三代头孢舒巴坦复合制剂对血流感染革兰阴性杆菌的体外抑菌效应研究  

Bacteriostasis Effect Research of Third-Generation Cephalosporin / Sulbactam Compound Preparations to Gram Negative Bacilli Causing Bloodstream Infections in vitro

作　　者：赵声远[1] 肖淑珍[1] 项瑾[2] 顾飞飞[1] 韩立中[1] 倪语星[1] 王辉[3] 王占伟[3] 刘国驹 

机构地区：[1]临床微生物科上海交通大学医学院附属瑞金医院,上海200025 [2]临床医学院检验系上海交通大学医学院附属瑞金医院,上海200025 [3]北京大学人民医院,北京100044 [4]湘北威尔曼制药股份有限公司,湖南长沙410329

出　　处：《今日药学》2015年第10期697-699,703,共4页Pharmacy Today

摘　　要：目的评估头孢噻肟/舒巴坦（CTX/SBT,2∶1）、和头孢哌酮/舒巴坦（CPZ/SBT,2∶1）对引起血流感染主要革兰阴性杆菌的体外抑菌效应。方法收集引起血流感染的产超广谱β内酰胺酶（extended-spectrumβ-lactamases,ESBLs）大肠埃希菌、非产ESBLs大肠埃希菌、产ESBLs肺炎克雷伯菌、非产ESBLs肺炎克雷伯菌、铜绿假单胞菌、鲍曼不动杆菌各50株,用琼脂平板二倍稀释法测定CTX/SBT、CPZ/SBT、头孢噻肟（CTX）、头孢曲松（CRO）、头孢哌酮（CPZ）的最低抑菌浓度（MIC）。结果复方制剂的抗菌活性均优于单药应用,可使MIC50的降幅达4-16倍;其中CTX/SBT的抑菌效果优于其他抗生素和CPZ/SBT复方,尤其是对产ESBLs的大肠埃希菌和肺炎克雷伯菌,其MIC50可从单用的128-256μg/m L降至16-32μg/m L。结论三代头孢舒巴坦复方制剂对引起血流感染的主要革兰阴性杆菌的体外抗菌效果均优于单用药物,其中CTX/SBT的抑菌效果最好,尤其是对于产ESBLs菌株。OBJECTIVE To evaluate the bacteriostasis effect of cephalosporin / sulbactam（ CTX / SBT,2 ∶ 1） and cefoperazone /sulbactam（ CPZ / SBT,2 ∶ 1） compound preparations to gram negative bacilli causing bloodstream infections in vitro. METHODS Fifty isolates of extended-spectrum β-lactamases（ ESBLs） producing Escherichia coli,non-ESBLs producing Escherichia coli,ESBLs producing Klebsiella pneumoniae,non-ESBLs producing Klebsiella pneumoniae,Pseudomonas aeruginosa and Acinetobacter baumannii were collected respectively,and then the minimum inhibitory concentrations（ MICs） of CTX / SBT,cefoperazone / sulbactam（ CPZ /SBT）,CTX,CRO and CPZ were determined by the agar dilution method. RESULTS The antibacterial activity of compound preparations were better than antibiotics used alone,producing a 4-16 times drop in MIC50. Among them,CTX / SBT was better than the other compound preparations,especially for ESBLs producing Escherichia coli and Klebsiella pneumoniae,the MIC50 of CTX / SBT were dropped to 16-32 μg / m L,while the MIC50 of CTX alone were 128-256 μg / m L. CONCLUSION Third-generation cephalosporin /sulbactam compound preparations showed higher antibacterial activity against gram negative bacilli causing bloodstream infections than antibiotics alone,and CTX / SBT was better than the other compound preparations,especially for ESBLs producing isolates.

关 键 词：头孢噻肟/舒巴坦 血流感染 革兰阴性杆菌 体外抗菌活性 

分 类 号：R965[医药卫生—药理学]