痰热清联合亚胺培南或米诺环素对广泛耐药肺炎克雷伯菌的体外抑菌作用

Inhibitory effect of Tanreqing combined with imipenem or minocycline on extensively drug-resistant Klebsiella pneumoniae in vitro

目的探讨痰热清注射液联合亚胺培南或米诺环素对广泛耐药肺炎克雷伯菌的联合抑菌效果。方法应用肉汤稀释法测定痰热清注射液联合亚胺培南、米诺环素单独或联合用药对30株广泛耐药肺炎克雷伯菌的最低抑菌浓度(MIC),统计单独及联合用药MIC分布、计算部分抑菌浓度(FIC)指数,判定联合用药的抑菌效果。结果痰热清与亚胺培南联合用药后,其各自MIC值范围、半数MIC(MIC_(50))、90%MIC(MIC_(90))分别比单独用药有所降低;痰热清与米诺环素联合用药后,MIC值范围、MIC_(90)分别比单独用药升高。痰热清联合亚胺培南FIC指数结果显示,FIC指数≤0.5为43.3%,0.5<FIC指数≤1为30.0%,1<FIC≤2为20.0%,FIC>2为6.7%;痰热清联合米诺环素FIC指数结果显示,FIC指数≤0.5为0,0.5<FIC指数≤1为0,1<FIC≤2为43.3%,FIC>2为56.7%。结论痰热清联合亚胺培南对广泛耐药肺炎克雷伯菌多数表现为协同作用和相加作用,体外联合抑菌作用较好;而痰热清与米诺环素联合多数表现为无关作用和拮抗作用,对广泛耐药肺炎克雷伯菌的体外联合抑菌作用较差。

Objective To investigate the bacteriostatic efficacy in vitro for extensively drug-resistant Klebsiella pneumoniae of tanreqing injection alone or combined with imipenem or minocycline.Method Using broth dilution method,the minimal inhibitory concentration(MIC)of tanreqing injection alone or combined with imipenem or minocycline for extensively drug-resistant Klebsiella pneumoniae of 30 strains were determined.The MIC distributions of single and combined medication were counted,and the fractional inhibitory concentration(FIC)index was calculated to judge the bacteriostatic efficacy of combined medication.Results After combined medication of tanreqing plus imipenem,the ranges of MIC,MIC50 and MIC90 were lower than those of single medication,respectively.After combined medication of tanreqing plus minocycline,the ranges of MIC,MIC50 and MIC90 were higher than those of single medication,respectively.FIC indexes of≤0.5,>0.5 to≤1,>1 to≤2 and>2 for tanreqing plus imipenem accounted for 43.3%,30.0%,20.0%and 6.7%,respectively.FIC indexes of≤0.5,>0.5 to≤1,>1 to≤2 and>2 for tanreqing plus minocycline accounted for 0,0,43.3%and 56.7%,respectively.Conclusions Most of the effects of tanreqing combined with imipenem on extensive drug-resistant Klebsiella pneumoniae are synergistic and additive with better combined bacteriostatic effect in vitro.Most of the effects of tanreqing combined with minocycline are irrelevant and antagonistic with poor combined bacteriostatic effect in vitro.