摘要
目的评价多黏菌素E(colistin)分别与米诺环素和磷霉素联用对临床分离得到的73株多重耐药鲍曼不动杆菌(multidrug-resistant Acinetobacter baumannii,MDR-Ab)的联合体外抗菌活性,探讨两药联用的抗MDR-Ab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73株临床分离Ab最低抑菌浓度,并计算FIC指数判定联合效应。FIC指数的判定标准:FIC≤0.5为协同作用,0.5<FIC<1为部分协同作用,FIC=1为相加作用,1<FIC<4为无关作用,FIC≥4为拮抗作用。结果多黏菌素E与米诺环素联用后,FIC指数分布情况:FIC≤0.5占6.85%,0.5<FIC≤1占61.64%,FIC=1占31.51%,1<FIC<4为0,FIC≥4为0;多黏菌素E与磷霉素联用后,FIC指数分布情况:FIC≤0.5占15.07%,0.5<FIC<1占47.95%,FIC=1占38.88%,1<FIC<4占4.11%,FIC≥4为0。结论多黏菌素E分别与米诺环素和磷霉素联合应用对73株临床分离的MDR-Ab菌株的体外抗菌效应表现为以协同作用、部分协同作用和相加作用为主,无拮抗作用,多黏菌素联用磷霉素极少部分菌株表现出无关作用。
OBJECTIVE To evaluate the antibiotic effects in vitro of colistin combined with other antibacterials respectively against 73 strains of multidrug-resistant Acinetobacter baurnannii （MDR-Ab）. METHODS The protocol was designed by checkerboard method and the MICs of drugs alone and combination against the 73 strains of Acinetobacter baumannii were determined by broth dilution method, the FIC index was calculated according to MIC results. The interaction was measured by the fractional inhibitory concentration index （FIC） ： antagonism was defined as FICI I〉 4, indifference as 1 〈 FICI 〈4, additivity as FICI = 1 ,partially synergism as 0. 5 〈 FICI 〈 1, and synergism as FICI~〈 0. 5. RESULTS Combined eolistin and minocycline showed 6. 85% synergism, 61.64% partially synergism, 31.55% additivity, no indifference, and antagonistic effect on MDR-AB strains. Combined colistin and fosfomycin demonstrated 15.07% synergism, 47.95% partially synergism, 32.88% additivity, 4. 11% indifference, and no antagonistic effect on MDR-AB strains. CONCLUSION The results suggested that synergism and partially synergism and addition of colistin combined with minocycline and fosfomyein respectively against 73 strains of Acinetobacter baurnannii were main action, there are little indifference and no antagonism.
出处
《中国药学杂志》
CAS
CSCD
北大核心
2015年第5期427-430,共4页
Chinese Pharmaceutical Journal
基金
"十二五"国家重大科技专项(2012ZX09303004-002)
