Department of Pediatrics, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Chang Gung University College of Medicine, Taiwan.
J Microbiol Immunol Infect. 2009 Oct;42(5):433-8.
To compare the antimicrobial activities of ertapenem, ciprofloxacin, ceftriaxone, piperacillin-tazobactam, and ampicillin-sulbactam against 12 common organisms that cause community-acquired bacteremia and to identify the most active agents for the treatment of extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli and Klebsiella pneumoniae.
1200 blood specimens from patients with community-acquired bacteremia were collected at Chang Gung Memorial Hospital, Kaohsiung, Taiwan. All isolates were identified by the API system, and each culture's antimicrobial susceptibility was determined by the standard disk-diffusion method. The minimal inhibitory concentrations of the antibiotics were detected by the Epsilimeter test.
The in vitro susceptibilities of 11 of the 12 common pathogens to ertapenem were 100%. The frequency of ESBL-producing E. coli and K. pneumoniae was 6.2% and 9.5%, respectively. Only 48% and 50% of E. coli and K. pneumoniae, respectively, were susceptible to ciprofloxacin. These data infer that ciprofloxacin should not be given for ESBL-producing E. coli and K. pneumoniae. Ceftriaxone and piperacillin-tazobactam had high activity against the most common pathogens isolated.
ESBL E. coli and K. pneumoniae are highly resistant to ciprofloxacin, so this antibiotic should be avoided for patients with community-acquired bacteremia. ESBL E. coli and K. pneumoniae are highly susceptible to ertapenem.
比较厄他培南、环丙沙星、头孢曲松、哌拉西林-他唑巴坦和氨苄西林-舒巴坦对 12 种常见社区获得性菌血症病原体的抗菌活性，并确定治疗产超广谱β-内酰胺酶（ESBL）大肠埃希菌和肺炎克雷伯菌的最有效药物。
在台湾高雄长庚纪念医院收集了 1200 份来自社区获得性菌血症患者的血样。所有分离株均通过 API 系统鉴定，每种培养物的药敏性均通过标准纸片扩散法测定。通过 Epsilometer 试验检测抗生素的最小抑菌浓度。
12 种常见病原体中，11 种对厄他培南的体外敏感性为 100%。产 ESBL 大肠埃希菌和肺炎克雷伯菌的频率分别为 6.2%和 9.5%。只有 48%和 50%的大肠埃希菌和肺炎克雷伯菌分别对环丙沙星敏感。这些数据表明，对于产 ESBL 的大肠埃希菌和肺炎克雷伯菌，不应使用环丙沙星。头孢曲松和哌拉西林-他唑巴坦对分离出的最常见病原体具有高活性。
产 ESBL 的大肠埃希菌和肺炎克雷伯菌对环丙沙星高度耐药，因此对于社区获得性菌血症患者，应避免使用该抗生素。产 ESBL 的大肠埃希菌和肺炎克雷伯菌对厄他培南高度敏感。
