美罗培南联合头孢哌酮舒巴坦对3种多重耐药革兰氏阴性杆菌的抗菌活性研究  

Study on Antibacterial Activities of Meropenem Combined with Cefoperazone Sulbactam to 3 Kinds of Multidrug Resistant Gram-negative Bacteria

作　　者：刘燕琳[1] 宋传杰[2,3] 尹玲[1] 梁晓燕[1] 张晗[1] 李长征[2,3] LIU Yanlin SONG Chuanjiea YIN Ling LIANG Xiaoyan ZHANG Han LI Changzheng(The Affiliated Hospital of Taishan Medical University, Shandong Tai＇ an 271000, China The Affiliated Tumor Hospital of Shandong University, Jinan 250117, China Shandong Academy of Medical Sciences, Jinan 250117, China)

机构地区：[1]泰山医学院附属医院,山东泰安271000 [2]山东大学附属肿瘤医院,济南250117 [3]山东省医学科学院,济南250117

出　　处：《中国药房》2017年第21期2912-2915,共4页China Pharmacy

基　　金：山东省中医药科技发展计划项目(No.2015-264)

摘　　要：目的:研究美罗培南(MPN)联合头孢哌酮舒巴坦(SCF)对3种多重耐药(MDR)革兰氏阴性杆菌的抗菌活性。方法:收集2016年1-12月泰山医学院附属医院收治患者的痰、血、尿、腹水或引流液标本,从中分离得到的MDR-大肠埃希菌(EC)、MDR-肺炎克雷伯菌(KPN)、MDR-鲍曼不动杆菌(AB)各50株,采用琼脂稀释法、棋盘法测定MPN、SCF、MPN+SCF对MDR-EC、MDRKPN、MDR-AB的半数抑菌浓度(MIC_(50))、90%抑菌浓度(MIC_(90))及平均抑菌浓度(MIC_G),计算联合抑菌浓度(FIC)指数,采用K-B纸片法进行药敏试验。结果:MPN单用时MDR-EC、MDR-KPN、MDR-AB的MIC_G分别为36.82、82.45、34.32μg/mL,SCF单用时MDR-EC、MDR-KPN、MDR-AB的MIC_G分别为42.14、112.67、24.11μg/mL,MPN+SCF时MDR-EC、MDR-KPN、MDR-AB的MIC_G分别为25.97、56.64、11.36μg/mL,MDR-EC、MDR-KPN中的MIC_G为MPN+SCF<MPN<SCF,MDR-AB中的MIC_G为MPN+SCF<SCF<MPN,差异均有统计学意义(P<0.05)。MPN+SCF对MDR-EC、MDR-KPN、MDR-AB的FIC最高分别为>0~0.5(78.00%)、>0~0.5(72.00%)、>0.5~1.0(82.00%)。结论:MPN联合SCF可有效提高对MDR-EC、MDR-KPN、MDR-AB等MDR革兰氏阴性杆菌的抗菌活性,且两药联用具有协同作用。OBJECTIVE： To study antibacterial activities of meropenem （MPN） combined with cefoperazone sulbactam （SCF） to 3 kinds of multidrug resistance （MDR） Gram-negative bacteria. METHODS： Each 50 strains of MDR-Escherichia coli （MDR-EC）, MDR-Klebsiella pneumoniae （MDR-KPN） and MDR-Acinetobacter baumannii （MDR-AB） were isolated from sputum, blood, urine, ascites or drainage specimens of patients during Jan. to Dec. in 2016 from the affilidated hospital of Taishan medical university. The agar dilution method and board method were used to determine MIC50,MIC90 and MICG of MPN, SCF, MPN＋SCF to MDR-EC, MDR-KPN, MDR-AB and calculate fractional inhibitory concentration （FIC）. Drug sensitivity test was conducted by K-B disk method. RESULTS： In terms of the MICG to MDR-EC, MDR-KPN, MDR-AB, MPN alone were respectively 36.82, 82.45, 34.32 μg/mL; SCF alone were respectively 42.14, 112.67, 24.11 μg/mL; MPN combined with SCF were respectively 25.97, 56.64, 11.36 μg/mL. In terms of MICG to MDR-EC, MDR-KPN, MICG showed that MPN＋SCF〈MPN〈SCF; in terms of MICG to MDR-AB, MICG showed that MPN＋SCF〈SCF〈MPN, with statistical significance （P〈0.05）. The highest of FIC of MPN＋SCF to MDR-EC, MDR-KPN and MDR-AB was respectively 〉0-0.5 （78.00%）,〉0-0.5（72.00%）,〉0.5-1.0 （82.00%）. CONCLUSIONS： MPN combined with SCF can effectively improve antibacterial activities to MDR Gram-negative bacteria as MDR-EC, MDR-KPN, MDR-AB. MPN combined with SCF has synergistic effects.

关 键 词：美罗培南 头孢哌酮舒巴坦 多重耐药 革兰氏阴性杆菌 抗菌活性 

分 类 号：R969[医药卫生—药理学]