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目的对老年患者多耐药和泛耐药鲍氏不动杆菌进行体外联合药敏试验,为临床治疗提供可靠的理论依据。方法采用琼脂稀释法对2012年1月-2013年12月114株多药耐药鲍氏不动杆菌进行体外联合药敏试验,联合方案共3种:头孢哌酮/舒巴坦(SCF)+多黏菌素E(PE)、多黏菌素E+美罗培南(MEM)、米诺环素(MH)+多黏菌素E,计算抑菌浓度(FIC)指数判断联用效果。结果 SCF和PE联合,94.7%表现为协同或相加,以相加为主;PE和MEM联合,99.1%表现为协同或相加,其中约40.0%为协同;PE和MH联合,99.1%表现为协同或相加,以协同作用为主,所有组合均无拮抗作用。结论 PE与SCF、MEM、MH体外联合应用效果显著,联用能有效降低单药最低抑菌浓度(MIC)值。
Objective To investigate the multidrug-resistant and pan-drug-resistant Acinetobacter baumannii in vitro in combination with drug susceptibility testing in elderly patients, so as to provide a reliable theoretical basis for clinical treatment. Methods The multidrug-resistant Acinetobacter baumannii strains from January 2012 to December 2013 were assayed by agar dilution method in vitro and in combination with three kinds of combination regimens: cefoperazone / sulbactam (SCF) + Polymyxin E (PE), polymyxin E + meropenem (MEM) and minocycline (MH) + polymyxin E were calculated to calculate the bacteriostasis concentration (FIC) index. RESULTS: The combination of SCF and PE showed synergistic or additive effects in 94.7% of patients. PE and MEM combined, 99.1% showed synergistic or additive effects, of which about 40.0% were synergistic. PE and MH combined, 99.1% For synergistic or additive, synergistic effect, no antagonism in all combinations. Conclusion PE and SCF, MEM, MH combined with a significant effect in vitro, combined with can effectively reduce the single drug minimum inhibitory concentration (MIC) value.