抗碳青霉烯类耐药肠杆菌科细菌感染治疗中的药敏研究  

Drug Sensitivity in the Treatment of Carbapenem-resistant Enterobacteriaceae Infection

作　　者：周赫 ZHOU He(Department of Laboratory,Jilin Central Hospital,Jilin Jilin 132013,China)

机构地区：[1]吉林省吉林市中心医院检验科,吉林吉林132013

出　　处：《中国卫生标准管理》2022年第8期116-119,共4页China Health Standard Management

摘　　要：目的分析头孢他啶/阿维巴坦联合比阿培南治疗抗碳青霉烯类耐药肠杆菌科细菌感染的药敏情况。方法选择2016年6月—2021年6月32株菌作为本次的研究对象,所选择的菌株均采用Vitek MS鉴定为肺炎克雷伯菌,进行体外药敏试验,对应用头孢他啶/阿维巴坦、比阿培南与头孢他啶/阿维巴坦联合比阿培南的最小抑菌浓度(minimum inhibitory concentration,MIC)值进行对比,以及抗碳青霉烯类耐药肺炎克雷伯菌对上述三种用药方式的药敏性。并分析产不同碳青霉烯酶的抗碳青霉烯类耐药肺炎克雷伯菌在不同用药方式下的MIC值。结果头孢他啶/阿维巴坦联合比阿培南与头孢他啶/阿维巴坦相比,MIC_(50)下降64倍,MIC_(90)下降8倍;头孢他啶/阿维巴坦联合比阿培南与比阿培南相比,MIC_(50)下降512倍,MIC_(90)下降256倍。药敏性从高到低:头孢他啶/阿维巴坦联合比阿培南>头孢他啶/阿维巴坦>比阿培南。产KPC-2抗碳青霉烯类耐药肺炎克雷伯菌,头孢他啶/阿维巴坦联合比阿培南与头孢他啶/阿维巴坦相比,MIC_(50)下降64倍,MIC_(90)下降8倍;产NDM-1抗碳青霉烯类耐药肺炎克雷伯菌,头孢他啶/阿维巴坦联合比阿培南与头孢他啶/阿维巴坦相比,MIC_(50)下降32倍,MIC_(90)下降4倍。结论将头孢他啶/阿维巴坦与比阿培南联合应用,能够分别降低头孢他啶/阿维巴坦与比阿培南对抗碳青霉烯类耐药肺炎克雷伯菌的MIC值,联合应用后增强了对该类细菌感染治疗的药敏性,有利于提升对该类细菌的治疗效果。Objective To analyze the drug susceptibility of ceftazidime/avibactam combined with biapenem in the treatment of carbapenemresistant enterobacteriaceae infections.Methods A total of 32 strains from June 2016 to June 2021 were selected as the subjects of this study.The selected strains were all identified as Klebsiella pneumoniae by Vitek MS,and an in vitro drug susceptibility test was performed.The minimum inhibitory concentration(MIC)values of ceftazidime/avibactam,biapenem and ceftazidime/avibactam combined with biapenem were compared,and the susceptibility of carbapenem-resistant Klebsiella pneumoniae of the above three modes of administration were compared.The MIC values of carbapenemresistant Klebsiella pneumoniae that produced different carbapenemases under different medications were analyzed.Results Compared with ceftazidime/avibactam,ceftazidime/avibactam combined with biapenem has a 64-fold decrease in MIC_(50) and an 8-fold decrease in MIC_(90);compared ceftazidime/avibactam combined with biapenem and biapenem,MIC_(50) decreased by 512 times and MIC_(90) decreased by 256 times.Drug susceptibility from high to low:ceftazidime/avibactam combined with biapenem>ceftazidime/avibactam>biapenem.KPC-2 produced carbapenem-resistant Klebsiella pneumonia,compared with ceftazidime/avibactam,the MIC_(50) of ceftazidime/avibactam combined with biapenem decreased by 64 times,and the MIC_(90) decreased by 8 times;NDM-1 produced carbapenem-resistant Klebsiella pneumonia,compared with ceftazidime/avibactam,the MIC_(50) of ceftazidime/avibactam combined with biapenem decreased by 32 times and the MIC_(90) decreased by 4 times.Conclusion The combined application of ceftazidime/avibactam and biapenem can reduce the MIC values of ceftazidime/avibactam and biapenem against carbapenem-resistant Klebsiella pneumoniae,respectively.The drug susceptibility against carbapenem-resistant Klebsiella pneumoniae is enhanced,which is beneficial to improve the therapeutic effect of anti-carbapenem-resistant Klebsiella pneumoniae infection

关 键 词：碳青霉烯 肺炎克雷伯菌 头孢他啶 阿维巴坦 比阿培南 药敏试验 

分 类 号：R451[医药卫生—治疗学]