Philippon A, Riou J Y, Guibourdenche M, Sotolongo F
Drugs. 1986;31 Suppl 3:64-9. doi: 10.2165/00003495-198600313-00014.
Beta-lactamase-producing isolates of Branhamella catarrhalis were first detected in France in 1977. The frequency of beta-lactamase producers has increased, especially since 1980. An agar iodometric test, a fast chromogenic test and an acidimetric test were used to assess the beta-lactamase-producing capabilities of 188 isolates of B. catarrhalis obtained mainly from sputum and the pharynx. Data from the first 2 procedures indicated positive beta-lactamase activity for all 49 strains of B. catarrhalis identified, but there were some discrepancies in the acidimetric test results. Evidence from a diffusion technique showed significant increases in the inhibition diameters surrounding filter discs impregnated with amoxycillin in the presence of clavulanic acid, or with ampicillin in the presence of sulbactam, compared with discs of the penicillins used alone. Two types of enzyme activity emerged from examination of isoelectric focusing patterns. Type I, having pI values of 5.35, 5.55 and 5.85, accounted for 87.2% of the enzyme-producing isolates. Type II, with pIs of 5.5, 5.9 and 6.25, occurred in 12.8% of isolates and appeared to be less widely distributed. The beta-lactamase inhibitors clavulanic acid and sulbactam in combination with benzylpenicillin produced potentiated effects, as demonstrated by significant reductions in MIC (33- and 44-fold decreases, respectively). Higher concentrations of each inhibitor similarly affected the MICs of amoxycillin. A weak synergy occurred with cefoxitin, a beta-lactamase-resistant beta-lactam antibiotic, and the 2 beta-lactamase inhibitors. Because B. catarrhalis has been shown to be a beta-lactamase-producing pathogenic organism, the addition of enzyme inhibitors, such as clavulanic acid and sulbactam, to standard therapy may be beneficial.
1977年在法国首次检测到产β-内酰胺酶的卡他布兰汉菌分离株。产β-内酰胺酶菌株的频率有所增加，尤其是自1980年以来。采用琼脂碘量法、快速显色法和酸度测定法评估了主要从痰液和咽部获得的188株卡他布兰汉菌的产β-内酰胺酶能力。前两种方法的数据表明，所鉴定的49株卡他布兰汉菌均具有阳性β-内酰胺酶活性，但酸度测定结果存在一些差异。扩散技术的证据表明，与单独使用青霉素的滤纸片相比，在克拉维酸存在下用阿莫西林浸渍的滤纸片周围的抑菌直径显著增加，或在舒巴坦存在下用氨苄西林浸渍的滤纸片周围的抑菌直径显著增加。通过等电聚焦图谱检查发现了两种类型的酶活性。I型的pI值为5.35、5.55和5.85，占产酶分离株的87.2%。II型的pI值为5.5、5.9和6.25，出现在12.8%的分离株中，似乎分布不太广泛。β-内酰胺酶抑制剂克拉维酸和舒巴坦与苄青霉素联合使用产生了增效作用，MIC显著降低（分别降低33倍和44倍）证明了这一点。每种抑制剂的较高浓度同样影响阿莫西林的MIC。头孢西丁（一种耐β-内酰胺酶的β-内酰胺抗生素）与这两种β-内酰胺酶抑制剂产生了微弱的协同作用。由于已证明卡他布兰汉菌是一种产β-内酰胺酶的致病生物，在标准治疗中添加酶抑制剂如克拉维酸和舒巴坦可能有益。
