Simonet M, Herrmann J L, Veron M
Laboratoire de Microbiologie, Hôpital Necker-Enfants Malades, Paris.
Pathol Biol (Paris). 1990 May;38(5):355-7.
The acute otitis media is a frequent infantile disease and, in 80% of cases, a bacterial strain can be isolated from the otorrhoea. Haemophilus influenzae and Streptococcus pneumoniae are the two major species isolated from auricular exudate, and represent two thirds of all isolated strains, with the others comprising Staphylococcus aureus, Branhamella catarrhalis, Pseudomonas aeruginosa, Enterobacteriaceae and corynebacteria. The treatment of this disease is based principally on beta-lactams (aminopenicillins, cephalosporins) administered by the oral route. Cefuroxime is a cephalosporin which is absorbed via the digestive tract in the form of cefuroxim-axetil. The activity of this compound was studied against 210 strains isolated from otorrhoea, collected from children who presented an acute otitis media during the first half of 1989. These strains were: 112 strains of H. influenzae, of which 23 produced a beta-lactamase; 21 strains of Streptococcus pneumoniae; 3 strains of Streptococcus pyogenes; 10 strains of Branhamella catarrhalis of which 9 produced a beta-lactamase; 18 strains of S. aureus; 14 strains of Enterobacteriaceae, and 32 strains of corynebacteria. The minimal inhibitory concentration (MIC) of cefuroxime-axetil was measured by dilution in agar. The MICs of cefuroxime against H. influenzae were low and similar (MIC 50 = 1 mg/l; MIC 90 = 1 mg/l) regardless of whether the strain secreted a beta-lactamase. Overall, 90% and 98% of the 210 strains tested here were inhibited by 1 and 4 mg/l of cefuroxime respectively. These results show that the antibacterial spectrum of cefuroxime-axetil appears to be ideally suited to the bacterial strains isolated from acute otitis media.
急性中耳炎是一种常见的婴幼儿疾病,80%的病例中可从耳漏中分离出细菌菌株。流感嗜血杆菌和肺炎链球菌是从耳分泌物中分离出的两种主要菌种,占所有分离菌株的三分之二,其他包括金黄色葡萄球菌、卡他布兰汉菌、铜绿假单胞菌、肠杆菌科细菌和棒状杆菌。该病的治疗主要基于口服β-内酰胺类药物(氨基青霉素、头孢菌素)。头孢呋辛是一种头孢菌素,以头孢呋辛酯的形式经消化道吸收。研究了该化合物对1989年上半年患急性中耳炎儿童耳漏中分离出的210株菌株的活性。这些菌株包括:112株流感嗜血杆菌,其中23株产生β-内酰胺酶;21株肺炎链球菌;3株化脓性链球菌;10株卡他布兰汉菌,其中9株产生β-内酰胺酶;18株金黄色葡萄球菌;14株肠杆菌科细菌和32株棒状杆菌。通过琼脂稀释法测定头孢呋辛酯的最低抑菌浓度(MIC)。无论菌株是否分泌β-内酰胺酶,头孢呋辛对流感嗜血杆菌的MIC均较低且相似(MIC50 = 1mg/L;MIC90 = 1mg/L)。总体而言,在此测试的210株菌株中,分别有90%和98%被1mg/L和4mg/L的头孢呋辛抑制。这些结果表明,头孢呋辛酯的抗菌谱似乎非常适合从急性中耳炎中分离出的细菌菌株。