黄连中药根碱分别联合阿米卡星与头孢哌酮/舒巴坦对泛耐药鲍曼不动杆菌的体外抑菌作用

In vitro antibacterial activity of Rhizoma Coptidis combined with amikacin or cefoperazone/sulbactam against pan-resistant Acinetobacter baumannii

目的探讨黄连中药根碱分别联合阿米卡星与头孢哌酮/舒巴坦2种抗菌药物对泛耐药鲍曼不动杆菌的抑菌作用。方法应用肉汤稀释法测定不同浓度组合黄连中药根碱与阿米卡星、头孢哌酮/舒巴坦对25株临床分离泛耐药鲍曼不动杆菌的最低抑菌浓度(MIC)及分级抑菌浓度(FIC)指数,并观察其对25株泛耐药鲍曼不动杆菌的体外抑菌效果。结果黄连中药根碱分别联合阿米卡星、头孢哌酮/舒巴坦后,其MIC范围与3药单独相比保持不变或有所降低,而黄连中药根碱联合头孢哌酮/舒巴坦的MIC及分布浓度均明显降低,差异有统计学意义(P<0.05)。在累计抑菌率相同时,联合用药的药物浓度较单独用药时低,其中黄连中药根碱联合头孢哌酮/舒巴坦的药物浓度降低最明显,差异有统计学意义(P<0.05)。黄连中药根碱联合阿米卡星用药的FIC指数为1.0~<2.0时占比为72%,以无关作用为主;黄连中药根碱联合头孢哌酮/舒巴坦用药的FIC指数为0.5~<1.0时占比为72%,以相加作用为主。结论黄连中药根碱联合头孢哌酮/舒巴坦增强了单独用药(头孢哌酮/舒巴坦)的抑菌效果,通过减少头孢哌酮/舒巴坦的用量可以延缓细菌耐药。

Objective To investigate the antibacterial activity of Rhizoma Coptidis combined with amikacin or cefoperazone/sulbactam against pan-resistant Acinetobacter baumannii.Methods The minimal inhibitory concentration(MIC)and graded inhibitory concentration(FIC)index of Rhizoma Coptidis,amikacin and cefoperazone/sulbactam against 25 clinical isolates of pan-resistant Acinetobacter baumannii were determined by chessboard design and broth dilution method,the antibacterial effect on 25 strains of pan-resistant Acinetobacter baumannii in vitro was observed.Results The MIC range of Rhizoma Coptidis combined with amikacin or cefoperazone/sulbactam remained unchanged or decreased compared with the three drugs alone,while the MIC and distribution concentration of Rhizoma Coptidis combined with cefoperazone/sulbactam decreased significantly(P<0.05).At the same cumulative bacteriostatic rate,the drug concentration of the combination drug was lower than that of the drug alone,among them,the combination of Rhizoma Coptidis and cefoperazone/sulbactam was the most obvious,and the difference was statistically significant(P<0.05).The proportion of Rhizoma Coptidis combined with amikacin in the range of FIC 1.0-<2.0 accounted for 72%,with irrelevant effect as the main;the proportion of Rhizoma Coptidis combined with cefoperazone/sulbactam in the range of FIC 0.5-<1.0 accounted for 72%,with additive action as the main.Conclusion The combination of Rhizoma Coptidis and cefoperazone/sulbactam can enhance the antibacterial effect of single drug(cefoperazone/sulbactam)by reducing the dosage of cefoperazone/sulbactam and then delaying bacterial resistance.