Forward K R, Franks P A, Low D E, Rennie R, Simor A E
Division of Microbiology, Department of Pathology and Laboratory Medicine, Queen Elizabeth II Health Sciences Centre, Halifax, Nova Scotia; Department of Microbiology and Infectious Diseases, Hôpital Maisoneuve-Rosemont, Montréal, Québec; Microbiology and Public Health, University of Alberta Hospital, Edmonton, Alberta; Wyeth-Ayerst Canada Inc; Department of Microbiology, Mount Sinai & Princess Margaret Hospitals; Department of Microbiology, Sunnybrook Health Science Centre, Toronto, Ontario.
Can J Infect Dis. 1998 Jan;9(1):33-44. doi: 10.1155/1998/730838.
To compare the activity of piperacillin/tazobactam with that of other broad parenteral antibiotics against aerobic and facultative anaerobic blood culture isolates in a Canada-wide survey.
Fifty-eight laboratories in nine provinces each contributed up to 50 consecutive clinically significant aerobic and facultative anaerobic isolates for susceptibility testing.
Participating hospitals included both tertiary care and community hospitals.
Testing was performed in five regional centres by using the same microbroth dilution method, and results were interpreted according to National Commitee for Clinical Laboratory Standards M7-A3 and M100-S5 guidelines.
Piperacillin/tazobactam and imipenem were both active against more than 99% of the 1616 strains of Enterobacteriaceae species tested. The minimum inhibitory concentration of 90% of isolates (MIC(90)) of all Enterobacteriaceae species was 2 mg/L for piperacillin/tazobactam compared with 64 mg/L for piperacillin alone. Seventeen per cent of strains of Enterobacteriaceae species were susceptible to piperacillin/tazobactam but resistant to piperacillin. Piperacillin/tazobactam was highly active against Pseudomonas aeruginosa, inhibiting 99.1% of strains. MIC(90) was 8 mg/L. Nine per cent of P aeruginosa strains were not susceptible to imipenem. Most of these strains had a MIC of 8 mg/L, which falls in the intermediate category. Ninety-seven per cent of P aeruginosa were susceptible to ciprofloxacin and 97.3% to tobramycin. Ninety-six per cent of strains of Actinobacter species were susceptible to piperacillin/tazobactam, whereas only 76% of strains were susceptible to piperacillin alone. Overall, piperacillin/tazobactam was the most active agent tested; 98% of all strains were susceptible, followed closely by imipenem, to which 97.8% of strains were susceptible.
Aerobic blood culture isolates from Canadian centres continue to be highly susceptible to a variety of antibiotics. The broad spectrum of activity of piperacillin/tazobactam suggests that this combination should be considered for empirical treatment of sepsis while awaiting results of cultures and susceptibility testing.
在一项全国性调查中，比较哌拉西林/他唑巴坦与其他注射用广谱抗生素对需氧及兼性厌氧血培养分离菌的活性。
来自9个省的58个实验室各自提供了多达50株连续的具有临床意义的需氧及兼性厌氧分离菌用于药敏试验。
参与的医院包括三级医疗机构和社区医院。
在5个区域中心采用相同的微量肉汤稀释法进行检测，并根据美国国家临床实验室标准委员会M7-A3和M100-S5指南解释结果。
哌拉西林/他唑巴坦和亚胺培南对所检测的1616株肠杆菌科细菌中的99%以上均有活性。所有肠杆菌科细菌90%菌株的最低抑菌浓度（MIC90），哌拉西林/他唑巴坦为2mg/L，而哌拉西林单药为64mg/L。17%的肠杆菌科菌株对哌拉西林/他唑巴坦敏感但对哌拉西林耐药。哌拉西林/他唑巴坦对铜绿假单胞菌高度活性，抑制99.1%的菌株。MIC90为8mg/L。9%的铜绿假单胞菌菌株对亚胺培南不敏感。这些菌株大多MIC为8mg/L，属于中介类别。97%的铜绿假单胞菌对环丙沙星敏感，97.3%对妥布霉素敏感。96%的放线菌属菌株对哌拉西林/他唑巴坦敏感，而仅76%的菌株对哌拉西林单药敏感。总体而言，哌拉西林/他唑巴坦是所检测的最具活性的药物；98%的所有菌株敏感，紧随其后的是亚胺培南，97.8%的菌株对其敏感。
加拿大各中心的需氧血培养分离菌对多种抗生素仍高度敏感。哌拉西林/他唑巴坦的广谱活性表明，在等待培养和药敏试验结果期间，该联合用药可考虑用于脓毒症的经验性治疗。
