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目的探讨美罗培南、哌拉西林/他唑巴坦、头孢吡肟、头孢他定、头孢噻肟和头孢曲松6种常用抗生素药物对产超广谱β-内酰胺酶大肠埃希菌的接种效应。方法 按照临床实验室标准化研究所推荐的微量肉汤稀释法测定6种抗菌药物对19株产超广谱β-内酰胺酶大肠埃希菌在标准接种浓度(5×105cfu/ml)和高接种浓度(5×107cfu/ml)下的最低抑菌浓度。结果美罗培南对19株产超广谱β-内酰胺酶大肠埃希菌不存在接种效应,哌拉西林/他唑巴坦只对部分基因型超广谱β-内酰胺酶菌株存在接种效应,头孢吡肟、头孢他定、头孢噻肟和头孢曲松对所有受试菌株均存在接种效应。结论对于产超广谱β-内酰胺酶大肠埃希菌引起的重度感染的治疗首选美罗培南,对于轻中度感染需根据药敏结果酌情考虑哌拉西林/他唑巴坦,对于第三、四代头孢菌素即使体外实验敏感也不建议应用。
Objective To investigate the effects of six commonly used antibiotics such as meropenem, piperacillin / tazobactam, cefepime, ceftazidime, cefotaxime and ceftriaxone on the development of extended-spectrum β-lactamase-producing Escherichia coli effect. Methods Six antibacterials were tested against 19 Escherichia coli producing ESBLs-producing Escherichia coli at the standard inoculation concentration (5 × 105cfu / ml) and high vaccination according to the micro broth dilution method recommended by Clinical Laboratory Standardization Institute Concentration (5 × 107cfu / ml) minimum inhibitory concentration. Results Meropenem had no inoculation effect on 19 strains of ESBLs-producing Escherichia coli. Piperacillin / tazobactam had inoculation effects on only some of the genotypes of ESBLs. Cefepime, ceftazidime, cefotaxime and ceftriaxone had inoculation effects on all tested strains. Conclusion For the treatment of severe infections caused by extended-spectrum β-lactamase-producing Escherichia coli, Meropenem should be the first choice and piperacillin / tazobactam should be considered according to the susceptibility results for mild to moderate infections. For the third, Fourth-generation cephalosporins even in vitro experiments are not recommended for use.