对铜绿假单胞菌的联合用药研究.docVIP

对铜绿假单胞菌的研究摘要:目的　探讨环丙沙星、依诺沙星、阿米卡星与临床常用的抗铜绿假单胞菌的β-内酰胺类抗菌药物体外联合的抗菌活性。方法　对200年2月至2009年12月细菌培养与药物敏感试验结果进行回顾性分析，了解铜绿假单胞菌的流行情况。采用棋盘法设计，微量肉汤稀释法测定不同浓度组合的抗菌药物对2009年1～12月的39株铜绿假单胞菌的最低抑菌浓度(MIC)，判定联合应用效应。结果　年间我院病房共分离出56株细菌，其中革兰阴性杆菌株，占72.%，革兰阳性球菌97株，占27.%。检出最多的细菌是铜绿假单胞菌株，鲍曼不动杆菌48株。不同浓度组合的抗菌药物对铜绿假单胞菌的最低抑菌浓度研究提示：环丙沙星、依诺沙星分别与头孢他啶、头孢吡肟、亚胺培南、美罗培南联合主要表现为协同和相加作用。发生协同的比率，环丙沙星组分别为36.4%、30.3%、27.3%、33.3%，依诺沙星组分别为24.2%、27.3%、18.2%、27.3%。阿米卡星与头孢他啶联合用药主要表现为协同作用，协同比率为57.6%，所有的联合均无拮抗作用。结论　阿米卡星与头孢他啶联合发生协同的比率高于环丙沙星和依诺沙星，环丙沙星组发生协同的比率大于依诺沙星组，二者差异并无统计学意义(P＞0.05)。细菌对抗菌药物耐药的种类越多，联合用药发生协同的比率越少。关键词: 铜绿假单胞菌；；抗菌Study on the combination of antimicrobials against Pseudomonas aeruginosa strains GAO Chen-lian,LUO Jian-wei （The Pixian Chinese medicine Hospital of Chendu,611730,China ） 【Abstract】:Objective To evaluate the antimicrobial activity of ciprofloxacin，enoxacin and amikacin combined with antipseudomonas β-lactams against Pseudomonas aeruginosa strains in vitro.Methods　A retrospective analysis was made among the results of bacteria culture and antimicrobial susceptibility testing conducted in ward from Feb.2008 to Dec.2009 to investigate the epidemic tendency of Pseudomonas aeruginosa.With the test designed by the chequerboard titration method，the minimal inhibitory concentrations(MIC) of antibiotics to strains of clinically were determined by broth dilution from Jan.2009 to Dec.2009.Results Three handred and fifty-six strains of bacteria were isolated，of which 259 (72.%) strains were Gram negative bacilli ,97(27.3%) strains were Gram positive coccus .The most detected bacteria were Pseudomonas aeruginosa (62 strains)，k.pneumoniae(51 strains)Acinetobacter baumannii (48 strains).The study demonstrates that respective combinations of ciprofloxacin and enoxacin with ceftazidime，cefepime，imipenem and meropenem mainly manifested synergistic and additive effect.The synergistic rate of ciprofloxacin-group was 36.4%,30.3%,27.3%,33.3% and enoxacin-group was 24.2%,27.3%,18.2%,27.3%.The combination of amikacin a