南方医科大学学报 ›› 2014, Vol. 34 ›› Issue (11): 1697-.

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泛耐药鲍曼不动杆菌的体外联合药敏分析

陆一丹,张亚莉,周浩,于芳,孙树梅,芮勇宇   

  • 出版日期:2014-11-20 发布日期:2014-11-20

Combined drug sensitivity test of 50 strains of extensively drug-resistant Acinetobacter
baumannii

  • Online:2014-11-20 Published:2014-11-20

摘要: 目的评价美罗培南与多西环素、环丙沙星、舒巴坦及头孢哌酮/舒巴坦联合用药对泛耐药鲍曼不动杆菌的体外抗菌效应。
方法采用棋盘法设计,微量肉汤稀释法测定不同浓度组合的抗菌药物对50株临床分离的泛耐药鲍曼不动杆菌的最低抑菌浓
度,并计算部分抑菌浓度(FIC)指数判定联合效应。结果美罗培南与多西环素联用后,其MIC50显著下降,FIC指数分布:FIC≤
0.5 占38%,0.5<FIC≤1 占62%,1<FIC≤2 为0,FIC>2 为0。美罗培南与环丙沙星联用后,其MIC50下降不明显,FIC 指数分布:
FIC≤0.5 为0,0.5<FIC≤1 占56%,1<FIC≤2 为44%,FIC>2 为0。美罗培南与舒巴坦联用后,其MIC50明显下降,FIC指数分布:
FIC≤0.5为26%,0.5<FIC≤1占74%,1<FIC≤2为0,FIC>2为0。美罗培南与头孢哌酮/舒巴坦联用后,其MIC50有所下降,FIC指
数分布:FIC≤0.5为10%,0.5<FIC≤1占90%,1<FIC≤2为0,FIC>2为0。结论美罗培南与多西环素、舒巴坦或者头孢哌酮/舒巴
坦联合,对泛耐药鲍曼不动杆菌均表现为协同和相加作用,没有无关作用和拮抗作用,具有良好的体外抗菌活性;而美罗培南与
环丙沙星联合表现出的相加作用和无关作用比例相当,对泛耐药鲍曼不动杆菌的体外抗菌活性较差。

Abstract: Objective To study the in vitro antibacterial activity of meropenem combined with doxycycline, ciprofloxacin,
sulbactam or cefoperazone/sulbactam against clinically isolated extensively drug-resistant Acinetobacter baumannii (XDRAB).
Methods Using a checker board synergy design, the minimal inhibitory concentration (MIC) of antibiotics against 50 isolates
of XDRAB was determined by broth microdilution antifungal susceptibility test. The fractional inhibitory concentration (FIC)
index was calculated to determine the combined effect of the antibiotics. Results Meropenem showed significantly reduced
MIC50 and enhanced antimicrobial activities when combined with doxycycline, sulbactam or cefoperazone/sulbactam. The
FIC results suggested that the main actions of doxycycline, sulbactam, and cefoperazone/sulbactam were synergistic (38%,
26%, and 10%, respectively) and addictive (62%, 74%, and 90%, respectively) without indifferent or antagonistic effects. The
main actions of meropenem combined with ciprofloxacin were additive (56%) and indifference (44%) with synergistic and
antagonistic effects. Conclusion Meropenem combined with doxycycline, sulbactam or cefoperazone/sulbactam shows
excellent activity against clinical isolates of XDRAB.