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目的使用无CLSI完整解释标准的药物,哌拉西林/他唑巴坦、替卡西林/棒酸、头孢吡肟治疗洋葱伯克霍尔德菌感染的家兔模型,观察比较何种体外药物敏感试验更能准确反应临床疗效。方法 57株临床分离的洋葱伯克霍尔德菌,感染57只家兔腹腔。将感染家兔分成3组(A、B、C组),每组19只;分别在48、72、96、120和144 h注射药物:A组每只家兔注射1 mL浓度为2 g/mL哌拉西林/他唑巴坦;B组每只家兔注射1 mL浓度为0.1g/mL头孢吡肟;C组每只家兔注射1 mL浓度为0.6 g/mL替卡西林/棒酸。比较肉汤稀释法(MIC法)、K-B法及VITEK法检测的药物敏感性结果与体内药物治疗的疗效关系。结果哌拉西林/他唑巴坦治疗组(A组),K-B法检测结果与家兔感染模型治疗过程相符率为72.2%,MIC法66.7%,VITEK法为66.7%。替卡西林/棒酸治疗组(B组),MIC法83.3%,VITEK法为77.8%,K-B法检测结果与家兔感染模型治疗过程相符率为50.0%。头孢吡肟治疗组(C组),MIC法88.9%,VITEK法为77.8%,K-B法检测结果与家兔感染模型治疗过程相符率为72.2%。结论在3种药物敏感性检测法中,哌拉西林/他唑巴坦以K-B法检测结果与感染家兔的抗感染疗效最为接近;替卡西林/棒酸及头孢吡肟均以MIC法与感染家兔的抗感染疗效最为接近;针对洋葱伯克霍尔德菌的感染建议临床使用不同的方法检测不同的药物体外敏感性。
Objective To investigate the in vitro drug sensitivity of a rabbit model of Burkholderia cepaciae infection using a drug without CLSI complete interpretation standard, piperacillin / tazobactam, ticarcillin / clavulanic acid and cefepime. Test more accurately reflect the clinical efficacy. Methods 57 clinical isolates of Burkholderia cepacia were infected with 57 rabbits. The infected rabbits were divided into 3 groups (A, B and C), 19 rats in each group. At 48, 72, 96, 120 and 144 h respectively, rabbits were injected with 1 mL of 2 g / mL piperacillin / tazobactam. In group B, 1 mL of cefepime was injected into each rabbit at a concentration of 0.1 g / mL. In group C, 1 mL of 0.6 g / mL ticarcillin / clavulanic acid . Compare the relationship between drug susceptibility measured by K-B method and VITEK method and curative effect of drug therapy in vivo by MIC method. Results In the group treated with piperacillin / tazobactam (group A), the K-B test was consistent with the treatment of rabbits infected with rabbits 72.2%, the MIC method was 66.7% and the VITEK method was 66.7%. Ticarcillin / clavulanic acid treatment group (group B), MIC method 83.3%, VITEK method was 77.8%, K-B method and rabbits infected with the model of the treatment process was 50.0%. In the cefepime treatment group (C group), 88.9% for the MIC method and 77.8% for the VITEK method. The consistency between the K-B method and the rabbit model of infection was 72.2%. Conclusion Among the three drug sensitivity test methods, the antibacterial efficacy of piperacillin / tazobactam by KB method was the closest to that of the infected rabbits. Ticarcillin / clavulanic acid and cefepime were all detected by MIC method and Rabbits infected with anti-infective effect is the closest; for Burkholderia cepacia infection clinical recommendations using different methods to detect different in vitro drug sensitivity.