多药耐药铜绿假单胞菌的体外联合药敏研究

目的评价美罗培南（meropenem，MEM）分别与依替米星（etimicin，ETM）、环丙沙星（ciprofloxacin，CIP）联合用药对临床分离多药耐药铜绿假单胞菌（muhipledrugresistantpseudomonasaeruginosa，MDRP）的体外抑菌作用。方法采用棋盘法设计，琼脂平板稀释法测定抗菌药物对38株临床分离的MDRP的最低抑菌浓度（MIC），并计算抑菌指数（FIC指数）判断联合抑菌效应。结果MEM与ETM联用后，63．2％为协同作用，36．8％为相加作用，没有无关作用和拮抗作用；MEM与CIP联用后，73．5％为协同作用，21．2％为相加作用，5．3％为无关作用，没有拮抗作用。上述药物联用后，各药MIC50及MIC90均明显降低，浓度一累积抑菌率曲线均表现为左移。结论MEM分别与ETM、CIP联用对MDRP体外联合抗菌效应主要表现为协同和相加作用。

Combined drug sensitivity test of multiple drug resistant Pseudomonas aeruginosa in vitro

Objective To assess the in vitro inhibitory effect of meropenem （MEM） in combination with etimicin （ETM） or ciprofloxacin （CIP） on clinically isolated multiple drug resistant pseudomonas aeruginosa （MDRP） strains. Methods The minimum inhibitory concentration （MIC） of MEM in combination with ETM or CIP for 38 clinically isolated MDRP strains was measured with agar plate dilution method. The fractional inhibitory concentration （FIC）index of MEM in combination with ETM or CIP for the 38 MDRP strains was calculated. Results The synergic effect and additive effect of MEM in combination with ETM on MDRP strains was 63.2% and 36.8%, respectively, with no unrelated and antagonistic effect. The synergic effect, additive effect, and unrelated effect of in combination with CIP on MDRP strains was 73.5%, 21.2% and 5.3%, respectively, with no antagonistic effect. The MIC50 and MIC90 of such drugs used in combination decreased significantly with their concentration-accumulative curves shifted to the left. Conclusion MEM in combination with ETM or CIP shows its in vitro inhibitory effect as synergic and additive effect on MDRP strains.