摘要
目的了解不同杀菌性抗生素杀菌过程致细菌内毒素释放的不同特点。方法采用鲎基质偶氮法检测常用抗生素在２倍最低抑菌浓度下对大肠杆菌杀菌过程中细菌内毒素的释放水平，分别计算活菌数持续下降阶段平均每减少一个对数数量级（ｌｇ）菌落形成单位所致内毒素的释放量（减数期释放率）和杀菌后期存活菌数基本稳定阶段内毒素水平的增加比率（稳定期递增率）。结果各种抗生素依其致内毒素释放能力的大小大致可分为高、中、低三群。β内酰胺类抗生素内部各品种间差别显著，氨曲南、头孢他定、头孢唑啉、头孢呋辛、氨苄西林属高释放品种，阿莫西林、克拉维酸、亚胺培南属低释放品种。氨基糖苷类各品种间差别无显著性，均属中等释放品种。喹诺酮类的环丙沙星属高释放品种，氧氟沙星属中等释放品种。而多粘菌素Ｂ则低于所有品种。各种抗生素的稳定期递增率除氨基糖苷类只有低递增率外，其余和减数期释放率的趋势基本一致。结论临床常用各种抗生素杀菌过程致内毒素释放的能力有着很大差异，增强此方面的认识有助于选择使用抗生素抗感染时对全身炎性反应综合征的控制。
Objective To investigate the characteristics of endotoxin release induced by differential anti biotic killing of bacteria. Methods Endotoxin liberating levels were measured with a chromogenic limulus amebocyte lysate test in antibiotics killing process of Escherichia coli with a two fold minimal inhibitory concentration (MIC) that is used clinically. The endotoxin release quantity induced by average one lg decrease in number of colony forming units (cfu) during the period of its continuous decrease and the endotoxin increase contributed by one lg cfu increase during the late stable period of the killing process were calculated as release rates and increase rates respectively. Results The endotoxin liberating potential of the antibiotics can be divided into high, middle, low groups according the amount of endotoxin released. There were obvious differences among beta lactams, some of them such as aztreonam, ceftazidime, cefotaxime, cefazolin and ampicillin belong to the high group, some of them such as amoxacillin, clavularic acid and imipenem belong to low group. There were no obvious differences among aminoglycosides, all of them belong to the middle group. Ciprofloxacin belongs to the high group, but ofloxacin belongs to the low group. Polymycin B is the lowest species among all the antibiotics. Apart from aminoglycosides which have low increase rate, the increase rate of other antibiotics is same as the release rate. Conclusion There are obvious differences in endotoxin liberating potential among the clinically used antibiotics. Thorough understanding of this phenomenon is essential for the selection of antibiotics in treating infective diseases and in control of systemic inflammatory response syndrome (SIRS).
出处
《中华内科杂志》
CAS
CSCD
北大核心
1998年第10期686-688,共3页
Chinese Journal of Internal Medicine
