亚胺培南与黏菌素联合使用在体外的活性是否超过产金属β-内酰胺酶肺炎克雷伯菌分离株的耐药问题？
Does the activity of the combination of imipenem and colistin in vitro exceed the problem of resistance in metallo-beta-lactamase-producing Klebsiella pneumoniae isolates?
作者信息
Souli Maria, Rekatsina Panagiota Danai, Chryssouli Zoi, Galani Irene, Giamarellou Helen, Kanellakopoulou Kyriaki
机构信息
4th Department of Internal Medicine, Athens University School of Medicine, University General Hospital Attikon, Chaidari, Greece.
出版信息
Antimicrob Agents Chemother. 2009 May;53(5):2133-5. doi: 10.1128/AAC.01271-08. Epub 2009 Mar 2.
Abstract
Using time-kill methodology, we investigated the interactions of an imipenem-colistin combination against 42 genetically distinct Klebsiella pneumoniae clinical isolates carrying a bla(VIM-1)-type gene. Irrespective of the imipenem MIC, the combination was synergistic (50%) or indifferent (50%) against colistin-susceptible strains, while it was antagonistic (55.6%) and rarely synergistic (11%) against non-colistin-susceptible strains (with synergy being observed only against strains with colistin MICs of 3 to 4 microg/ml). The combination showed improved bactericidal activity against isolates susceptible either to both agents or to colistin.
摘要
采用时间杀菌法，我们研究了亚胺培南-黏菌素联合用药对42株携带bla(VIM-1)型基因的基因不同的肺炎克雷伯菌临床分离株的相互作用。无论亚胺培南的最低抑菌浓度如何，该联合用药对黏菌素敏感菌株具有协同作用（50%）或无作用（50%），而对非黏菌素敏感菌株具有拮抗作用（55.6%）且很少有协同作用（11%）（仅在黏菌素最低抑菌浓度为3至4μg/ml的菌株中观察到协同作用）。该联合用药对两种药物均敏感或对黏菌素敏感的分离株显示出增强的杀菌活性。
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