秦皮乙素对产KPC碳青霉烯耐药肺炎克雷伯菌的体外抗菌效果  

Effect of Esculetin inhibiting for KPC-producing Klebsiella pneumoniae in vitro

作　　者：王蕾[1] 刘志远[2] 潘健[2] 张婷菊[2] 齐杰[2] 张国军[1] 

机构地区：[1]首都医科大学附属北京天坛医院检验科,北京100050 [2]中国中医科学院广安门医院检验科,北京100053

出　　处：《检验医学与临床》2017年第23期3483-3486,共4页Laboratory Medicine and Clinic

摘　　要：目的观察秦皮乙素对产碳青霉烯酶(KPC)碳青霉烯耐药肺炎克雷伯菌的体外抗菌效果。方法采用改良Hodge试验、美罗培南加抑制剂3-氨基苯硼酸(APBA)、乙二胺四乙酸(EDTA)等试验来检测菌株产KPC表型;PCR扩增KPC基因并测序;MLST-PCR法检测菌株ST分型;肉汤微量稀释法检测秦皮乙素的最小抑菌浓度(MIC);按棋盘法联合药敏试验检测秦皮乙素与亚胺培南、庆大霉素、左氧氟沙星体外联合抗菌效果。结果所有菌株均携带KPC-2基因;MLST分型均为ST11型;秦皮乙素单独抗菌的MIC值为0.5~1.0mg/mL。秦皮乙素与亚胺培南联合药敏试验,分级抑菌浓度(FIC)指数均大于2。与庆大霉素联合,庆大霉素MIC≥1 024μg/mL时,FIC指数均为2;MIC≤512μg/mL时,FIC指数为0.31~1.0。与左氧氟沙星联合,FIC指数均为2。结论秦皮乙素对产KPC酶碳青霉烯耐药肺炎克雷伯菌具有明确的抗菌作用,与亚胺培南联合时存在拮抗作用,与庆大霉素联合时两药联合抗菌结果显示为无关、相加或协同作用,与左氧氟沙星的结果均表现为无关。Objective To examine the effect of bacteriostasis of Esculetin against Klebsiella pneumoniae carbapenemase（KPC）-producing Klebsiella pneumoniae.Methods Modified Hodge test,meropenem combined with 3-aminophenylboronic acid（APBA）and EDTA were conducted to detect carbapenemases.KPC gene and sequencing were determined by PCR.The molecular typing of strains was analyzed by MLST-PCR.Minimal inhibitory concentrations（MICs）of Esculetin against the strains for research were determined by broth dilution in the 96-well microplates.Synergy effects between Esculetin and antibiotic（imipenem,gentamycin,levoloxacin）were designed with chessboard test.Results Modified Hodge Test and APBA inhibiting test were positive in all strains.All samples were KPC-2-producing Klebsiella pneumoniae,and predominantly to a single sequence type,ST11.The tests showed the MICs of Esculetin were 0.5-1.0 mg/mL.The result was FIC higher than 2 in the combination of Esculetin with imipenem in all strains.Different results were observed in the combination between Esculetin and gentamicin according to the MIC of gentamicin.FIC was equal to 2 when the MIC higher than 1 024μg/mL.FIC was in the range of 0.3-1.0 when MIC was lower than 512μg/mL.The combination between Esculein and levoloxacin obtained that FIC was equal to 2 in all specimens.Conclusion Esculein has obvious antibacterial effect on KPC-producing Klebsiella pneumoniae.The antagonistic effect is observed in the combination between Esculein and imipenem.The combined efficacy of Esculein and gentamicin are different according to MICs of gentamicin.And there is indifferent action between Esculein and levoloxacin.

关 键 词：秦皮乙素 碳青霉烯耐药肺炎克雷伯菌 抗菌作用 

分 类 号：R978.11[医药卫生—药品]