3种第3代头孢菌素对常见肠杆菌科细菌的体外抗菌活性比较  

Comparison among in Vitro Antimicrobial Activities of Three Kinds of Third Generation Cephalosporins to Common Enterobacter Bacteria

作　　者：周迎端 

机构地区：[1]重庆市永川中医医院检验科,重庆402160

出　　处：《中国药业》2013年第18期26-27,共2页China Pharmaceuticals

摘　　要：目的比较头孢他啶、头孢曲松、头孢哌酮3种第3代头孢菌素对临床常见肠杆菌科细菌的体外抗菌活性。方法收集2011年8月至11月医院临床分离的大肠埃希菌、肺炎克雷伯菌各30株,阴沟肠杆菌22株,用Kirby-Bauer琼脂扩散法做体外药物敏感性试验,并采用NCCLS推荐表型确认试验检测超广谱β-内酰胺酶(ESBLs)。结果 82株肠杆菌科细菌对头孢他啶的耐药率(40.24%)低于头孢曲松(60.98%)及头孢哌酮(62.20%),其中阴沟肠杆菌对3种头孢菌素的整体耐药率最高。60株大肠埃希菌和肺炎克雷伯菌中,检出产ESBLs阳性菌株22株,检出率为36.67%。结论3种头孢菌素中头孢他啶对临床常见肠杆菌科细菌体外抗菌活性优于头孢曲松和头孢哌酮。产ESBLs是肠杆菌科细菌对β-内酰胺类抗菌药物耐药的重要机制,应加强产ESBLs菌的检测及采取有效控制措施,以指导临床合理使用第3代头孢菌素。Objective To compare the in vitro antimicrobial activities of three kinds of third generation cephalosporins ceftazidime,ceflri- axone and cefoperazone to clinical common enterobacter bacteria. Methods 30 strains of Escherichia coli ,30 strains of Klebsiella pneu- moniae and 22 strians of enterobacter cloacae from our hospital during Aμgust -November 2011 were collected and performed in vitro susceptibility test by the Kirby- Bauer agar diffusion method;and phenotypic validation test recommended by the NCCLS was adopted to detect extended spectrum beta-lactamase （ESBLs）. Results The resistance rate of 82 strains of enterobacter bacteria to ceftazidime was 40.24% ,which was lower than 60.98% to ceftriaxone and 62. 10% to cefoperazone. Among them,the total resistance rate of en- terobacter cloacae to three kinds of cephalosporins was highest. Among 60 strains of Escherichia coli and Klebsiella pneumoniae, 22 strains of ESBLs producing positive strains were detected with the detection rate of 36. 67%. Conclusion Among 3 kinds of ccphalosporins,the in vitro antimicrobial activity of ceftazidime to clinical common enterobacter bacteria is better than that of ceflriaxone and cefoperazone. Producing ESBLs is the important mechanism for the resistance of enterobacter bacteria to beta lactam antibacterial drμgs. ESBLs- producing bacteria detection should be strengthened and the effective control measures should be adopted for guiding clinical rational use of third generation cephalosporins.

关 键 词：头孢他啶 头孢曲松 头孢哌酮 体外抗菌活性 肠杆菌科 超广谱β-内酰胺酶 

分 类 号：R969.3[医药卫生—药理学] R978.11[医药卫生—药学]