首页|多黏菌素B联合抗菌药对不同耐药基因型耐碳青霉烯类肠杆菌目细菌的体外协同作用

多黏菌素B联合抗菌药对不同耐药基因型耐碳青霉烯类肠杆菌目细菌的体外协同作用

扫码查看
原文链接
  • NETL
  • NSTL
  • 万方数据
目的 评价多黏菌素B与美罗培南、阿米卡星、磷霉素联合对携带不同耐药基因的耐碳青霉烯类肠杆菌目细菌(CRE)的体外抗菌效果。方法 收集本院检验科2019年至2021年分离的CRE 76株，进行细菌鉴定并确认碳青霉烯酶基因型，采用微量肉汤稀释法测定多黏菌素B、美罗培南、阿米卡星、磷霉素对CRE的最低抑菌浓度(MIC)，采用微量棋盘稀释法进行多黏菌素B与美罗培南、阿米卡星、磷霉素的体外联合药敏试验，计算部分抑菌浓度指数(FICI)判断相互作用。结果 经鉴定，76株CRE中有携带blaKPC基因24株，携带blaNDM基因28株，携带blaOXA-48-like基因24株。CRE菌株对多黏菌素B、美罗培南、阿米卡星、磷霉素的耐药率分别为3％、92％、39％、45％。多黏菌素B与美罗培南的协同+部分协同率最高，为54％，其次为磷霉素(43％)，最低为阿米卡星(18％)。对于携带blaKPC、blaOXA-48-like、blaNDM基因的CRE，多黏菌素B与磷霉素联合的协同+部分协同率分别为37％、42％、50％，与美罗培南联合分别为75％、21％和64％，与阿米卡星联合分别为8％、25％、21％。未发现多黏菌素B与这三种抗菌药物存在拮抗作用。结论 多黏菌素B联合美罗培南对CRE的协同抑菌作用最好，联合效果与细菌耐药基因型有关，积极开展耐药基因检测有助于促进临床合理使用抗菌药物。
In vitro synergistic effect of polymyxin B combined with antibacterial drugs on different resistant genotypes of carbapenem-resistant Enterobacteriaceae
AIM To assess the in vitro antibacterial activity of polymyxin B in combination with meropenem,amikacin,and fosfomycin against carbapenem-resistant Enterobacteriaceae(CRE)strains carrying various resistance genes.METHODS A total of 76 CRE strains isolated from the clinical laboratory of our hospital between 2019 and 2021 were collected for identification and confirmation of carbapenemase genotype.The minimum inhibitory concentrations(MIC)of polymyxin B,meropenem,amikacin,and fosfomycin against CRE were determined using the broth microdilution method.The in vitro combined sensitivity tests of polymyxin B with meropenem,amikacin,and fosfomycin were performed using the microdilution checkerboard method to calculate the fractional inhibitory concentration index(FICI)for determining their interactions.RESULTS Among the 76 strains of CRE,24 strains were identified to carry the blaKPC,while 28 strains carried the blaNDM and another 24 strains carried the blaOXA-48-like.The drug-resistance rates of CRE strains to polymyxin B,meropenem,amikacin,and fosfomycin were determined as 3％,92％,39％,and 45％,respectively.The highest synergistic+partial synergistic rate was observed in combination of polymyxin B with meropenem(54％),followed by fosfomycin(43％)and amikacin(18％).For CRE carrying blaKPC,blaOXA-48-like,or blaNDM,the synergistic+partial synergistic rates of polymyxin B combined with fosfomycin were 37％,42％,and 50％,respectively,while combined with meropenem were 75％,21％,and 64％,respectively,and combined with amikacin were 8％,25％,and 21％,respectively.No antagonistic effect was observed between polymyxin B and these three antibiotics.CONCLUSION The combination of polymyxin B and meropenem exhibits the best synergistic antibacterial effect against CRE,and the combined effect is related to the drug-resistance genotype of bacteria,so active detection of drug-resistance genes can help to promote the rational use of antibiotics in clinical practice.

polymyxin Bcarbapenem-resistant Enterobacteriaceaemultiple drug resistance genemicrobial sensitivity tests

范陈良、吴晓燕、李小四、郁俊杰

展开 >

嘉兴市第二医院检验科,浙江嘉兴 314000

多黏菌素B 耐碳青霉烯类肠杆菌科 多药耐药基因 微生物敏感性试验

浙江省卫生健康科技计划项目

2021KY1109

2024

10.14109/j.cnki.xyylc.2024.06.15

中国新药与临床杂志
中国药学会 上海市食品药品监督管理局科技情报研究所

中国新药与临床杂志

CSTPCD北大核心
影响因子：0.967
ISSN：1007-7669
年,卷(期)：2024.43(6)
  • 20