24种抗菌药对临床分离葡萄球菌的体外抗菌活性  

The in vitro activity of 24 antimicrobial agents against clinical isolates of staphylococci

作　　者：李胜利[1] 张婴元[1] 周乐[1] 吴培澄[1] 吴卫红[1] 吴湜[1] 

机构地区：[1]复旦大学附属华山医院抗生素研究所,上海200040

出　　处：《中国抗感染化疗杂志》2001年第2期75-78,共4页Chinese Journal of Infection and Chemotherapy

摘　　要：目的 :比较 2 4种抗菌药对临床分离葡萄球菌的体外抗菌活性。方法 :受试药物为 2 4种抗菌药 ,受试菌为临床分离的2 71株金葡菌和 135株凝固酶阴性葡萄球菌。琼脂稀释法测定抗菌药对细菌的最低抑菌浓度。结果 :万古霉素、替考拉宁和利福平对甲氧西林耐药金黄色葡萄球菌 (MRSA)具有高度抗菌活性 ,抑菌率分别为 10 0 %、99.2 %和 95 .4% ;其他抗菌药的抑菌率低于 5 0 %。甲氧西林敏感金黄色葡萄球菌 (MSSA)对青霉素的敏感率仅 17.1% ,对四环素、克林霉素以及红霉素的敏感率为 70 %左右 ,对大多数 β内酰胺类抗生素的敏感率 >90 %。耐甲氧西林的凝固酶阴性葡萄球菌 (MRCNS)对万古霉素、替考拉宁和利福平的敏感率分别为 10 0 %、99.2 %和 94.9%。甲氧西林敏感的凝固酶阴性葡萄球菌 (MSCNS)对绝大多数受试药物的敏感率 >90 % ,青霉素的抑菌率低于 5 0 %。结论 :万古霉素等糖肽类抗生素为甲氧西林耐药葡萄球菌 (MRS)感染的可靠选用药物 ,重症感染者尚应联合利福平、磷霉素等抗菌药 ,不宜选用 β内酰胺类抗生素 ;由MSS所致感染则可根据药敏选用糖肽类以外的各类抗菌药。Objective:To compare the in vitro activity of 24 antimicrobial agents against clinical isolates of staphylococci. Methods: Twenty four antimicrobial agents were tested in this study. Staphylococcal strains were isolated from inpatients, including 271 strains of Staphylococcus aureus and 135 strains of coagulase negative Staphylococcus. Agar dilution method was used to determine the minimum inhibitory concentrations (MIC) of various antimicrobial agents. Results: Vancomycin, teicoplanin and rifampicin showed excellent activity against methicillin resistant S. aureus (MRSA), the inhibition rates being 100%, 99.2% and 95.4% respectively. Most of the other tested antimicrobial agents showed poor activity against MRSA with inhibition rates nearly less than 50% in general. Of the methicillin sensitive S. aureus (MSSA) isolates, only 17.1% were sensitive to penicillin, 70% sensitive to tetracycline, clindamycin and erythromycin, and more than 90% sensitive to other β lactams. Vancomycin, teicoplanin and rifampicin could inhibit 100%, 99.2% and 94.9% of methicillin resistant coagulase negative Staphylococcus (MRCNS) isolates. The susceptibility rates of methicillin sensitive coagulase negative Staphylococcus (MSCNS) to most antimicrobial agents were more than 90%, but less than 50% to penicillin. Conclusions: Glycopeptides including vancomycin and teicoplanin were reliable antibiotics for the treatment of infections caused by methicillin resistant Staphylococcus (MRS). However, in case of severe infections, glycopeptide combined with rifampicin and fosfomycin should be considered. β lactam antibiotics are not recommended for the treatment of MRS infections. The treatment of methicillin susceptible Staphylococcus infections should based on susceptibility data.

关 键 词：抗菌药 葡萄球菌 体外抗菌活性 琼脂稀释法 最低抑菌浓度 

分 类 号：R446.5[医药卫生—诊断学]