亚胺培南与舒巴坦联合应用对多重耐药肺炎克雷伯菌的体外试验研究

发布时间：2018-01-01 06:33

本文关键词：亚胺培南与舒巴坦联合应用对多重耐药肺炎克雷伯菌的体外试验研究　出处：《实用医学杂志》2016年03期 　论文类型：期刊论文

【摘要】：目的:评价多种抗生素及联合应用对耐碳青霉烯酶类肺炎克雷伯菌(KPN)的体外抗菌活性。方法:选取24株临床分离多重耐药KPN菌株,经改良Hodge实验验证其是否产碳青霉烯酶;采用微量肉汤稀释法,测定多黏菌素对各菌株的最低抑菌浓度(MIC);对7株多黏菌素MIC中介的KPN,应用棋盘法检测亚胺培南与头孢哌酮-舒巴坦等4种抗生素联合应用的MIC值,计算ΣFIC值,判断是否具有协同作用。结果:受试菌均产碳青霉烯酶,多数对多黏菌素敏感,7株MIC为中介;联合药敏实验显示仅亚胺培南与头孢哌酮-舒巴坦联合时ΣFIC≤0.5,表现为协同作用。结论:亚胺培南与头孢哌酮-舒巴坦联合应用表现为协同作用,可有效提高临床治疗效果,为临床调整治疗方案提供实验依据。
[Abstract]:Objective: To evaluate the combined application of antibiotics and carbapenem resistant enzymes of Klebsiella pneumoniae (KPN) antibacterial activity in vitro. Methods: a total of 24 clinical isolates of multidrug-resistant strain KPN, the modified Hodge experiment to test whether the carbapenemases; using the broth microdilution method, determination of the minimum inhibitory concentration of hormone all strains of colistin (MIC); 7 strains of polymyxin MIC mediated KPN combined application of checkerboard assay of imipenem and cefoperazone sulbactam 4 antibiotics such as MIC value, calculated Sigma FIC value, judge whether it has synergistic effect. Results: the bacteria were carbapenemases and the most susceptible to polymyxin, 7 strains of MIC as an intermediary; combined drug susceptibility test showed that imipenem and cefoperazone sulbactam combined Sigma FIC 0.5, showed a synergistic effect. Conclusion: the combined application of imipenem and cefoperazone sulbactam showed a synergistic effect, It can effectively improve the effect of clinical treatment, and provide experimental basis for clinical adjustment of the treatment plan.

【作者单位】：南京中医药大学附属医院/江苏省中医院检验科;
【基金】：江苏省中医药局科技项目(国家中医临床研究基地开放课题)(编号:JD201504)
【分类号】：R446.5
【正文快照】： 肺炎克雷伯菌(Klebsiella pneumoniae,KPN)是院内感染最常见的致病菌之一, 随着碳青霉烯类药物治疗多药耐药KPN的广泛应用, 碳青霉烯类耐药的KPN比例呈快速上升的趋势, 给临床抗感染治疗带来极大困难[1]。多黏菌素由于肾毒性及神经毒性在过去几十年中限制了其临床应用, 然而

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