替加环素与头孢哌酮/舒巴坦联用对耐亚胺培南鲍曼不动杆菌体外抗菌活性分析  

In vitro effect of cefoperazone/sulbactam combined the tigecyclin on imipenem-resistant Acinetobacter baumannii clinical isolates

作　　者：龚燕飞 曾强 刘湘林 张祖萍[2] 陈中湘 彭华 

机构地区：[1]岳阳市第一人民医院检验科,岳阳414000 [2]中南大学湘雅医学院,长沙410000

出　　处：《中国抗生素杂志》2013年第12期947-950,959,共5页Chinese Journal of Antibiotics

基　　金：湖南省科技计划项目;项目编号:2011SK3040

摘　　要：目的分析替加环素与头孢哌酮／舒巴坦联用，对耐亚胺培南的鲍曼不动杆菌（IRAB）体外抗菌活性。方法收集本院分离的鲍曼不动杆菌共65株，采用琼脂稀释法检测上述细菌对替加环素的最低抑菌浓度（MIC）；将不同浓度替加环素与头孢哌酮／舒巴坦用棋盘法设计，用琼脂稀释法测定不同浓度组合的抗菌药对菌株的MIC，并计算部分抑菌浓度指数（FICI）；PCR扩增碳青霉烯酶基因。结果IRAB对替加环素的MIC50值为2mg／L，耐药率为21％。头孢哌酮／舒巴坦同替加环素联用后，FICI均为0．5-4．0。IRAB有84％（32／38）菌株携带blaOXA-23基因，亚胺培南敏感鲍曼不动杆菌（ISAB）均未检测到blaOXA-23基因。结论替加环素对携带blaOXA-23基因的鲍曼不动杆菌具有较强体外抗菌活性；替加环素与头孢哌酮／舒巴坦联用后，表现为无相关作用。Objective To analyze the activities in vitro and interactions of cefoperazone/sulbactam combined with tigecyclin against imipenem-resistant Acinetobacter baumannii. Methods A total of 65 Acinetabacter baumannii were collected. The minimum inhibitory concentrations （MIC） to tigecyclin were determined by agar dilution method. The protocol was designed by checkerboard method and the minimal inhibitory concentrations（MICs） of cefoperazone/sulbactam combined with tigecyclin against the IRAB were determined by agar dilution method. The fractional inhibitory concentration index（FICI） was calculated according to MIC results. PCR was used to amplify carbapenemase genes. Results The resistance of IRAB to tigecycline was 22%, MICs0 value was lmg/L. FIC1 were all between 0.5 and 4.0 in these two combination groups. 32 strain of 38 IRAB carried blaoxA.23 gene. blaoxA.23 gene were not detected in ISAB group. Conclusion Tigecyclin was certain sensitivity to IRAB carried blaoxA.23 gene. The interactions of cefoperazone/sulbactam combined with tigecyclin against imipenem-resistant Acinetobacter baumannii showed indifferent.

关 键 词：鲍曼不动杆菌 替加环素 棋盘法 部分抑菌浓度指数 

分 类 号：R978.1[医药卫生—药品]