摘要
目的:探讨肺炎患者体内肺炎克雷伯菌释放内毒素的影响因素。方法:查阅文献,对肺炎克雷伯菌释放内毒素可能产生影响的因素进行Logistic回归分析,明确影响因素后利用我院保存的肺炎克雷伯菌株进行体外实验,以抗菌药物标准菌株液稀释浓度梯度、培养时间、抗菌药物单用或联用为变量,利用EDS-99细菌内毒素检测仪定量测定内毒素释放量。结果:抗菌药物标准菌株液稀释浓度、培养时间和两种抗菌药物联用是肺炎克雷伯菌释放内毒素的影响因素,是否使用M-H肉汤培养基不对肺炎克雷伯菌释放内毒素产生影响。同种抗菌药物相同时间下细菌释放内毒素量大小顺序为1倍最低抑菌浓度(MIC)> 10倍MIC> 100倍MIC,同种抗菌药物相同浓度下细菌释放内毒素量大小顺序为8 h> 4 h> 2 h> 1 h,相同时间和浓度下单独使用抗菌药物比联合使用细菌释放内毒素量更多。结论:在临床肺炎克雷伯菌抗菌药物选用时,应结合肺炎克雷伯菌释放内毒素的影响因素,合理选用抗菌药物。
Objective:To investigate the factors influencing the release of endotoxin from Klebsiella pneumoniae in patients with pneumonia.Methods:Logistic regression analysis was carried out on the factors that could affect the release of endotoxin from Klebsiella pneumoniae.After the factors were determined,the klebber strains preserved in our hospital were tested in vitro,and the dilution concentration gradient,culture time,single use or combined use of antimicrobial agents were used as variables.The endotoxin release quantity was determined quantitatively by EDS-99 bacterial endotoxin test instrument.Results:The dilution concentration,culture time and the combination of two kinds of antibiotics were the factors affecting the release of endotoxin from Klebsiella pneumoniae,whether using M-H broth or not didn t affect the release of endotoxin.The order of bacterial release in the same time of the same antibacterials was 1 times of the minimum inhibitory concentration(minimum inhibitory concentration,MIC)>10 times of MIC>100 times of MIC.The order of the release endotoxin in the same concentration of the same antibacterial agents was 8 h>4 h>2 h>1 h.When the antibacterial drugs used alone at the same time and concentration,more endotoxin was released than the combined use of bacteria.Conclusion:In the selection of antibiotics for clinical Klebsiella pneumoniae,antibiotics should be rationally selected according to the factors influencing the release of endotoxin by Klebsiella pneumoniae.
作者
杨文平
刘爽
王海滨
亓玉心
刘长江
周玉法
YANG Wenping;LIU Shuang;WANG Haibin;QI Yuxin;LIU Changjiang;ZHOU Yufa(Department of Respiratory,Laiwu People s Hospital,Laiwu 271100,China)
出处
《东南大学学报（医学版）》
CAS
2018年第5期858-863,共6页
Journal of Southeast University(Medical Science Edition)
基金
国家自然科学基金资助项目(D010106)
