摘要
目的了解抗菌药物对多重耐药鲍曼不动杆菌的体外联合抗菌活性,为临床治疗多重耐药鲍曼不动杆菌感染提供实验依据。方法采用常规培养方法分离细菌,应用全自动细菌分析仪对其进行鉴定。药敏试验采用K-B纸片法,MIC测定采用琼脂平板倍比稀释法,按CLSI规定标准进行。结果从临床分离的菌株中共筛选出30株多重耐药鲍曼不动杆菌。奈替米星对多重鲍曼不动杆菌没有抑菌作用;亚胺培南、美罗培南的敏感率约为50%;其他常用抗菌药物(如头孢哌酮/舒巴坦、多西环素、利福平、莫西沙星)的敏感率均小于35%。碳青酶烯类药物(亚胺培南、美罗培南)与头孢哌酮/舒巴坦联合的协同作用高于其他抗菌药联合物;多西环素、利福平分别与亚胺培南、美罗培南联合时均无协同作用;所有这些联合抗菌药物均未出现拮抗作用。结论对多重耐药鲍曼不动杆菌引起的感染,应选择亚胺培南或美罗培南与头孢哌酮/舒巴坦联合治疗,以有效地控制感染,防止耐药株在医院内感染的扩散。
Objective To study the antibacterial activity of combined antibacterials against muhidrug resistant Acinetobacter baumannii in vitro, and provides experimental data for clinical treatmen. Methods All the strains were separated by the method of conventicnal culture and identified by automatic bacterial analysator. Kirby - Bauer paper disk method was used in the susceptibility test. Agar plate double dilution was used in the MIC detection according to the standard of CLSI. Results Thirty strains of muhidrug - resistant Acinetobacter baumannii were chosen from the clinically separated bacterial strains. Netilmicin had no bacteriostasis against Acinetobacter baumannii. The sensitive rates of imipenem and meropenem were about 50%. The sensitive rates of other common antibacterials such as cefoperazone/sulbactam, doxycycline, rifampicin, moxifloxacin were all less than 35%. The synergy of carbapenems（ imipenem and meropenem）combined with cefoperazone/sulbactam was much stronger than that of the other antibacterial combinations. There was no synergy when doxycycline and rifampicin were respectively combined with imipenem and meropenem. In addition, the antagonism did not occurred in the combination of above antibactcrials. Conclusion Muhidrug - resistant Acinetobacter baumannii infection should be treated by the therapeutic alliance of imipenem or meropenem with cefoperazone/sulbactam in order to effectively control the infection and prevent the diffusion of drug - resistant strains in hospitals.
出处
《西南国防医药》
CAS
2011年第11期1170-1172,共3页
Medical Journal of National Defending Forces in Southwest China
关键词
鲍曼不动杆菌
最低抑菌浓度
协同作用
抗菌药物
联合治疗
Acinetobacter baumannii
minimum inhibitory concentration
synergy
antibactarials
therapeutic alliance
