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目的评价4个组合(多黏菌素E+利福平、多黏菌素E+美罗培南、头孢哌酮/舒巴坦+阿米卡星、头孢哌酮/舒巴坦+左氧氟沙星)联合应用对4株耐碳青霉烯类铜绿假单胞菌(CRPA)的体外抗菌效应。方法用时间-杀菌曲线法(TKA)测定联合抗菌活性。结果 4个组合在最小抑菌浓度(MIC)下联合后,24 h时的菌落数较最强单药组分别降低(2.68~7.08),(5.67~7.08),(2.00~4.20),(0.39~2.43)log_(10)CFU·m L~(-1);4个组合在1/2 MIC下联合时分别降低(5.52~8.53),(2.74~3.00),(0.48~3.01),(0.42~1.17)log_(10)CFU·m L~(-1)。棋盘法和TKA的测定结果比较差异均有统计学意义(P<0.05)。结论多黏菌素E与利福平、美罗培南联合均为协同杀菌作用,头孢哌酮/舒巴坦与阿米卡星联合表现协同抑菌作用,头孢哌酮/舒巴坦与左氧氟沙星联合效果不佳。
Objective To evaluate the efficacy and safety of 4 combinations (polymyxin E + rifampin, polymyxin E + meropenem, cefoperazone / sulbactam + amikacin, cefoperazone / sulbactam + levofloxacin) In Vitro Antibacterial Effect of Strain of Carbapenem - resistant Pseudomonas Aeruginosa (CRPA). Methods The combined antibacterial activity was determined by time-kill curve method (TKA). Results After four combinations were combined at MIC, the number of colonies at 24 h decreased (2.68 ~ 7.08), (5.67 ~ 7.08), (2.00 ~ 4.20), (0.39 ~ 2.43) log_ (10) CFU · m L ~ (-1) respectively; the combination of four combinations decreased by 5.52 ~ 8.53, 2.74 ~ 3.00, 0.48 ~ 3.01, 0.42 ~ 1.17) log_ (10) CFU · m L ~ (-1). There was significant difference between the results of chessboard and TKA (P <0.05). Conclusions Combination of polymyxin E and rifampicin and meropenem is synergistic bactericidal activity. Cefoperazone / sulbactam combined with amikacin has a synergistic antimicrobial effect, and cefoperazone / sulbactam combined with levofloxacin Poor.