论文部分内容阅读
目的评价多黏菌素E联合磷霉素对74株产碳青霉烯酶肺炎克雷伯菌(Klebsiella pneumoniae carbapenemase-producing K.pneumoniae,KPC-Kp)的体外抗菌效应。方法分别用微量肉汤稀释法和琼脂平板稀释法测定多黏菌素E和磷霉素对74株KPC-Kp的最低抑菌浓度(MIC)值。用棋盘法计算部分抑菌浓度指数来判定联合效应。从中随机选取6株KPC-Kp测定多黏菌素E与磷霉素单用或联用的时间杀菌曲线。结果 MIC结果:多黏菌素敏感率100%,磷霉素敏感率为35.14%,FIC结果:多黏菌素E与磷霉素联合用药协同率为12.16%,部分协同率为39.19%,相加为6.76%,无关为41.89%,无拮抗作用。杀菌曲线结果:对于磷霉素敏感菌株,多黏菌素E联合磷霉素有明显的协同作用,磷霉素耐药菌株则没有明显协同作用。结论对于磷霉素敏感菌株,多黏菌素E与磷霉素联合用药在体外对KPC-Kp以协同作用和相加作用为主,杀菌曲线也显示了较好的协同作用,而磷霉素耐药菌株和多黏菌素协同作用较差。
Objective To evaluate the in vitro antibacterial activity of polymyxin E and fosfomycin against 74 Klebsiella pneumoniae carbapenemase producing K. pneumoniae (KPC-Kp) strains. Methods The minimum inhibitory concentration (MIC) of polymyxin E and fosfomycin against 74 strains of KPC-Kp were determined by micro broth dilution method and agar plate dilution method respectively. The chessboard method was used to calculate the partial inhibitory concentration index to determine the combined effect. Six strains of KPC-Kp were randomly selected to determine the bactericidal time curve of polymyxin E and fosfomycin alone or in combination. Results The MIC results showed that the sensitivity of polymyxin was 100% and the sensitivity of fosfomycin was 35.14%. The FIC results showed that the synergistic rate of polymyxin E and fosfomycin was 12.16% and the partial synergy was 39.19% Plus 6.76%, nothing to 41.89%, no antagonism. Bactericidal curve results: for fosfomycin-sensitive strains, polymyxin E combined with fosfomycin have a synergistic effect, fosfomycin-resistant strains did not significantly synergistic effect. Conclusion For the fosfomycin-sensitive strains, the combination of polymyxin E and fosfomycin in vitro KPC-Kp to synergistic and additive role, the sterilization curve also showed a good synergistic effect, and fosfomycin Drug-resistant strains and colistin synergistic effect is poor.