【摘要】 目的　考察及评价注射用头孢噻肟钠、注射用头孢哌酮钠、注射用头孢曲松钠、注射用头孢他啶、注射用头孢呋辛钠和注射用头孢唑林钠 6种头孢菌素的抗菌作用特点。方法　采用琼脂二倍稀释法测定注射用头孢噻肟钠、注射用头孢哌酮钠等 6种头孢菌素对临床分离 194株致病菌 (其中产超广谱 β-内酰胺酶4 1株 ,产 β-内酰胺酶 12 1株、非产酶 73株 )的 MIC值。超声波破碎仪提取粗酶液 ,用紫外分光光度法测定各抗生素对 β-内酰胺酶相对水解率。结果　注射用头孢噻肟钠、注射用头孢哌酮钠、注射用头孢曲松钠和注射用头孢他啶 4种第三代头孢菌素对临床分离 194株致病菌的抗菌活性强于头孢呋辛钠和头孢唑林钠 2种第二代头孢菌素。所有头孢菌素对临床分离的 ESBL s菌株的耐药性均较非产酶株严重。β-内酰胺酶稳定性试验结果表明 :头孢哌酮钠、头孢噻肟钠、头孢曲松钠和头孢他啶对 SHV- 1、SHV- 2、SHV- 4、SHV- 5、TEM- 1、TEM- 5和 D31等β-内酰胺酶的相对水解率分别在 4 0 %～ 90 %范围内 ,均较头孢呋辛和头孢唑林低。结论　头孢噻肟钠、头孢哌酮钠、头孢曲松钠和头孢他啶等 4种第三代头孢菌素对临床治疗分离菌株仍具有较好的抗菌作用 ,但也出现不少耐药菌株。建议临床使用第三代头孢菌素时与酶抑制剂联合应用 ,?更多还原

【Abstract】 Objective To investigate and evaluate the characteristics of in vitro antibacterial activity of cefotaxime,cefoperazone,ceftriaxone,ceftazidime,cefuroxime and cefazolin for injection. Methods MICs of six cephalosporins against 194 clinical isolates,including 41 extended-spectrum β-lactamase producing isolates,121 β-lactamase producing isolates and 73 β-lactamase non-producing isolates,were determined by agar dilution method. Activity of β-lactamases and the relative rates of hydrolysis of these antibiotics were determined by ultra violet spectrophotometry. Results The in vitro antibacterial activities of the third generation of cephalosporins were stronger than the second generation. The in vitro antibacterial activities of cephalosporins against gram-negative bacteria were stronger than against gram-positive bacteria. The results of β-lactamases hydrolysis showed that the hydrolysis relative rates of cefotaxime,cefoperazone,ceftriaxone and ceftazidime were between 40% and 90%,which were lower than those of cefuroxime and cefazolin agaist SHV-1,SHV-2,SHV-4,SHV-5,TEM-1,TEM-5 and D31. Conclusion The third generation of cephalosporins are still the best choice for clinical infection treatment,and it is worthy of further validation and exploitation for the combination with β-lactamase inhibitors.更多还原