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[耐青霉素肺炎球菌的敏感性]

[Sensitivity of penicillin-resistance pneumococci].

作者信息

Cullmann W, Schlunegger H

机构信息

Pharma-Forschung/Infectious Diseases, F. Hoffmann-La Roche AG, Basel.

出版信息

Immun Infekt. 1993 Feb;21(1):9-12.

PMID:8330895
Abstract

Fifty-three clinical Streptococcus pneumoniae isolates from Hungary and Spain which were either moderately susceptible to penicillin G (MIC 0.25-1 mg/l) or highly resistant (MIC > or = 2 mg/l) were studied for their antibacterial susceptibility to the following 14 agents: penicillin G, amoxicillin, mezlocillin, cefotaxime, ceftriaxone, amikacin, cotrimoxazole, erythromycin, rifampicin, vancomycin, fosfomycin, doxycycline, ciprofloxacin, and the dual-action compound Ro 23-9424. Rifampicin was the most active compound (MIC90 < or = 0.015 mg/l) followed by imipenem (MIC90 0.25 mg/l), vancomycin (MIC90 1 mg/l), cefotaxime and ceftriaxone (MIC90 1 mg/l), the dual-action compound Ro 23-9424 and amoxicillin (MIC90 2 mg/l). Most of the isolates were less sensitive to ciprofloxacin (MIC90 4 mg/l), doxycycline and erythromycin (MIC90 16 mg/l) and resistant to cotrimoxazole (MIC90 640 mg/l). Furthermore, synergism between penicillin G or ceftriaxone on the one hand, amikacin or rifampicin on the other hand was studied in all 53 isolates. A combination of a beta-lactam with amikacin resulted mostly in an additive effect, as was the case for the rifampicin combinations. The selection of rifampicin-resistant clones can be repressed by the addition of a beta-lactam thus suggesting such a combination of rifampicin with a beta-lactam as a possible therapeutic approach.

摘要

对来自匈牙利和西班牙的53株临床肺炎链球菌分离株进行了研究,这些分离株对青霉素G中度敏感(MIC为0.25 - 1mg/L)或高度耐药(MIC≥2mg/L),检测它们对以下14种药物的抗菌敏感性:青霉素G、阿莫西林、美洛西林、头孢噻肟、头孢曲松、阿米卡星、复方新诺明、红霉素、利福平、万古霉素、磷霉素、强力霉素、环丙沙星以及双效化合物Ro 23 - 9424。利福平是活性最强的化合物(MIC90≤0.015mg/L),其次是亚胺培南(MIC90 0.25mg/L)、万古霉素(MIC90 1mg/L)、头孢噻肟和头孢曲松(MIC90 1mg/L)、双效化合物Ro 23 - 9424和阿莫西林(MIC90 2mg/L)。大多数分离株对环丙沙星(MIC90 4mg/L)、强力霉素和红霉素(MIC90 16mg/L)敏感性较低,对复方新诺明耐药(MIC90 640mg/L)。此外,对所有53株分离株研究了青霉素G或头孢曲松与阿米卡星或利福平之间的协同作用。β-内酰胺类与阿米卡星联合大多产生相加作用,利福平联合用药也是如此。添加β-内酰胺类可抑制耐利福平克隆的选择,因此提示利福平与β-内酰胺类联合可能是一种治疗方法。

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