替加环素单药及与5种抗菌药物联用对耐碳青霉烯类鲍曼不动杆菌的体外抑菌及生物膜清除作用研究  

In vitro inhibitory activity and biofilm eradication effects of tigecycline alone and in combination with five other antibacterial agents against carbapenem-resistant Acinetobacter baumannii

作　　者：李佳慧[1] 陈华乐[2] 张能华 周翠[1] 张艺之 王冲 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,温州325035 [2]温州医科大学附属第二医院检验科,温州325027 [3]浙江中医药大学附属嘉兴中医院检验科,嘉兴314001

出　　处：《中国抗生素杂志》2018年第2期121-126,共6页Chinese Journal of Antibiotics

基　　金：温州市科技局资助项目(No.Y20150312)

摘　　要：目的评价替加环素单用及与其他5种临床常用抗菌药物分别联合使用,对耐碳青霉烯类鲍曼不动杆菌(carbapenems-resistant Acinetobacter baumannii,CRAB)的体外抑菌及生物膜清除作用。方法微量肉汤稀释法测定替加环素、阿米卡星、美罗培南、环丙沙星、黏菌素和舒巴坦对42株CRAB的最低抑菌浓度(minimal inhibititory concentration,MIC)和最低生物被膜清除浓度(minimal biofilm eradication concentration,MBEC)。棋盘稀释法测定替加环素分别联用阿米卡星、美罗培南、环丙沙星、黏菌素和舒巴坦对42株CRAB的MIC值和MBEC值,并计算分级抑菌浓度指数(fractional inhibitory concentration index,FICI)和分级生物膜清除浓度指数(fractional eradication concentration index,FECI)。结果替加环素与5种抗菌药物分别联用后,对CRAB的抑菌作用和生物被膜清除作用表现为协同或无关,均未发现拮抗现象。其中替加环素与阿米卡星联用后具有较高的协同抑菌率(47.6%,20/42),而替加环素与环丙沙星联用后则具有较高的生物膜协同清除率(30.9%,13/42)。结论与单药相比,替加环素与5种药物分别联用,对CRAB的体外抑菌及生物膜清除作用具有一定的增强效果。Objective To evaluate the inhibitory and biofilm eradication effects oftigecycline （TGC） alone and in combination with five other antibacterial agents commonly used in clinic on carbapenem-resistant Acinetobacter baumannii （CRAB） isolates in vitro. Methods The minimal inhibitory concentration （MIC） and minimal biofilm eradication concentration （MBEC） of TGC, amikacin （AMK）, meropenem （MEM）, cipfloxacin （CIP）, colistin （CL）, sulbactam （SUL） to 42 CRAB isolates were detected by the broth dilution method. In addition, the MIC and MBEC of 42 CRAB isolates to TGC in combination with AMK, MEM, CIP, CL, SUL were measured by the checkerboard dilution method, and then the fractional inhibitory concentration index （FICI） and fractional eradication concentration index （FECI） were calculated. Results The majority of inhibitory and biofilm eradication effects of the combinations of TGC with the five antibacterial agents separately for CRAB were synergy or uncorrelated. No effects of antagonism were observed in the combinations. The group of TGC＋AMK had the highest inhibitory rate, which was 47.6% （20/42）, and the highest biofilm eradication rate was in the group of TGC＋CIP, which was 30.9% （13/42）. Conclusion Comparing to the effect of the single agent, TGC combined with five other antibiotics separately can improve the inhibitory and the biofilm eradication effects for CRAB in vitro.

关 键 词：耐碳青霉烯类鲍曼不动杆菌 替加环素 药物联用 微量肉汤稀释法 棋盘稀释法 

分 类 号：R978.1[医药卫生—药品]