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[茨城县耐甲氧西林金黄色葡萄球菌感染情况调查——茨城县传染病协会]

[Survey of MRSA infection in Ibaraki-ken--Ibaraki Association for infectious diseases].

作者信息

Hasegawa S, Yoshizawa Y, Nakai T, Sawahata T, Ishida H, Irokawa M, Iwata S, Goto A, Shinohara Y, Togawa S

机构信息

University of Tsukuba.

出版信息

Nihon Rinsho. 1992 May;50(5):961-9.

PMID:1507451
Abstract

This study which was undertaken at several major hospitals in Ibaraki-ken revealed that, 1) the proportion of Staphylococcus aureus in all the isolates ranged from 5% to 17% and the prevalence of MRSA in isolates of Staphylococcus aureus varied from 51% to 82% depending upon each individual hospital. 2) the clinical response to FOM and CMZ combination therapy was 88.9% and, to FOM and CZON was 57.1% showing no statistical differences between the two regimens. 3) in vitro analyses assessed by the FIC index of 251 isolates revealed that FOM had an additive or synergistic effect with CMZ in 53.8%, with CZON in 66.9%, with minocycline (MINO) in 43.8%, with cefamandole (CMD) in 61.8%, with cefazolin (CEZ) in 62.9% and with imipenem/cliastatin sodium (IPM/CS) in 68.9% at all isolates. 4) the cumulative curve of susceptibility to single CMZ and the combination of CMZ and FOM revealed that the blood levels of CMZ at 3 hours after intravenous administration covered 57% of isolates when used alone and 82% of isolates when in combination with FOM. The blood levels of CZON at 3 hours covered 5% of isolates when used alone and 41% when in combination with FOM. The extent of the therapeutic effect increased from 6% to 42% by CMD, from 12% to 54% by CEZ, from 20% to 58% by IPM/CS and from 78% to 84% by MINO. The combination of CMZ and FOM was found to be the most effective for enhanced effects on MRSA in vitro.

摘要

这项在茨城县几家主要医院开展的研究表明,1)在所有分离菌株中,金黄色葡萄球菌的比例在5%至17%之间,金黄色葡萄球菌分离株中耐甲氧西林金黄色葡萄球菌(MRSA)的流行率因各医院而异,在51%至82%之间。2) 对FOM和CMZ联合治疗的临床反应率为88.9%,对FOM和CZON联合治疗的临床反应率为57.1%,两种治疗方案之间无统计学差异。3) 通过FIC指数对251株分离菌株进行的体外分析表明,FOM与CMZ、CZON、米诺环素(MINO)、头孢孟多(CMD)、头孢唑林(CEZ)以及亚胺培南/西司他丁钠(IPM/CS)的联合使用在所有分离菌株中分别有53.8%、66.9%、43.8%、61.8%、62.9%和68.9%表现出相加或协同作用。4) 单一CMZ以及CMZ与FOM联合使用的药敏累积曲线显示,静脉给药后3小时CMZ的血药浓度单独使用时覆盖57%的分离菌株,与FOM联合使用时覆盖82%的分离菌株。CZON在静脉给药后3小时的血药浓度单独使用时覆盖5%的分离菌株,与FOM联合使用时覆盖41%的分离菌株。CMD使治疗效果范围从6%提高到42%,CEZ从12%提高到54%,IPM/CS从20%提高到58%,MINO从78%提高到84%。发现CMZ与FOM联合使用对体外增强抗MRSA效果最为有效。

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