Blondeau J M, Suter M, Borsos S
Saskatoon District Health and St Paul's Hospital (Grey Nuns) and the Department of Pathology, University of Saskatchewan, Saskatoon, Canada.
J Antimicrob Chemother. 1999 Mar;43 Suppl A:25-30.
The susceptibility of Canadian isolates of three respiratory tract pathogens (Haemophilus influenzae, Moraxella catarrhalis and Streptococcus pneumoniae) to several antimicrobial agents were tested by two different methods. Beta-lactamase was produced by 68/211 (32.2%) of H. influenzae isolates and 64/75 (85.3%) of M. catarrhalis isolates. For S. pneumoniae, 19/156 (12.2%) isolates were resistant to penicillin (MIC > or = 0.12 mg/L) and two isolates had MICs of 1.5 mg/L. For some combinations of agents and organisms, different methods gave different values for the proportion of isolates susceptible. Regardless of methodology, for H. influenzae, the most active antimicrobials based on proportion of strains susceptible were ciprofloxacin (100%) and cefpodoxime (98.5-100%). For M. catarrhalis, the most active agents were azithromycin, cefaclor, cefixime, cefpodoxime, cefuroxime, ciprofloxacin, clarithromycin and loracarbef (100% each); the least active was ampicillin. Against penicillin-sensitive and -resistant pneumococci, the activity was not significantly different for azithromycin and clarithromycin (93.4-100%) and ciprofloxacin (MIC90 2.0 and 1.5 mg/L, respectively) but was different for cefuroxime (99.3% and 31.6%, respectively), cefaclor (MIC90 0.75 and > or = 256 mg/L, respectively), cefpodoxime (MIC90 0.047 and 1.5 mg/L, respectively) and loracarbef (MIC90 0.75 and > or = 256 mg/L, respectively). This study indicates the increasing incidence, in Canada, of beta-lactamase resistance in H. influenzae and M. catarrhalis and penicillin resistance in S. pneumoniae.
采用两种不同方法检测了从加拿大分离出的三种呼吸道病原体(流感嗜血杆菌、卡他莫拉菌和肺炎链球菌)对几种抗菌药物的敏感性。68/211(32.2%)的流感嗜血杆菌分离株和64/75(85.3%)的卡他莫拉菌分离株产生β-内酰胺酶。对于肺炎链球菌,19/156(12.2%)的分离株对青霉素耐药(MIC≥0.12mg/L),有两株分离株的MIC为1.5mg/L。对于某些药物与病原体的组合,不同方法得出的敏感分离株比例值不同。无论采用何种方法,对于流感嗜血杆菌,基于敏感菌株比例,最有效的抗菌药物是环丙沙星(100%)和头孢泊肟(98.5 - 100%)。对于卡他莫拉菌,最有效的药物是阿奇霉素、头孢克洛、头孢克肟、头孢泊肟、头孢呋辛、环丙沙星、克拉霉素和氯碳头孢(均为100%);最无效的是氨苄西林。对于青霉素敏感和耐药的肺炎球菌,阿奇霉素和克拉霉素(93.4 - 100%)以及环丙沙星(MIC90分别为2.0和1.5mg/L)的活性无显著差异,但头孢呋辛(分别为99.3%和31.6%)、头孢克洛(MIC90分别为0.75和≥256mg/L)、头孢泊肟(MIC90分别为0.047和1.5mg/L)和氯碳头孢(MIC90分别为0.75和≥256mg/L)的活性不同。本研究表明,在加拿大,流感嗜血杆菌和卡他莫拉菌对β-内酰胺酶耐药以及肺炎链球菌对青霉素耐药的发生率在增加。