摘要
目的：在体外探讨莫西沙星（ MFX）、头孢哌酮/舒巴坦（ CFS）单用及联合使用对耐碳青霉烯类鲍曼不动杆菌（ CRAB）防耐药突变浓度（ MPC）的影响,为防止细菌耐药的产生提供理论依据。方法采用棋盘法设计,微量肉汤稀释法测定抗菌药物对20株临床分离 CRAB的最低抑菌浓度（ MIC）,计算部分抑菌浓度（ FIC）指数。用肉汤富集浓度为1013 CFU＆#183; L-1 CRAB,采用琼脂平板稀释法测定 MFX 和CFS单用及联合使用对20株临床分离CRAB的MPC,并计算相应的选择指数（ SI）。结果 MFX联合CFS后,主要表现为协同和相加作用,无拮抗作用。 MFX和CFS单用对上述20株CRAB的选择指数分别为：4-128、8-64,两者联合后选择指数下降为：1-8、4-16,联合用药较单独用药选择指数分别下降2-16、2-4倍。结论 MFX与CFS联用后,均可降低其单用对CRAB的MPC,缩小耐药突变选择窗,防止耐药突变菌株的产生。
Aim To study the change of mutant prevention concentration （MPC） in carbapenem-resistant Acinetobacter baumannii （CRAB） treated with moxifloxacin （ MFX ） and/ or cefoperazone/ sulbactam （CFS） in vitro, and provide a theoretical support for preventing the bacterial resistance. Methods To calculate the fractional inhibitory concentration （FIC） index, the minimum inhibitory concentration （MIC） of 20 clinical isolates of CRAB treated with MFX and/ or CFS was determined by checkerboard microdilution assay. In addition, to calculate the selection index （SI）, the MPC of 20 clinical isolates of CRAB treated with MFX and/ or CFS was determined by agar plate dilution assay. Results Our study showed that there was synergistic/ addictive action, rather than antagonism action against clinical isolates of CRAB when treated with MFX ＋ CFS. The SI of the 20 isolates treated with MFX or CFS alone was 4 -128 and 8 -64 respectively, but reduced to 1 -8 and 4 -16 when treated with MFX ＋ CFS, which decreased by 2 -16 and 2 -4 times respectively compared with the single treat- ment. Conclusion These results suggest that the combination treatment of MFX ＋ CFS against clinical isolates of CRAB might lower the MPC of the isolates treated with MFX/ CFS alone, narrow the mutant selection window, and prevent the generation of drug - resistant mutants.
出处
《中国药理学通报》
CAS
CSCD
北大核心
2014年第6期825-828,共4页
Chinese Pharmacological Bulletin
基金
天津市科技支撑计划重点项目(No 09ZCKFSH01300)
