克林霉素对小鼠社区获得性耐甲氧西林金黄色葡萄球菌肺炎的治疗价值  

Efficacy of clindamycin for treatment of community-acquired methicillin-resistant Staphylococcus aureus pneumonia in a murine model

作　　者：徐若男[1] 胡旸[1] 刘颖梅[1] 张隽[1] 焦风伟[1] 杨爽利[1] 曹彬[1] 童朝晖[1] 

机构地区：[1]首都医科大学附属北京朝阳医院北京市呼吸疾病研究所,100020

出　　处：《国际呼吸杂志》2013年第10期721-725,共5页International Journal of Respiration

基　　金：国家自然科学基金（81050030）;北京市自然科学基金（7102064）

摘　　要：目的研究克林霉素对小鼠社区获得性耐甲氧西林金黄色葡萄球菌（CA-MRSA）肺炎的疗效。方法将63只小鼠随机分为对照组、高菌量组和低菌量组，分别经鼻滴人等体积的PBS、高浓度CA—MRSA菌液和低浓度CA—MRSA菌液。感染后6h再分别将高菌量组和低菌量组小鼠随机分为感染组和克林霉素组，分别经腹腔注射双蒸水和克林霉素溶液。观察高菌量组小鼠的生存时间。检测低菌量组小鼠的肺部载菌量和病理变化，支气管肺泡灌洗液（BALF）中肿瘤坏死因子a（TNF-a）和巨噬细胞炎症蛋白2（MIP-2）的浓度、白细胞和中性粒细胞计数。结果感染组小鼠的生存率为33．3％，肺组织中有大量细菌繁殖，肺组织实变，甚至坏死，BALF中TNF—a和MIP-2的浓度、白细胞和中性粒细胞计数均较对照组明显升高。与感染组比较，克林霉素组小鼠的生存率提高，肺组织的载菌量、病理损伤、炎症指标均明显减轻。结论本实验成功建立了小鼠CA—MRSA肺炎模型，克林霉素对CA—MRSA肺炎有重要的治疗价值。Objective To investigate the efficacy of clindamycin in the treatment of community- acquired methicillin resistant Staphylococcus aureus （CA-MRSA） pneumonia in mice. Methods 63 BALB/c mice were randomly divided into control group, high and low inoculation group, which were respectively administrated intranasally PBS,high and low CA MRSA inoculum. At 6 h after inoculation, mice from high and low CA MRSA inoculation group were then respectively divided into infection group and clindamycin group, which were respectively administrated double distilled water and clindamycin by intraperitoneal injection. The survival time of the mice from high inoculation group was observed. For the mice from low inoculation group, the bacteria loading and histopathology changes in the lung were investigated. In bronchoalveolar lavage fluid （BALF）, the levels of tumor necrosis factor-~ and macrophage inflammatory protein-2 were measured and the leukocytes and neutrophil were counted. Results Compared with the mice from control group, those from infection group presented lower survival rate, higher bacteria loading, and more severe damage in the lung, as well as more inflammatory cells and inflammatory factors in BALF. In addition, the survival rate, bacteria loading, pathological changes and inflammatory reactions were significantly improved in the mice from clindamycin group compared with those from infection group. Conclusions Our study indicates that clindamycin is an attractive option for the treatment of CA-MRSA pneumonia.

关 键 词：克林霉素 社区获得性耐甲氧西林金黄色葡萄球菌 肺炎 

分 类 号：R446.5[医药卫生—诊断学]