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目的为临床合理应用抗生素提供科学依据。方法选择2003-06~2004-06从中国医科大学附属第一医院收治患者中分离出的黏质沙雷菌和阴沟杆菌野生型(10株)及高诱导型(5株)实验菌株进行头孢他啶筛选实验后测定AmpC酶活性,用三维试验检测突变,并计算突变率。结果野生型黏质沙雷菌、阴沟杆菌及高诱导型黏质沙雷菌经头孢他啶筛选后未检测出AmpC酶活性。高诱导型阴沟杆菌,诱导剂浓度为2倍最低抑菌浓度(2MIC)时与MIC、1/2MIC相比AmpC酶活性、突变率差异有显著性意义,而MIC与1/2MIC相比差异无显著性意义。结论头孢他啶对AmpC酶诱导作用具有菌种差异性,对同一菌种不同表型诱导性差异有显著性意义;诱导剂浓度是影响AmpC酶活性的因素。
Objective To provide a scientific basis for clinical rational use of antibiotics. Methods From 2003-06 to 2004-06, ceftazidime was screened from wild-type (10 strains) and high-induced (5 strains) strains of Serratia marcescens and Enterobacter cloacae isolated from patients admitted to the First Affiliated Hospital of China Medical University from 2003-06 to 2004-06. The AmpC enzyme activity was determined after the experiment, the three-dimensional test was used to detect the mutation, and the mutation rate was calculated. Results AmpC enzyme activity was not detected after screening of wild-type Serratia marcescens, Enterobacter cloacae and high inducible Serratia marcescens with ceftazidime. Compared with MIC and 1 / 2ICIC, AmpC enzyme activity and mutation rate of high-inducible Enterobacter cloacae inducing agent 2-fold minimum inhibitory concentration (2MIC) were significantly different, while the difference between MIC and 1 / 2MIC was no significant difference Significant significance. Conclusions Ceftazidime has different species-inducing effects on AmpC enzyme, and has significant difference on the induction of different phenotypes of the same species. The concentration of inducer is the factor that affects AmpC enzyme activity.