多粘菌素B联合不同抗菌药物对耐碳青霉烯类肺炎克雷伯菌的体外抗菌作用

摘要
图/表
参考文献
相关文章 (15)

全文: PDF (1538 KB) HTML (1 KB)
输出: BibTeX | EndNote (RIS)

摘要目的：评价多粘菌素B分别与美罗培南、利福平联合用药对临床分离的耐碳青霉烯类肺炎克雷伯菌（CRKP）的体外抗菌作用。方法：采用肉汤稀释法和棋盘稀释法测定多粘菌素B分别联用美罗培南和利福平对20株临床分离的CRKP的最低抑菌浓度，并计算部分抑菌浓度指数。结果：多粘菌素B与美罗培南联用后对CRKP有协同作用的占55%，表现出相加作用占45%，不存在无关和拮抗作用；多粘菌素B与利福平联用后对CRKP协同作用的占65%，相加作用占35%，不存在无关和拮抗作用。结论：多粘菌素B与美罗培南或利福平联用在体外对CRKP抗菌效应均主要表现为协同和相加作用。

	服务
	把本文推荐给朋友
	加入我的书架
	加入引用管理器
	E-mail Alert
	RSS
	作者相关文章
	吴正海
	刘海洋
	陈华乐
	段达荣
	周铁丽

关键词 ： , 肺炎克雷伯菌, 碳青霉烯酶, 多粘菌素B, 美罗培南, 利福平, 联合用药

Abstract：Objective: To evaluate the combined inhibitory effect of polymyxin B with meropenem and rifampicin respectively against carbapenem-resistant Klebsiella pneumoniae (CRKP) strains in vitro. Methods: Combined inhibitory effect of polymyxin B and meropenem, polymyxin B and rifampicin in vitro was assayed by detecting the minimum inhibitory concentration and calculating the fractional inhibitory concentration index for 20 CRKP strains with the checkerboard dilution method. Results: Combined polymyxin B and meropenem showed 55% synergic effect, 45% additive effect, no indifferent and antagonistic effect on CRKP strains. Combined polymyxin B and rifampicin displayed 65% synergic effect, 35% additive effect, no indifferent and antagonistic effect on CRKP strains. Conclusion: Combined polymyxin B and meropenem, combined polymyxin B and rifampicin show a combined synergic and additive inhibitory on CRKP strain in vitro.

Key words： Klebsiella pneumoniae carbapenemases polymyxin B meropenem rifampicin drug-combination

收稿日期: 2017-06-05

基金资助:温州市科技局科研基金资助项目（Y20170204）。

通讯作者: 周铁丽，教授，Email：wyztli@163.com

作者简介: 吴正海（1985-），男，浙江台州人，主管技师，在职硕士生。

链接本文:

https://xb.wmu.edu.cn/CN/ 或 https://xb.wmu.edu.cn/CN/Y2017/V47/I12/898

[1] 曹慧玲, 舒钊彻, 杨琳, 等. 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[J]. 实用医学杂志, 2016, 32(3): 475-478.
[2] LY N S, BULITTA J B, RAO G G, et al. Colistin and doripenem combinations against Pseudomonas aeruginosa: profiling the time course of synergistic killing and prevention of resistance[J]. J Antimicrob Chemother, 2015, 70(5): 1434-1442.
[3] National Committee for Clinical Laboratory Standards. Performance standards for antimicrobial susceptibility testing; Twenty-fourth informational supplement[S]. M100-S24, CLSI, 2014.
[4] 沈绍清, 任浩洋, 蔡芸. 多黏菌素联合用药研究进展[J]. 中国抗生素杂志, 2016, 41(3): 166-172.
[5] 胡付品, 朱德妹, 汪复, 等. 2015年CHINET细菌耐药性监测[J]. 中国感染与化疗杂志, 2016, 16(6): 685-694.
[6] PITOUT J D , NORDMANN P, POIREL L. Carbapenemase-producing Klebsiella pneumoniae, a key pathogen set for global nosocomial dominance[J]. Antimicrob Agents Chemother, 2015, 59(10): 5873-5884.
[7] BRATU S, TOLANEY P, KARUMUDI U, et al. Carbapenemase-producing Klebsiella pneumoniae in Brooklyn, NY: molecular epidemiology and in vitro activity of polymyxin B and other agents[J]. J Antimicrob Chemother, 2005, 56(1): 128-132.
[8] ELEMAM A, RAHIMIAN J, DOYMAZ M. In vitro evaluation of antibiotic synergy for polymyxin B-resistant carbapenemase-producing Klebsiella pneumoniae[J]. J Clin Microbiol, 2010, 48(10): 3558-3562.
[9] TASCINI C, TAGLIAFERRI E, GIANI T, et al. Synergistic activity of colistin plus rifampin against colistin-resistant KPC-producing Klebsiella pneumoniae[J]. Antimicrob Agents Chemother, 2013, 57(8): 3990-3993.
[10] QURESHI Z A, PATERSON D L, POTOSKI B A, et al. Treatment outcome of bacteremia due to KPC-producing Klebsiella pneumoniae: superiority of combination antimicrobial regimens[J]. Antimicrob Agents Chemother, 2012, 56(4): 2108-2113.
[11] WAREHAM D W, BEAN D C. In-vitro activity of polymyxin B in combination with imipenem, rifampicin and azithromycin versus multidrug resistant strains of Acinetobacter baumannii producing OXA-23 carbapenemases[J]. Ann Clin Microbiol Antimicrob, 2006, 5(1): 1-5.
[12] 杨德青, 倪文涛, 王睿, 等. 多黏菌素耐药革兰阴性菌研究的文献计量分析[J]. 中国临床药理学杂志, 2016, 32(17): 1617-1620.