替加环素与5种抗菌药物对耐左氧氟沙星嗜麦芽窄食单胞菌的体外药敏试验及联合药敏试验

doi:10.3969/j.issn.1006-7795.2021.04.018

首都医科大学学报 ›› 2021, Vol. 42 ›› Issue (4): 623-628.doi: 10.3969/j.issn.1006-7795.2021.04.018

替加环素与5种抗菌药物对耐左氧氟沙星嗜麦芽窄食单胞菌的体外药敏试验及联合药敏试验

尉景娟, 马立艳, 苏建荣^*

首都医科大学附属北京友谊医院临床检验中心,北京 100050

收稿日期:2020-10-22 出版日期:2021-08-21 发布日期:2021-07-29
基金资助:
首都临床特色应用研究(吴阶平)(Z141107006614005)。

In vitro antibacterial activities of tigecycline in combination with 5 antimicrobial agents for Stenotrophomonas maltophilia determined by broth microdilution method and chequerboard

Wei Jingjuan, Ma Liyan, Su Jianrong^*

Center of Clinical Laboratory, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China

Received:2020-10-22 Online:2021-08-21 Published:2021-07-29
Contact: * E-mail:youyilab@163.com
Supported by:
Jieping Wu Medical Foundation of Beijing Municipal Science & Technology Commission (Z141107006614005).

摘要/Abstract

摘要： 目的观察替加环素与左氧氟沙星、复方新诺明、米诺环素、头孢他啶、头孢哌酮-舒巴坦的单药及联合使用对耐左氧氟沙星的嗜麦芽窄食单胞菌(Stenotrophomonas maltophilia, SMA)的体外抗菌作用。方法 33株耐左氧氟沙星的嗜麦芽窄食单胞菌分离自首都医科大学附属北京友谊医院的患者血液及无菌部位体液标本,根据其耐药程度不同分为3组(耐左氧氟沙星SMA 17株;耐左氧氟沙星及复方新诺明SMA 11株;耐左氧氟沙星、复方新诺明及米诺环素SMA 5株)。采用微量肉汤稀释法分别测定6种抗菌药物对其最低抑菌浓度(minimum inhibitory concentration, MIC)。采用棋盘式微量肉汤稀释法进行替加环素与其他5种抗菌药物的联合药敏试验,计算部分抑菌指数(fractional inhibitory concentration, FIC)以判定其联合效果。结果替加环素对耐左氧氟沙星SMA和耐左氧氟沙星及复方新诺明SMA的敏感率分别为76.4%和54.5%,稍低于米诺环素的敏感率。联合药敏结果显示,替加环素与左氧氟沙星、头孢他啶、头孢哌酮-舒巴坦联合使用对SMA显示出一定的协同作用,替加环素与复方新诺明和米诺环素没有表现出明显的协同作用,均未显示拮抗作用。结论替加环素单独或联合使用可以作为临床治疗SMA感染的备选用药。

关键词: 替加环素, 嗜麦芽窄食单胞菌, 微量肉汤稀释法, 棋盘式微量肉汤稀释法

Abstract: Objective To investigate the In vitro antibacterial activities of tigecycline combined with levofloxacin, sulfamethoxazole-trimethoprim(SXT), minocycline, ceftazidime, cefperazone-sulbactam for Stenotrophomonas maltophilia (SMA) isolates resistant to levofloxacin. Methods Totally 33 SMA isolates resistant to levofloxacin were cultured from patients with bacteremia and tissue infection and collected from Beijing Friendship Hospital, Capital Medical University. All SMA isolates were divided into 3 groups: levofloxacin resistant isolates(n=17); levofloxacin resistant, SXT resistant isolates(n=11);levofloxacin resistant, SXT resistant, minocycline resistant isolates(n=5). The susceptibility of 6 agents against these SMA were tested by broth microdilution method. Tigecycline combined with levofloxacin, sulfamethoxazole-trimethoprim(SXT), minocycline, ceftazidime, cefperazone-sulbactam against these isolates were performed by chequerboard dilution. The fractional inhibitory concentration (FIC) index was calculated to evaluate the efficiency of these combination. Results Susceptibilities of tigecycline to levofloxacin resistant SMA and levofloxacin resistant, SXT resistant SMA were 76.4% and 54.5%, respectively, and it's a bit lower than susceptibilities of minocycline. According to the results of chequerboard, the combination of tigecycline with levofloxacin, ceftazidime, cefperazone-sulbactam showed synergy against some SMA isolates. None of the combinations showed antagonistic activity. Conclusions Tigecycline combined with levofloxacin, ceftazidime or cefperazone-sulbactam may be a choice for treating SMA infection in clinical practice.

Key words: tigecycline, Stenotrophomonas maltophilia, broth microdilution method, chequerboard dilution

中图分类号:

R446.5

尉景娟, 马立艳, 苏建荣. 替加环素与5种抗菌药物对耐左氧氟沙星嗜麦芽窄食单胞菌的体外药敏试验及联合药敏试验[J]. 首都医科大学学报, 2021, 42(4): 623-628.

Wei Jingjuan, Ma Liyan, Su Jianrong. In vitro antibacterial activities of tigecycline in combination with 5 antimicrobial agents for Stenotrophomonas maltophilia determined by broth microdilution method and chequerboard[J]. Journal of Capital Medical University, 2021, 42(4): 623-628.

参考文献

[1] Lodise T P, Echols R, Wang W, et al. Prevalence and microbiology of carbapenem resistance among six gram-negative pathogens in bloodstream infections in US hospitals, 2010-2015[J]. Open Forum Infect Dis, 2018, 5:S360.
[2] Adegoke A A, Stenstrom T A, Okoh A I. Stenotrophomonas maltophilia as an emerging ubiquitous pathogen: looking beyond contemporary antibiotic therapy[J]. Front Microbiol, 2017, 8:2276.
[3] Clinical and Laboratory Standards Institute.Performance standards for antimicrobial susceptibility testing[S].2020, M100-S30.
[4] 中国医疗保健国际交流促进会临床微生物与感染分会, 中华医学会检验医学分会临床微生物学组, 中华医学会微生物学与免疫学分会临床微生物学组. 多黏菌素类与替加环素及头孢他啶/阿维巴坦药敏方法和报告专家共识[J]. 中华检验医学杂志, 2020, 43(10): 964-972.
[5] Tangdiin T,Hickman R A,Forsberg P, et al. Evaluation of double- and triple-antibiotic combinations for VIM- and NDM-producing Klebsiella pneumoniae by in vitro time-kill experiments[J]. Antimicrob Agents Chemother,2014, 58(3):1757-1762.
[6] Chang Y T,Lin C Y,Chen Y H, et al. Update on infections caused by Stenotrophomonas maltophilia with particular attention to resistance mechanisms and therapeutic options[J]. Front Microbiol, 2015, 6:893.
[7] 秦立霞,李芳,赵会海.感染性无菌体液细菌分布及耐药性分析[J].临床误诊误治,2020,33(3):77-82.
[8] 付黎明,朱平.雾化吸入阿米卡星对治疗老年重症社区获得性肺炎的疗效观察[J].首都医科大学学报,2018,39(3):428-432.
[9] 赵鹏英,宋兵.风湿性瓣膜病合并嗜麦芽窄食单胞菌感染性心内膜炎1例[J].心肺血管病杂志,2018,37(10):940-941.
[10] 段忠亮,秦娟秀,李敏, 等. 上海某医院临床分离嗜麦芽窄食单胞菌分子流行病学分析[J]. 中国感染与化疗杂志,2017,17(3):283-288.
[11] Hu L F, Xu X H, Li H R, et al. Surveillance of antimicrobial susceptibility patterns among Stenotrophomonas maltophilia isolated in China during the 10-year period of 2005-2014[J]. J Chemother, 2018,30(1):25-30.
[12] Farrell D J, Sader H S, Jones R N. Antimicrobial susceptibilities of a worldwide collection of Stenotrophomonas maltophilia isolates tested against tigecycline and agents commonly used for S. maltophilia infections[J]. Antimicrob Agents Chemother, 2010, 54(6):2735-2737.
[13] Hand E, Davis H, Kim T, et al. Monotherapy with minocycline or trimethoprim/sulfamethoxazole for treatment of Stenotrophomonas maltophilia infections[J]. J Antimicrob Chemother, 2016, 71(4):1071-1075.
[14] Bostanghadiri N, Ghalavand Z, Fallah F, et al. Characterization of phenotypic and genotypic diversity of Stenotrophomonas maltophilia strains isolated from selected hospitals in Iran[J]. Front Microbiol, 2019, 10:1191.
[15] Watson L, Esterly J, Jensen A O, et al. Sulfamethoxazole/trimethoprim versus fluoroquinolones for the treatment of Stenotrophomonas maltophilia bloodstream infections[J]. J Glob Antimicrob Resist, 2018, 12:104-106.
[16] Nys C, Cherabuddi K, Venugopalan V, et al. Clinical and microbiologic outcomes in patients with monomicrobial Stenotrophomonas maltophilia infections[J]. Antimicrob Agents Chemother, 2019, 63(11):e00788-19.
[17] Pfaller M A, Huband M D, Shortridge D, et al. Surveillance of omadacycline activity tested against clinical isolates from the United States and Europe as part of the 2016 SENTRY Antimicrobial Surveillance Program[J]. Antimicrob Agents Chemother, 2018, 62(4): e02327-17.
[18] Rizek C,Ferraz J R,van der Heijden I M,et al. In vitro activity of potential old and new drugs against multidrag-resistant gram-negatives[J]. J Infect Chemother, 2015, 21(2):114-117.
[19] Biagi M, Tan X, Wu T, et al. Activity of potential alternative treatment agents for stenotrophomonas maltophilia isolates nonsusceptible to levofloxacin and/or trimethoprim-sulfamethoxazole[J]. J Clin Microbiol, 2020, 58(2):e01603-19.
[20] Nicodemo A C, Paez J I. Antimicrobial therapy for Stenotrophomonas maltophilia infections[J]. Eur J Clin Microbiol Infect Dis, 2007,26(4): 229-237.
[21] Karamanlioğlu D, Dizbay M. In vitro combination of tigecycline with other antibiotics in Stenotrophomonas maltophilia isolates[J]. Turk J Med Sci, 2019,49(2): 683-686.

替加环素与5种抗菌药物对耐左氧氟沙星嗜麦芽窄食单胞菌的体外药敏试验及联合药敏试验

In vitro antibacterial activities of tigecycline in combination with 5 antimicrobial agents for Stenotrophomonas maltophilia determined by broth microdilution method and chequerboard

PDF

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 7

编辑推荐

Metrics

本文评价

[1]	乔莉, 曹洋, 袁宏勋, 王瑶. ICU中心静脉导管相关性血流感染的危险因素及病原菌分析[J]. 首都医科大学学报, 2020, 41(1): 125-130.
[2]	张树琛, 王杉, 朱凤霞, 时琰丽, 李东, 鲁炳怀. B群链球菌显色培养基在孕产妇B群链球菌筛查中的性能评价[J]. 首都医科大学学报, 2016, 37(5): 680-683.
[3]	代芳芳, 赵秀英, 于艳华, 张立丽, 陈铭, 袁星星, 李宁. 医院内宽嗜性铜绿假单胞菌噬菌体的分离筛选[J]. 首都医科大学学报, 2013, 34(5): 727-732.
[4]	王雅杰;王璨;方芳;史从宁;蒋迪;张国军;吕虹;杨华卫;常铮. 常见革兰阳性细菌鉴定与耐药检测基因芯片的临床应用[J]. 首都医科大学学报, 2007, 28(2): 140-144.
[5]	董方;甄景慧;张美和. 北京儿童医院ICU细菌流行分布及耐药性监测[J]. 首都医科大学学报, 2005, 26(3): 353-356.
[6]	曹世俭. Giemsa染色用于显示幽门螺杆菌[J]. 首都医科大学学报, 1996, 17(3): 220-220.
[7]	马立艳, 孙伟, 夏帅, 苏建荣. 腹腔感染耐碳青霉烯类肺炎克雷伯菌的毒力特征[J]. 首都医科大学学报, 2021, 42(5): 733-738.