鲍曼不动杆菌对多种抗生素与舒巴坦复合制剂的最低抑菌浓度(MIC)比较分析

Comparison of the minimal inhibitory concentration(MIC) in the third-generation cephalosporins with its' sulbactam combinations against Acinetobacter baumannii

目的探讨舒巴坦与常用第三代头孢菌素联用对本院临床标本中分离出的鲍曼不动杆菌最低抑菌浓度(MIC)的影响,为临床联合用药治疗多药耐药鲍曼不动杆菌感染提供实验依据。方法选取本院临床标本中分离出的鲍曼不动杆菌39株分为三组。采用琼脂稀释法检测单药不同浓度梯度亚胺培南、头孢哌酮、头孢他啶、头孢曲松对各组细菌的最低抑菌浓度(MIC),以及这四种药物分别与相同浓度梯度的舒巴坦联用后对各组细菌的最低抑菌浓度。结果琼脂稀释法测得各药物与舒巴坦联用后比其单独使用时对细菌的MIC有明显变化,其中头孢哌酮/舒巴坦MIC为259.1μg/ml,头孢哌酮MIC为21.0μg/ml,头孢他啶/舒巴坦MIC为143.7μg/ml,头孢他啶MIC为24.0μg/ml,头孢曲松/舒巴坦MIC为157.3μg/ml,头孢曲松MIC为23.0μg/ml。亚胺培南/舒巴坦MIC没有显著变化。结论对鲍曼不动杆菌的体外抗菌试验显示,舒巴坦与三代头孢菌素联合应用能有效的降低第三代头孢菌素对多药耐药鲍氏不动杆菌的MIC值,对于对三代头孢菌素耐药的菌株,在达到一定药物浓度的情况下联合制剂可使其MIC降至敏感范围内。

Objective To investigate the effect of minimal inhibitory concentration（MIC） on sulbactam combinated with the third-generation cephalosporins against muhidrug-resistance Aeinetobacter baumannii so as to provide basis for clinical application. Methods A total of 39 concecutive clinical isolates of Acinetobacter banmannii received in the affiliated hospital of North Sichuan Medical College. And they are divided into three groups：Group A（4 isolates susceptible to the third-generation cephalosporins）, Group B （25 isolates resistant to the third-generation cephalosporins but susceptible to imipenem ） , Group C （ 10 isolates resistant to both the third-generation cephalosporins and imipenem） . The MICs of the third-generation eephalosporins （IMP, CFP, CAZ, CRO） used alone and its＇ Sulbaetam combinations were tested in different concentration gradient by the agar dilution test. Results The MICs tested by agar dilution test of CFP、CAZ、CRO（ except imipenem） eombihated with sullbactam were obviously decreased than they used alone except IMP/SB. And the MIC of CFP/SB is 259. μg/ml , the MIC of CFP is 21.0μg/ml ; the MIC of CAZ/SB is 143.7μg/ml , the MIC of CAZ is 24. 0μg/ml ; the MIC of CRO/SB is 157. 3μ/ml , the MIC of CRO is 23, 0μg/ml. Conclusions The muirresistant Aeinetobaeter baumannii was more sensitive to the third-generation eephalosporins combinated with sul- lbaetam than others. And to those resistant to the third-generation eephalosporins , the combinated antibiotics can make it sensitive in a certain drug concentration.