Patankar Manjusha, Sukumaran Sangita, Chhibba Anita, Nayak Usha, Sequeira Loraine
Department of Pharmacology, Dr. D.Y Patil Medical College, Navi Mumbai, India.
J Assoc Physicians India. 2012 Nov;60:22-4.
The emergence and subsequent widespread dissemination of bacterial resistance to a variety of beta-lactam antibiotics by the elaboration of ESBL (Extended Spectrum Beta Lactamase) poses a serious threat to the effective use of beta lactam antibiotics and cephalosporins. Cefoperazone combination with the beta lactamase inhibitor tazobactam would be a strong basis for rational therapeutics when dealing with ESBL producing pathogen mediated infections.
The objective of the study was to investigate the in vitro efficacy of cefoperazone-tazobactam and cefoperazone-sulbactam against ESBL producing respiratory and urinary pathogens.
54 samples (34 samples of urine and 20 samples of sputum) were collected from 9 hospitals in Mumbai. The pathogens isolated from urine included E. coli (n = 27), K. pneumoniae (n = 6), and Serratia marcescens (n = 1). The pathogens isolated from sputum included Pseudomonas aeruginosa (n = 5), Streptococcus pneumoniae (n = 1) and Klebsiella pneumoniae (n = 14). The Kirby Bauer disc diffusion method was used to evaluate the susceptibility of the isolated pathogens to cefoperazone-tazobactam and cefoperazone-sulbactam.
In sputum samples, all the isolates of Pseudomonas aeruginosa were susceptible to cefoperazone-tazobactam while one isolate was resistant to cefoperazone-sulbactam. Streptococcus pneumoniae and Klebsiella pneumoniae were sensitive to both the antibiotic formulations. In uropathogens, higher susceptibility rates to cefoperazone-tazobactam (96% vs. 89%) were observed for Escherichia coli. Similarly higher rates of susceptibility to cefoperazone-tazobactam were observed for Klebsiella as compared to cefoperazone-sulbactam (83% vs. 67%). Serratia marcescens was sensitive to cefoperazone-tazobactam but was intermediate resistant to cefoperazone-sulbactam. The isolates of Klebsiella pneumoniae that were resistant to cefoperazone-sulbactam were susceptible to cefoperazone-tazobactam.
The results of the current in vitro study corroborate the efficacy of the beta lactamase inhibitor tazobactam in improving the spectrum of activity and efficacy of cefoperazone.
通过产生超广谱β-内酰胺酶（ESBL），细菌对多种β-内酰胺类抗生素产生耐药性并随后广泛传播，这对β-内酰胺类抗生素和头孢菌素的有效使用构成了严重威胁。头孢哌酮与β-内酰胺酶抑制剂他唑巴坦联合使用，将为治疗由产生ESBL的病原体介导的感染提供合理治疗的有力依据。
本研究旨在调查头孢哌酮-他唑巴坦和头孢哌酮-舒巴坦对产生ESBL的呼吸道和泌尿道病原体的体外疗效。
从孟买的9家医院收集了54份样本（34份尿液样本和20份痰液样本）。从尿液中分离出的病原体包括大肠杆菌（n = 27）、肺炎克雷伯菌（n = 6）和粘质沙雷氏菌（n = 1）。从痰液中分离出的病原体包括铜绿假单胞菌（n = 5）、肺炎链球菌（n = 1）和肺炎克雷伯菌（n = 14）。采用 Kirby Bauer 纸片扩散法评估分离出的病原体对头孢哌酮-他唑巴坦和头孢哌酮-舒巴坦的敏感性。
在痰液样本中，所有铜绿假单胞菌分离株对头孢哌酮-他唑巴坦敏感，而1株对头孢哌酮-舒巴坦耐药。肺炎链球菌和肺炎克雷伯菌对两种抗生素制剂均敏感。在尿路病原体中，大肠杆菌对头孢哌酮-他唑巴坦的敏感性较高（96% 对 89%）。同样，与头孢哌酮-舒巴坦相比，肺炎克雷伯菌对头孢哌酮-他唑巴坦的敏感性更高（83% 对 67%）。粘质沙雷氏菌对头孢哌酮-他唑巴坦敏感，但对头孢哌酮-舒巴坦中介耐药。对头孢哌酮-舒巴坦耐药的肺炎克雷伯菌分离株对头孢哌酮-他唑巴坦敏感。
当前体外研究结果证实了β-内酰胺酶抑制剂他唑巴坦在扩大头孢哌酮活性谱和提高其疗效方面的作用。
