Kiyota H, Machida T, Onodera S, Suzuki H, Goto H, Takamizawa S, Mitani H, Kawahara M, Igarashi H, Endoh K
Department of Urology, Jikei University, School of Medicine.
Kansenshogaku Zasshi. 1993 May;67(5):435-9. doi: 10.11150/kansenshogakuzasshi1970.67.435.
We compared the antimicrobial activities of penems in human urine with those in Mueller-Hinton broth in order to clarify the usefulness of penems for urinary tract infections. Furthermore, we also investigated the influence of urine components, such as pH, magnesium concentration and calcium concentration, on the antimicrobial activities of penems. Three penems, i.e., imipenem, panipenem and meropenem were employed. And two bacterial strains, i.e., Escherichia coli NIHJ JC-2 and Pseudomonas aeruginosa 18s, were tested. There was no significant difference in MBCs between human urine and Mueller-Hinton broth against E. coli. However, MBCs of penems in human urine was lower than those in Mueller-Hinton broth against P. aeruginosa. On the other hand, MBCs of penems against these two strains were low when urine pH was high or urine calcium concentration was low. No influence of urine magnesium concentration on MBCs of penems was seen. From these results, it was suggested that we should measure the antimicrobial activities of penems not only in Mueller-Hinton broth, but also in human urine, when we administer penems to patients with urinary tract infections. And we should foresee the clinical effects of penems against urinary tract infections paying attention to urine pH of the patients.
为阐明青霉烯类药物对尿路感染的有效性，我们比较了青霉烯类药物在人尿和穆勒-欣顿肉汤中的抗菌活性。此外，我们还研究了尿液成分，如pH值、镁浓度和钙浓度对青霉烯类药物抗菌活性的影响。使用了三种青霉烯类药物，即亚胺培南、帕尼培南和美罗培南。并测试了两种细菌菌株，即大肠杆菌NIHJ JC-2和铜绿假单胞菌18s。人尿和穆勒-欣顿肉汤对大肠杆菌的最低杀菌浓度（MBC）没有显著差异。然而，青霉烯类药物在人尿中的MBC低于在穆勒-欣顿肉汤中对铜绿假单胞菌的MBC。另一方面，当尿液pH值高或尿钙浓度低时，青霉烯类药物对这两种菌株的MBC较低。未观察到尿镁浓度对青霉烯类药物MBC的影响。从这些结果表明，当我们给尿路感染患者使用青霉烯类药物时，不仅应在穆勒-欣顿肉汤中测量其抗菌活性，还应在人尿中测量。并且我们应关注患者的尿液pH值，预测青霉烯类药物对尿路感染的临床效果。
