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多黏菌素单药治疗与联合其他抗菌药物治疗碳青霉烯类耐药 ST2 分离株的疗效比较。

The efficacy of colistin monotherapy versus combination therapy with other antimicrobials against carbapenem-resistant ST2 isolates.

机构信息

Jiamusi University, Jiamusi, Heilongjiang, China.

The First Affiliated Hospital of Jiamusi University, Jiamusi, Heilongjiang, China.

出版信息

J Chemother. 2020 Nov;32(7):359-367. doi: 10.1080/1120009X.2020.1764282. Epub 2020 May 19.

Abstract

This study aimed to investigate the efficacy of colistin both alone and in combination with either meropenem or levofloxacin against CRAB clinical isolates. The OXA carbapenemase genes and multilocus sequence typing were detected after 35 CRAB isolates biochemical identification. Then, the minimum inhibitory concentrations, minimum bactericidal concentrations, antibiotic interactions of the test antibiotics, and synergistic effects were determined by the checkerboard method and time-kill assays. The chromosomal gene was detected in all isolates, and and were present in 91.4% and 25.7% of the isolates, respectively. The combination of colistin and meropenem displayed the highest rate of synergy (51.4%) against the 35 isolates, while the colistin-levofloxacin combination showed a higher rate of indifference interaction (22.9%) than that of the colistin-meropenem (8.6%) combination. The synergistic effect of colistin against the CRAB isolates was confirmed. The combination of colistin with meropenem is recommended against CRAB isolates.

摘要

本研究旨在探讨黏菌素单独使用以及与美罗培南或左氧氟沙星联合使用对碳青霉烯类耐药鲍曼不动杆菌(CRAB)临床分离株的疗效。对 35 株 CRAB 分离株进行生化鉴定后,检测了 OXA 碳青霉烯酶基因和多位点序列分型。然后,采用棋盘法和时间杀伤试验测定了试验抗生素的最小抑菌浓度、最小杀菌浓度、抗生素相互作用和协同作用。所有分离株均检出染色体基因 ,91.4%和 25.7%的分离株分别携带 和 。黏菌素与美罗培南联合对 35 株分离株显示出最高的协同作用率(51.4%),而黏菌素-左氧氟沙星联合的无关相互作用率(22.9%)高于黏菌素-美罗培南(8.6%)联合。黏菌素对 CRAB 分离株的协同作用得到了证实。建议黏菌素与美罗培南联合用于治疗 CRAB 分离株。

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