耐碳青霉烯鲍曼不动杆菌的体外联合药敏试验研究.pdfVIP

耐碳青霉烯鲍曼不动杆菌的体外联合药敏试验研究 1* 2 刘 盼 ，王志达 （1.赤峰学院附属医院，内蒙古赤峰 024005 ；2.赤峰学院第二附属医院，内蒙古赤峰 024000） 中图分类号 R978.1 文献标志码 A 文章编号 1672 －2124 （2014）08 －0705 －03 摘 要 目的：对耐碳青霉烯鲍曼不动杆菌进行体外联合药敏试验，寻找有效的抗菌药物组合。方法：选取临床分离的耐碳青霉 烯鲍曼不动杆菌株72 株，采取棋盘法设计微量肉汤稀释法进行抗菌药联合体外抑菌试验，判断抗菌药联合应用效应。结果：头孢 哌酮/舒巴坦与利福平、米诺环素、美罗培南联合应用及米诺环素与美罗培南联合应用对耐青霉烯鲍曼不动杆菌的抗菌效应主要 表现为协同和相加作用；头孢哌酮/舒巴坦与左氧氟沙星联合应用主要表现为无关作用，小部分表现为协同和相加作用。结论：建 议对耐碳青霉烯鲍曼不动杆菌引起的院内感染，可联合应用头孢哌酮/舒巴坦和米诺环素、利福平、美罗培南或者联合应用米诺环 素和美罗培南进行治疗。 关键词 鲍曼不动杆菌；碳青霉烯；抗菌药物联合应用；体外药敏试验 Susceptibility Test in vitro on Carbapenem-resistant Acinetobacter baumannii 1 2 LIU Pan ，WANG Zhi-da （1. Chifeng College Affiliated Hospital ，Inner Mongolia Chifeng 024005 ，China ；2. Chifeng College Affiliated Second Hospital ，Inner Mongolia Chifeng 024000 ，China ） ABSTRACT OBJECTIVE ：To conduct susceptibility test in vitro on carbapenem-resistant Acinetobacter baumannii so as to estab- lish effective antimicrobial drug combinations. METHODS ：72 strains of clinically isolated carbapenem-resistant Acinetobacter bau⁃ mannii were given in vitro susceptibility test using checkerboard method design broth dilution method to identify the effect of com- bined use of antimicrobial drugs. RESULTS ：The combinations of cefoperazone/sulbactam with rifampin ，minocycline and meropen- em or the combination of minocycline with meropenem showed synergic and additive antibacterial effects on carbapenem-resistant Acinetobacter baumannii ；the combination of cefoperazone/sulbactam with levofloxacin mainly manifested as irrelevant effect with synergic and additive antibacterial effect noted in small proportion. CONCLUSIONS ：It is recommended to use cefoperazone/sulbac- tam plus minocycline ，rifampin and meropenem or use minocycline plus meropenem for treatment of nosocomial infections induced by carbapenem-resistant Acinetobacter baumannii . KEYWORDS