阴沟肠杆菌Amp C酶的诱导性及对酶抑制剂的敏感性研究  

The inducibility of Amp C enzyme of Enterobacrter cloacae and its susceptibility to enzyme inhibitor

作　　者：张永龙[1] 李家泰[1] 赵鸣武[2] 

机构地区：[1]北京大学第一医院临床药理研究所,100083 [2]北京大学第三医院呼吸科

出　　处：《中华医学杂志》2001年第4期227-230,共4页National Medical Journal of China

摘　　要：目的　探讨阴沟肠杆菌AmpC酶的特性及对酶抑制剂的敏感性。方法　用琼脂稀释法研究第四代头孢菌素头孢吡肟 ,第三代头孢菌素头孢他啶、头孢噻肟与 β 内酰胺酶抑制剂舒巴坦联合对 10株头孢他啶耐药菌的体外抗菌活性。应用紫外法和反转录多聚酶链反应 (RT PCR)研究临床常用β 内酰胺类抗生素对AmpC酶的诱导作用以及 3种抑制剂对AmpC酶的抑制作用。 结果　舒巴坦不能增强头孢他啶的抗菌作用 ,第四代头孢菌素头孢吡肟对头孢他啶耐药菌有较好的抗菌活性。亚胺培南对AmpC酶的诱导作用较强 ,酶抑制剂R0 4812 2 0具有较好的抑制作用。结论　产AmpC酶的阴沟肠杆菌引起的感染可考虑选用第四代头孢菌素头孢吡肟进行治疗。Objective To study the inducibility of Amp C enzyme of Enterobacrter cloacae and its susceptibility to enzyme inhibitor. Methods The in vitro activities of the fourth generation cephalosporins ——cefepime, the third generation cephalosporins ——cefuroxime, cefotaxime, ceftazidime combined with β lactamase inhibitor sulbactam against 10 strains of ceftazidime resistant Enterobacter cloacae selected from the hospitals was studied with agar two fold dilution method. The inducibility of β lactam antibiotics in common use clinically to Amp C enzyme and the inhibitory action of 3 inhibitors to Amp C enzyme were studied with ultraviolet spectrophotometry and RTPCR. Results Sulbactam can not enhance the activity of ceftazidime against Enterobacter cloacae . Cefepime has a strong activity against ceftazidime resistant Enterobacter cloacae . Imipenem has a strong inductive action to Amp C enzyme. Ro481220 has a strong inhibitory action to Amp C enzyme. Conclusion Infections caused by Enterobacter cloacae producing Amp C enzyme can be treated by cefepime.

关 键 词：阴沟肠杆菌 酶诱导 AMPC酶 酶抑制剂 抗生素 敏感性 

分 类 号：R446.5[医药卫生—诊断学]