Department of Medical Microbiology, Istanbul Faculty of Medicine, Istanbul University, Capa, Istanbul, Türkiye.
Department of Public Health, Istanbul Faculty of Medicine, Istanbul University, Capa, Istanbul, Türkiye.
Braz J Microbiol. 2023 Dec;54(4):2817-2826. doi: 10.1007/s42770-023-01141-9. Epub 2023 Oct 13.
This study aimed to compare the efficacy of fosfomycin, colistin, tobramycin and their dual combinations in an experimental sepsis model. After sepsis was established with a Pseudomonas aeruginosa isolate (P1), antibiotic-administered rats were divided into six groups: Fosfomycin, tobramycin, colistin and their dual combinations were administered by the intravenous or intraperitoneal route to the groups. The brain, heart, lung, liver, spleen and kidney tissues of rats were cultured to investigate bacterial translocation caused by P1. Given the antibiotics and their combinations, bacterial colony counts in liver tissues were decreased in colistin alone and colistin plus tobramycin groups compared with control group, but there were no significant differences. In addition, a non-statistical decrease was found in the spleen tissues of rats in the colistin plus tobramycin group. There was a > 2 log CFU/ml decrease in the number of bacterial colonies in the kidney tissues of the rats in the fosfomycin group alone, but the decrease was not statistically significant. However, there was an increase in the number of bacterial colonies in the spleen and kidney samples in the group treated with colistin as monotherapy compared to the control group. The number of bacterial colonies in the spleen samples in fosfomycin plus tobramycin groups increased compared to the control group. Bacterial colony numbers in all tissue samples in the fosfomycin plus colistin group were found to be close to those in the control group. Colistin plus tobramycin combinations are effective against P. aeruginosa in experimental sepsis, and clinical success may be achieved. New in vivo studies demonstrating the ability of P. aeruginosa to biofilm formation in tissues other than the lung are warranted in future.
本研究旨在比较磷霉素、黏菌素、妥布霉素及其联合用药在实验性脓毒症模型中的疗效。使用一株铜绿假单胞菌（P1）建立脓毒症后，将接受抗生素治疗的大鼠分为六组：通过静脉或腹腔途径分别给磷霉素、妥布霉素、黏菌素及其联合用药组给药。培养大鼠的脑、心、肺、肝、脾和肾组织，以研究 P1 引起的细菌易位。与对照组相比，单独使用黏菌素和黏菌素联合妥布霉素组的大鼠肝组织细菌菌落计数减少，但无统计学差异。此外，在黏菌素联合妥布霉素组的大鼠脾脏组织中发现细菌菌落数有非统计学意义的减少。单独使用磷霉素组大鼠肾脏组织中细菌菌落数减少超过 2 个对数 CFU/ml，但无统计学意义。然而，与对照组相比，单独使用黏菌素组的大鼠脾脏和肾脏样本中的细菌菌落数增加。与对照组相比，磷霉素联合妥布霉素组的大鼠脾脏样本中的细菌菌落数增加。磷霉素联合黏菌素组所有组织样本中的细菌菌落数均接近对照组。黏菌素联合妥布霉素联合用药对实验性脓毒症中的铜绿假单胞菌有效，临床可能取得成功。未来有必要进行新的体内研究，证明铜绿假单胞菌在肺以外的组织中形成生物膜的能力。
