盐酸小檗碱和亚胺培南联合作用对耐碳青霉烯类铜绿假单胞菌体外抗菌活性的影响

Effect of berberine hydrochloride and imipenem on the antibacterial activity of carbapenem resistant Pseudomonas aeruginosa(CPA) in vitro

目的评价亚胺培南、盐酸小檗碱两种药物联合使用对耐碳青霉烯类铜绿假单胞菌(CPA)体外抗菌活性产生的影响,探讨两种联合用药方案可行性,为抗菌药物联合使用合理性进一步提高可靠参考依据。方法收集2016年2月～2017年5月本院临床分离的80株CPA,采用肉汤稀释法实施亚胺培南、盐酸小檗碱耐碳青霉烯类铜绿假单胞菌最小抑菌浓度(MIC)检测;采用棋盘稀释法实施亚胺培南联合盐酸小檗碱对CPA的MIC,将联合指数(FIC)计算出来。结果单独使用盐酸小檗碱、亚胺培南时,两种药物对CPA的MIC的均值分别为261.00、8.75μg/mL;两药联合使用后,亚胺培南、盐酸小檗碱对CPA的MIC值均有明显减少,均值分别下降为8.11、4.48μg/mL;两药联用时,对88.42%的50株CPA表现为相加抗菌作用,对6.56%CPA表现为协同抗菌作用,对5.02%CPA表现出无拮抗作用。结论亚胺培南、盐酸小檗碱联合使用时,二者主要表现为协同作用,表明联合能够有效提高两种药物各自对CPA的抗菌敏感性,因此将该方案应用于CPA感染治疗可能获得更理想效果。

Objective To evaluate the effect of imipenem and berberine hydrochloride on the antibacterial activity of carbapenem resistant Pseudomonas aeruginosa（CPA） in vitro, and to explore the feasibility of the two combination regimens, so as to provide a reliable reference for further improving the rationality of the combined use of antibiotics. Methods Eighty clinical isolates of CPA in our hospital from February 2016 to May 2017 were collected, the minimal inhibitory concentration（MIC） of imipenem and berberis hydrochloride against carbapenem resistant Pseudomonas aeruginosa was determined by broth dilution method. The MIC of CPA with imipenem and berberine hydrochloride was carried out by chessboard dilution method,and the combined index（FIC） was calculated. Results When berberine hydrochloride and imipenem were used alone, the mean value of the two drugs to the MIC of CPA was 261g/mL and 8.75g/mL respectively. The combination of two drugs, imipenem and berberine hydrochloride on CPA value of MIC was significantly reduced, the average dropped to 8.11μg /mL and 4.48μg /mL. When the two drugs were combined, 50 strains of CPA of 88.42% were treated with antibacterial action, and 6.56% CPA showed synergistic antiseptic effect and no antagonistic effect on 5.02% CPA. Conclusion Imipenem and berberine hydrochloride shows synergistic effect. It shows that combination can effectively improve the antimicrobial susceptibility of two drugs to CPA. Therefore, the application of this program to CPA infection may achieve better results.