亚胺培南联合头孢哌酮／舒巴坦对耐碳青霉烯鲍曼不动杆菌的抗菌作用  

The antibacterial activity of imipenem in combination with cefoperazone-sulbactam against carbapenemresistant Acinetobacter baumannii

作　　者：于亮[1] 王梅[1] 

机构地区：[1]山东省泰安市中心医院呼吸重症科,271000

出　　处：《中华传染病杂志》2013年第7期396-398,共3页Chinese Journal of Infectious Diseases

摘　　要：目的探讨亚胺培南与头孢哌N／舒巴坦在抗耐碳青霉烯鲍曼不动杆菌中的相互作用。方法检测亚胺培南、头孢哌酮／舒巴坦对26株耐碳青霉烯鲍曼不动杆菌的最低抑菌浓度（MIC）值，计算亚胺培南与头孢哌酮／舒巴坦联用时的部分抑菌浓度（FIC）指数，琼脂板纸片扩散法（K—B法）检测亚胺培南与头孢哌酮／舒巴坦的相互作用。结果亚胺培南和头孢哌N／舒巴坦的MIC。值均为16mg／L，MIC。值均为64mg／L。亚胺培南与头孢哌N／舒巴坦联用时的FIC指数≤O．5者16株，FIC指数≥2．O者lO株。对FIC值≤O．5细菌，亚胺培南与头孢哌酮／舒巴坦联用呈协同作用；对FIC值≥2．0细菌，亚胺培南与头孢哌酮／舒巴坦联用呈拮抗作用。结论对于耐碳青霉烯鲍曼不动杆菌，亚胺培南与头孢哌N／舒巴坦联用对其表现为拮抗或协同的抗菌作用，临床上治疗耐碳青霉烯鲍曼不动杆菌感染应慎用头孢哌酮／舒巴坦联合亚胺培南，防止两药产生拮抗作用。Objective To investigate the interaction of in vitro antibacterial activity between cefoperazone sulbactam and imipenem against carbapenem-resistant Acinetobacter baumannii. Methods The minimum inhibitory concentrations （MIC） of imipenem and cefoperazone-sulbactam against Acinetobacter baumannii were detected and the fractional inhibitory concentration （FIC） index of imipenem/cefoperazone-sulbactam combination was calculated by broth micro-dilution method. The interactions of imipenem and cefoperazone-sulbactam were assayed by K-B agar plate method. Results The MICs0 of cefoperazone-sulbactam and imipenem were both 16 rag/L, and MICg0 of the two drugs were both 64 mg/L. Among the 26 strains of Acinetobacter baumannii, 16 strains had FIC indexes 40.5, and 10 had FIC indexes2. 0. K-B agar plate assay showed that the cefoperazone- sulbactam/imipenem combination was synergistic for strains with FIC indexes0.5, and antagonistic for strains with FIC indexes 2. 0. Conclusions Imipenem in combination with cefoperazone- sulbactam can be either antagonistic or synergistic against carbapenem-resistant Acinetobacter baurnannii. The clinical use of cefoperazone-sulbactam/imipenem combination for the treatment of carbapenem resistance Acinetobacter baumannii infections should be cautious in case of antagonism.

关 键 词：亚胺培南 头孢哌酮 舒巴克坦 鲍氏不动杆菌 

分 类 号：R96[医药卫生—药理学]