多粘菌素B联合美罗培南用于泛耐药铜绿假单胞菌体外抗菌活性的有效性分析

The Effectiveness Analysis of Polymyxin B in Combination with Meropenem for Pan-drug Resistant Pseudomonas Aeruginosa Vitro Antimicrobial Activity

目的：对多粘菌素B联合美罗培南用于泛耐药铜绿假单胞菌体外抗菌活性的有效性进行分析。方法：用微量肉汤稀释法、棋盘法等对多粘菌素B与美罗培南单独用药及两者联合用药后进行测定,临床分离出的60株泛耐药铜绿假单胞菌的最小抑菌浓度（MIC）,并计算出部分抑菌浓度指数（FIC）,同时依据FIC指数来判定出联合效应的类型,判定其有效性。结果：多粘菌素B和美罗培南在联用后,药物对泛耐药铜绿假单胞菌的MIC值都明显降低,FIC指数处于0-0.5的占全部菌株数量的60%;FIC指数处于0.5-1.0的占全部菌株数量的30%;FIC指数处于1.0-2.0的占全部菌株数量的10%;无FIC指数大于2的菌株。结论：多粘菌素B和美罗培南两药联用后,主要以协同作用及相加作用为主,测定分离的60株泛耐药铜绿假单胞菌具备抗菌作用,但是并不具备拮抗作用。多粘菌素B联合美罗培南用于疾病临床治疗,可有效提高临床治疗效果,且安全性较高,值得临床推广。

Objective：To analyze the effectiveness of polymyxin B in combination with meropenem for pan-drug resistant pseudomonas aeruginosa vitro antimicrobial activity.Method：After polymyxin B and meropenem were used alone and used together, the minimum inhibitory concentration of the 60 strains of pan-drug resistant pseudomonas aeruginosa which were clinically separated was tested through broth dilution method, checkerboard method and so on.And also the fractional inhibitory concentration index（FIC） was calculated.At the same time, the type and the effectiveness of the joint effect was determined according to the fractional inhibitory concentration index.Result：After the joint use of Polymyxin B and Meropenem, the fractional inhibitory concentration index of the medicine on the pan-drug resistant pseudomonas aeruginosa significantly reduced.Among these 60 strains of pan-drug resistant pseudomonas aeruginosa, those whose FIC at 0-0.5 accounted for 60%, at 0.5-1.0 accounted for 30%, at 1.0-2.0 accounted for 10%, but none of them whose FIC was over 2.Conclusion：When Polymyxin B and Meropenem are used together, they are mainly dominated by synergistic and additive effect.The 60 strains of pan-drug resistant pseudomonas aeruginosa which are separated have antibacterial effect.However, they do not have antagonistic effects.