体外联合用药对耐碳青霉烯铜绿假单胞菌的抗菌活性研究  

In vitro activity of antibiotic combination against carbapenems-resistant Pseudomonas aeruginosa

作　　者：杨德青[1,2] 倪文涛[3] 王睿[2] 王瑾[2] 

机构地区：[1]大理大学药学与化学学院,云南大理671000 [2]中国人民解放军总医院药物/器械临床试验中心,北京100853 [3]中国人民解放军总医院呼吸科,北京100853

出　　处：《中国临床药理学杂志》2016年第24期2269-2272,2276,共5页The Chinese Journal of Clinical Pharmacology

基　　金：国家"十二五"重大科技专项基金资助项目(2012ZX09303004-002)

摘　　要：目的评价4个组合(多黏菌素E+利福平、多黏菌素E+美罗培南、头孢哌酮/舒巴坦+阿米卡星、头孢哌酮/舒巴坦+左氧氟沙星)联合应用对4株耐碳青霉烯类铜绿假单胞菌(CRPA)的体外抗菌效应。方法用时间-杀菌曲线法(TKA)测定联合抗菌活性。结果 4个组合在最小抑菌浓度(MIC)下联合后,24 h时的菌落数较最强单药组分别降低(2.68~7.08),(5.67~7.08),(2.00~4.20),(0.39~2.43)log_(10)CFU·m L^(-1);4个组合在1/2 MIC下联合时分别降低(5.52~8.53),(2.74~3.00),(0.48~3.01),(0.42~1.17)log_(10)CFU·m L^(-1)。棋盘法和TKA的测定结果比较差异均有统计学意义(P<0.05)。结论多黏菌素E与利福平、美罗培南联合均为协同杀菌作用,头孢哌酮/舒巴坦与阿米卡星联合表现协同抑菌作用,头孢哌酮/舒巴坦与左氧氟沙星联合效果不佳。Objective To evaluate the in vitro antibacterial effects of four combinations （colistin combined with rifampin and meropenem respec- tively, cefoperazone/sulbactam combined with amikacin and levofloxacin separately） against four strains carbapenems -resistant Pseudomonas aeruginosa（ CRPA）. Methods Time - kill assay （TKA） was used to determine the combined antibacterial activity. Results At 24 h, the four combinations at minimum inhibitory concentration （MIC） resulted in reduction of （2. 68 -7.08）, （5.67 -7.08）, （2. 00 -4. 20）, （0. 39 - 2. 43） log10 CFU·mL^-1 in viable bacteria compared with the most active single agent. The combination at concentration of 1/2 resulted in reduction of （5.52-8.53）, （2.74-3.00）, （0.48-3.01）, （0.42-1.17） log10 CFU·mL^-1 The difference of results between punnett square and TKA was significant （P 〈 0. 05）. Conclusion According to results of TKA, combination of colistin, rifampin and meropenem showed synergetic sterilization; cefoperazone/sulbactam combined with amikacin exhibited synergetic inhibitory activity; the effect of cefoperazone/sulbactam combined with levofloxacin was not ideal.

关 键 词：耐碳青霉烯类铜绿假单胞菌 联合用药 时间-杀菌曲线法 

分 类 号：R978.1[医药卫生—药品]