帕尼培南联合舒巴坦对鲍曼不动杆菌体外抗菌活性的研究

Efficacy of panipenem combined sulbactam on vitro antibacterial activity of acinetobacter baumannii

目的探讨帕尼培南与舒巴坦联合应用对鲍曼不动杆菌体外抗菌活性的影响。方法选择帕尼培南敏感和耐药鲍曼不动杆菌各40株菌株,用微量肉汤稀释法及联合药敏棋盘法测定帕尼培南与舒巴坦单用及联合使用的MIC值,计算部分抑菌指数(∑FIC),确定两种药物的体外联合效应。结果帕尼培南敏感鲍曼不动杆菌联合使用帕尼培南及舒巴坦较单独用药MIC50及MIC90均下降了2个倍比稀释度,帕尼培南耐药菌株联合用药后MIC50及MIC90均下降了1个倍比稀释度;联合给药对帕尼培南敏感菌株的协同作用为30.0%(12/40),部分协同为45.0%(18/40),相加作用为15.0%(6/40);帕尼培南耐药菌株结果显示协同作用为10.0%(4/40),部分协同为57.5%(23/40),相加作用为22.5%(9/40),2组无关作用均为10.0%(4/40),无菌株存在拮抗作用。结论帕尼培南联合舒巴坦在体外试验中对于鲍曼不动杆菌主要表现为协同和部分协同作用,两种药物联合较单药治疗能更有效地抑制鲍曼不动杆菌的生长。

Objective To evaluate the synergy effect of panipenem combined sulbactam on vitro antibacterial activity of acinetobacter baumannii. Methods Forty strains of panipenem-susceptible and panipenem resistant acinetobacter bau-mannii were randomly selected respectively, and the minimum inhibitory concentration （MIC） values of panipenem and/or sulbactam were determined using microbroth dilution method and checkerboard method. The fractional inhibitory in-dex （ΣFIC） were calculated, and then the vitro combination effect of panipenem and sulbactam were determined. Re-sults Compared with the single drug group, in the combination group of panipenem and sulbactam, the MIC50 and MIC90 of panipenem-susceptible acinetobacter baumannii decreased two times in dilution, while the MIC50 and MIC90 de-creased one times in dilution in panipenem-resistant strains. For the panipenem-susceptible strains, The combination of panipenem and sulbactam demonstrated 30.0% （12/40） synergism, 45.0% （18/40） partial synergism, 15.0%（6/40） addi tive, For the panipenem-resistant strains, the synergistic effect was 10.0%（4/40）, partially synergistic effect was 57.5%（23/40）, the additive effect was 22.5% （9/40）, and indifference effect of the two groups was 10.0% （4/40）. No strain had antagonistic effect. Conclusion In vitro tests, panipenem and sulbactam combination show synergism or partial syner-gism against most acinetobacter. baumannii isolates. Compared with the alone use, the combination of panipenem and sulbactam is more effective in inhibiting the growth of acinetobacter baumannii.