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目的在体外探讨环丙沙星(CIP)、阿米卡星(AMK)、头孢他啶(CAZ)两两联合是否有利于减少铜绿假单胞菌耐药突变体的产生。方法分别应用琼脂平板稀释法和棋盘格法测定单独以及联合之后的最低抑菌浓度(MIC),采用琼脂平板稀释法测定单独及联合时对铜绿假单胞菌的防耐药突变浓度(MPC),并计算选择指数(SI)即MPC/MIC,根据SI下降的程度来判断防耐药突变能力。结果CIP、AMK、CAZ单药对铜绿假单胞菌的SI分别为16、16、>32。两两联合后各自单药的SI分别为:CIP+AMK(CIP-8,AMK-4);CIP+CAZ(CIP-4,CAZ-8);AMK+CAZ(AMK-8,CAZ-4)。结论以上3种药物任意两两联合均可以降低单独用药时对铜绿假单胞菌的SI,有利于防止铜绿假单胞菌耐药突变体的产生。
OBJECTIVE: To investigate whether combination of ciprofloxacin (CIP), amikacin (AMK) and ceftazidime (CAZ) could reduce the generation of drug-resistant mutants of Pseudomonas aeruginosa in vitro. Methods The minimal inhibitory concentrations (MICs) were determined by agar plate and checkerboard method respectively. The antimicrobial resistance (MPC) concentrations of Pseudomonas aeruginosa alone and in combination were determined by agar plate dilution method. , And calculate the selection index (SI) MPC / MIC, according to the degree of decline in SI to determine the ability to prevent drug-resistant mutations. Results The SI of CIP, AMK and CAZ alone was 16, 16 and> 32 for Pseudomonas aeruginosa, respectively. The SI of the respective monotherapy after each combination was CIP + AMK (CIP-8, AMK-4), CIP + CAZ (CIP-4, CAZ-8), AMK + CAZ (AMK-8, CAZ- 4) . Conclusions Any combination of the above three drugs can reduce the SI of Pseudomonas aeruginosa when used alone, which is good for preventing the emergence of drug-resistant mutant of Pseudomonas aeruginosa.