produced AmpC, and 41 （13.0%） produced both ESBLs and AmpC. Cefminox showed excellent antibacterial activity against both ESBLs-positive and ESBLs-negative E. coli and K. pneumoniae strains, Proteus spp. and Morganella spp. The MIC50 and MIC90 values were mostly less than 2 mg/L. Cefminox demonstrated better antimicrobial activity than that of cefmetazole and cefoxitin. The activity of cefminox was higher than cefathiamidine and cefuroxime, cefoperazone-sulbactam and piperacillin-tazobactam against the E. coli and K. pneurnoniae strains without ESBLs or AmpC, but lower than carbapenems against ESBLs-producers and AmpC-producers of E. coli and K. pneumoniae, and other Enterobacteriaceae bacteria. The activity of cefminox was poor against AmpC-producing E. coli and K. pneumoniae, Enterobacter, Serratia spp. , Citrobacter spp. , P. aeruginosa or A. baurnannii. However, cefminox was highly active against Fusobacteriurn spp. , showing MIC50≤0. 06 mg/L and MIC90 = 1 mg/L. Cefminox also showed good antimicrobial activity against other anaerobes. Conclusions Cefminox has broad-spectrum antimicmbial activity against both ESBLs-positive and ESBLs-negative E. coli and K. pneumoniae strains, Proteus spp. , Morganella spp. and anaerobic clinical isolates. These results indicate that cefminox is the appropriate choice for treatment of infections caused by such cefminox-sensitive isolates.

关 键 词：头孢米诺 超广谱Β内酰胺酶 厌氧菌 

分 类 号：R446.5[医药卫生—诊断学]