脆弱拟杆菌群所致菌血症：菌种分布、β-内酰胺酶产生情况及抗菌药物敏感性模式
Bacteremia due to Bacteroides fragilis group: distribution of species, beta-lactamase production, and antimicrobial susceptibility patterns.
作者信息
Aldridge Kenneth E, Ashcraft Deborah, O'Brien Megan, Sanders Charles V
机构信息
Department of Medicine (Infectious Diseases), Louisiana State University Health Sciences Center, New Orleans, Louisiana 70112, USA.
出版信息
Antimicrob Agents Chemother. 2003 Jan;47(1):148-53. doi: 10.1128/AAC.47.1.148-153.2003.
Abstract
A retrospective analysis of susceptibility data on 542 blood isolates of the Bacteroides fragilis group tested from 1987 to 1999 by the same NCCLS-recommended broth microdilution method throughout is presented. Metronidazole, beta-lactam-beta-lactamase inhibitor combinations, carbapenems, and trovafloxacin were the most active agents (susceptibility of >or=93%). Among the cephalosporin-cephamycins, the order of activity was cefoxitin > ceftizoxime > cefotetan = cefotaxime = cefmetazole > ceftriaxone. All isolates were resistant to penicillin G, and 22% were resistant to clindamycin. The susceptibility rates to piperacillin-tazobactam, imipenem, and meropenem were affected least among isolates resistant to cefoxitin or clindamycin. Except for piperacillin-tazobactam, imipenem, and meropenem, the B. fragilis species was more susceptible than were the non-B. fragilis species. These data underscore the importance of susceptibility testing of the B. fragilis group and can serve as a guide in the choice of empirical antimicrobial therapy.
摘要
本文呈现了一项回顾性分析，该分析针对1987年至1999年期间采用相同的美国国家临床实验室标准委员会（NCCLS）推荐的肉汤微量稀释法检测的542株脆弱拟杆菌属血液分离株的药敏数据。甲硝唑、β-内酰胺-β-内酰胺酶抑制剂联合制剂、碳青霉烯类以及曲伐沙星是活性最强的药物（药敏率≥93%）。在头孢菌素-头霉素类药物中，活性顺序为头孢西丁＞头孢唑肟＞头孢替坦 = 头孢噻肟 = 头孢美唑＞头孢曲松。所有分离株对青霉素G耐药，22%的分离株对克林霉素耐药。对头孢西丁或克林霉素耐药的分离株中，对哌拉西林-他唑巴坦、亚胺培南和美罗培南的药敏率受影响最小。除哌拉西林-他唑巴坦、亚胺培南和美罗培南外，脆弱拟杆菌比非脆弱拟杆菌更易药敏。这些数据强调了脆弱拟杆菌属药敏试验的重要性，并可作为经验性抗菌治疗选择的指导。
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