Shangguan Zui-Fei, Chen Hong-Lei, Li Yi-Fan, Shi Na, Mao Qi-Fen
Department of Clinical Laboratory, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou, Zhejiang, 310006, People's Republic of China.
Department of Clinical Laboratory, Tongde Hospital of Zhejiang Province, Hangzhou, Zhejiang, 310012, People's Republic of China.
Infect Drug Resist. 2025 Jan 13;18:227-237. doi: 10.2147/IDR.S490029. eCollection 2025.
This study aimed to investigate the status of carbapenem-resistant strains of isolated from the Department of Microbiology, Zhejiang Tongde Hospital between September 2023 and February 2024, and to examine the in vitro antibacterial effect of Reduning combined with polymyxin on carbapenem-resistant (CRKP), which may provide evidence on the application of Reduning in the clinical anti-infective therapy.
A total of 50 different isolates of CRKP were collected, and the minimum inhibitory concentrations (MIC) of polymyxin, Reduning and polymyxin plus Reduning were measured with microbroth dilution method. Then, the fractional inhibition concentration index (FICI) was calculated.
A total of 50 strains of CRKP were isolated, sputum and clean urine were the most common source of CRKP, and intensive care unit was the most common source department. More than 90% of CRKP strains were resistant to cefepime, ceftazidime, piperacillin/tazobactam, and cefoperazone/sulbactam. The rate of resistance to levofloxacin was high, but that to tobramycin, tigecycline, and compound sulfamethoxazole was low. In addition, MIC of Reduning plus polymyxin for CRKP was lower than that of Reduning or polymyxin alone. Among 50 strains of CRKP, FICI ≤0.5 was noted in 7 strains, 0.5 < FICI ≤ 1.0 in 43 strains, and none had FICI >1.0. The results showed Reduning combined with polymyxin B exerted additive effect on CRKP and conferred synergistic effect on several strains of CRKP.
Reduning has antibacterial effect on CRKP in vitro, and the addition of Reduning can reduce the dose of polymyxin in the treatment of CRKP.
本研究旨在调查2023年9月至2024年2月间从浙江同德医院微生物科分离出的耐碳青霉烯类菌株的情况,并检测热毒宁联合多黏菌素对耐碳青霉烯类肺炎克雷伯菌(CRKP)的体外抗菌效果,为热毒宁在临床抗感染治疗中的应用提供依据。
共收集50株不同的CRKP菌株,采用微量肉汤稀释法测定多黏菌素、热毒宁及多黏菌素加热毒宁的最低抑菌浓度(MIC)。然后计算部分抑菌浓度指数(FICI)。
共分离出50株CRKP菌株,痰液和清洁尿液是CRKP最常见的来源,重症监护病房是最常见的来源科室。超过90%的CRKP菌株对头孢吡肟、头孢他啶、哌拉西林/他唑巴坦和头孢哌酮/舒巴坦耐药。对左氧氟沙星的耐药率较高,但对妥布霉素、替加环素和复方磺胺甲恶唑的耐药率较低。此外,热毒宁加 多黏菌素对CRKP的MIC低于单独使用热毒宁或多黏菌素。在50株CRKP菌株中,7株FICI≤0.5,43株0.5<FICI≤1.0,无FICI>1.0的菌株。结果表明,热毒宁联合多黏菌素B对CRKP有相加作用,并对几株CRKP产生协同作用。
热毒宁对CRKP有体外抗菌作用,并可在治疗CRKP时减少多黏菌素的用量。