依替米星体外抗菌活性及其与β-内酰胺类抗菌药物的协同作用研究  

In vitro Antimicrobial Activity of Etimicin and Its Synergistic Effect with β-Lactams

作　　者：杨启文[1] 徐英春[1] 王辉[1] 张小江[1] 谢秀丽[1] 原英[1] 陈民钧[1] 

机构地区：[1]中国医学科学院北京协和医院检验科,北京100730

出　　处：《中华医院感染学杂志》2008年第7期1010-1013,共4页Chinese Journal of Nosocomiology

摘　　要：目的研究依替米星对临床常见病原菌的体外抗菌活性以及依替米星与β-内酰胺类抗菌药物的联合抑菌效果。方法纸片扩散法比较依替米星与其他药物对临床常见病原菌的体外抗菌活性,肉汤棋盘法测试依替米星与哌拉西林对甲氧西林敏感金黄色葡萄球菌(MSSA)和依替米星与头孢他啶对铜绿假单胞菌的体外协同作用。结果依替米星对克雷伯菌属、非产超广谱β-內?访?ESBLs)的大肠埃希菌、肠杆菌属、变形菌属保持了较高的活性(敏感率68.9%～100.0%),对MSSA和凝固酶阴性葡萄球菌的敏感率也较高(85.1%～96.3%),对铜绿假单胞菌的敏感率为59.8%;在氨基糖苷类药物中,其敏感率高于庆大霉素,稍逊于阿米卡星;依替米星与哌拉西林对MSSA的联合抑菌效应,以及依替米星与头孢他啶对铜绿假单胞菌的联合抑菌效应均获得90.0%的协同率,联合后各抗菌药物的MIC50及MIC90均比单药的MIC50、MIC90低75.0%～87.5%。结论依替米星对大多数临床分离菌株有较高的体外抗菌活性,其与β-内酰胺类药物在体外对MSSA和铜绿假单胞菌有较好的联合抑菌效果。OBJECTIVE To investigate the in vitro activity of etimicin against clinically isolated pathogens and the in vitro combination effect of etimicin and β-lactams. METHODS The in vitro activity of etimicin against clinically isolated pathogens with other antibiotics by disk diffusion test was compared. The in vitro combination effects of etimicin-piperacillin against meticillin-susceptible Staphylococcus aureus （MSSA） and etimicin-ceftazidime against Pseudomonas aeruginosa were investigated by broth checkerboard test. RESULTS Etimicin had high in vitro activity against Klebsiella spp, non-ESBLs-producing Escherichia coil, Enterobacter spp and Proteus spp （susceptibility rate 68.9-100.0 %）. It also had good activity against MSSA and coagulase-negative Staphylococcus （susceptibility rate 85. 1-96. 3%）. The susceptibility rate against P. aeruginosa was 59. 8%. The activity of etimicin was higher than gentamicin and lower than amikacin. Both the synergistic rate of etimicin-piperacillin against MSSA and etimicin-ceftazidime against P. aeruginosa were 90%. The MIC50 and MIC90 in combination were 4-8 times lower than those of single drug. CONCLUSIONS Etimicin has high in vitro activity against most clinically isolated pathogens. The combination of etimicin and %-lactams has good in vitro ＇synergistic effect against MSSA and P. aeruginosa.

关 键 词：依替米星 协同 抗菌药物 

分 类 号：R978.1[医药卫生—药品]