Antibacterial activity study of several β-lactam/β-lactamase inhibitor combinations in vitro

目的：比较不同β内酰胺类／β内酰胺酶抑制剂对肠杆菌科细菌的体外抗菌活性。方法收集临床分离肠杆菌科细菌，用平皿二倍稀释法测定抗菌药最低抑菌浓度（ MIC），根据2014版美国临床实验室标准化委员会（ CLSI）折点判读结果，用SPSS17.0统计软件处理数据。结果共收集到2166株肠杆菌科细菌。哌拉西林对大肠埃希菌的MIC50和MIC90分别是256，512μg· mL－1，加用他唑巴坦后MIC50和MIC90则分别为2，8μg· mL－1。对产超广谱β内酰胺酶（ ESBLs）大肠埃希菌和肺炎克雷伯菌，哌拉西林／他唑巴坦敏感率最高为93.7％和86.1％，头孢哌酮／他唑巴坦为91.59％和82.59％，头孢哌酮／舒巴坦为74.4％和58.37％。复方制剂对非产ESBLs大肠埃希菌和肺炎克雷伯菌的敏感率与单用β内酰胺类相差不大。β内酰胺类抗菌药对普通变形杆菌的敏感率比奇异变形杆菌高，但加用β内酰胺酶抑制剂后两者敏感率差不多。美洛西林／舒巴坦对摩根菌属敏感率为97.4％，明显高于单用美洛西林的76.3％。头孢噻肟／他唑巴坦和头孢曲松／他唑巴坦对肠杆菌科细菌的MIC90比单用头孢噻肟和头孢曲松低。结论β内酰胺类／β内酰胺酶抑制剂对肠杆菌科细菌的抗菌活性比单用β内酰胺类抗菌药强，尤其对产ESBLs大肠埃希菌和肺炎克雷伯菌差异更为明显，其中以哌拉西林／他唑巴坦的抗菌活性最强。Objective To evaluate the antibacterial activities of severalβ-lactam/β-lactam inhibitor combinations in vitro.Methods All the clinical isolates were Enterobacteriaceae collected from hospitals and the susceptibility tests were performed using agar dilution method recom-mended by CLSI.The minimum inhibitory concentration ( MIC ) results were interpreted according to the breakpoints of CLSI (2014) guideline.The data was analyzed by software SPSS17.0.Results A total of 2166 Enterobacteriaceae were collected and were performed MIC tests.Based on the MIC results, the MIC50 and MIC90 of piperacillin to Escherichia coli were 256 , 512 μg · mL-1 , while piperacillin/tazobactam were 2 , 8μg· mL-1 , respectively.The sensitive rates of piperacillin/tazobactam to ESBLs -producing Escherichia coli and Klebsiella pneumoniae were 93.7% and 86.1%, cefoperazone/tazobactam were 91.5% and 82.5%, while cefoperazone /sulbactam were 74.4% and 58.39%. Among ESBLs -non -producing Escherichia coli and Klebsiella pneumoniae, there is not much difference between using β-lactam/β-lactam inhibitor combinations and β-lactams alone.β-lactam antibiotics have higher sensitive rates to Proteus vulgaris than Proteus mirabilis, butβ-lactam/β-lactam inhibitor combinations have no difference against them.The sensitive rate of mezlocillin/sulbactam to Morganella spp.was 97.4%, significantly higher than mezlocillin alone with sensitive rate 76.3%.The MIC90 of cefotaxime/tazobactam and ceftriaxone/tazobactam were lower than using cefotaxime and ceftriaxone alone.Conclusion β-lactam/β-lactam inhibitor combinations have greater antimicrobial activity to Enterobacteriaceae than β-lactams alone, especially for ESBLs-producing Escherichia coli and Klebsiella pneumoniae.Among them, piperacillin/tazobactam has the greatest antimicrobial activity.中文核心期刊要目总览(PKU)中国科技核心期刊(ISTIC)中国科学引文数据库(CSCD)11916-9203