Recent advances in the development of antibacterial potentiators / 中华检验医学杂志

Multidrug-resistant bacteria that can′t be treated with any common antibacterial drugs have become a global medical crisis. Therefore, there is an urgent need for new antibacterial potentiators to restore the sensitivity of bacteria to the antibacterial drug. This review elaborates on the novel antibacterial synergistic methods and their underlying mechanisms, clinical experimental data and efficacy, and the progress of drug research and development. This review aims to raise awareness about antibacterial potentiators among the public.

Analysis on sensitivity of β-lactam/β-lactamase inhibitors to bifidobacteria and lactobacilli / 重庆医学

Objective To analyze the susceptibility situation of bifidobacteria and lactobacilli from child intestinal tract on β-lactam/β-lactamase inhibitor complex.Methods According to the method of the Bergey Bacterial Identification Manual,45 strains of bifidobacteria and 39 strains of lactobacilli were isolated from the stool specimens of 36 healthy children.The susceptibility tests of bifidobacteria and lactobacilli to ampicillin,amoxicillin/clavulanate,ampicillin/sulbactam,piperacillin,piperacillin/tazobactam,ticarcillin,ticarcillin/clavulanate,cefoperazone and cefoperazone/sulbactam were performed by adopting the E-test method.Then the statistical analysis was conducted.Results The sensitivity percentages of 45 strains of bifidobacteria to ampicillin,amoxicillin/clavulanate,ampicillin/sulbactam,piperacillin,piperacillin/tazobactam,ticarcillin,ticarcillin/clavulanate and cefoperazone were 77.78％,95.56％,88.89％,73.33％,91.11％,68.89％,84.44％ and 82.22％ respectively,which of 39 strains of lactobacilli to above antibiotic drugs were 74.36％,94.87％,92.31％,71.79％,92.31％,69.23％,89.74％ and79.49％,respectively.Except having no judgment due to without the CLSI drug susceptibility MIC interpretation criteria of cefoperazone/sulbactam,the sensitivity percentages of other β-lactam/β-lactamase inhibitor complex were higher than those of single β-lactam antibi otics,the sensitive number P values of bifidobacteria in ampicillin with amoxicillin/clavulanate and piperacillin with piperacillin/tazobactam were 0.01 and 0.03 respectively,which of lactobacilli in ampicillin with amoxicillin/clavulanate,ampicillin with ampicillin/sulbactam,piperacillin with piperacillin/tazobactam,ticarcillin with ticarcillin/clavulanate were 0.01,0.03,0.02 and 0.03 respectively.Conclusion β-lactam/β-lactamase inhibitors complex has stronger effect for inhibiting child intestinal tract bifidobacteria and lactobacilli than single β-lactam antibiotics.

Incidence and risk factor analysis of antibiotic-associated diarrhea of pediatric patients with severe bacterial pneumo-nia / 临床儿科杂志

ObjectiveTo investigate the incidence and risk factors of antibiotic-associated diarrhea (AAD) of pediatric patients with severe bacterial pneumonia.MethodsClinical data of 1086 pediatric patients with severe bacterial pneumonia from January 2010 through January 2014 were recruited. The incidence and risk factors of AAD were retrospectively analyzed. ResultsThe incidence of AAD in 1086 pediatric patients with severe bacterial pneumonia was 36.74%. The incidence of AAD in patients younger than 2 years old were higher than that in those older than 2 years, once or more times of mechanical venti-lation history were higher than that with no arrangements of this treatment, administering of combined antibiotics therapy were higher than that with single antibiotics, and the incidence of AAD due to amoxicillin/clavulanate, piperacillin/tazobactam, cefo- perazone/sulbactam in pediatric patients were 43.55%, 43.75%, and 45.03%, respectively. Three β-lactam/β-lactamase inhibitors above were risk factors of AAD through multivariate Logistic regression analysis.ConclusionThe high incidence of AAD in pediatric patients with severe bacterial pneumonia was associated with some risk factors, including younger than 2 years old, me-chanical ventilation, combined antibiotics therapy and administration of β-lactam/β-lactamase inhibitor (amoxicillin/clavulanate, piperacillin/tazobactam, cefoperazone/sulbactam).

Role of β−lactamase in the susceptibility of clinical isolates to β−lactam antibiotics.

Combination of β−lactam antibiotic with β−lactamase inhibitor has been proven to overcome resistance caused by β−lactamase production. An evaluation to the MIC of some β−lactam antibiotics to β−lactamase producing isolates will be reported. A. anitratus, E. coli, K. pneumoniae, Proteus sp, Pseudomonas sp, S. aureus, S. epidermidis, S. pneumoniae, S. viridans, and β−hemolytic Streptococcus, were challenged to Ampicillin/Sulbactam (AMS), Amoxicillin/Clavulanic acid (AMC), Cefoperazone (CFP), Cefoperazone/Sulbactam (CSL), Ceftriaxone (CRO), dan Cefotaxime (CTX) using ETest techniques. β−lactamase production was identified using Cefinase disk. Sixtyfour percent of isolates were capable of producing β−lactamase. All E. coli and K. pneumoniae tested were β−lactamase producer, none of Proteus sp, Pseudomonas sp, and S. epidermidis tested produced β−lactamase. In β−lactamase producing group, Sulbactam was able to reduce resistance to CFP from 25% to 5%. About 20% of β−lactamase producing isolates which were resistant to CFP, were susceptible to CSL. Susceptibility of S.viridans to AMS, AMC, CFP, and CSL was higher than 80%, but less than 50% to CRO and CTX. S. pneumoniae was less susceptible to tested antibiotics, 50 to 60% susceptibility was shown to AMC, CFP, and CSL. S.aureus was 60 to 70% susceptible, while β−haemolytic Streptococcus showed good response to the tested antibiotics. Only 30% or less of K. pneumoniae and E. coli was susceptible to AMS and AMC. A. anitratus showed good susceptibility only to AMS (78%) and CSL (89%). Sixtyfour percent of isolate studied produced β−lactamase. β−lactamase inhibitor could reduce resistance of β−lactamase producing organism to β−lactam antibiotic from 25 to 5 percent.