左氧氟沙星联合阿米卡星对肺炎克雷伯菌耐药突变选择窗的研究  

Study of levofloxacin combined with amikacin on Mutant selection window against Klebsiella Pneumoniae

作　　者：邵世峰[1] 张丽霞[1] 刘刚[1] 杜钟珍[1] 吴琦[1] 

机构地区：[1]天津市海河医院,天津300350

出　　处：《临床肺科杂志》2012年第8期1379-1381,共3页Journal of Clinical Pulmonary Medicine

摘　　要：目的探讨左氧氟沙星联合阿米卡星对肺炎克雷伯菌突变选择窗(MSW)的影响。方法琼脂倍比稀释法测定左氧氟沙星及其与阿米卡星联合对30株肺炎克雷伯菌的防突变浓度(MPC)和最低抑菌浓度(MIC),计算并比较左氧氟沙星单独及其与阿米卡星联合对肺炎克雷伯菌的选择指数(SI)。结果与阿米卡星联合,使左氧氟沙星对肺炎克雷伯菌的MPC范围由2～16 mg/l降至1～8 mg/L,MPC50由2 mg/L降至1 mg/L,MPC90由8 mg/L降至2 mg/L,P<0.01;左氧氟沙星单药及与联合阿米卡星对肺炎克雷伯菌的选择指数(SI)范围均在2～64,两组SI50均为16;SI90均为32,P>0.05;左氧氟沙星联合阿米卡星组较左氧氟沙星组SI降低的菌株有15株,无变化的有11株,增高的为4株。结论联合阿米卡星可降低左氧氟沙星对肺炎克雷伯菌的MPC,主要使左氧氟沙星对肺炎克雷伯菌的MSW变窄。Objective To evaluate the influence of combined with amikacin on the mutant selection window （MSW） of levofloxacin against Klebsiella Pneumoniae. Methods the mutant prevent concentration （MPC） and MIC of levofloxacin alone and combined with ami- kacin against 30 strains Klebsiella Pneumoniac were determined by agar plates dilution method,respectively. The selection index （SI） be- tween levofloxaein alone and combined with amikacin against Klebsiella Pneumoniae were calculated and compared. Results Combined with amikaciu, MPC range of levofloxacin against Klebsiella Pneumoniae were down from 2 - 16 mg/L to 1 - 8 mg/L, MPC50 down from 2 mg/L to 1 mg/L, MPC90 down from 8 mg/L to 2 mg/L, P 〈 0.01 ; SI range, SI50 and SI90 of levofloxacin alone group were equal to levoflox- acin combined with amikacin group. SI range 2 - 64, SI50 = 16, SI90 = 32, P 〉 0. 05 ; Compared with levofloxacin alone group, there were 15 strains of Klebsiella Pneumoniae which SI decreased, there were 11 strains which SI non-changed, and 4 strains which SI increased, in levofloxacin combined with amikacin group. Conclusion Combined with amikacin could decrease the MPCs of levofloxacin against Kleb- siella Pneumonia, The influence of combined with amikacin on MSW of levofloxacin against Klebsiella Pneumonia was that MSW was nar- rowed, non-changed or enlarged. The major influence was the MSW narrowed.

关 键 词：左氧氟沙星 肺炎克雷伯菌 突变选择窗 联合 

分 类 号：R446.5[医药卫生—诊断学]