多粘菌素B联合不同抗菌药物对耐碳青霉烯类肺炎克雷伯菌的体外抗菌作用

摘要

目的:评价多粘菌素B分别与美罗培南、利福平联合用药对临床分离的耐碳青霉烯类肺炎克雷伯菌(CRKP)的体外抗菌作用.方法:采用肉汤稀释法和棋盘稀释法测定多粘菌素B分别联用美罗培南和利福平对20株临床分离的CRKP的最低抑菌浓度,并计算部分抑菌浓度指数.结果:多粘菌素B与美罗培南联用后对CRKP有协同作用的占55％,表现出相加作用占45％,不存在无关和拮抗作用;多粘菌素B与利福平联用后对CRKP协同作用的占65％,相加作用占35％,不存在无关和拮抗作用.结论:多粘菌素B与美罗培南或利福平联用在体外对CRKP抗菌效应均主要表现为协同和相加作用.%Objective: To evaluate the combined inhibitory effect of polymyxin B with meropenem and rifampicin respectively against carbapenem-resistant Klebsiella pneumoniae (CRKP) strains in vitro. Methods:Combined inhibitory effect of polymyxin B and meropenem, polymyxin B and rifampicin in vitro was assayed by detecting the minimum inhibitory concentration and calculating the fractional inhibitory concentration index for 20 CRKP strains with the checkerboard dilution method. Results: Combined polymyxin B and meropenem showed 55％ synergic effect, 45％ additive effect, no indifferent and antagonistic effect on CRKP strains. Com-bined polymyxin B and rifampicin displayed 65％ synergic effect, 35％ additive effect, no indifferent and antago-nistic effect on CRKP strains. Conclusion: Combined polymyxin B and meropenem, combined polymyxin B and rifampicin show a combined synergic and additive inhibitory on CRKP strain in vitro.