Barry A L, Pfaller M A, Fuchs P C, Packer R R
Clinical Microbiology Institute, Tualatin, Oregon 97062.
Antimicrob Agents Chemother. 1994 Oct;38(10):2419-25. doi: 10.1128/AAC.38.10.2419.
Clinical isolates of Haemophilus influenzae, Streptococcus pneumoniae, Streptococcus pyogenes, and Moraxella catarrhalis were gathered from 19 different clinical laboratories throughout the continental United States. The in vitro activities of 12 orally administered antimicrobial agents were compared by broth microdilution tests with 3,151 bacterial isolates. Among 890 H. influenzae isolates, 30% were capable of producing beta-lactamase enzymes (12 to 41% in different medical centers). Most of the 619 beta-lactamase-negative H. influenzae strains were susceptible to ampicillicin (MIC, < or = 1.0 micrograms/ml): 5 strains were intermediate in susceptibility (MIC, 2.0 micrograms/ml) and 1 strain was ampilicillin resistant (MIC, 4.0 micrograms/ml). Ninety-two percent of 698 M. catarrhalis strains were beta-lactamase positive. Of 799 S. pneumoniae isolates, 15% were intermediate in susceptibility to penicillin and 7% were resistant to penicillin. The prevalence of penicillin-susceptible pneumococci in different institutions ranged from 63 to 95%. Only 1% of 764 S. pyogenes isolates were resistant to the macrolides, but 5% of S. pneumoniae isolates were macrolide resistant. Only 71% of 58 penicillin-resistant S. pneumoniae isolates were erythromycin susceptible, whereas 97% of the 622 penicillin-susceptible strains were erythromycin susceptible. Penicillin-resistant pneumococci were also relatively resistant to the cephalosporins and amoxicillin. Penicillin-susceptible pneumococci were susceptible to amoxicillin-clavulanic acid (MIC for 90% of isolates tested [MIC90], < or = 0.12/0.06 microgram/ml), cefixime (MIC90, 0.25 microgram/ml), cefuroxime axetil (MIC90, < or = 0.5 microgram/ml), cefprozil (MIC90, < or = 0.5 micrograms/ml), cefaclor (MIC90, 0.5 microgram/ml), and loracarbef (MIC90, 1.0 microgram/ml). Most strains of the other species remained susceptible to the study drugs other than amoxicillin.
从美国大陆19个不同的临床实验室收集了流感嗜血杆菌、肺炎链球菌、化脓性链球菌和卡他莫拉菌的临床分离株。通过肉汤微量稀释试验对3151株细菌分离株比较了12种口服抗菌药物的体外活性。在890株流感嗜血杆菌分离株中，30%能够产生β-内酰胺酶（不同医疗中心为12%至41%）。619株β-内酰胺酶阴性流感嗜血杆菌菌株中的大多数对氨苄西林敏感（MIC，≤1.0微克/毫升）：5株敏感性为中介（MIC，2.0微克/毫升），1株对氨苄西林耐药（MIC，4.0微克/毫升）。698株卡他莫拉菌菌株中有92%为β-内酰胺酶阳性。在799株肺炎链球菌分离株中，15%对青霉素敏感性为中介，7%对青霉素耐药。不同机构中对青霉素敏感的肺炎球菌患病率在63%至95%之间。764株化脓性链球菌分离株中只有1%对大环内酯类耐药，但5%的肺炎链球菌分离株对大环内酯类耐药。58株耐青霉素肺炎链球菌分离株中只有71%对红霉素敏感，而622株青霉素敏感菌株中有97%对红霉素敏感。耐青霉素肺炎球菌对头孢菌素类和阿莫西林也相对耐药。对青霉素敏感的肺炎球菌对阿莫西林-克拉维酸（90%受试分离株的MIC[MIC90]，≤0.12/0.06微克/毫升）、头孢克肟（MIC90，0.25微克/毫升）、头孢呋辛酯（MIC90，≤0.5微克/毫升）、头孢丙烯（MIC90，≤0.5微克/毫升）、头孢克洛（MIC90，0.5微克/毫升）和氯碳头孢（MIC90，1.0微克/毫升）敏感。除阿莫西林外，其他菌种的大多数菌株对研究药物仍敏感。
