上海交通大学学报（医学版）

上海交通大学学报（医学版）

• 论著（临床研究） • 上一篇    下一篇

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

徐正鹏，施 燕，窦 懿，王文奎   

  1. 上海交通大学 医学院附属瑞金医院灼伤整形科， 上海 200025
  • 出版日期:2015-02-28 发布日期:2015-02-27
  • 作者简介:徐正鹏（1965—）， 男， 主治医师， 学士; 电子信箱: 13916854885@163.com。

In vitro bacteriostasis effect of cephalosporin/sulbactam compound preparations on Gram negative bacilli causing bloodstream infections

XU Zheng-peng, SHI Yan, DOU Yi, WANG Wen-kui   

  1. Department of Burns, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
  • Online:2015-02-28 Published:2015-02-27

PDF (PC)

1497

摘要：

目的 评估头孢舒巴坦复合制剂对引起血流感染的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（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30株，采用琼脂平板二倍稀释法测定第三代复合制剂头孢噻肟/舒巴坦（CTX/SBT）、头孢曲松/舒巴坦（CRO/SBT）和头孢哌酮/舒巴坦（CPZ/SBT）及单方制剂头孢噻肟（CTX）、头孢曲松(CRO)、头孢哌酮(CPZ)的最低抑菌浓度（MIC），计算50%最低抑菌浓度（MIC50）。结果 复合制剂的抑菌效应均优于单方制剂，MIC50的降幅可达4~8倍。CTX/SBT的抑菌效果优于CRO/SBT和CPZ/SBT，其对产ESBLs大肠埃希菌和肺炎克雷伯菌的MIC50降至32~64 μg/mL，与CTX单药相比降低了8倍。结论 3种第三代头孢舒巴坦复合制剂对引起血流感染的主要革兰阴性杆菌的体外抑菌效果均优于单方制剂，其中CTX/SBT的抑菌效果最好，尤其是针对产ESBLs菌株。

关键词: 头孢噻肟/舒巴坦, 血流感染, 革兰阴性杆菌, 抑菌效应, 体外

Abstract:

Objective To evaluate the in vitro bacteriostasis effect of cephalosporin/sulbactam compound preparations on Gram negative bacilli that cause bloodstream infections. Methods Thirty isolates of each of following bacteria that can cause bloodstream infections were collected, i.e. ESBLs producing Escherichia coli，nonESBLs producing Escherichia coli, ESBLs producing Klebsiella pneumoniae, non-ESBLs producing Klebsiella pneumoniae, Pseudomonas aeruginosa, and Acinetobacter baumannii. The minimum inhibitory concentrations (MIC) of CTX/SBT, ceftriaxone/sulbactam (CRO/SBT), cefoperazone/sulbactam (CPZ/SBT), CTX, CRO, and CPZ were determined by the agar dilution method and 50% minimun inhibitory concentrations (MIC50) were calculated. Results The antibacterial activity of three third-generation cephalosporin/sulbactam compound preparations was better than that of single prescription preparations. MIC50 decreased 4-8 times. The antibacterial activity of CTX/SBT was better than that of CRO/SBT and CPZ/SBT. MIC50 of CTX/SBT against ESBLs producing Escherichia coli and Klebsiella pneumoniae decreased to 32-64 μg/mL, which was 8 times lower than that of CTX preparation. Conclusion For Gram negative bacilli that can cause bloodstream infections, the antibacterial activity of three third-generation cephalosporin/sulbactam compound preparations is better than that of single prescription preparations. The antibacterial activity of CTX/SBT is the best, especially for ESBLs producing isolates.

Key words: cephalosporin/sulbactam compound preparations, bloodstream infections, Gram negative bacilli, bacteriostasis effect, in vitro