利福平联合碳青霉烯类药物对多药耐药鲍氏不动杆菌体外抗菌活性研究  

In vitro activity of rifampicin in combination with carbapenems drugs against clinical respiratory tract isolates of Acinetobacter baumannii

作　　者：周光[1] 佘丹阳[2] 管希周[2] 罗燕萍[1] 陈刚[1] 褚佳琪 李丰田[1] 张樱[1] 

机构地区：[1]解放军总医院微生物科,北京100853 [2]解放军总医院呼吸内科,北京100853

出　　处：《中华医院感染学杂志》2014年第3期615-616,619,共3页Chinese Journal of Nosocomiology

基　　金：国家自然科学基金青年科学基金项目(81301464);北京自然科学基金项目(7122166)

摘　　要：目的评价利福平联合亚胺培南、美罗培南对患者呼吸道标本分离的耐碳青霉烯类鲍氏不动杆菌体外抗菌效应,为临床联合用药提供治疗依据。方法收集2011年1月-2012年12月11所医院临床患者送检的105株耐亚胺培南和美罗培南鲍氏不动杆菌,采用琼脂稀释法测定不同浓度组合的抗菌药物最低抑菌浓度,并计算部分抑菌浓度指数(FICI)判定联合效应。结果利福平联合亚胺培南、利福平联合美罗培南联用后,其MIC50和MIC90降低,联合效应主要表现为相加作用,无拮抗作用,与亚胺培南联用后,相加作用为72.64%高于与美罗培南联用52.83%;部分菌株显示协同作用,其中与亚胺培南联用协同作用为3.77%,与美罗培南联用协同作用5.66%。结论利福平与亚胺培南或美罗培南联用后主要表现为相加作用,部分为协同作用,对于严重的多药耐药鲍氏不动杆菌引起的呼吸道感染,可采用利福平和亚胺培南或美罗培南联合治疗方案。OBJECTIVE To evaluate the antibacterial effect of rifampicin combined with either imipenem or meropenem against Acfnetobacter baumannif, in order to guide clinical therapy. METHODS A total of 105 strains of A. baumannii resistant to imipenem or meropenem were collected from Jan. 2011 to Dec. 2012. The checker board microdilution method was used to test the lowest concentration for antibacteria in different concentration combination of drugs. The fractional inhibitory concentration index （FICI） was calculated for each combination. RESULTS The MIC50 and MIC50 of rifampicin in combinations were decreased and antimicrobial activity was improved. The additive effect （72. 64%）was higher in rifampicin/imipenem than in rifampicin/meropenem （52.83%）. Synergistic effect appeared in some strains, in which the synergistic effect with imipenem （3.77%） was lower than that with meropenem （5. 66%）. CONCLUSION Additive effect is the most results in the combination of rifampicin with imipenem and meropenem and part of the results is synergistic effect. Rifampicin in combinations is recommended against serious multidrug-resistant a. baumann{i respiratory tract infections.

关 键 词：鲍氏不动杆菌 利福平 抗菌药物 药敏试验 

分 类 号：R978.1[医药卫生—药品]