Rotimi V O, Onyenefa P I, Banjo T O, Ogunsola F T, Adenuga A
Department of Medical Microbiology & Parasitology, College of Medicine, University of Lagos, Nigeria.
West Afr J Med. 1994 Apr-Jun;13(2):81-6.
In vitro susceptibility of several strains of six different species of clinical facultative pathogens involved in nosocomial infections in our hospital was investigated by a series of disc diffusion, broth dilution and Chequerboard titration testing. With disc diffusion method all the test strains, except Streptococcus pyogenes, were resistant to penicillin. 46% of the Klebsiella aerogenes and 73% of the Pseudomonas strains were generally resistant to cefotaxime. The minimum inhibitory concentration (MIC) of the antibiotics correlated well with the results of the disc diffusion tests. Synergistic effects were demonstrated by various combinations of gentamicin, ampicillin, clindamycin, colistin, cefoxitin, and ceftriazone against resistant strains of S. aureus, Pseudomonas aeruginosa, Escherichia coli and Klebsiella aerogenes. Against S. aureus the effect of gentamicin/clindamycin demonstrated indifference. The need for stringent caution is strongly advocated in the selection of combination therapy for serious infections caused by some hospital bacterial strains particularly in acute care units. The clinical microbiologist should be consulted at all times during the process of selection of an appropriate combined therapy for expert guidance.
通过一系列纸片扩散法、肉汤稀释法和棋盘滴定试验，对我院医院感染中涉及的六种不同临床兼性病原体的多个菌株进行了体外药敏试验。采用纸片扩散法时，除化脓性链球菌外，所有测试菌株均对青霉素耐药。46%的产气克雷伯菌和73%的假单胞菌菌株通常对头孢噻肟耐药。抗生素的最低抑菌浓度（MIC）与纸片扩散试验结果相关性良好。庆大霉素、氨苄西林、克林霉素、黏菌素、头孢西丁和头孢曲松的各种组合对金黄色葡萄球菌、铜绿假单胞菌、大肠埃希菌和产气克雷伯菌的耐药菌株显示出协同作用。对于金黄色葡萄球菌，庆大霉素/克林霉素的效果显示无差异。强烈主张在为某些医院细菌菌株引起的严重感染选择联合治疗时要极其谨慎，尤其是在急性护理病房。在选择合适的联合治疗过程中，应随时咨询临床微生物学家以获得专家指导。
