磷霉素钠联合用药对耐药鲍曼不动杆菌药物敏感性的实验研究  

Experimental research on susceptibility of drug-resistant Acinetobacter baumannii to fosfomycin sodium combinations

作　　者：关卫[1] 韩颖[1] 胡艳敏[1] 丛云峰[1] 肖洋[1] 

机构地区：[1]黑龙江省医院急救中心检验科,黑龙江哈尔滨150001

出　　处：《中华医院感染学杂志》2017年第6期1215-1217,共3页Chinese Journal of Nosocomiology

摘　　要：目的针对耐药鲍曼不动杆菌进行联合药敏试验,为临床联合用药提供依据。方法选取2015年6月-2016年9月入住重症医学科和呼吸科的医院获得性肺炎患者,经实验室筛选耐药鲍曼不动杆菌30株,采用琼脂稀释结合纸片扩散法;制作含磷霉素钠菌培养平板,药物浓度分别为0mg/L,70mg/L,140mg/L,280mg/L;在含药平板上贴头孢哌酮舒巴坦、头孢哌酮、亚胺培南西司他丁钠、阿米卡星、左氧氟沙星和哌拉西林药敏贴片,常规培养。结果磷霉素钠与头孢哌酮舒巴坦联合,鲍曼不动杆菌对药物的敏感性从0株(磷霉素钠浓度0mg/L),分别增加为7株(磷霉素钠浓度70mg/L)和19株(磷霉素钠浓度140mg/L),有显著协同作用,P<0.05;磷霉素钠与左氧氟沙星联合,鲍曼不动杆菌对药物的敏感性从0株(磷霉素钠浓度0mg/L),分别增加为0株(磷霉素钠浓度70mg/L)和8株(磷霉素钠浓度140mg/L),也有显著协同作用,P<0.05;磷霉素钠与头孢哌酮、亚胺培南、阿米卡星和哌拉西林没有显著协同作用。磷霉素钠头孢哌酮/舒巴坦组合与磷霉素钠左氧氟沙星组合头对头比较,P<0.05;结论针对多药耐药鲍曼不动杆菌,磷霉素钠头孢哌酮舒巴坦组合和磷霉素钠左氧氟沙星组合有显著协同作用,但前者更好。OBJECTIVE To conduct the combined drug susceptibility testing for drug-resistant Acinetobacter baumannii so as to provide guidance for clinical drug combination.METHODS The patients with hospital-acquired pneumonia who were hospitalized in critical care medicine department and respiratory department from Jun 2015 to Sep 2016 were enrolled in the study.Totally 30 strains of drug-resistant A.baumannii were screened out by the clinical laboratory,the culture plates containing fosfomycin sodium were made by using agar dilution combined with disk diffusion method,and the drug concentrations were 0mg/L,70mg/L,140mg/L,and 280mg/L,respectively.The plates were stuck with drug susceptibility testing pasters：cefoperazone-sulbactam,cefoperazone,imipenem cilastatin sodium,amikacin,levofloxacin,piperacillin;the conventional culture was carried out.RESULTS As for fosfomycin sodium in combination with cefoperazone-sulbactam,the A.baumannii strains that were susceptible to the drug was increased from 0（fosfomycin sodium concentration 0mg/L）to 7（fosfomycin sodium concentration 70mg/L）and 19（fosfomycin sodium concentration 140mg/L）,showing significant synergistic effect P〈0.05.As for fosfomycin sodium in combination with levofloxacin,the A.baumannii strains that were susceptible to the drug was increased from 0（fosfomycin sodium concentration 0mg/L）to 0（fosfomycin sodium concentration70mg/L）and 8（fosfomycin sodium concentration 140mg/L）,showing significant synergistic effect P〈0.05.However,fosfomycin sodium in combination with cefoperazone,imipenem,amikacin,or piperacillin did not show significant synergistic effect.There was significant difference between the fosfomycin sodium in combination with cefoperazone-sulbactam and fosfomycin sodium in combination with levofloxacin（P〈0.05）.CONCLUSION As for the multidrug-resistant A.baumannii,the fosfomycin sodium in combination with cefoperazone-sulbactam and fosfomycin sodium in combination with levofloxacin show significant synergistic effect,however,

关 键 词：耐药鲍曼不动杆菌 药敏试验 联合药敏试验 磷霉素钠 

分 类 号：R378[医药卫生—病原生物学]