亚胺培南联合头孢他啶对产KPC-2酶肺炎克雷伯菌的体外抗菌效果  

Antibacterial effect of imipenem combined with ceftazidime on KPC-2 enzyme producing Klebsiella pneumoniae in vitro

作　　者：盛巍 叶美娟 卢冰清 程韬 凌迎春[4] Sheng Wei;Ye Meijuan;Lu Bingqing;Cheng Tao;Ling Yingchun(Department of Pharmacy,the Second Hospital of Jinhua,Zhejiang Province,Jinhua 321000,China;Geriatric Ward I,the Second Hospital of Jinhua,Zhejiang Province,Jinhua 321000,China;President's Office,Lanxi District of the Second Hospital of Jinhua,Zhejiang Province,Jinhua 321000,China;Department of Laboratory,Shaoxing Seventh People's Hospital,Zhejiang Province,Shaoxing 312000,China)

机构地区：[1]浙江省金华市第二医院药剂科,金华321000 [2]浙江省金华市第二医院老年一病区,金华321000 [3]浙江省金华市第二医院兰溪院区院长办公室,金华321000 [4]浙江省绍兴市第七人民医院检验科,绍兴312000

出　　处：《中国医药》2022年第2期266-268,共3页China Medicine

基　　金：浙江省医学会临床科研资金项目(2018ZYC-A128)。

摘　　要：目的探讨亚胺培南联合头孢他啶对产KPC-2酶肺炎克雷伯菌的体外抗菌效果。方法回顾性分析浙江省金华市第二医院2019年1月至2020年12月收治的150例产KPC-2酶肺炎克雷伯菌感染患者的临床资料,送检标本中共分离出产KPC-2酶的肺炎克雷伯菌150株,分析检出菌株的标本分布情况、药物敏感试验结果、KPC基因型筛查结果以及亚胺培南联合头孢他啶的最低抑菌浓度值。结果 150株产KPC-2酶肺炎克雷伯菌检出标本来源为痰液84株(56.0%)、尿液43株(28.7%)、分泌物11株(7.3%)、血液9株(6.0%)、腹腔积液3株(2.0%);菌株对亚胺培南的耐药率为48.7%(73/150),对头孢他啶的耐药率为100%(150/150),对二者联合的耐药率为22.7%(34/150);均为携带blaKPC-2基因型。亚胺培南与头孢他啶联合的分级抑菌浓度指数<0.5,两种药物存在协同作用。结论亚胺培南联合头孢他啶对产KPC-2酶肺炎克雷伯菌具有明显的体外抗菌效应,为临床治疗产KPC-2酶肺炎克雷伯菌感染增加了一种用药选择。Objective To investigate the antibacterial effect of imipenem combined with ceftazidime on KPC-2 enzyme producing Klebsiella pneumoniae in vitro. Methods From January 2019 to December 2020, Clinical data of 150 patients with KPC-2 enzyme producing Klebsiella pneumoniae infection treated in the Second Hospital of Jinhua, Zhejiang Province were retrospectively analyzed. A total of 150 strains of KPC-2 enzyme producing Klebsiella pneumoniae were isolated. The sample distribution, drug sensitivity test results, KPC genotype screening results and the minimum inhibitory concentration of imipenem combined with ceftazidime were analyzed. Results Among 150 strains of KPC-2 enzyme producing Klebsiella pneumoniae were detected, including 84 strains(56.0%)of sputum, 43 strains(28.7%) of urine, 11 strains(7.3%) of secretion, 9 strains(6.0%) of blood and 3 strains(2.0%) of peritoneal effusion. The resistance rate to imipenem was 48.7%(73/150), the resistance rate to ceftazidime was 100%(150/150), and the resistance rate to the combination of the two was 22.7%(34/150). All of the strains carried blaKPC-2 genotype;the combined minimum inhibitory concentration value of the two drugs was <0.5, and the two drugs had synergistic effect. Conclusion Imipenem combined with ceftazidime has obvious antibacterial effect on KPC-2 enzyme producing Klebsiella pneumoniae in vitro, which increases a choice for clinical treatment of KPC-2 enzyme producing Klebsiella pneumoniae infection.

关 键 词：肺炎克雷伯菌 亚胺培南 头孢他啶 产KPC-2酶 药物敏感试验 

分 类 号：R517.6[医药卫生—内科学]