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含黏菌素疗法协同效应实现的耐多药感染挽救治疗——初步研究

Salvage Therapy Against Infections of MDR Achieved by Synergistic Effect of Colistin-Containing Therapies-Preliminary Study.

作者信息

Kmiecikowski Paweł, Gabriel Aniela, Depka Dagmara, Bogiel Tomasz

机构信息

Microbiology Student Science Club, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, 9 Maria Skłodowska-Curie Street, 85-094 Bydgoszcz, Poland.

Microbiology Department, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, 9 Maria Skłodowska-Curie Street, 85-094 Bydgoszcz, Poland.

出版信息

Microorganisms. 2025 May 25;13(6):1206. doi: 10.3390/microorganisms13061206.

Abstract

Infections caused by multi-drug-resistant are a global threat. The World Health Organization has recognized carbapenem-resistant as critical pathogens for which further research and development of effective drugs are needed. The aim of this study was to identify antibiotic combinations with possible potential for additive or synergistic action with colistin, and thus to find new therapeutic possibilities for the treatment of infections caused by multi-drug-resistant . The research involved the two multi-drug-resistant strains isolated from hospitalized patients. In this study, six antibiotics were chosen to combine with colistin: amikacin, gentamicin, ampicillin/sulbactam, tigecycline, imipenem, and meropenem. For both strains, the synergistic activity of colistin and ampicillin/sulbactam was demonstrated, and additive activity for ABA25, colistin, and meropenem or imipenem. The MICs of antibiotics that showed synergism with colistin were reduced by 8- to 128-fold. Additive interactions have been shown in colistin combination with carbapenems, aminoglycosides, and tigecycline. The results prove the synergistic effect of the tested antibiotics, which may be helpful in the selection of potentially effective multi-drug therapies and their application in clinical practice, which may involve reducing the doses of colistin in therapy and its toxicity.

摘要

耐多药菌引起的感染是全球性威胁。世界卫生组织已将耐碳青霉烯类菌认定为关键病原体,需要对其进一步开展有效药物的研发工作。本研究的目的是确定与黏菌素可能具有相加或协同作用潜力的抗生素组合,从而找到治疗耐多药菌引起感染的新治疗方法。该研究涉及从住院患者中分离出的两株耐多药菌。在本研究中,选择了六种抗生素与黏菌素联合使用:阿米卡星、庆大霉素、氨苄西林/舒巴坦、替加环素、亚胺培南和美罗培南。对于这两株菌,均证明了黏菌素与氨苄西林/舒巴坦具有协同活性,以及ABA25、黏菌素与美罗培南或亚胺培南具有相加活性。与黏菌素表现出协同作用的抗生素的最低抑菌浓度降低了8至128倍。已证明黏菌素与碳青霉烯类、氨基糖苷类和替加环素联合使用时有相加相互作用。结果证明了受试抗生素的协同作用,这可能有助于选择潜在有效的多药治疗方案并将其应用于临床实践,这可能包括在治疗中降低黏菌素的剂量及其毒性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4b69/12195407/fce6370b15be/microorganisms-13-01206-g001.jpg

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