药物对美罗培南抑制耐碳青霉烯类抗菌药物鲍曼不动杆菌的影响  

Antibacterial effects of some drugs on meropenem against the carbapenem-resistant Acinetobacter baumannii in vitro

作　　者：于亮[1] 王梅[1] 姜梅杰[1] 李玉臣[1] 刘爱华[1] 

机构地区：[1]山东省泰安市中心医院呼吸重症科,泰安市271000

出　　处：《中华实验和临床感染病杂志（电子版）》2012年第6期91-94,共4页Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition)

摘　　要：目的探讨体外药物对美罗培南抑制耐碳青霉烯类抗菌药物的鲍曼不动杆菌的影响。方法采用PCR法对6株耐碳青霉烯类抗菌药物的鲍曼不动杆菌产生碳青霉烯酶进行鉴定;微量肉汤稀释法观察大蒜素、头孢哌酮/舒巴坦和美罗培南的最小抑菌浓度值(MIC),计算大蒜素、头孢哌酮/舒巴坦分别与美罗培南两药联用的部分抑制浓度指数(FIC)。检测维生素C联用美罗培南和单用美罗培南的抑菌率。结果鲍曼不动杆菌IMP、OXA-23型碳青霉烯酶基因PCR扩增阳性。大蒜素、美罗培南、头孢哌酮/舒巴坦对6株耐碳青霉烯类抗菌药物鲍曼不动杆菌的MIC值分别为512mg/L、128mg/L和1024mg/L,大蒜素联用美罗培南的FIC值为0.25,头孢哌酮/舒巴坦联合美罗培南的FIC值为1.25。亚抑菌状态下,相同浓度美罗培南联合维生素C后,其抑菌率显著降低。结论头孢哌酮/舒巴坦联用美罗培南对本研究组中的耐碳青霉烯类抗菌药物的鲍曼不动杆菌无协同作用;大蒜素联用美罗培南对本研究组中的耐碳青霉烯类抗菌药物的鲍曼不动杆菌具有体外协同作用;维生素C可降低美罗培南的抑菌率。Objective To investigate the antibacterial effects of some drugs on meropenem against the carbapenem-resistant Acinetobacter baumannii in vitro. Methods The carbapenemase genotypes produced by Acinetobacter baumannii were identified by PCR. Bio-detection microplate assay were applied to determine MIC values for Acinetobacter baumannii to the allicin, meropenem and cefoperazone sulbactam, and calculated the FIC indexes of cefoperazone sulbactam with meropenem and allicin combined with meropenem. The inhibitory rates of meropenem alone and meropenem combined with vitamin C were also detected by microplate assay. Results All resistant Acinetobacter baumannii produced IMP and OXA-23 typed carbapenemases. MIC values of allicin, cefoperazone sulbactam and meropenem were 512 mg/L, 128 mg/L and 1024 mg/L, respectively. FIC values of allicin combined with meropenem and cefoperazone sulbactam combined with meropenem were O. 25 and 1.25, respectively. The rate of bacterial inhibition reduced significantly after the same concentration of meropenem combined with vitamin C in sub-MIC mode. Conclusions Allicin had antibiotic synergy effects with meropenem in vitro for carbapenem-resistant Acinetobacter baumannii, which did not occur for cefoperazone sulbactam, vitamin C could decrease the bacterial inhibitory rate of meropenem.

关 键 词：碳青霉烯酶 鲍曼不动杆菌 美罗培南 维生素C 头孢哌酮 舒巴坦 大蒜素 

分 类 号：R446.5[医药卫生—诊断学]