摘要
目的:分析不同抗菌药物单用和联合应用抗多重耐药鲍曼不动杆菌作用效果。方法:测定不同单种抗菌药物和多种抗菌药物联合应用,对鲍曼不动杆菌的最小抑菌浓度(MICs),然后用该浓度的不同单种抗菌药物及抗菌药物组合治疗鲍曼不动杆菌感染的小鼠,观察各药对感染小鼠的保护作用。结果:亚胺培南/西司他丁钠、哌拉西林/他唑巴坦、头孢哌酮/他唑巴坦、利福平、头孢他啶、丁胺卡那、环丙沙星的MIC分别为(μg/ml):64、512、64、250、2048、2048、150;特治星(128μg/ml)使丁胺卡那(μg/ml)从2048下降到64,舒普深(32μg/ml)可使利福平(μg/ml)从128下降到8,舒普深(32μg/ml)与丁胺卡那(1024μg/ml)联合有效,泰能(32μg/ml)与丁胺卡那(1024μg/ml)联合无效,特治星(256μg/ml)与利福平(128μg/ml)、泰能(16μg/ml)与利福平(128μg/ml)联合均无效;特治星(140.4mg/24h)、特治星(70.2mg/24h)与丁胺卡那(7.8mg/24h)、舒普深(41.6mg/24h)与丁胺卡那(7.8mg/24h)联合治疗,对感染小鼠的保护率(%)分别为30,100,100,舒普深(83.2mg/24h)、泰能(83.2mg/24h)治疗组小鼠全部死亡。结论:多重耐药鲍曼不动杆菌对常见抗菌药物的MIC均显著增加,特治星治疗多重耐药鲍曼不动杆菌比其他抗菌药物效好。特治星与丁胺卡那联合、舒普深与丁胺卡那联合联合治疗有效,而泰能对丁胺卡那、特治星等抗菌药物具有拮抗作用。合理的多药联合不仅对治疗多重耐药鲍曼不动杆菌有效,而且可以减少药物剂量。
Objective：To analyze the antibiosis effection of single antibiotics and antibiotics combination on multi-drug resistant Acinetobacter baumarnii in vivo and in vitro. Methods ：We determined the minimum inhabitant concentration （MICs） of 7 antibiotics and several antibiotics combination to multi-drug resistant Acinetobacter baumarnii . The mice infected by multi-drug resistant Acinetobacter baumarnii were treated with Imipenem-Cilastatin Sodium, Cefperazone-Sulbactam , Piperacillin-Tazobactam, Amikacin and Suloerazon, Amikacin and Tazocillin. Results ： The MIC （μg/ml） of Tienem, Tazocillin, Suloerazon, Rifampicin, Ceftazidime, Amikacin, Ciprofloxacin were 64,512,64,250, 2048,2048, 150, respectively. Tazocillin （ 128μg/ml ） could decreased the MIC of Amikacin from 2048 to 128, Suloerazon （32μg/ml） could decreased the MIC of Rifampicin from 250 to 16. The antibiotics combination of Suloerazon（32） and Amikacin（1024） could inhabit multi-drug resistant Acinetobacter baumarnii,but antibiotics combination of Tienem（32） and Amikacin（1024） ,Tazocillin（256） and Rifampicin（128） ,could not inhabit multi-drug resistant Acinetobacter baumarnii. The protection rate （%） of Tazocillin （140. 4 mg/24h）, antibiotics combination of Tazocillin （70. 2 mg/24h） and Amikacin （7. 8 mg/24h）, Suloerazon （41.6mg/24h） and Amikacin （7.8mg/24h） were 30,100,100,respectively. The infectious mice treated with Tienem （83.2 mg/24h）and Suloerazoa （83. 2 mg/24h） all died. Conclusion： There were obviously increased in MICs of common antibiotics for multi-drug resistant Acinetobacter baumarnii, but, the protective efficiency of Tazocillin on infectious mice is superior to the other antibiotics. It is more efficicently appling both Tazocillin and Amikacin, Suloerazon and Amikacin. But Tienem has antagonistic action on Amikacin or Tazocillin and so on. Reasonly, combinately, antibiotics application are available to multi-drug resistant Acinetobacter baumarnii, also reduce the
关键词
多重耐药
鲍曼不动杆菌
药物浓度
联合用药
药敏试验
Multidrug resistant
Acinetobacter baumarnii
Drug concentration
Antibiotics combination
Antibiotics Susceptibility test
