多粘菌素B联合不同抗菌药物对耐碳青霉烯类肺炎克雷伯菌的体外抗菌作用  

Antibacterial activity of polymyxin B in combination with several antimicrobial agents against carbapenem-resistant Klebsiella pneumoniae in vitro

作　　者：吴正海 刘海洋[1] 陈华乐[2] 段达荣[3] 周铁丽[1] 

机构地区：[1]温州医科大学附属第一医院医学检验中心,浙江温州325015 [2]温州医科大学附属第二医院医学检验中心,浙江温州325027 [3]台州市第一人民医院医学检验中心,浙江台州318020

出　　处：《温州医科大学学报》2017年第12期898-901,共4页Journal of Wenzhou Medical University

基　　金：温州市科技局科研基金资助项目(Y20170204)

摘　　要：目的:评价多粘菌素B分别与美罗培南、利福平联合用药对临床分离的耐碳青霉烯类肺炎克雷伯菌(CRKP)的体外抗菌作用。方法:采用肉汤稀释法和棋盘稀释法测定多粘菌素B分别联用美罗培南和利福平对20株临床分离的CRKP的最低抑菌浓度,并计算部分抑菌浓度指数。结果:多粘菌素B与美罗培南联用后对CRKP有协同作用的占55%,表现出相加作用占45%,不存在无关和拮抗作用;多粘菌素B与利福平联用后对CRKP协同作用的占65%,相加作用占35%,不存在无关和拮抗作用。结论:多粘菌素B与美罗培南或利福平联用在体外对CRKP抗菌效应均主要表现为协同和相加作用。Objective： To evaluate the combined inhibitory effect of polymyxin B with meropenem and rifampicin respectively against carbapenem-resistant Klebsiella pneumoniae （CRKP） strains in vitro. Methods： Combined inhibitory effect of polymyxin B and meropenem, polymyxin B and rifampicin in vitro was assayed by detecting the minimum inhibitory concentration and calculating the fractional inhibitory concentration index for 20 CRKP strains with the checkerboard dilution method. Results： Combined polymyxin B and meropenem showed 55% synergic effect, 45% additive effect, no indifferent and antagonistic effect on CRKP strains. Com- bined polymyxin B and rifampicin displayed 65% synergic effect, 35% additive effect, no indifferent and antago- nistic effect on CRKP strains. Conclusion： Combined polymyxin B and meropenem, combined polymyxin B and rifampicin show a combined synergic and additive inhibitory on CRKP strain in vitro.

关 键 词：肺炎克雷伯菌 碳青霉烯酶 多粘菌素B 美罗培南 利福平 联合用药 

分 类 号：R378[医药卫生—病原生物学]