β-內(nèi)酰胺類抗菌藥物誘導(dǎo)異質(zhì)性萬古霉素中介金黃色葡萄球菌及其藥敏試驗研究
發(fā)布時間：2019-06-18 08:03
【摘要】：目的體外觀察β-內(nèi)酰胺類抗菌藥物能否誘導(dǎo)產(chǎn)生異質(zhì)性萬古霉素中介金黃色葡萄球菌(hVISA),并對其進(jìn)行藥敏試驗。方法挑選醫(yī)院2015年8月-10月臨床MRSA 5株,選擇頭孢他啶、哌拉西林/他唑巴坦、美羅培南3種常用β-內(nèi)酰胺藥物,逐步誘導(dǎo)菌株,應(yīng)用菌群分析曲線法檢測hVISA,E-test法測定hVISA對萬古霉素、利奈唑胺、替加環(huán)素、達(dá)托霉素的MIC,棋盤格法測定聯(lián)合藥敏試驗。結(jié)果 3種β-內(nèi)酰胺類抗菌藥物誘導(dǎo)產(chǎn)生的hVISA菌株分別為3株、3株、1株。7株hVISA對萬古霉素的MIC范圍在2~4mg/L,聯(lián)合利福平、左氧氟沙星、夫西地酸藥物后,hVISA對萬古霉素的MIC范圍分別為1~4mg/L,1~4mg/L,1~2mg/L,對利奈唑胺、替加環(huán)素、達(dá)托霉素的MIC范圍分別為0.25~1mg/L,0.125~0.5mg/L,0.064~0.25mg/L。結(jié)論體外β-內(nèi)酰胺類抗菌藥物可以誘導(dǎo)產(chǎn)生hVISA,頭孢類與半合成青霉素類較碳青霉烯類抗菌藥物更容易誘導(dǎo)產(chǎn)生hVISA,聯(lián)合用藥不能顯著降低hVSA對萬古霉素的MIC值,新型治療MRSA藥物利奈唑胺、替加環(huán)素、達(dá)托霉素對hVISA均較為敏感,可有效治療hVISA感染。
[Abstract]:Objective to observe whether 尾-lactam antibiotics can induce heterogeneous vancomycin mediated Staphylococcus aureus (hVISA), in vitro and to test its drug sensitivity. Methods five clinical MRSA strains were selected from August to October 2015. Three common 尾-lactam drugs, ceftazidime, piperacillin / tazobactam and meropenem, were selected to induce the strains step by step. The combined drug sensitivity test of hVISA to vancomycin, linazodine, tegacycline and tetromycin was detected by hVISA,E-test method. Results the MIC range of vancomycin induced by three 尾-lactam antibiotics was 3, 3 and 1, respectively. the MIC range of 7 strains of hVISA to vancomycin was 2: 4 mg / L, and the MIC range of hVISA to vancomycin was 1: 4 mg / L, 1 / 4 mg / L, 1 / 2 mg / L, 0.25 mg / L and 0.25 mg / L, respectively. 0.064 脳 0.25 mg 路L ~ (- 1) 路L ~ (- 1). Conclusion 尾-lactam antibiotics can induce the production of hVISA, cephalosporins and semi-synthetic penicillins more easily than carbapenem antibiotics in vitro. The combined use of hVISA, can not significantly reduce the hVISA, to vancomycin. The new MRSA drugs, linidazolam, tegacycline and tetracycline are sensitive to hVISA, and can effectively treat hVISA infection.
【作者單位】： 濱州市人民醫(yī)院呼吸內(nèi)科;山東大學(xué)齊魯醫(yī)院呼吸科;
【分類號】：R446.5
[Abstract]:Objective to observe whether 尾-lactam antibiotics can induce heterogeneous vancomycin mediated Staphylococcus aureus (hVISA), in vitro and to test its drug sensitivity. Methods five clinical MRSA strains were selected from August to October 2015. Three common 尾-lactam drugs, ceftazidime, piperacillin / tazobactam and meropenem, were selected to induce the strains step by step. The combined drug sensitivity test of hVISA to vancomycin, linazodine, tegacycline and tetromycin was detected by hVISA,E-test method. Results the MIC range of vancomycin induced by three 尾-lactam antibiotics was 3, 3 and 1, respectively. the MIC range of 7 strains of hVISA to vancomycin was 2: 4 mg / L, and the MIC range of hVISA to vancomycin was 1: 4 mg / L, 1 / 4 mg / L, 1 / 2 mg / L, 0.25 mg / L and 0.25 mg / L, respectively. 0.064 脳 0.25 mg 路L ~ (- 1) 路L ~ (- 1). Conclusion 尾-lactam antibiotics can induce the production of hVISA, cephalosporins and semi-synthetic penicillins more easily than carbapenem antibiotics in vitro. The combined use of hVISA, can not significantly reduce the hVISA, to vancomycin. The new MRSA drugs, linidazolam, tegacycline and tetracycline are sensitive to hVISA, and can effectively treat hVISA infection.
【作者單位】： 濱州市人民醫(yī)院呼吸內(nèi)科;山東大學(xué)齊魯醫(yī)院呼吸科;
【分類號】：R446.5
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