磷霉素氨丁三醇与临床常用抗菌药物体外联合抗菌作用研究

In vitro synergistic interactions between fosfomycin tromethamine and commonly used antibiotics

目的评价磷霉素氨丁三醇与临床常用抗菌药物对我国近3年临床分离尿路感染重要病原菌大肠埃希菌和肠球菌体外联合抗菌效果。方法联合药敏测定采用棋盘法,最低抑菌浓度(MIC)测定采用琼脂二倍稀释法。对来自全国18家医院近3年临床分离的217株菌进行了联合药敏测定。结果磷霉素氨丁三醇与米诺环素联合对万古霉素敏感粪肠球菌、与氨曲南联合对超广谱β-内酰胺酶阳性大肠埃希菌表现出较好协同作用,协同率>40%。结论磷霉素与多种其他类抗菌药物体外可产生协同作用,但在不同菌种、不同研究中存在一定差异,可能与研究方法不同、菌株耐药背景不同有关。未来引入临床数据,考察体外与临床相关性,将对临床合并用药的选择更有指导意义。

Objective To evaluate the in vitro activity and synergy of fosfomycin tromethamine with commonly used antibiotic against Enterococcus faecalis and Escherichia coli,which are main pathogene in urinary tract infection in recent three years. Methods Minimal inhibitory concentrations（ MIC） were tested by agar dilution method and combination effects were measured by checkerboard method. A total of 217 stains from 18 tertiary hospitals in recent three years were studied. Results More than 40 % of synergy was detected with fosfomycin tromethamine in combination with minocycline against vancomycin-susceptible Enterococcus faecalis, and with aztreonam against extended-spectrum β-lactamases（ ESBLs） positive Escherichia coli. Conclusion Synergy was found with fosfomycin tromethamine in combination with many kind of antimicrobial agents. But the results of in vitro synergy tests may be different because of various genetic backgrounds of stains, methods, etc.Therefore,more deep understand of correlation between in vitro test and clinical outcomes will help medical to select antibiotic more suitable.