依替米星与头孢哌酮/舒巴坦及哌拉西林/他唑巴坦体外联合应用对碳青霉烯耐药鲍曼不动杆菌的抑制作用  

Drug chemosensitivity test of etimicin combined with cefoperazone/sulbactam or piperacillin/tazobactam against carbapenem-resistant Acinetobacter baumannii

作　　者：龚美亮[1] 李晓霞[1] 周玉[1] 徐雅萍[1] 丛玉隆[1] 

机构地区：[1]解放军总医院南楼检验科,北京100853

出　　处：《解放军医学院学报》2016年第8期876-878,共3页Academic Journal of Chinese PLA Medical School

摘　　要：目的研究依替米星(etimicin,ETM)与头孢哌酮/舒巴坦(cefoperazone/sulbactam,SCF)及哌拉西林/他唑巴坦(piperacillin/tazobactam,TZP)在体外联合应用对碳青霉烯耐药鲍曼不动杆菌(carbapenem-resistant Acinetobacter baumannii,CRAB)的抑制作用。方法测定3种药物单独应用及ETM与SCF、TZP联合应用(棋盘法设计)对60株碳青霉烯耐药鲍曼不动杆菌的最低抑菌浓度(minimum inhibitory concentration,MIC),计算体外分级抑菌浓度(fractional inhibitory concentration,FTC)指数。结果 ETM与SCF联合应用,FIC指数分布为协同作用8.3%,相加作用56.7%,无关作用35.0%,拮抗作用0;ETM与TZP联合应用,FIC指数分布为协同作用6.7%,相加作用63.3%,无关作用30.0%,拮抗作用0。上述两组药物联合应用后,各抗菌药物MIC_(50)与MIC_(90)均较单用降低;药物联用浓度-累积抑菌率曲线均较单用左移。结论 ETM分别与SCF及TZP体外联合应用对CRAB的抑制作用主要表现为协同和相加。Objective To evaluate the combined inhibitory effect of etimicin（ETM） and cefoperazone/sulbactam（SCF）, etimicin（ETM） and piperacillin/tazobactam（TZP） respectively on clinically isolated carbapenem-resistant Acinetobacter baumannii（CRAB） strains in vitro. Methods This test was based on chessboard method. Individual used and combined inhibitory effect of ETM and SCF, ETM and TZP in vitro was assayed by detecting the minimum inhibitory concentration（MIC） and calculating the fractional inhibitory concentration（FIC） index in 60 CRAB strains with the micro-broth dilution method. Results Combination of ETM and SCF showed synergic effect, additive effect, indifferent effect and antagonistic effect of 8.3%, 56.7%, 35.0% and 0 on the CRAB strains respectively. Combination of ETM and TZP displayed synergic effect, additive effect, indifferent effect and antagonistic effect of 6.7%, 63.3%, 30.0% and 0 on the CRAB strains respectively. The MIC50 and MIC90 of these drugs were significantly lower when they were used in combination with their concentration-accumulative curves shifting to the left. Conclusion Combination of ETM and SCF, ETM and TZP show a synergic and additive inhibitory effect on CRAB strains in vitro.

关 键 词：依替米星 头孢哌酮/舒巴坦 哌拉西林/他唑巴坦 鲍曼不动杆菌 碳青霉烯耐药 体外药敏试验 

分 类 号：R96[医药卫生—药理学]