Yamaguchi K, Ohno A, Takahashi S, Hayashi M, Yamanaka K, Hirakata Y, Mitsuyama J
Department of Microbiology, Toho University School of Medicine.
Jpn J Antibiot. 1998 Jan;51(1):11-25.
In vitro antibacterial activity of the third-generation oral cephem cefteram (CFTM)--ten years after its first use in the clinical setting--against recent clinical isolates was evaluated and compared with those of other oral cephems. A total of 851 clinical isolates belonging to 13 species used in this study were collected from five medical institutions across Japan during 1996. CFTM showed excellent antibacterial activity against methicillin-susceptible S. aureus and S. pyogenes, equivalent to those of other third-generation oral cephems, except cefixime. Of the S. pneumoniae strains, a high proportion, 34.1%, were penicillin-resistant strains (PRSP), with MIC values of 2.0 micrograms/ml or above, but the MIC50 of CFTM against PRSP was 1.0 microgram/ml. CFTM and the other third-generation oral cephems showed potent antibacterial activity against E. coli, K. pneumoniae, and P. mirabilis. A few strains of E. coli, however, were highly resistant to third-generation oral cephems; that might include extended-spectrum beta-lactamase producing strains. MIC values against P. vulgaris varied significantly, depending on whether they were determined by the broth micro-dilution method or the agar dilution method; growth was observed at high concentrations in the broth micro-dilution method, in which the skip phenomenon was demonstrated, but not in the agar dilution method. The reason for this discrepancy is unknown. Most strains of S. marcescens, C. freundii, and E. cloacae demonstrated resistance to CFTM and the other third-generation oral cephems. CFTM and the other third-generation oral cephems showed excellent antibacterial activities against M. (B.) catarrhalis, N. gonorrhoeae, and H. influenzae, including ampicillin-resistant strains.
第三代口服头孢烯类药物头孢特仑新戊酯（CFTM）在临床首次应用十年后，对近期临床分离菌株的体外抗菌活性进行了评估，并与其他口服头孢菌素进行了比较。1996年期间，从日本各地的五家医疗机构收集了本研究中使用的属于13个菌种的851株临床分离菌株。CFTM对甲氧西林敏感的金黄色葡萄球菌和化脓性链球菌显示出优异的抗菌活性，与除头孢克肟外的其他第三代口服头孢菌素相当。在肺炎链球菌菌株中，有34.1%的高比例菌株为青霉素耐药菌株（PRSP），其MIC值为2.0微克/毫升或更高，但CFTM对PRSP的MIC50为1.0微克/毫升。CFTM和其他第三代口服头孢菌素对大肠杆菌、肺炎克雷伯菌和奇异变形杆菌显示出强大的抗菌活性。然而，少数大肠杆菌菌株对第三代口服头孢菌素有高度耐药性；这可能包括产超广谱β-内酰胺酶的菌株。针对普通变形杆菌的MIC值根据采用肉汤微量稀释法还是琼脂稀释法测定而有显著差异；在肉汤微量稀释法中，在高浓度下观察到生长，出现了跳越现象，但在琼脂稀释法中未观察到。这种差异的原因尚不清楚。大多数粘质沙雷氏菌、弗氏柠檬酸杆菌和阴沟肠杆菌菌株对CFTM和其他第三代口服头孢菌素耐药。CFTM和其他第三代口服头孢菌素对卡他莫拉菌、淋病奈瑟菌和流感嗜血杆菌（包括氨苄西林耐药菌株）显示出优异的抗菌活性。
