拉氧头孢的体外抗菌作用  

In vitro activity of moxalactam against clinical isolates

作　　者：杨洋[1] 朱德妹[1] 叶信予[1] 郭燕[1] 吴湜[1] 吴卫红[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5期365-375,共11页Chinese Journal of Infection and Chemotherapy

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

摘　　要：目的评价拉氧头孢对近期临床分离病原菌的体外抗菌活性。方法按CLSI推荐的琼脂稀释法测定拉氧头孢对612株近期临床分离菌的MIC,并与有关抗菌药物进行比较。结果拉氧头孢对包括产ESBLs的大肠埃希菌和肺炎克雷伯菌在内的受试肠杆菌科细菌均具有良好的抗菌活性,对铜绿假单胞菌、鲍曼不动杆菌、洋葱伯克霍尔德菌、嗜麦芽窄食单胞菌等不发酵糖革兰阴性杆菌的抗菌活性弱;对受试厌氧菌亦有一定的抗菌活性。与其他抗菌药物相比较,拉氧头孢对产ESBLs的大肠埃希菌和肺炎克雷伯菌及肠杆菌属细菌的抗菌活性明显优于头孢他啶、头孢曲松和头孢吡肟;对其他肠杆菌科细菌的抗菌活性与上述3种头孢菌素类抗生素大致相仿。拉氧头孢对肠杆菌科细菌的抗菌活性优于或相仿于头孢哌酮-舒巴坦和哌拉西林-他唑巴坦;大多优于头孢米诺;但较亚胺培南(变形杆菌属和摩氏摩根菌除外)和美罗培南等碳青霉烯类抗生素差。结论拉氧头孢对肠杆菌科细菌及脆弱拟杆菌具有良好的抗菌活性,提示该药可应用于治疗以上各类敏感菌所致的感染。Objective To evaluate the in vitro activity of moxalactam against recent clinical isolates. Methods The minimum in- hibitory concentrations （MICs） of moxalactam were determined with 612 strains of bacterial isolates collected from clinical set- tings in the hospitals of Shanghai and other 10 provinces in China during 2010-2011 and compared with selected comparators. Results were analysed according to CLSI 2012 breakpoints. Results Moxalactam showed potent anti-bacterial activity against Enterobacteriaceae including ESBL producing E. coli and K. pneumonia. However, moxalactam provided poor activity against P. aeruginosa and A. baumannii. Moxalactam also had modest activity against anaerobes. In comparison with other antibiot- ics, moxalactam was superior to ceftazidime, ceftriaxone and cefepime against Enterobacter spp. , ESBL-producing E. coli and K. pneumoniae, but similar to these three antibiotics against other Enterobacteriaceae. Its activity against Enterobacteriaceae was similar or slightly better than cefoperazone-sulbactam and piperacillin-tazobactam, much better than cefminox, whereas poorer than carbapenems. Its activity against P. aeruginosa and A. baumannii was poorer than other agents. Its activity a- gainst B. fragilis group, Prevotella spp. , Fusobacterium spp. , Peptostreptococcus spp. , and Veillonella spp. was poorer than imipenem, similar or slightly poorer than cefminox and metronidazole. Conclusions Moxalactam exhibits good activity a- gainst Enterobacteriaceae and B. fragilis. It is highly stable to extended β-lactamases. These results indicate that moxalactam may be one of the appropriate drugs for the treatment of infections caused by above moxalactam-susceptible clinical isolates.

关 键 词：拉氧头孢 超广谱Β内酰胺酶 肠杆菌科 厌氧菌 药敏试验 

分 类 号：R446.5[医药卫生—诊断学]