摘要
目的了解常见菌对常用抗生素的敏感性及产β－内酰胺酶的情况。方法采用微量肉汤稀释及纸片法测定了１９７株革兰阴性杆菌对１４种抗生素的敏感性，并进行了β－内酰胺酶的研究。结果１９７株革兰阴性杆菌对１４种抗生素的敏感率为：伊米配能－西司他丁９８％，丁胺卡那霉素９０％，头孢他啶８９％，头孢哌酮－舒巴坦８８％，头孢哌酮８６％，妥布霉素８１％，其余均＜８０％。细菌产β－内酰胺酶的检出率，大肠杆菌为５４％；绿脓杆菌为４２％，克雷白菌属为２９％，其余细菌均＜２０％。此外，还发现４株菌产生了能水解第三代头孢菌素的酶。结论伊米配能－西司他丁、丁胺卡那霉素、头孢他啶及头孢哌酮－舒巴坦的抗菌活性最强，覆盖率最广。产酶株主要分布在大肠杆菌和绿脓杆菌。
Objective To detect the sensitivity of common bacteria to antibiotics and the production of β lactamase. Methods 197 clinical bacterial isolates were collected. The sensitivity to 14 antibiotics was determined by microdilution method with MH broth but that to imipenem cilastatin was determined by agar diffusion method. Penicillinase and cephalosporinase were detected by emzyme detecting discs. The inducible class I β lactamase was shown by double disc test. β lactamase was isolated and assayed in 11 isolates. Results Among the 14 antibiotics, imipenem cilastatin, amikacin, ceftazidime and sulbactam cefoperazone showed a very good antibacterial activity against most gram negative bacteria including Enterobacteriaceae and P.aeruginosa . Ciprofloxacin also showed a good activity against most gram negative bacteria but E.coli. Ampicillin showed a quite low activity. The penicillinase producing rate and cephalosporinase producing rate were 21% and 28%, respectively. These β lactamase producing strains were mostly found in E.coli and P.aeruginosa . These cephalosporinase producing isolates showed higher resistant rates to many cephalosporins except the imipenem cilastatin, ceftazidime and sulbactam cefoperazone. The inducible class I β lactamase was mostly found in P.aeruginosa, Enterobacter spp and Citrobacter freundii . The β lactamase from 4 of the isolates hydrolized the third generation cephalosporins. Conclusion Imipenem cilastatin, amikacin, ceftazidime and sulbactam cefoperazone can be used for empirical treatment of severe gram negative bacteria infection.
出处
《中华内科杂志》
CAS
CSCD
北大核心
1998年第3期171-179,共9页
Chinese Journal of Internal Medicine
