洋葱伯克霍尔德菌感染家兔抗感染疗效与体外药物敏感性的比较  

Comparison of the anti-infective drug sensitivity in rabbit model of Burkholderia cepacia infection and the effect of antimicrobial sensitivity monitoring in vitro

作　　者：吕火祥[1] 胡庆丰[1] 沈蓓琼[1] 杨广宇[1] 俞赛[2] 

机构地区：[1]浙江省人民医院检验医学中心,浙江杭州310014 [2]温州医学院检验医学院,浙江温州325035

出　　处：《中国微生态学杂志》2011年第7期658-660,共3页Chinese Journal of Microecology

基　　金：浙江省医药卫生科学研究基金(2007B006)

摘　　要：目的使用无CLSI完整解释标准的药物,哌拉西林/他唑巴坦、替卡西林/棒酸、头孢吡肟治疗洋葱伯克霍尔德菌感染的家兔模型,观察比较何种体外药物敏感试验更能准确反应临床疗效。方法 57株临床分离的洋葱伯克霍尔德菌,感染57只家兔腹腔。将感染家兔分成3组(A、B、C组),每组19只;分别在48、72、96、120和144 h注射药物:A组每只家兔注射1 mL浓度为2 g/mL哌拉西林/他唑巴坦;B组每只家兔注射1 mL浓度为0.1g/mL头孢吡肟;C组每只家兔注射1 mL浓度为0.6 g/mL替卡西林/棒酸。比较肉汤稀释法(MIC法)、K-B法及VITEK法检测的药物敏感性结果与体内药物治疗的疗效关系。结果哌拉西林/他唑巴坦治疗组(A组),K-B法检测结果与家兔感染模型治疗过程相符率为72.2%,MIC法66.7%,VITEK法为66.7%。替卡西林/棒酸治疗组(B组),MIC法83.3%,VITEK法为77.8%,K-B法检测结果与家兔感染模型治疗过程相符率为50.0%。头孢吡肟治疗组(C组),MIC法88.9%,VITEK法为77.8%,K-B法检测结果与家兔感染模型治疗过程相符率为72.2%。结论在3种药物敏感性检测法中,哌拉西林/他唑巴坦以K-B法检测结果与感染家兔的抗感染疗效最为接近;替卡西林/棒酸及头孢吡肟均以MIC法与感染家兔的抗感染疗效最为接近;针对洋葱伯克霍尔德菌的感染建议临床使用不同的方法检测不同的药物体外敏感性。Objective To treat rabbit models of Burkholderia cepacia infection by using drugs without complete CLSI interpretive standard,including piperacillin/tazobactam,ticarcillin/clavulanic acid and cefepime,and compare which drug sensitivity test in vitro can more accurately reflect the clinical efficacy.Methods 57 clinical isolates of Burkholderia cepacia were used to infect 57 rabbits intraperitoneally.The infected rabbits were divided into 3 groups（A,B and C）,19 in each group.Then,at 48,72,96,12 and 144 h,respectively,each rabbit in Group A was injected 1 mL of 2 g/mL Piperacillin-Tazobactam,each rabbit in Group B was injected 1 mL of 0.6 g/mL Ticarcillin-clavulanate,and each rabbits in Group C with 1 mL of 0.1 g/mL Cefepime.The sensitivity test results by MIC method,disc agar diffusion method（K-B method） and VITEK method and their relationship with the efficacy of treatment were compared.Results The consistency of K-B assay results of Piperacillin/tazobactam treatment group（group A） with the treatment of infection model was 72.2%,while that of MIC method was 66.7%,and that of VITEK method was 66.7% as well.In Ticarcillin/clavulanic acid treatment group（group B）,the consistency of MIC method was 83.3%,that of VITEK method was 77.8%,and that of K-B method was 50.0%.In Cefepime treatment group（group C）,the consistency of MIC method was 88.9%,that of VITEK method was 77.8%,and that of K-B method was 72.2%.Conclusion Among the 3 antimicrobial sensitivity test methods,the KB result of piperacillin/tazobactam was the closest to the results of anti-infective efficacy in infected rabbits,while the MIC results of ticarcillin/clavulanic acid and cefepime were the closest to the results of anti-infective efficacy;For the treatment of Burkholderia cepacia infection,it is suggested to determine the drug sensitivity in vitro using different methods.

关 键 词：洋葱伯克霍尔德菌 家兔 药物敏感性 疗效 

分 类 号：R378[医药卫生—病原生物学]