多黏菌素B与其他抗菌药物联用对泛耐药铜绿假单胞菌体外抗菌活性的研究  

In vitro activities of polymyxin B in combination with other antimicrobials against pan-drug-resistant strains of Pseudomonas aeruginosa

作　　者：刘立凡[1,2] 李丹[1] 褚云卓[3] 陈佰义[1] 

机构地区：[1]中国医科大学附属第一医院感染病科,沈阳110001 [2]沈阳医学院沈洲医院干诊科,沈阳110002 [3]中国医科大学附属第一医院检验科,沈阳110001

出　　处：《中国抗生素杂志》2012年第7期524-527,共4页Chinese Journal of Antibiotics

摘　　要：目的评价多黏菌素B与左氧氟沙星、亚胺培南、哌拉西林／三唑巴坦体外联合应用，对临床分离的30株泛耐药铜绿假单胞菌的抗菌效应。方法采用微量肉汤稀释法、棋盘设计法测定多黏菌素B与左氧氟沙星、亚胺培南及哌拉西林／三唑巴坦单用及联合应用对临床分离的30株泛耐药铜绿假单胞菌的最小抑菌浓度（MIC），并计算FIC指数，判定联合效应：FIC≤0．5为协同作用，0．5〈FIC≤1．0为相加作用，1．0〈FIC≤2．0为无关作用，FIC〉2．0为拮抗作用。结果多黏菌素B与左氧氟沙星、亚胺培南及哌拉西林／三唑巴坦联用后，各种药物对泛耐药铜绿假单胞菌的MIC值均显著降低，FIC指数在0～0．5、0．5～1的百分率分别为：左氧氟沙星联合组66．67％、26．67％，亚胺培南联合组46．67％、40％，哌拉西林／三唑巴坦联合组60％、33．33％。结论多黏菌素B与左氧氟沙星、亚胺培南、哌拉西林／三唑巴坦联用，对临床分离的30株泛耐药铜绿假单胞菌抗菌作用以协同和相加为主，无拮抗作用。Objective To evaluate the in vitro activities of polymyxin B in combination with levofloxacin, imipenem and piperacillin/tazobactam against 30 strains of pan-drug resistant Pseudomonas aeruginosa. Methods The MICs of polymyxin B and levofloxacin, imipenem piperacillin/tazobactam in single-use or in combination against 30 strains of pan-drug resistant Pseudomonas aeruginosa were determined by broth microdilution method and checkerboard method. The FIC index was calculated according to MIC results. Results The MICs of polymyxin B combined with levofloxacin, imipenem and piperacillin/tazobactam were reduced significantly compared with single- use. The percentage of the FIC indexes less than 0.5, between 0.5 and 1 were 66.67% and 26.67% in levofloxacin combination group, 46.67% and 40% in imipenem combination group, 60% and 33.33% in piperacillin/tazobactam combination gorup. Conclusions The results indicate that the combinations of polymyxin B with levofloxacin, imipenem and piperacillin/tazobactam have good synergistic and additive effects against pan-drug resistant Pseudomonas aeruginosa, there is no antagonism.

关 键 词：泛耐药铜绿假单胞菌 多黏菌素B 联合用药 FIC 

分 类 号：R378.991[医药卫生—病原生物学]