哌拉西林他唑巴坦对类鼻疽伯克霍尔德菌的体外抗菌活性评估

Evaluation of antibacterial activity of piperacillin-tazobartan against Burkholderia pseudomallei in vitro

目的评估哌拉西林他唑巴坦体外抗类鼻疽伯克霍尔德菌的活性,为临床用药提供理论依据。方法采用E-test法,对临床分离的109株类鼻疽伯克霍尔德菌进行哌拉西林他唑巴坦最低抑菌浓度(MIC)的检测,计算MIC50和MIC90,与有CLSI敏感性判断标准的亚胺培南、强力霉素、复方磺胺甲噁唑、头孢他啶、四环素、阿莫西林克拉维酸及有EUCAST敏感性判断标准的美罗培南药敏检测结果进行比较。结果所检测的8种抗菌药物的MIC50分别为哌拉西林他唑巴坦0.25/4μg/mL、亚胺培南0.5μg/mL、美罗培南0.5μg/mL、强力霉素0.5μg/mL、复方磺胺甲噁唑1μg/mL、头孢他啶1μg/mL、四环素2μg/mL、阿莫西林克拉维酸2μg/mL;MIC90分别为哌拉西林他唑巴坦0.5μg/mL、亚胺培南0.5μg/mL、美罗培南1μg/mL、复方磺胺甲噁唑2/38μg/mL、头孢他啶2μg/mL、强力霉素2μg/mL、四环素4μg/mL、阿莫西林克拉维酸4μg/mL。所测有CLSI判断标准的6种抗菌药物敏感性显示,亚胺培南、头孢他啶、阿莫西林克拉维酸的敏感性均为100%,其他药物敏感性依次为强力霉素99.08%,复方磺胺甲噁唑95.41%,四环素94.49%。结论哌拉西林他唑巴坦体外对类鼻疽伯克霍尔德菌的MIC50和MIC90均低于其他7种抗菌药物,表明其在体外对该菌有较强的抗菌活性,结合其体内药代学特点,临床可尝试使用以获取体内对该菌药效学的评估。

Objective To evaluate the antibacterial activity of piperacillin-tazobartan against Burkholderia pseudomallei in vitro,and provide theoretical basis for its clinical application.Methods The minimum inhibitory concentrations(MIC)of piperacillin-tazobartan against 109 strains of Burkholderia pseudomallei isolated from the patients with melioidosis were detected by the E-test method,and MIC50 and MIC90 were calculated.Then,the results were compared with those of antimicrobial susceptibility of imipenem,doxycycline,trimethoprim-sulfamethoxazole,ceftazidime,tetracycline and amoxicillin-clavulanic acid with the CLSI Performance Standards for Antimicrobial Susceptibility and that of meropenem with the EUCAST Performance Standards.Results The MIC50 values of piperacillin-tazobactam,imipenem,meropenem,doxycycline,trimethoprim-sulfamethoxazole,ceftazidime,tetracycline,and amoxicillin-clavulanic acid were 0.25μg/mL,0.5μg/mL,0.5μg/mL,0.5μg/mL,1μg/mL,1μg/mL,2μg/mL and 2μg/mL,respectively,and their MIC90 values were 0.5μg/mL,0.5μg/mL,1μg/mL,2μg/mL,2μg/mL,2μg/mL,4μg/mL and 4μg/mL,respectively.All the isolates were sensitive(100%)to ceftazidime,imipenem and amoxicillin-clavulanic acid,and the rates of antimicrobial sensitivity for doxycycline,tetracycline-sulfamethoxazole and tetracycline were 99.08%,95.41%and 94.49%,respectively.Conclusion The MIC50 and MIC90 values of piperacillin-tazobactam against Burkholderia pseudomallei in vitro are lower than those of the other seven antibiotics,indicating that it has strong antibacterial activity against Burkholderia pseudomallei.Combined with its pharmacokinetic characteristics in vivo,piperacillin-tazobactam can be used clinically to evaluate its pharmacodynamics in vivo.