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目的观察秦皮乙素对产碳青霉烯酶(KPC)碳青霉烯耐药肺炎克雷伯菌的体外抗菌效果。方法采用改良Hodge试验、美罗培南加抑制剂3-氨基苯硼酸(APBA)、乙二胺四乙酸(EDTA)等试验来检测菌株产KPC表型;PCR扩增KPC基因并测序;MLST-PCR法检测菌株ST分型;肉汤微量稀释法检测秦皮乙素的最小抑菌浓度(MIC);按棋盘法联合药敏试验检测秦皮乙素与亚胺培南、庆大霉素、左氧氟沙星体外联合抗菌效果。结果所有菌株均携带KPC-2基因;MLST分型均为ST11型;秦皮乙素单独抗菌的MIC值为0.5~1.0mg/mL。秦皮乙素与亚胺培南联合药敏试验,分级抑菌浓度(FIC)指数均大于2。与庆大霉素联合,庆大霉素MIC≥1 024μg/mL时,FIC指数均为2;MIC≤512μg/mL时,FIC指数为0.31~1.0。与左氧氟沙星联合,FIC指数均为2。结论秦皮乙素对产KPC酶碳青霉烯耐药肺炎克雷伯菌具有明确的抗菌作用,与亚胺培南联合时存在拮抗作用,与庆大霉素联合时两药联合抗菌结果显示为无关、相加或协同作用,与左氧氟沙星的结果均表现为无关。
Objective To observe the antimicrobial effect of aescine in vitro against carbapenem-resistant carbapenem-resistant Klebsiella pneumoniae producing carbapenemase (KPC). Methods The modified Hodge test, Meropenem inhibitor 3-aminobenzene boronic acid (APBA) and ethylenediaminetetraacetic acid (EDTA) were used to test the phenotype of KPC strains. KPC gene was amplified by PCR and sequenced. MLST-PCR Staphylococcus aureus isolates were tested for ST genotyping. The minimum inhibitory concentration (MIC) of aesculetin was determined by broth microdilution method. The antimicrobial activity of aesculetin, imipenem, gentamicin and levofloxacin effect. Results All strains were carrying KPC-2 gene. MLST typing was ST11 type. The MIC value of aescine alone was 0.5-1.0 mg / mL. Aescin B combined with imipenem susceptibility test, grading inhibitory concentration (FIC) index were greater than 2. When combined with gentamicin, the FIC index was 2 when the MIC of gentamicin was more than 1 024μg / mL, and the FIC index was 0.31 ~ 1.0 when the MIC was less than 512μg / mL. In combination with levofloxacin, the FIC index was 2. Conclusions Aesculetin has a definite antibacterial activity against KPC producing carbapenem-resistant Klebsiella pneumoniae, which shows antagonism when combined with imipenem. When combined with gentamycin, the antibacterial activity of the two drugs is Irrelevant, additive, or synergistic effects have been shown to be independent of levofloxacin results.