环丙沙星诱导对铜绿假单胞菌最低抑菌浓度的影响  

Study on minimal inhibitory concentration effects of Pseudomonas aeruginosa induced by ciprofloxacin

作　　者：高雅婷[1] 李晓霞[2] 康建邦[2] 张智琪[1] 张瑞琴[2] 段金菊[2] 

机构地区：[1]山西医科大学药学院,太原030001 [2]山西医科大学第二医院药学部,太原030013

出　　处：《中国临床药理学杂志》2017年第2期123-126,135,共5页The Chinese Journal of Clinical Pharmacology

摘　　要：目的探讨铜绿假单胞菌经环丙沙星诱导前后对4种喹诺酮类药物最低抑菌浓度(MIC)的影响。方法以临床分离的铜绿假单胞菌为研究对象,以环丙沙星作为诱导药物,选择0.5×MIC、1×MIC、2×MIC、4×MIC 4种诱导浓度共诱导5代,用琼脂倍比稀释法测定诱导前及诱导1,3,5代菌株对环丙沙星、左氧氟沙星、氧氟沙星和莫西沙星的MIC。用重复测量方差分析方法进行统计分析。结果不考虑环丙沙星诱导浓度间的差异,不同代数间菌株对4种喹诺酮类药物MIC的差异有统计学意义(P<0.05);不考虑诱导代数间的差异,不同环丙沙星诱导浓度间菌株对4种喹诺酮类药物MIC的差异有统计学意义(P<0.05)。诱导代数因素与诱导浓度因素间菌株对环丙沙星、左氧氟沙星和氧氟沙星MIC有交互影响(P<0.05)。结论从0.5×MIC到4×MIC环丙沙星浓度对铜绿假单胞菌均有较强的诱导作用,使喹诺酮类药物对铜绿假单胞菌的MIC有较大改变,提示临床上使用喹诺酮类药物治疗铜绿假单胞菌感染时应考虑药代动力学/药效学理论,充分优化治疗方案。Objective To investigate effects of the induction by ciprofloxacinon on minimal inhibitory concentration（ MIC） of Pseudomonas aeruginosa to four quinolones. Methods Clinical isolates of Pseudomonas aeruginosa induced five generations by ciprofloxacin with four concentrations of 0. 5 × MIC,1 × MIC,2 × MIC and 4 × MIC,and used the agar dilution method to measure MICs of all strains before inductions and in induced generations of one,three and five to ciprofloxacin,levofloxacin,ofloxacin and moxifloxacin. The statistical Analysis method is repeated measures analysis of variance. Results MIC changes from different induced times without consideration of differences in concentrations of ciprofloxacin were statistically significant（ P〈0. 05）; MIC changes from different concentrations of ciprofloxacin without consideration of differences in inducing times were statistically significant（ P〈0. 05）.Between inducing times and concentrations of ciprofloxacin,MICs of strains to ciprofloxacin,ofloxacin and levofloxacin have interaction（ P〈0. 05）.Conclusion Ciprofloxacin concentrations from 0. 5 × MIC to 4 × MIC all have a strong induction to Pseudomonas aeruginosa,and also have a greater impact on MICs of Pseudomonas aeruginosa to quinolones,suggesting that using quinolones in the treatment of Pseudomonas aeruginosainfection in clinical is necessorily refer to the pharmacokinetics / pharmacodynamics theory,and fully optimize therapeutic regimens.

关 键 词：铜绿假单胞菌 喹诺酮类 体外诱导 重复测量方差分析 

分 类 号：R978.1[医药卫生—药品]