多黏菌素E联合磷霉素对产碳青霉烯酶肺炎克雷伯菌的体外抗菌活性研究

发布时间：2018-03-12 16:36

本文选题：多黏菌素E　切入点：磷霉素　出处：《中国药学杂志》2017年13期 　论文类型：期刊论文

【摘要】：目的评价多黏菌素E联合磷霉素对74株产碳青霉烯酶肺炎克雷伯菌(Klebsiella pneumoniae carbapenemase-producing K.pneumoniae,KPC-Kp)的体外抗菌效应。方法分别用微量肉汤稀释法和琼脂平板稀释法测定多黏菌素E和磷霉素对74株KPC-Kp的最低抑菌浓度(MIC)值。用棋盘法计算部分抑菌浓度指数来判定联合效应。从中随机选取6株KPC-Kp测定多黏菌素E与磷霉素单用或联用的时间杀菌曲线。结果 MIC结果:多黏菌素敏感率100%,磷霉素敏感率为35.14%,FIC结果:多黏菌素E与磷霉素联合用药协同率为12.16%,部分协同率为39.19%,相加为6.76%,无关为41.89%,无拮抗作用。杀菌曲线结果:对于磷霉素敏感菌株,多黏菌素E联合磷霉素有明显的协同作用,磷霉素耐药菌株则没有明显协同作用。结论对于磷霉素敏感菌株,多黏菌素E与磷霉素联合用药在体外对KPC-Kp以协同作用和相加作用为主,杀菌曲线也显示了较好的协同作用,而磷霉素耐药菌株和多黏菌素协同作用较差。
[Abstract]:Objective to evaluate the in vitro antibacterial effect of polymyxin E combined with fosfomycin against 74 strains of Klebsiella pneumoniae carbapenemase-producing K. pneumoniae KPC-Kp. Methods the concentrations of polymyxin E and phosphorus in 74 strains of Klebsiella pneumoniae carbapenemase-producing K. pneumoniae KPC-Kp were determined by micro broth dilution method and Agar plate dilution method, respectively. The minimum inhibitory concentration (MIC) of mycin on 74 strains of KPC-Kp was determined. The combined effect was determined by calculating partial inhibitory concentration index by chessboard method. Six strains of KPC-Kp were randomly selected to determine the bactericidal curve of polymyxin E and fosfomycin for single or combined use. Results: the MIC results showed that the sensitivity rate of polymyxin was 100%, the sensitivity rate of fosfomycin was 35.14%, the synergistic rate of polymyxin E and fosfomycin was 12.1616g, the partial synergistic rate was 39.19, the sum was 6.76g, and there was no antagonistic effect on the bactericidal curve. Results: for fosfomycin sensitive strains, Polymyxin E combined with fosfomycin has obvious synergistic effect, while phosphomycin resistant strain has no obvious synergistic effect. The synergistic and additive effects of polymyxin E and fosfomycin on KPC-Kp in vitro were observed. The bactericidal curve also showed a good synergistic effect, but the synergistic effect between phosphomycin resistant strains and polymyxin was poor.
【作者单位】：沈阳药科大学生命科学与生物制药学院;中国人民解放军总医院呼吸科;中国人民解放军总医院药物/器械临床试验中心;中国人民解放军总医院药材处;
【基金】：“十二五”国家重大科技专项基金资助项目(2012ZX09303004-002)
【分类号】：R96

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