不同抗菌药物诱导革兰阴性菌释放内毒素的体外试验研究  

In vitro test of release of endotoxin from gram-negative bacteria induced by different antibiotics

作　　者：史利克[1] 王悦[1] 王世博[1] 王黎一[1] 郭璐[1] 张弛[1] 高冰[1] 宋文杰[2] 

机构地区：[1]河北医科大学第二医院感染控制处,河北石家庄050000 [2]河北医科大学第二医院检验科,河北石家庄050000

出　　处：《中华医院感染学杂志》2015年第21期4805-4807,4833,共4页Chinese Journal of Nosocomiology

基　　金：河北省中医药管理局科研计划基金资助项目(2015026);河北医科大学第二医院科学研究基金资助项目(2h1201119)

摘　　要：目的检测不同抗菌药物作用不同时间诱导革兰阴性菌释放内毒素(LPS)的浓度,为抗感染治疗预防内毒素血症提供依据。方法试验于2014年8-10月进行,将1麦氏浊度各菌株菌悬液0.5ml与不同浓度的抗菌药物0.5ml溶液混匀,得到0.5个麦氏浊度的待测溶液,将待测菌悬液0.2ml直接加入反应主剂中溶解,使用微量加样器转移至10mm×75mm标准玻璃反应管中,用MB-80微生物快速动态检测系统检测内毒素浓度,使用SPSS17.0进行统计处理。结果阿米卡星(0.125mg/L)与大肠埃希菌、肺炎克雷伯菌、铜绿假单胞菌、鲍氏不动杆菌作用1min释放的LPS差异无统计学意义,阿米卡星浓度为2、8mg/L时大肠埃希菌释放LPS与其他3种菌相比差异均有统计学意义(P<0.05),美罗培南0.125mg/L、阿米卡星2mg/L、头孢哌酮/舒巴坦64mg/L与大肠埃希菌作用3min与1min时的LPS检测值差异均有统计学意义(P<0.05),美罗培南0.125mg/L、阿米卡星2mg/L、哌拉西林/他唑巴坦16mg/L、头孢他啶32mg/L、头孢哌酮/舒巴坦64mg/L与肺炎克雷伯菌分别作用3、5、10min检测的LPS结果的差异无统计学意义。结论不同抗菌药物浓度、不同作用时间诱导革兰阴性菌内毒素释放的水平有影响,同一抗菌药物对不同革兰阴性细菌诱导释放内毒素的能力也不同,临床使用抗菌药物治疗革兰阴性菌引起的感染时,应尽量减少抗菌药物诱导内毒素升高引起的内毒素血症危害。OBJECTIVE To detect the concentrations of released endotoxin from the gram-negative bacteria induced by different antibiotics for different time periods so as to provide guidance for prevention of endoxemia.METHODS The experiment was conducted from Aug 2014 to Oct 2014,the various bacteria suspension（0.5ml）of 1 McIntosh turbidity and different concentrations of antimicrobial solution（0.5ml）were blended,this solution concentration was 0.5 McIntosh turbidity,and 0.2 ml of this solution was dissolved by directly adding it to the reaction principal agent,and this solution was transferred into a 10×75mm standard glass reaction tube with the use of micro pipette,the concentrations of endotoxin were detected by using the MB-80 microbial fast dynamic detection system,and the statistical analysis was performed by means of SPSS17.0software.RESULTS There was no statistically significant difference in the concentration of released endotoxin induced by amikacin（0.125mg/L）for 1min among the Escherichia coli,Klebsiella pneumoniae,Pseudomonas aeruginosa,and Acinetobacter baumannii.There was statistically significant difference in the released endotoxin between the E.coli and other three species as the concentrations of amikacin were 2mg/L and 8mg/L,respectively（P〈0.05）.There was statistically significant difference in the released endotoxin of E.coli induced by 0.125 mg/L of meropenem,2 mg/L of amikacin,and 64mg/L of cefoperazone-sulbactam for 3 min and 1 min（P〈0.05）.There was no statistically significant5 min,and 10 min,respectively.CONCLUSION The concentrations of the released endotoxin of the gram-negative badifference in the released endotoxin of K.pneumoniaeinduced by 0.125mg/L of meropenem,2mg/L of amikacin,16mg/L of piperacillin-tazobactam,32 mg/L of ceftazidime,and 64 mg/L of cefoperazone-sulbactam for 3min,cteria are influenced by the concentration of antibiotic and the induction time.The same antibiotic vary in the ability of inducing the release of endotoxin of the gram-negative bacteria.It is

关 键 词：内毒素 革兰阴性菌 抗菌药物 体外试验 

分 类 号：R446[医药卫生—诊断学]