头孢曲松和亚胺培南对脓毒症大鼠肠道菌群及细菌耐药性的影响

Influence of ceftriaxone and imipenem to sepsis in the rat intestinal flora and bacterial drug resistance

目的探讨头孢曲松和亚胺培南对脓毒症大鼠肠道各种菌类数量以及细菌耐药性的影响。方法从48只健康SD大鼠中随机抽取8只为正常对照组,其余40只按照15mg/kg腹腔注射内毒素的方式建立内毒素脓毒症模型;根据建模后24 h是否应用抗生素以及抗生素应用时限再将40只内毒素脓毒症模型鼠细分为脓毒症未治疗组、脓毒症头孢曲松3d组、脓毒症头孢曲松7d组、脓毒症亚胺培南3d组和脓毒症亚胺培南7d组(n=8)。在用头孢曲松和亚胺培南腹腔注射治疗期间,在给药第3d和第7d后分别取大肠内容物进行肠道杆菌、肠球菌和真菌的定量培养和细菌的菌种鉴定。结果用抗生素治疗后,2组大鼠肠道优势菌大肠杆菌和粪肠球菌数量均显著减少(P<0.05),头孢曲松选择出铜绿假单胞菌和阴沟杆菌,亚胺培南选择出肺炎克雷伯杆菌、变形杆菌和屎肠球菌等条件致病菌,均表现出耐药倾向。结论头孢曲松和亚胺培南抗生素可引起原籍菌群数锐减,铜绿假单胞菌和屎肠球菌等条件致病菌成为优势菌群,引发肠道微生态环境紊乱。

Objective To study the influence of ceftriaxone and imipenem to sepsis in the rat intestinal flora and bacterial drug resistance.Methods 8 rats were randomly included in normal control group from 48 healthy SD,and the rest of them were built the endotoxin sepsis model using 15 mg/kg intraperitoneal injection of endotoxin.According to whether to apply antibiotics and application deadlines in 24 h after modeling,40 rats were randomly subdivided into sepsis without treatment group,sepsis ceftriaxone 3 d group,sepsis ceftriaxone 7 d group,sepsis imipenem 3 d group and sepsis imipenem 7 d group(n=8).During ceftriaxone and imipenem injection treatment,in the corresponding time,colon contents were taken for enterobacteriaceae,enterococcus strains of quantitative culture and bacteria and fungi identification. Results After treatment with antibiotics,the number of rat intestinal bacteria decreased significantly(P<0.05).Ceftriaxone selected pseudomonas aeruginosa and enterobacter cloacae,while imipenem selected klebsiella pneumoniae, proteus and excrement enterococcus conditional pathogenic bacteria.All showed the inclination resistance. Conclusion Ceftriaxone and imipenem antibiotics could decrease the original bacteria number,so pseudomonas aeruginosa and excrement enterococcus conditional pathogenic bacteria could become advantage bacterium group,causing intestinal micro ecological environment disruption.