替加环素对肺炎克雷伯菌的防耐药突变浓度研究

发布时间：2018-06-21 23:12

本文选题：替加环素 + 肺炎克雷伯菌　；参考：《中国感染与化疗杂志》2017年06期

【摘要】：目的考察替加环素对肺炎克雷伯菌的潜在耐药性。方法测定替加环素对于药敏背景不同的肺炎克雷伯菌防突变浓度(MPC)和最低抑菌浓度(MIC)。比较MIC与MPC之间的相关性,考察是否能用MIC推测MPC值。结合MPC和防耐药突变窗(MSW)与替加环素药动学参数评估替加环素单药治疗对于肺炎克雷伯菌的潜在耐药性。结果碳青霉烯类耐药、喹诺酮类耐药组肺炎克雷伯菌对替加环素的MPC较碳青霉烯类敏感、喹诺酮类敏感组高出8倍。替加环素对于肺炎克雷伯菌的MPC范围在4~512 mg/L,MPC90为64 mg/L,远高于替加环素血药浓度。结论替加环素长期单药治疗对于肺炎克雷伯菌的潜在耐药率较高,不宜单独使用,提示临床应加强监测替加环素菌株敏感性及替加环素疗效。
[Abstract]:Objective to investigate the potential resistance of tegicycline to Klebsiella pneumoniae. Methods the anti-mutation concentration (MPC) and minimum inhibitory concentration (MIC) of tigicycline against Klebsiella pneumoniae with different drug sensitive background were determined. To compare the correlation between MIC and MPC, and to investigate whether the MPC value can be inferred from MIC. Combined with MPC, antimicrobial resistance window (MSW) and tigicycline pharmacokinetic parameters, the potential resistance of tegacyclin monotherapy to Klebsiella pneumoniae was evaluated. Results the resistance of carbapenems to carbapenes, the susceptibility of Klebsiella pneumoniae to tegacycline in quinolone resistant group was 8 times higher than that of carbapenem group and quinolone group. The MPC range of tegicycline against Klebsiella pneumoniae was at 4.512mg / L, 64 mg / L, which was much higher than that of tigicycline. Conclusion the potential resistance rate of tegicycline to Klebsiella pneumoniae is high for a long time and should not be used alone. It is suggested that the clinical monitoring of the sensitivity of tegacycline strain and the efficacy of tegacycline should be strengthened.
【作者单位】：北京大学人民医院药剂科;北京医院检验科;
【分类号】：R446.5

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