磷霉素对革兰阴性菌的体外抗菌活性研究

In vitro antimicrobial activity of fosfomycin against gram-negative bacilli

关键词:  革兰阴性菌  磷霉素  耐药性

Key words:  gram-negative bacilli  fosfomycin  resistance

摘要:

［目的］了解磷霉素对革兰阴性菌的体外抗菌活性。［方法］应用K-B纸片扩散法对革兰阴性菌进行体外敏感性实验。［结果］大肠埃希菌、肺炎克雷伯菌、阴沟肠杆菌和产气肠杆菌对磷霉素耐药率为10%~22%；其他肠杆菌、铜绿假单胞菌及鲍曼不动杆菌分别为35%~41%、71%和95%。产ESBLs的大肠埃希菌和肺炎克雷伯菌对磷霉素的耐药率为16%和22%；肺炎克雷伯产酶菌耐药率（22%）明显高于非产酶菌（4%）。对磷霉素敏感株而言，磷霉素对大肠埃希菌抑菌环直径远大于肺炎克雷伯菌。［结论］对产ESBLs大肠埃希菌、肺炎雷伯菌、阴沟肠杆菌和产气肠杆菌引起的感染，可选用磷霉素，磷霉素对大肠埃希菌的抗菌活性高于肺炎克雷伯菌。对非发酵菌则不宜选用磷霉素进行临床治疗。

Abstract:

［Objective］To determine the in vitro activity of fosfomycin against gram-negative bacilli.［Methods］Antimicrobial susceptibility of clinical isolates was tested by kirby-Bauer method.［Results］The resistant rates of E.coli,K.pneumoniae,Enterobacter cloacae and Enterobacter aerogenes to fosfomycin were 10% to 22%.The resistant rates of other Enterobacteriaceae,Paeruginosa and A.baumannii to fosfomycin were 35% to 41%,71% and 95% respectively.The resistant rate (22%) of ESBLs-producing K.pneumoniae to fosfomycin was higher than that (4%) of non-ESBLs producing strains.The bacteriostatic circle diameter of fosfomycin in E.coli susceptibilitic strains were bigger than that in K.pneumoniae.［Conclusions］Fosfomycin can be selected against infections caused by ESBLs-producing E.coli,K.pneumoniae,Enterobacter cloacae and Enterobacter aerogenes but can not be selected against infections caused by nonfermenting gram-negative bacilli.The in vitro antimicrobial activity of fosfomycin in E.coli was higher than that in K.pneumoniae