替考拉宁与左氧氟沙星、利福平联用对耐甲氧西林金黄色葡萄球菌的体外抗菌活性研究

Study on Comhined Use of Teicoplanin with Levofloxacin Rifampicin Against Methicillin Resistance Staphylococcus Aureus

目的了解替考拉宁与左氧氟沙星、利福平联合应用对耐甲氧西林金黄色葡萄球菌（MRSA）的体外抗菌活性，为临床合理用药提供帮助。方法常规方法培养分离细菌，用VITEK-Ⅱ微生物自动分析仪鉴定到种。MRSA鉴定采用乳胶凝集试剂盒，最低抑菌浓度（MIC）测定采用微量肉汤稀释法。结果替考拉宁、左氧氟沙星、利福平单独用药对110株MR—SA的MIC90分别为4．0，64．0，256．0mg／L，而抑菌率分别为100．0％，5．0％和28．0％。替考拉宁与左氧氟沙星、利福平联合用药后MIC90均为4．0mg／L，FIC〈1的值分别为35．0％和69．0％。结论替考拉宁与左氧氟沙星、利福平联合用药对MRSA的MIC90比单药提高4倍以上。替考拉宁与利福平联合应用以协同作用为主。临床上治疗由MRSA引起的感染应根据患者的个体情况并结合药敏试验结果联合应用抗菌药物。

Objective To understand in vitro antibacterial activity of Combined use of Teicoplanin （TEC） with Levofloxacin （LVX） and Rifampicin （RIF） against methicillin resistance Staphylococcu aureus（MRSA） in order to provide help for rational drug use to clinic. Methods Isolates were cultured and identified by routine procedure and VITEK- I automatic microbe analysis instrument. MRSA detection used latex coagulation method. Minimum inhibitory concentration （MIC） used micro-broth dilution method in Accordance with CLSI standard. Results The MIC90 of TEC,LVX and RIF against 110 strains MRS were 4.0, 64. 0 mg/L and 256. 0 mg/L,their inhibitory bacteria rates were 100. 0%, 5.0% and 28.0% respectively. The MICgo of combined use of TEC with LVX,RIF were 4. 0,4.0 mg/L,their value of FIC〈1 were 35.0% and 69.0% respectively. Conclusion TEC combining with RIF were main synergism that antibacterial activity en- hanced above four times. Clinic should be according to patient indivudial situation and drug sensitive test results to be best to choose combined use of drug to treat severe infection against MRSA.