比較新舊Beta-Lactam類抗生素與氨基苷醣類抗生素對常見臨床分離菌之抗菌力　第Ⅰ報：葡萄球菌屬

Antibacterial Activity of old and New Beta-Lactam Antibiotics and Aminoglycosides Against Common Clinical Isolates: Part Ⅰ. Staphylococcl

朱夢麟(Mong-Ling Chu) ； 葉淑貞(Shu-Jen Yeh) ； 林明先(Ming-Hsien Lin)

《Acta Paediatrica Sinica》 25卷4期 (1984/12) Pp. 391-399

摘要

葡萄球菌之感染在目前醫院中，仍然是佔有一相當重要地位。近年來爲克服日漸增加抗藥細菌的感染，許多新β-lactam 類與氨基苷醣類抗生素産生，爲明瞭目前葡萄球菌對於這些抗生素之感受性，我們收集從民國71年初至12月底在三軍總醫院自臨床體檢分離出來葡萄球菌，計金黃葡萄球菌102株，表皮葡萄球菌90株，以瓊脂平板稀釋法測定其對13種新舊 beta-lactam 類抗生素及6種氨基苷醣類抗生素之最低抑菌濃度(MICμg/ml)。並計算其最低抑菌濃度之幾何平均值範圍及抑制百分之50及90總測菌所需抗生素濃度，同時再以快速acidometric法測産生beta-lactamase, 另外再以試管稀釋法來測102株金黃葡萄對於oxacillin之最低抑菌及最低殺菌濃度，以測有無耐藥性(tolerance)菌。其結果顯示1．在penicillin類抗生素中，對抗葡萄球菌仍以抗penicillinease半合成之penicillin, 例如oxacillin爲最優，其感受率高速94%~99%，而penicillin, ampicillin, carbenillin及pieracillin僅9%至23%有效。2．在cephem類中，第1代cephem其抗菌力最高，第2代次之，最新的cephem類第3代反而最差。3．氨基苷醣類抗生素中，除kanamycin較差外，其他5種抗生素其感受性並無大並異。4．Oxacillin耐藥性(tolerance)之金黃葡萄球菌，在我們醫院中約佔8.8%。

並列摘要

Antibacterial activities of five parenteral penicillin antibiotics (penicillin, oxacillin, ampicillin, carbenicillin and piperacillin), nine cephem antibiotics (cephalothin, cefamandole, cefoxitin, cefmetazole, cefotaxime, moxalactum, cefoperazone, cefsulodin and cefmenoxime) and six aminoglycoside antibiotics (kanamycin, genta-micin, tobramycin, sisomicin, amikacin and netilmicin) against 102 clinical isolates of Staphylococcus aureus and 90 clinical isolates of Staphylococcus epidermidis were studied. The minimal inhibitory concentration (MIC) was dermined by the agar dilution method; beta-lactamase activits was determined by the rapid acidometric method. The broth dilution method was used to determine the MIC and minimal bactericidal concentration (MBC) of oxacillin for Staphylococcus aureus and the Staphylococcus aureus was considered to be oxacillin tolerance strain if the ratio of MBC/MIC was greater than 32.
The results were as follows:
1. Among the penicillin antibiotics, oxacillin was the most active antibiotic, inhibiting 90% of both Staphylococci at a concentration of 1μg/ml. The other penicillin antibiotics only had 9% to 23% susceptibility and all resistant strains produced beta-lactamase.
2. In general, the newer cephems tend to be less active against than the old cephems. The lowest geometric mean of minimal inhibitory concentration was observed with cephalothin. It inhibited 90% of the isolates at a concentration of 0.25μg/ml.
3. Among the aminoglycoside antibiotics, with the exception of kanamycin, all other 5 aminoglycosides had equally good antibacterial activity.
4. The percentage of oxacillin-tolerance strains of Staphylococus aureus in our hospital was about 8.8%.

並列關鍵字

antibacterial activity ； beta-lactam antibiotics ； aminoglycosides ； staphylococcus ； tolerance strain