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阿奇霉素对铜绿假单胞菌烧伤创面感染的影响。

Effects of azithromycin in Pseudomonas aeruginosa burn wound infection.

机构信息

Pulmonary Medicine Division, Department of Pediatrics, National Jewish Health, Denver, CO 80206, USA.

出版信息

J Surg Res. 2013 Aug;183(2):767-76. doi: 10.1016/j.jss.2013.02.003. Epub 2013 Feb 24.

Abstract

BACKGROUND

Cutaneous thermal injuries (i.e., burns) remain a common form of debilitating trauma, and outcomes are often worsened by wound infection with environmental bacteria, chiefly Pseudomonas aeruginosa.

MATERIALS AND METHODS

We tested the effects of early administration of a single dose of azithromycin, with or without subsequent antipseudomonal antibiotics, in a mouse model of standardized thermal injury infected with P aeruginosa via both wound site and systemic infection. We also tested the antimicrobial effects of these antibiotics alone or combined in comparative biofilm and planktonic cultures in vitro.

RESULTS

In our model, early azithromycin administration significantly reduced wound and systemic infection without altering wound site or circulating neutrophil activity. The antimicrobial effect of azithromycin was additive with ciprofloxacin but significantly reduced the antimicrobial effect of tobramycin. This pattern was reproduced in biofilm cultures and not observed in planktonic cultures of P aeruginosa.

CONCLUSION

These data suggest that early administration of azithromycin following burn-related trauma and infection may reduce P aeruginosa infection and potential interactions with other antibiotics should be considered when designing future studies.

摘要

背景

皮肤热损伤(即烧伤)仍然是一种常见的致残性创伤,其结果往往因环境细菌(主要是铜绿假单胞菌)引起的伤口感染而恶化。

材料与方法

我们通过创面和全身感染,在感染铜绿假单胞菌的标准化热损伤小鼠模型中,测试了早期单剂量阿奇霉素给药,联合或不联合后续抗假单胞菌抗生素的效果。我们还单独或联合使用这些抗生素,在体外比较生物膜和浮游培养物中测试了它们的抗菌效果。

结果

在我们的模型中,早期阿奇霉素给药可显著减少创面和全身感染,而不会改变创面部位或循环中性粒细胞的活性。阿奇霉素的抗菌作用与环丙沙星相加,但显著降低了妥布霉素的抗菌作用。这种模式在生物膜培养物中得到重现,但在铜绿假单胞菌的浮游培养物中未观察到。

结论

这些数据表明,烧伤相关创伤和感染后早期给予阿奇霉素可能会减少铜绿假单胞菌感染,在设计未来研究时应考虑与其他抗生素的潜在相互作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ea45/3713079/698e8a3a3c30/nihms443576f1.jpg

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