碳青霉烯耐药鲍曼不动杆菌的联合药敏研究  

Combined drug sensitivity test of carbapenem-resistant acinetobacter Baumannii

作　　者：夏静静[1] 龚美亮[2] 徐雅萍[2] 周玉[2] 方向群[1] 

机构地区：[1]解放军总医院南楼呼吸科,北京100853 [2]解放军总医院南楼检验科,北京100853

出　　处：《军医进修学院学报》2012年第2期179-180,F0003,共3页Academic Journal of Pla Postgraduate Medical School

摘　　要：目的评价头孢哌酮/舒巴坦(CFS)与利福平(RFP)、米诺环素(MIN)及左氧氟沙星(LEV)对临床分离碳青霉烯耐药鲍曼不动杆菌(CRAB)的体外联合抑菌作用。方法采用棋盘法设计,微量肉汤稀释法测定抗菌药物对60株临床分离的CRAB的最低抑菌浓度(MIC),并计算抑菌指数(FIC指数)判断联合抑菌效应。结果 CFS与RFP联用后,80%为协同作用,16.7%为相加作用,3.3%为无关作用,无拮抗作用;CFS与MIN联用后,11.7%为协同作用,45%为相加作用,35%为无关作用,8.3%为拮抗作用;CFS与LEV联用时,6.7%为协同作用,40%为相加作用,53.3%为无关作用,无拮抗作用。上述药物联用后,各药MIC50均明显降低,浓度-累积抑菌率曲线均表现为左移。结论 CFS与RFP、MIN联用对CRAB体外联合抗菌效应主要表现为协同和相加作用。CFS与LEV联用主要表现为无关作用,但仍有近半数菌株表现为协同和相加作用。Objective To evaluate the combined in vitro inhibitory effect of cefoperazone/sulbactam （CFS）, rifampicin （RFP）, minocycline（MIN） and levofloxacin（LEV） on clinically isolated carbapenem-resistant acinetobacter Baumannii （CRAB） strains. Methods Combined in vitro inhibitory effect of CFS, RFP, MIN and LEV was assayed by detecting the maximal inhibitory concentration and calculating the fractional inhibitory concentration （FIC） index for 60 CRAB strains with the micro-broth dilution method. Results Combined CFS and RFP showed 80% synergic effect, 16.7% additive effect, 3.3% indifferent effect and no antagonistic effect on CRAB strains. Combined CFS and MIN displayed tl .7% synergic effect, 45% additive effect, 35% indifferent effect and 8.3% antagonistic effect on CRAB strains. Combined CFS and LEV demonstrated 6.7% synergic effect, 40% additive effect, 53.3% indifferent effect and no antagonistic effect on CRAB strains. The MICso of these drugs was significantly lower when they were used in combination with their concentration-accumulative curves shifted to the left. Conclusion Combined CFS, RFP and M1N shows a combined in vitro synergic and additive inhibitory effect on CRAB strains. Combined CFS and LEV displays an indifferent effect on CRAB strains, and a synergic and additive effect on nearly 50% CRAB strains.

关 键 词：头孢哌酮/舒巴坦 利福平 米诺环素 左氧氟沙星 鲍曼不动杆菌 碳青霉烯耐药 联合用药 药敏实验 

分 类 号：R453.2[医药卫生—治疗学]