头孢吡肟对产质粒型AmpC酶铜绿假单胞菌大鼠肺炎的治疗作用研究  

Efficacy of cefepime on pneumonia caused by Pseudomonas aeruginosa producing plasmid AmpC β-lactamase in rats

作　　者：刘立坤[1] 薛芳[2] 李永乾[1] 

机构地区：[1]河北医科大学第三医院输血科,石家庄050051 [2]河北医科大学,石家庄050017

出　　处：《国际呼吸杂志》2011年第2期99-102,共4页International Journal of Respiration

摘　　要：目的 评价头孢吡肟对产质粒介导AmpC酶铜绿假单胞菌感染治疗效果.方法 选取产质粒介导AmpC酶铜绿假单胞菌3株,建立大鼠肺炎模型.3株菌体外药物敏感试验对头孢他啶均耐药,第1株菌对头孢吡肟敏感（MIC=4 mg/L）,第2株对头孢吡肟在敏感折点（MIC=8 mg/L）,第3株菌对头孢吡肟耐药（MIC=16 mg/L）,每组设2个亚组（头孢吡肟亚组和生理盐水对照亚组）,治疗96 h后评价治疗效果.结果 第1组头孢吡肟亚组生存率（80.8%）高于后两组（61.5%、50.0%）和生理盐水对照亚组（34.6%）,肺组织匀浆菌落计数（10.3±3.2）低于后两组（12.0±2.6、12.1±1.8）和生理盐水对照亚组（15.3±4.9）（P值均＜0.05）.第2组头孢吡肟亚组生存率（61.5%）高于第3组（50.0%）和生理盐水对照亚组（30.8%）,肺组织匀浆菌落计数（12.0±2.6）低于生理盐水对照亚组（16.0±5.5）（P值均＜0.05）.结论 体外药敏试验中头孢吡肟在敏感折点MIC=8 mg/L时对大鼠肺炎模型的治疗效果明显低于MIC＜8 μg/ml的治疗效果.Objective To investigate the efficacy of cefepime on pneumonia caused by Pseudomonas aeruginosa producing plasmid AmpC β-lactamase. Methods Three strains of Pseudomonas aeruginosa were used to make pneumonia rat model. The drug sensitivity test showed that three strains were all resistant to ceftazidime. The first strain was sensitive to cefepime （MIC=4 mg/L）, the sensitivity of the second strain to cefepime was at turning point （MIC=8 mg/L）, the third strain was resistant to cefepime （MIC=16 mg/L）. Each group was divided into two subgroups： cefepime subgroup and normal sodium subgroup. The efficacy was evaluated at 96 h after treatment. Results In the first group, the survival rate in cefepime subgroup （80. 8 % ）was higher than that in other two groups （61.5 %, 50.0% ） and normal sodium subgroup （34.6%）, the bacterial count in cefepime subgroup （10. 3±3. 2） was lower than that in other two groups （ 12.0± 2.6,12. 1 ±1.8） and normal sodium subgroup （ 15.3 ± 4.9） （all P 〈0. 05）. In the second group, the survival rate in cefepime subgroup （61.5 % ）was higher than that in the third group （50. 0 % ） and normal sodium subgroup （30.8 % ）, the bacterial count in cefepime subgroup （ 12.0 ± 2.6）was lower than that in normal sodium subgroup （16.0±5.5） （all P 〈0.05）. Conclusions The efficacy of cefepime on pneumonia rats at MIC=8 mg/L is lower than that at MIC〈8 mg/L.

关 键 词：头孢吡肟 铜绿假单胞菌 AMPC β-内酰胺酶 

分 类 号：R446.5[医药卫生—诊断学]