Sood Smita
Microbiologist, Department of Laboratory Medicine (Super Religare laboratories Ltd.), Fortis Escorts Hospital , Jaipur, India .
J Clin Diagn Res. 2013 Feb;7(2):224-8. doi: 10.7860/JCDR/2013/4564.2733. Epub 2013 Feb 1.
The extensive use of the β-lactam antibiotics in hospitals and in the community has created major resistance problems which has led to increased morbidity, mortality and healthcare costs. The use of the β-lactamase inhibitors in combination with the β-lactam antibiotics is currently the most successful strategy used for circumventing the resistance mechanisms.
To evaluate the in-vitro activity of six commercially available β-lactam/β-lactamase inhibitor combinations against Gram Negative Bacilli (GNB).
A total of 384 non duplicate, consecutive, gram negative bacilli (278 Enterobacteriaceae and 106 non fermenters) isolated from various clinical samples were subjected to antimicrobial sensitivity testing by the Kirby-Bauer method. The following β-lactam/β-lactamase inhibitor combinations were tested: amoxycillin-clavulanic acid, ampicillin-sulbactam, cefoperazonesulbactam, piperacillin-tazobactam, cefepime-tazobactam and ticarcillin-clavulanic acid.
Against the Enterobacteriacae, the sensitivity of Cefepime- tazobactam was 90. 64%, followed by Cefoperazone-sulbactam (84.89%) and Piperacillin - tazobactam (53.95 %). The sensitivity of the non fermenters was the highest for Cefepime- tazobactam (49.04%) and was least for Ampicillin-sulbactam and Amoxycillinclavulanic acid (4.71% each). Cefepime-tazobactam was sensitive for all the extended spectrum β-lactamase (ESBL) isolates.
Among the six β-lactam/β-lactamase inhibitor combinations tested, Cefepime-tazobactam exhibited the best in-vitro activity against the gram negative bacilli isolated at our centre.
β-内酰胺类抗生素在医院和社区的广泛使用引发了严重的耐药问题，导致发病率、死亡率上升以及医疗成本增加。目前，将β-内酰胺酶抑制剂与β-内酰胺类抗生素联合使用是规避耐药机制最成功的策略。
评估六种市售β-内酰胺/β-内酰胺酶抑制剂组合对革兰氏阴性杆菌（GNB）的体外活性。
采用 Kirby-Bauer 法，对从各种临床样本中分离出的 384 株非重复、连续的革兰氏阴性杆菌（278 株肠杆菌科细菌和 106 株非发酵菌）进行药敏试验。测试了以下β-内酰胺/β-内酰胺酶抑制剂组合：阿莫西林-克拉维酸、氨苄西林-舒巴坦、头孢哌酮-舒巴坦、哌拉西林-他唑巴坦、头孢吡肟-他唑巴坦和替卡西林-克拉维酸。
对于肠杆菌科细菌，头孢吡肟-他唑巴坦的敏感性为 90.64%，其次是头孢哌酮-舒巴坦（84.89%）和哌拉西林-他唑巴坦（53.95%）。对于非发酵菌，头孢吡肟-他唑巴坦的敏感性最高（49.04%），氨苄西林-舒巴坦和阿莫西林-克拉维酸的敏感性最低（均为 4.71%）。头孢吡肟-他唑巴坦对所有超广谱β-内酰胺酶（ESBL）分离株均敏感。
在所测试的六种β-内酰胺/β-内酰胺酶抑制剂组合中，头孢吡肟-他唑巴坦对在我们中心分离出的革兰氏阴性杆菌表现出最佳的体外活性。
