多重耐药鲍曼不动杆菌体外联合用药抗菌活性的研究  

Combined antibacterial activities of multidrug-resistant strains of Acinetobacter Baumannii in vitro

作　　者：李从荣[1] 潘月华[1] 

机构地区：[1]武汉大学人民医院检验科,湖北武汉430060

出　　处：《中国现代医学杂志》2015年第22期37-40,共4页China Journal of Modern Medicine

摘　　要：目的评价体外联合用药对多重耐药的鲍曼不动杆菌（MDRAB）的杀茵效果以及外排泵抑制剂对抗生素敏感性的恢复作用。方法使用肉汤倍比稀释法分别检测头孢哌酮／舒巴坦（SCF）、米诺环素（MH）、SCF与MH联合用药、碳酰氰间氯苯腙（CCCP）与MH联合用药及CCCP与SCP联合用药对临床分离的24株MDIKAB最低抑菌浓度（MIC），并计算抑菌浓度指数（FIC）。结果SCF、MH单用MIC与联合使用MIC比较。单独用药均明显高于联合用药，差异具有统计学意义（t=2．19，P〈0．01；t=1．68，P〈0．05；C=2．68，P〈0．01）oSCF和MH分别与CCCP联用时的MIC明显低于SCF与MH联用时的MIC，差异具有统计学意义（c=1．76，P〈O．01；t=2．20，P〈0．01）。SCF与MH联合应用FIC指数O．o~0．5占50．00％，O．5～1．0占45．83％，1．0—2．0占4．17％。结论SCF与MH联合用药具有协同和相加作用；抗生素与外排泵抑制剂联用可降低抗生素MIC及用量，恢复其敏感性。[ Objective ] To analyze the effect of the combined antibacterial activity against multidrug-resistant Acinetobacter baumannii （MDRAB） in vitro and the recovery effect of antibiotic sensitivity by efflux pump inhibitors. [Methods] The minimum inhibitory concentrations （MICs） of cefoperazone/sulbactam （SCF）, minocycline （MI-I）, SCF combined with MH, carbonyl cyanide m-chloro-phenylhydrazone （CCCP） combined with MH, CCCP combined with SCF for 24 strains of MDRAB seperated in clinic were detected by broth dilution method. The Fractional Inhibitory Concentration （FIC） index was calculated according to MIC results. [ Results ] The MICs of SCF, MH single were significantly higher than those of the combination （t = 2.19, P 〈 0.01; t = 1.68, P 〈 0.05; t = 2.68, P 〈 0.01）. The MICs of SCF, MH combined with CCCP repectively were significantly lower than the MIC of SCF combined with MH （t = 1.76, P 〈 0.01; t = 2.20, P 〈 0.01）. The percentage of the FIC indexes less than 0.5, between 0.5 and 1.0, be- tween 1.0 and 2.0 were 50.00%, 45.83% and 4.17%. [ Conclusions ] Combined use of cefoperazone/sulbactam and minocycline has a collaborative and additive effect. Efflux pump inhibitors combined with antibiotic can reduce the MIC and dosage of antibiotics, what＇s more, they can recover antibiotic sensitivity.

关 键 词：多重耐药鲍曼不动杆菌 头孢哌酮/舒巴坦 米诺环素 碳酰氰间氯苯腙 最低抑菌浓度 

分 类 号：R446.5[医药卫生—诊断学]