4种外排泵抑制剂对鲍曼不动杆菌耐药性的抑制影响  

Reversal of multidrug-resistance in Acinetobacter baumannii by four efflux pump inhibitors

作　　者：周云[1] 凌保东[2] 

机构地区：[1]川北医学院药物研究所药理学教研室,南充637000 [2]成都医学院药物研究所药理学教研室,成都610500

出　　处：《中国抗生素杂志》2013年第6期461-466,472,共7页Chinese Journal of Antibiotics

基　　金：四川省重点科技资助项目(2013jy0065)

摘　　要：目的检测4种外排泵抑制剂对5种抗菌药物耐药的影响,了解主动外排泵耐药机制在鲍曼不动杆菌菌株中的作用,为外排泵抑制剂的开发和鲍曼不动杆菌感染的治疗提供实验室数据。方法临床收集鲍曼不动杆菌116株,采用琼脂平皿二倍稀释法测定5种抗菌药物对实验菌株的最低抑菌浓度(MIC),同批测定加入外排泵抑制剂后抗菌药物的MIC值。结果庆大霉素加羰基氰氯苯腙(CCCP)后显示出外排阳性的菌株数量最多,有87株(75%);其他显示外排阳性菌株的数量分别为:利血平+氯霉素(46.6%),奥美拉唑+氯霉素(33.6%),维拉帕米+庆大霉素(17.2%)。外排泵抑制剂对头孢唑林的耐药性无影响。结论 4种所用外排泵抑制剂可不同程度逆转鲍曼不动杆菌的耐药,以CCCP筛选外排阳性菌效果最佳。当存在明显的酶水解耐药机制时,外排泵抑制剂对耐药性无影响。Objective To understand the role and distribution of multidrug efftux pumps in clinical isolates of Acinetobacter baumannii through antimicrobial susceptibility testing in the absence or presence of one of 4 efflux pump inhibitors （EPIs） and thus to provide information for selection of antibiotics for the treatment of mutlidrug- resistant infections. Methods A total of 116 non-duplicate clinical isolates were recovered and antimicrobial susceptibility was conducted by agar dilution methods with or without the inclusion of an EPI. Results The results showed that 87 isolates （75%） after treatment of gentamicin with carbonyl cyanide-m-chlorophenylhydrazone （CCCP） were positive of efflux mechanism. The treatment of reserpine with chloramphenicol, omeprazole with chloramphenicol, and verapamil with gentamicin suggested 46.6%, 33.6% and 17.2%, respectively. EPIs did not have impact on resistance to cefazolin. Conclusion These 4 EPIs tested partially reversed the multidrug resistance of A. baumannii and CCCP appears to be an optimal agent for assessing the presence of multidrug efflux pumps. However, with a predominant presence of enzymatic drug inactivation mechanism, effect of EPIs can be masked.

关 键 词：鲍曼不动杆菌 外排泵抑制剂 

分 类 号：R378[医药卫生—病原生物学]