目的：评价头孢拉宗与阿米卡星或异帕米星联用对临床分离的11株产ESBLs和AmpC酶（双产酶）阴沟肠杆菌的体外抗菌效应。方法：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临床分离的11株双产酶阴沟肠杆菌的最低抑菌浓度，并计算联合抑菌指数（fractional inhibitory concentration, FIC），判定联合效应。结果：头孢拉宗与阿米卡星或异帕米星联用后，对11株双产酶阴沟肠杆菌的MIC50比单独应用明显降低。头孢拉宗与阿米卡星联用FIC分布为：FIC≤0.5占27.27%，0.54为0；头孢拉宗与异帕米星联用FIC分布为：FIC≤0.5占27.27%，0.54为0。结论：头孢拉宗与阿米卡星联用对11株双产酶阴沟肠杆菌多数呈协同、部分协同和相加作用，以相加作用为主，无关作用较少，无拮抗作用；头孢拉宗与异帕米星联用对11株双产酶阴沟肠杆菌多数呈部分协同和协同作用，以部分协同作用为主，相加和无关作用作用较少，无拮抗作用。%Objective:To investigate in vitro antibiotic effects of cefbuperazone combined with amikacin or isepamicin against 11 clinical isolates producing ESBLs and AmpC enzyme (distocia enzyme) of Enterobacter cloacae. Methods: Using the checkerboard design and broth microdilution method for the determination of minimum inhibitory concentration and the calculation of combined antibacterial index (FIC) when different concentration combinations of antimicrobial agents were used against Enterobacter cloacae. Results:The values of MIC50 of cefbuperazone in combination with amikacin or isepamicin against 11 strains of distocia enzyme Enterobacter cloacae were significantly reduced. The FIC indexs of cefbuperazone combined with amikacin accounted for 27.27%(less than 0.5), 27.27%(from 0.5 to 1), 36.36%(equal to 1), 9.1%(from 1 to 4), and 0 (more than 4). The FIC indexs of cefbuperazone combined with isepamicin accounted for 27.27%(less than 0.5), 54.55%(from 0.5 to 1), 9.09%(equal to 1), 9.09%(from 1 to 4), and 0 (more than 4). Conclusion:The FIC index mainly indicated the synergism and additivity of cefbuperazone in combination with amikacin or isepamicin against 11 strains of distocia enzyme Enterobacter cloacae.
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