多黏菌素与美罗培南或阿米卡星联合治疗对碳青霉烯类耐药. 的协同作用
Synergetic Effects of Combined Treatment of Colistin With Meropenem or Amikacin on Carbapenem-Resistant .
机构信息
Department of Microbiology, Yongchuan Hospital of Chongqing Medical University, Chongqing, China.
Department of Microbiology, The First Affiliated Hospital of Jiamusi University, Jiamusi, China.
出版信息
Front Cell Infect Microbiol. 2019 Dec 10;9:422. doi: 10.3389/fcimb.2019.00422. eCollection 2019.
The purpose of this study was to investigate the synergistic and bactericidal effects of combinations of colistin with meropenem or amikacin and provide laboratory data needed for development of therapeutic strategies for the treatment of carbapenem-resistant (CRKP) infection. We found that minimum inhibitory concentration (MIC) of colistin, meropenem and amikacin were 232, 4256, and 1~16384 μg/ml, respectively. The minimum bactericidal concentration of the antibiotics was either 1× or 2×MIC. Treatments of 6 CRKP isolates at 1 μg/ml colistin completely killed 2 of them and suppressed 4 others growth. 4 CRKP isolates at 16 μg/ml meropenem or amikacin completely killed and suppressed 2 others growth. 2 CRKP isolates showed synergic effects in all colistin combination and 3 CRKP isolates showed synergic effects in part of colistin combination. Our data suggest that colistin in combination with either meropenem or amikacin could be a valid therapeutic option against colistin-resistant CRKP isolates. Moreover, the combination of colistin-amikacin is less expensive to treat CRKP infections in Eastern Heilongjiang Province.
本研究旨在探讨黏菌素与美罗培南或阿米卡星联合使用的协同杀菌作用，并为开发治疗碳青霉烯类耐药肠杆菌科（CRKP）感染的治疗策略提供所需的实验室数据。我们发现，黏菌素、美罗培南和阿米卡星的最低抑菌浓度（MIC）分别为 232、4256 和 1~16384μg/ml，抗生素的最低杀菌浓度为 1×或 2×MIC。6 株 CRKP 分离株在 1μg/ml 黏菌素下的处理完全杀死了其中 2 株，抑制了另外 4 株的生长。4 株 CRKP 分离株在 16μg/ml 美罗培南或阿米卡星下完全杀死并抑制了另外 2 株的生长。2 株 CRKP 分离株在所有黏菌素联合用药中表现出协同作用，3 株 CRKP 分离株在部分黏菌素联合用药中表现出协同作用。我们的数据表明，黏菌素联合美罗培南或阿米卡星可能是治疗黏菌素耐药 CRKP 分离株的有效治疗选择。此外，黏菌素-阿米卡星联合治疗在黑龙江东部地区治疗 CRKP 感染的费用更低。
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