Ernst E J, Hashimoto S, Guglielmo J, Sawa T, Pittet J F, Kropp H, Jackson J J, Wiener-Kronish J P
College of Pharmacy, University of Iowa, Iowa City, Iowa 52242, USA.
Antimicrob Agents Chemother. 1999 Oct;43(10):2389-94. doi: 10.1128/AAC.43.10.2389.
The effect of antibiotics on the acute lung injury induced by virulent Pseudomonas aeruginosa PA103 was quantitatively analyzed in a rat model. Lung injury was induced by the instillation of PA103 directly into the right lower lobes of the lungs of anesthetized rats. The alveolar epithelial injury, extravascular lung water, and total plasma equivalents were measured as separate, independent parameters of acute lung injury. Four hours after the instillation of PA103, all the parameters were increased linearly depending on the dose of P. aeruginosa. Next, we examined the effects of intravenously administered antibiotics on the parameters of acute lung injury in D-galactosamine-sensitized rats. One hour after the rats received 10(7) CFU of PA103, an intravenous bolus injection of aztreonam (60 mg/kg) or imipenem-cilastatin (30 mg/kg) was administered. Despite an MIC indicating resistance, imipenem-cilastatin improved all the measurements of lung injury; in contrast, aztreonam, which had an MIC indicating sensitivity, did not improve any of the lung injury parameters. The antibiotics did not generate different quantities of plasma endotoxin; therefore, endotoxin did not appear to explain the differences in lung injury. This in vivo model is useful to quantitatively compare the efficacies of parenteral antibiotic administration on Pseudomonas airspace infections.
在大鼠模型中对抗生素对强毒铜绿假单胞菌PA103诱导的急性肺损伤的影响进行了定量分析。通过将PA103直接滴入麻醉大鼠的右下肺叶来诱导肺损伤。将肺泡上皮损伤、肺血管外水分和总血浆当量作为急性肺损伤的单独、独立参数进行测量。滴入PA103后4小时,所有参数均随铜绿假单胞菌剂量呈线性增加。接下来,我们研究了静脉注射抗生素对D-半乳糖胺致敏大鼠急性肺损伤参数的影响。在大鼠接受10(7)CFU的PA103后1小时,静脉推注氨曲南(60mg/kg)或亚胺培南-西司他丁(30mg/kg)。尽管最低抑菌浓度显示耐药,但亚胺培南-西司他丁改善了所有肺损伤测量指标;相比之下,最低抑菌浓度显示敏感的氨曲南并未改善任何肺损伤参数。抗生素产生的血浆内毒素量没有差异;因此,内毒素似乎无法解释肺损伤的差异。这种体内模型有助于定量比较胃肠外给予抗生素对假单胞菌气腔感染的疗效。