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目的 :研究头孢地尼和头孢克洛对呼吸道常见分离菌的体外抗菌活性。方法 :采用琼脂稀释法测定头孢地尼和头孢克洛对 5 2 3株临床分离株的最低抑菌浓度 (MIC) ,Etest法测定青霉素对肺炎球菌的MIC ,用Nitrocefin测试细菌的 β内酰胺酶 ,用纸片确证法检测大肠埃希菌和肺炎克雷伯菌的超广谱 β内酰胺酶 (ESBLs) ,用WHONET5分析试验结果。 结果 :5 2 3株临床分离株对头孢地尼的敏感率范围为 91.3%～ 10 0 .0 % ,MIC50 和MIC90 范围分别为 0 .0 32～ 0 .2 5mg/L和 0 .0 6 4～ 1mg/L ,对头孢克洛的敏感率范围为 82 .6 %～ 10 0 .0 % ,MIC50 和MIC90 范围分别为 0 .2 5～ 4mg/L和 1～ 16mg/L。此外 ,30株青霉素中度敏感肺炎链球菌 (PISP)对头孢地尼和头孢克洛的敏感率分别为 6 6 .7%和 4 6 .7%。产ESBLs的 5 4株大肠埃希菌和 5 1株肺炎克雷伯菌及 8株青霉素耐药的肺炎链球菌 (PRSP)对这 2种头孢菌素的耐药率均为 10 0 %。结论 :对青霉素敏感的肺炎链球菌、甲氧西林敏感的金黄色葡萄球菌、流感嗜血杆菌、卡他莫拉菌、β溶血链球菌 ,非产ESBLs的大肠埃希菌和肺炎克雷伯菌 ,头孢地尼比头孢克洛有较高的抗菌活性和较低的MIC值。对PISP头孢地尼比头孢克洛有较好的抗菌活性 ,产ESBLs的大肠埃希菌和肺炎克雷伯菌及PRSP
Objective: To study the in vitro antibacterial activity of cefdinir and cefaclor on respiratory tract common isolates. Methods: The minimum inhibitory concentrations (MICs) of cefdinir and cefaclor on 523 clinical isolates were determined by agar dilution method. The MICs of penicillin against pneumococci were determined by Etest, and the bacterial β-lactamases were tested by Nitrocefin , Extended-spectrum beta-lactamases (ESBLs) of Escherichia coli and Klebsiella pneumoniae by disk validation, and the results of the assay were analyzed using WHONET5. Results: The sensitivity of 523 clinical isolates to cefdinir ranged from 91.3% to 100.0%, the MIC50 and MIC90 ranged from 0.032 to 0.25 mg / L and 0.604 ~ 1 mg / L, the susceptibility rate to cefaclor ranged from 82.6% to 100.0%, and the MIC50 and MIC90 ranged from 0.52 to 4 mg / L and 1 to 16 mg / L, respectively. In addition, the susceptibilities of 30 strains of penicillin-susceptible Streptococcus pneumoniae (PISP) to cefdinir and cefaclor were 66.7% and 46.7%, respectively. Five strains of ESBLs-producing Escherichia coli and 51 strains of Klebsiella pneumoniae and 8 strains of penicillin-resistant Streptococcus pneumoniae (PRSP) were 100% resistant to both cephalosporins. CONCLUSIONS: Penicillin-susceptible Streptococcus pneumoniae, methicillin-susceptible Staphylococcus aureus, Haemophilus influenzae, Moraxella catarrhalis, β-hemolytic streptococcus, non-ESBLs-producing Escherichia coli and Klebsiella pneumoniae Cefdinir had higher antibacterial activity and lower MIC value than cefaclor. Cefdinir PISP Cefaclor has better antibacterial activity, ESBLs-producing Escherichia coli and Klebsiella pneumoniae and PRSP