摘要
Abstract
Objective To study the in vitro activity of sulbactam(SUL),cefoperazone/sulbactam(CFS) and tigecycline(TIG) in combination with other 5 antibiotics separately against 70 strains of multi-drug resistant Acinetobacter baumannii(MDR-AB) isolated from hospitalized patients.Methods From July 2016 to March 2017, the MDR-AB strain collected from the First Affiliated Hospital of Jinzhou Medical University was used for the experiment.The minimum inhibitory concentrations(MIC) of SUL,CFS,meropenem(MER),biapenem(BPM),imipenem(IPM),TIG,polymyxin B(PMB), levofloxacin(LVX),alone and in combination,for 70 strains of MDR-AB were determined by broth microdilution method and checkerboard titration method.The effect of the combination of drugs was determined by the fractional inhibitory concentration(FIC) index,which was calculated according to the MIC results.And statistical analysis of the results of FIC index was performed. Results All the strains of MDR-AB showed resistance to SUL,CFS,MER,BPM and IPM.The combination of SUL,CFS or TIG with other 5 antibiotics showed synergistic,additive or unrelated effects and no antagonistic effects.The differences in curative effect between SUL+MER and CFS+MER,SUL+BPM and CFS+BPM,SUL+IPM and CFS+IPM,SUL+PMB and CFS+PMB were not significant(χ2=0.574,3.257,5.180,6.959,P>0.05).The curative effect between the 5 SUL combinations(SUL+TIG,SUL+MER,SUL+BPM,SUL+IPM,and SUL+PMB) differed significantly(χ2=101.501,P<0.05).Moreover,the 5 TIG combinations(TIG+MER,TIG+BPM,TIG+IPM,TIG+SUL,TIG+PMB and TIG+LVX) presented obviously different curative effect(χ2=54.460,P<0.05).The differences between the effects of TIG+LVX on TIG-resistant and TIG-sensitive strains were significant(χ2=13.490,P<0.05).Conclusion The main component which plays a major role against MDR-AB in CFS is SUL.Either TIG or SUL combined with MER has higher synergistic rate.TIG+LVX against TIG-resistant strains has higher synergistic rate.关键词
多重耐药鲍曼不动杆菌/药物疗法,联合/微生物敏感性试验/棋盘法Key words
Multi-drug resistant Acinetobater baumannii/Drug therapy,combination/Microbial sensitivity tests/Checkerboard method分类
医药卫生
