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目的研究27种抗菌药物单用和两药联合应用在抗两家医院临床分离的醋酸钙鲍曼复合不动杆菌的效果。方法收集并分离临床来源的100株醋酸钙鲍曼复合不动杆菌,采用琼脂二倍稀释法测定抗菌药物对醋酸钙鲍曼复合不动杆菌的MIC值,同时采用微量棋盘稀释法,计算组分抑菌浓度(FIC)指数。结果临床分离的100株醋酸钙鲍曼复合不动杆菌,对亚胺培南、美罗培南和头孢哌酮/舒巴坦的耐药率较低,分别为27%、15%和12%。对其中16株多重耐药菌株,用美罗培南和加替沙星、帕珠沙星、莫西沙星、阿米卡星体外联用,50%的多重耐药菌株有相加的抗菌活性;而美罗培南和依替米星体外联用,37.5%的多重耐药菌株有相加的抗菌活性,均无协同和拮抗作用。结论多重耐药的醋酸钙鲍曼复合不动杆菌对美罗培南、亚胺培南、头孢哌酮/舒巴坦较敏感;美罗培南和部分喹诺酮类药物、部分氨基糖苷类药物体外联用,仅部分多重耐药菌株有相加的抗菌活性。
Objective To study the effect of 27 kinds of antibacterials combined with two drugs in the clinical isolation of Acinetobacter baumannii isolated from two hospitals. Methods 100 strains of Acinetobacter baumannii isolated from clinical samples were collected and separated. The MIC of antibacterial drugs against Acinetobacter baumannii was determined by agar double dilution method. At the same time, micro-chessboard dilution method was used to calculate the components Bacteriostatic concentration (FIC) index. Results The clinical isolates of 100 strains of Acinetobacter baumannii showed low resistance to imipenem, meropenem and cefoperazone / sulbactam, which were 27%, 15% and 12% respectively. Of the 16 multidrug-resistant strains, there were additive antibacterial activities with meropenem and gatifloxacin, pazufloxacin, moxifloxacin and amikacin in combination with 50% multi-drug resistant strains; and Meropenem and etimicin in vitro combination, 37.5% of the multi-drug resistant strains have additive antibacterial activity, no synergistic and antagonistic effect. Conclusions Multi-drug resistant Acinetobacter baumannii is more sensitive to meropenem, imipenem and cefoperazone / sulbactam. Meropenem and some quinolones, some aminoglycosides are combined in vitro, and only Some multi-drug resistant strains have additive antibacterial activity.