多黏菌素B异质性耐药鲍曼不动杆菌的体外联合药敏研究  

A study on combined in vitro drug sensitivity test of polymyxin-B heteroresistant Acinetobacter baumannii

作　　者：赵玉杰[1] 秦玲[1] 吴巧萍[1] 周世平 ZHAO Yu-jie;QIN Ling;WU Qiao-ping;ZHOU Shi-ping(Ningbo Medical Center Lihuili Hospital,Zhejiang 315040,China)

机构地区：[1]浙江省宁波市医疗中心李惠利医院,浙江315040

出　　处：《中国卫生检验杂志》2023年第4期397-400,共4页Chinese Journal of Health Laboratory Technology

基　　金：宁波市自然基金项目(2019A610390);浙江省医药卫生科技计划项目(2023KY245)。

摘　　要：目的 探讨本院鲍曼不动杆菌对多黏菌素B异质性耐药及联合用药对异质性耐药株的体外抗菌作用。方法 挑选346株多重耐药鲍曼不动杆菌,微量肉汤稀释法检测对多黏菌素B的最低抑菌浓度(minimal inhibitory concentration, MIC)。纸片扩散法和群体谱分析法(population analysis profiles, PAPs)筛选多黏菌素B异质性耐药株。多黏菌素B对异质性耐药株的联合抑菌效应判断采用棋盘法。结果 346株鲍曼不动杆菌对多黏菌素B高度敏感。PAPs从中筛选出7株异质性耐药株。多黏菌素B与美罗培南联合的作用最佳,协同比例为57.1%(4/7),相加比例为14.3%(1/7)。多黏菌素B联合左氧氟沙星作用次之,协同比例为42.9%(3/7),相加比例为57.1%(4/7)。多黏菌素B联合头孢哌酮//舒巴坦的作用最差,协同比例仅14.3%(1/7)。结论 本院多重耐药鲍曼不动杆菌对多黏菌素B敏感性高,但存在异质性耐药现象。多黏菌素B与美罗培南或左氧氟沙星联合的体外抗菌效应最好。Objective This paper aims to investigate the drug resistance of Acinetobacter baumannii on polymyxin-B heterogeneity and in vitro antibacterial effect on heterogeneous resistant strains. Methods A total of 346 strains of multidrug resistant Acinetobacter baumannii were selected, and the minimal inhibitory concentration(MIC) of polymyxin B was detected by broth microdilution method. Polymyxin-B heteroresistant strains were detected by disk diffusion method and population spectrum analysis(PAPs). The combined antibacterial effect of polymyxin B on heteroresistant strains was determined by Chequer-board method. Results A total of 346 strains of Acinetobacter baumannii were highly sensitive to polymyxin B. Seven polymyxin B heteroresistant strains were screened by PAPs. Polymyxin B combined with meropenem showed synergistic ratio of 57.1%(4/7 strains) and additive ratio of 14.3%(1/7 strains), followed by polymyxin B combined with levofloxacin, accounting for 42.9%(3/7 strains) of synergistic effect and 57.1%(4/7) of additive effect. Polymyxin B combined with cefoperazone/sulbactam had the worst effect, and the synergistic effect was only 14.3%(1/7 strains). Conclusion Multidrug-resistant Acinetobacter baumannii was highly sensitive to polymyxin B, but there was heteroresistance. Polymyxin B combined with meropenem or levofloxacin had the best antibacterial effects in vitro.

关 键 词：多黏菌素B 鲍曼不动杆菌 异质性耐药 联合药敏 

分 类 号：R446[医药卫生—诊断学]