磷霉素联合碳青霉烯类抗尿路感染耐药铜绿假单胞菌的体外协同作用研究  

Synergistic Effect of Fosfomycin Combined with Carbapenems against Drug-resistant Pseudomonas aeruginosa Isolated from Urinary Tract Infections in vitro

作　　者：孙凤军[1] 熊志坚[2] 冯伟[1] 孙艺璇[1] 夏培元[1] 

机构地区：[1]第三军医大学第一附属医院药剂科,重庆400038 [2]八一电影制片厂门诊部,北京100073

出　　处：《中国药房》2016年第20期2765-2767,共3页China Pharmacy

基　　金：国家自然科学基金资助项目(No.81373451)

摘　　要：目的:探讨磷霉素(FOS)联合碳青霉烯类抗尿路感染耐药铜绿假单胞菌的体外协同作用。方法:采用琼脂平板倍比稀释法检测耐碳青霉烯类铜绿假单胞菌的最低抑菌浓度,棋盘法测定其联合抑菌浓度指数,96孔板结晶紫法考察FOS与碳青霉烯类联用对其生物膜的影响。结果:12株耐碳青霉烯类铜绿假单胞菌对FOS及阿米卡星的敏感性较高,对亚胺培南和美罗培南的耐药率均达100%。FOS与亚胺培南联用时,4株(33.3%)为协同作用;FOS与美罗培南联用时,5株(41.7%)为协同作用;均未出现拮抗作用。FOS和碳青霉烯类联用对耐碳青霉烯类铜绿假单胞菌的生物膜均有抑制作用(P<0.05或P<0.01)。结论:FOS联合碳青霉烯类对部分耐碳青霉烯类铜绿假单胞菌具体外协同作用,其机制可能与抑制细菌生物膜有关。OBJECTIVE： To investigate synergistic effect of carbapenems combined with fosfomycin （FOS） on carbapenems-re- sistant Pseudomonas aeruginosa isolates from urinary tract infections in vitro. METHODS： The minimum inhibitory concentration was detected using agar double dilution method. The fractional inhibitory concentration index was determined by checkerboard meth- od. The effect of carbapenems combined with FOS on biofilm of P. aeruginosa isolates was determined using 96 crystal violet stain- ing. RESULTS： 12 strains of carbapenem-resistant P. aeruginosa isolates were highly sensitive to FOS and amikacin, and were com- pletely resistant to imipenem and meropenem. The combination of imipenem with FOS could induce a synergistic effect on 4 strains （33.3%）; meropenem combined with FOS could induce a synergistic effect on 5 strains （41.7%）; no antagonistic effect of carbap- enems combined with FOS appeared. FOS combined with carbapenems could inhibit the biofilm of carbapenems-resistant P. aerugi- nosa （P〈0.05 or P〈0.01）. CONCLUSIONS： The combination of carbapenems with FOS possesses in vitro synergistic antibacteri- al effect on part of carbapenems-resistant P. aeruginosa isolates, the mechanism of which may be associated with inhibiting the biofilm.

关 键 词：耐药铜绿假单胞菌 磷霉素 碳青霉烯类 尿路感染 协同作用 

分 类 号：R969.3[医药卫生—药理学] R978.1[医药卫生—药学]