双黄连联合抗菌药物对广泛耐药肺炎克雷伯菌体外抑菌的研究  

In vitro antibacterial study of Shuanghuanglian combined with antibiotic for extensively drug resistant Klebsiella pneumoniae

作　　者：马冬梅 陶庆春 蒋东葵 张一瑶 MA Dongmei;TAO Qingchun;JIANG Dongkui;ZHANG Yiyao(Department of Clinical Laboratory,the Third Affiliated Hospital of Beijing University of Traditional Chinese Medicine,Beijing 100029,China)

机构地区：[1]北京中医药大学第三附属医院检验科,北京100029

出　　处：《国际检验医学杂志》2020年第9期1052-1055,1059,共5页International Journal of Laboratory Medicine

基　　金：北京中医药大学基金项目(2016-JYB-JSMS-083)。

摘　　要：目的探讨双黄连分别联合亚胺培南、头孢哌酮/舒巴坦和米诺环素对广泛耐药肺炎克雷伯菌的抑菌效果。方法应用肉汤稀释法测定双黄连粉针剂联合亚胺培南、头孢哌酮/舒巴坦、米诺环素对30株广泛耐药肺炎克雷伯菌的最低抑菌浓度(MIC),统计单独及联合用药的MIC分布,计算部分抑菌浓度(FIC)指数分布情况,判定联合用药抑菌效果。结果双黄连联合亚胺培南对广泛耐药肺炎克雷伯菌的FIC指数结果显示:FIC指数≤0.5占6.7%,FIC指数>0.5~1.0占53.3%,FIC指数>1.0~2.0占33.3%,FIC指数>2.0占6.7%。双黄连联合头孢哌酮/舒巴坦对广泛耐药肺炎克雷伯菌的FIC指数结果显示:FIC指数≤0.5为0,FIC指数>0.5~1.0占13.3%,FIC指数>1.0~2.0占23.3%,FIC指数>2.0占63.3%。双黄连联合米诺环素对广泛耐药肺炎克雷伯菌的FIC指数结果显示:FIC指数≤0.5为0,FIC指数>0.5~1.0占3.3%,FIC指数>1.0~2.0占30.0%,FIC指数>2.0占66.7%。结论双黄连联合亚胺培南对广泛耐药肺炎克雷伯菌多数表现为协同作用和相加作用,体外联合抑菌作用较好;而双黄连分别与头孢哌酮/舒巴坦、米诺环素联合多数表现为无关作用和拮抗作用,对广泛耐药肺炎克雷伯菌的体外联合抑菌作用较差。Objective To investigate the combined bacteriostatic effect of Shuanghuanglian powder injection combined with imipenem,cefoperazone/sulbactam and minocycline on Klebsiella pneumoniae in vitro.Methods The minimal inhibitory concentration(MIC)of Shuanghuanglian powder injection combined with imipenem,cefoperazone/sulbactam and minocycline against 30 strains of Klebsiella pneumoniae was determined by broth dilution method.The MIC distribution of single and combined drugs was counted,and the FIC index of part of them was calculated to determine the antibacterial effect of combined drugs.Results The results of FIC index of Shuanghuanglian powder injection combined with imipenem for Klebsiella pneumoniae showed that:FIC index≤0.5 accounted for 6.7%,FIC index>0.5-1.0 accounted for 53.3%,FIC index>1.0-2.0 accounted for 33.3%,FIC index>2.0 accounted for 6.7%.The results of FIC index of Shuanghuanglian powder injection combined with cefoperazone/sulbactam for Klebsiella pneumoniae showed that:FIC index≤0.5 accounted for 0,FIC index>0.5-1.0 accounted for 13.3%,FIC index>1.0-2.0 accounted for 23.3%,FIC index>2.0 accounted for 63.3%.The results of FIC index of Shuanghuanglian powder injection combined with minocycline for Klebsiella pneumoniae showed that:FIC index≤0.5 accounted for 0,FIC index>0.5-1.0 accounted for 3.3%,FIC index>1.0-2.0 accounted for 30.0%,FIC index>2.0 accounted for 66.7%.Conclusion The combination of Shuanghuanglian and imipenem showed synergistic and additive effects on Klebsiella pneumoniae,and the combination in vitro had better antibacterial effect.However,the combination of Shuanghuanglian,cefoperazone/sulbactam and minocycline showed no significant and antagonistic effects,but the combination of Shuanghuanglian and cefoperazone/sulbactam and minocycline had poor in vitro antibacterial effect on Klebsiella pneumoniae.

关 键 词：部分抑菌浓度 广泛耐药肺炎克雷伯菌 双黄连粉针剂 

分 类 号：R446.5[医药卫生—诊断学]