热毒宁联合抗生素对30株ICU耐碳青霉烯鲍曼不动杆菌体外抑菌效果观察

Study on the bacteriostatic effect of Reduning combined with antibiotics on acinetobacter baumannii resistant to 30 strains of carbapenem in ICU in vitro

目的研究热毒宁分别联合亚胺培南西司他丁钠、头孢哌酮钠舒巴坦钠、哌拉西林钠他唑巴坦、头孢他啶对耐碳青霉烯鲍曼不动杆菌的体外抑菌效果。方法采用肉汤稀释法测定热毒宁与4种抗生素单独及联合用药对30株耐碳青霉烯鲍曼不动杆菌的最低抑菌浓度(MIC),计算部分抑菌浓度(FIC)指数,评价药物联合应用的抑菌效果。结果热毒宁分别与4种抗生素联合抑菌的MIC值范围、50%MIC(MIC50)、90%MIC(MIC90)较单用药均有不同程度的降低。热毒宁125μL/mL时,头孢哌酮钠舒巴坦钠32μg/mL菌株数量最多,抑菌效果最明显;热毒宁250μL/mL时,亚胺培南西司他丁钠64μg/mL菌株数量最多,抑菌作用最明显;热毒宁联合亚胺培南西司他丁钠FIC指数≤0.5为3.3%,>0.6~0.9为93.3%,1~2为3.3%,>2为0;热毒宁联合头孢哌酮钠舒巴坦钠FIC≤0.5为6.7%,>0.6~0.9为93.3%,1~2为0,>2为0;热毒宁联合哌拉西林钠他唑巴坦FIC指数≤0.5为13.3%,>0.6~0.9为76.7%,1~2为10.0%,>2为0;热毒宁联合头孢他啶FIC指数≤0.5为13.3%,0.6~0.9为80.0%,1~2为6.7%,>2为0。结论热毒宁联合4种抗生素对耐碳青霉烯鲍曼不动杆菌抑菌主要为协同和相加作用,未有拮抗。中西药体外联合抑菌作用明显,热毒宁联合头孢哌酮钠舒巴坦钠、亚胺培南西司他丁钠效果最佳。

Objective To study the antibacterial effect of Reduning combined with imipenem sitastatin sodium,cefoperazone sodium and sulbactam sodium,piperacillin sodium and ceftazidime on acinetobacter baumannii resistant to carbapenem in vitro.Methods The minimum inhibitory concentration(MIC)of Reduning and four antibiotics against 30 strains of carbapenem resistant acinetobacter baumannii was determined by broth dilution method,and the partial inhibitory concentration(FIC)index was calculated to evaluate the antibacterial effect of the drugs in combination.Results The MIC value range,MIC50%(MIC50),and MIC90%(MIC90)of the four antibiotics were significantly lower than that of the single drug.With Reduning 125μl/ml,cefoperazone sodium and sulbacartan sodium 32μg/ml,the number of strains was the highest and the bacteriostatic effect was the most obvious.With Reduning 250μl/ml,imipenem Cistantin sodium 64μg/ml had the largest number of strains and the most obvious bacteriostatic effect.The FIC index of ceftazidime combined with imipenemen Cistantin sodium≤0.5 was 3.3%,0.6~0.9 was 93.3%,1~2 was 3.3%,and>2 was 0.The FIC index of cefoperazone sodium and sulbactam sodium FIC≤0.5 was 6.7%,0.6~0.9 was 93.3%,1~<2 was 0,and>2 is 0.The FIC index of piperacillin sodium≤0.5 was 13.3%,0.6~0.9 was 76.7%,1~2 was 10.0%,and>2 was 0.The FIC of ceftazidime sodium index≤0.5 was 13.3%,0.6~0.9 was 80.0%,1~2 was 6.7%,and>2 was 0.Conclusion The effects of Reduning combined with four antibiotics against acinetobacter baumannii were synergistic and additive,without antagonism.Cefoperazone sodium and sulbactam sodium and imipenem Cistantin sodium had the best effect in vitro.