摘要
目的探讨氨曲南(aztreonam,ATM)与头孢他啶/阿维巴坦(ceftazidime averbatan,CAZ/AVI)联合使用对产金属β-内酰胺酶(metallo-β-lactamases,MBLs)肠杆菌目细菌的体外协同作用。方法收集四川大学华西医院2019年11月—2020年4月临床分离的32株产MBLs且同时满足对ATM及CAZ/AVI耐药;采用PCR扩增技术进行基因型检测,采用微量肉汤稀释法测定ATM及CAZ/AVI的MIC及棋盘稀释法检测ATM联合CAZ/AVI对产MBLs的肠杆菌目细菌的协同作用。结果32株产MBLs的菌株中,产NDM-1型金属酶19株,产NDM-5型金属酶12株及产IMP型金属酶1株;ATM联合CAZ/AVI对其中26株产MBLs的菌株有体外协同作用,占比81.3%;未出现无关和拮抗作用。结论ATM联合CAZ/AVI对产NDM金属酶菌株体外有协同抗菌作用的可能性较高,因此有条件情况下,如果临床治疗需要最好做联合药敏试验以更好的指导临床用药。
Objective To investigate the in vitro synergistic activity of aztreonam(ATM)and ceftazidime/avibactam(CAZ/AVI)on metal-β-lactamases-producing(MBLs)Enterobacteriaceae bacteria.Methods 32 metallo-β-lactamases-producing strains were isolated from West China Hospital,Sichuan University from November 2019 to April 2020 which were resistant to aztreonam and ceftazidime/avibactam were collected,the genes were analyzed by polymerase chain reaction,the minimum inhibitory concentration of aztreonam and ceftazidime/avibactam were determined by using micro broth dilution method and the synergistic activity of ATM combined with CAZ/AVI on metallo-β-lactamases-producing.Enterobacteriaceae were determined by using checkerboard dilution.Results Among the 32 strains of MBLs-producing,19 strains coproducing NDM-1,12 strains coproducing NDM-5 and 1 IMP were identifed;ATM and CAZ/AVI has synergistic activity on the MBLs of 26 plants,which is 81.3%.There was no correlation and antagonism.Conclusion ATM combined with CAZ/AVI is more likely to have synergistic antibacterial effect on NDM metalloenzyme producing strains in vitro,therefore,clinical treatment needs to do combined drug sensitivity test to better guide clinical medication.
作者
周海英
曹原
邓劲
廖全凤
吴思颖
刘雅
张为利
康梅
Zhou Hai-ying;Cao Yuan;Deng Jin;Liao Quan-feng;Wu Si-ying;Liu Ya;Zhang Wei-li;Kang Mei(Clinical Laboratory,Zhenxiong County People's Hospital,Zhenxiong 657200;Clinical Laboratory,Kaifeng Hospital of Traditional Chinese Medicine,Kaifeng 475000;Clinical Microbiology Laboratory,Department of Experimental Medicine,West China Hospital,Sichuan University,Chengdu 610041)
出处
《中国抗生素杂志》
CAS
CSCD
北大核心
2021年第8期784-788,共5页
Chinese Journal of Antibiotics
