头孢西丁等8种抗菌药物单用或联用对产ESBLs肺炎克雷伯菌的体外抗菌活性比较

发布时间：2019-04-20 10:50

【摘要】：目的:探讨头孢西丁等8种抗菌药物单用或联用对产ESBLs肺炎克雷伯菌体外抗菌活性的影响。方法:收集2013年7月-2014年1月我院收治的患者痰、血、尿液、大便标本,从中分离得到50株产超广谱β-内酰胺酶(ESBLs)的肺炎克雷伯菌,采用微量肉汤稀释法、棋盘法分别测定哌拉西林/他唑巴坦、美洛西林/舒巴坦、异帕米星、美罗培南、头孢他啶、头孢噻肟、左氧氟沙星与头孢西丁单独及联用时对临床分离的50株产ESBLs肺炎克雷伯菌的最低抑菌浓度(MIC),计算联合抑菌浓度(FIC)指数,应用FIC指数来计算及判读抗菌药物联用对产ESBLs肺炎克雷伯菌体外抗菌作用的效果。结果:哌拉西林/他唑巴坦、美洛西林/舒巴坦与头孢西丁联合应用后,能显著降低各自的MIC值,分别有62.5%与53.5%的菌株表现为协同作用;37.5%与46.5%的菌株表现为相加作用。结论:对产ESBLs肺炎克雷伯菌的感染,可使用哌拉西林/他唑巴坦、美洛西林/舒巴坦与头孢西丁进行联合治疗。
[Abstract]:Aim: to investigate the effects of cefoxitin and other 8 antimicrobial agents on the antibacterial activity of Klebsiella pneumoniae producing ESBLs in vitro. Methods: from July 2013 to January 2014, 50 strains of Klebsiella pneumoniae producing extended-spectrum 尾-lactamase (ESBLs) were isolated from sputum, blood, urine and stool. Piperacillin / tazobactam, meloxicillin / sulbactam, imipamicin, meropenem, ceftazidime and cefotaxime were determined by chess board method. The minimal inhibitory concentration (MIC),) of levofloxacin and cefoxitin against 50 clinical isolates of Klebsiella pneumoniae producing ESBLs was calculated by (FIC) index. FIC index was used to calculate and interpret the antibacterial effect of ESBLs-producing Klebsiella pneumoniae in vitro. Results: combined application of piperacillin / tazobactam, mezlocillin / sulbactam and cefoxitin significantly decreased their MIC values. 62.5% and 53.5% strains showed synergistic effects. 37.5% and 46.5% of the strains showed additive effect. Conclusion: piperacillin / tazobactam, meloxicillin / sulbactam and cefoxitin can be used in the treatment of ESBLs-producing Klebsiella pneumoniae infection.
【作者单位】：河北医科大学第二医院药学部;河北医科大学第二医院心脏外科;
【分类号】：R969

【相似文献】