头孢美唑与加替沙星联合应用对33株产ESBLs细菌的作用研究.pdfVIP

头孢美唑与加替沙星联合应用对 33株产 ESBLs细菌的作用 贺密会 裴斐 周筱青 王睿 柴栋 方翼 常红霞 解放军总医院药材处 北京 100853 摘 要 目的 评价头孢美唑与加替沙星对33 株临床分离的产超广谱 -内酰胺酶 ESBL 细菌的联合抗菌效应 方法 采用棋盘法设计 微量肉汤稀释法测定 测定不同浓度组合的 两种抗菌药物对33 株ESBL 菌 其中20 株大肠埃希菌 13 株肺炎克雷伯菌 的最低抑菌 浓度 并计算FIC 指数 结果 头孢美唑与加替沙星联合应用后对大肠埃希菌和肺炎克雷伯 菌的浓度累积抑菌百分率曲线均比单独应用明显左移 FIC 指数结果表明 头孢美唑与加替 沙星联合应用后对大肠埃希菌60%为协同作用 40%为相加作用 无无关作用 无拮抗作用 对肺炎克雷伯菌53.85%为协同作用 38.46%为相加作用 7.69%无关作用 无拮抗作用 结 论 对多种抗生素耐药的ESBL 菌对加替沙星耐药率较高 对头孢美唑较稳定 两种抗菌药 联合应用后MIC 明显降低 抗菌作用明显加强 关键词 ESBL头孢美唑 加替沙星 联合药敏 The study on the antibacterial activity of Cefmetazole combine with gatifloxacin against 33 strains extended-spectrum beta-lactamase production bacteria He Mihui Pei Fei Zhou Xiaoqing Chai Dong Fang Yi Wang Rui Chang Hongxia The Chinese PLA General Hospital Beijing 100853 ABSTRCT: To evaluate the antibiotic effects of Cefmetazole combined with gatifloxacin against 33 strains ESBL (extended-spectrum beta-lactamase)-producing bacteria . The protocol was designed by checkerboard method and the MI Cs of cefathiamidine alone and combined with other 6 antibiotics against the 90 strains of Gram positive cocci (including 30 strains of Staphylococcus aureus, 30 strains of Staphylococcus epidermidis, 30 strains of Enterococcus faecalis) were determined by broth dilution method , the FIC index was calculated according to MIC results. The MIC50 of cefathiamidine were reduced significantly when combined with vancomycin, netilmicin, amikacin, ciprofloxacin, levofloxacin or gatifloxacin .The percentage of the FIC index less than 0.5, from 0.5 to 1, from 1 to 2, more than 2 was 60~90%, 10~33.3%, 0~13.3%, 0% respectively. The results suggested that synergism and additivity of cefathiamidine combined with vancomycin, netilmicin, amikacin, ciprofloxacin, levofloxacin or gatiflox