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2022 年第 2 期 第 17 卷

亚胺培南联合头孢他啶对产KPC-2酶肺炎克雷伯菌的体外抗菌效果

Antibacterial effect of imipenem combined with ceftazidime on KPC-2 enzyme producing Klebsiella pneumoniae in vitro

作者:盛巍1叶美娟2卢冰清1程韬3凌迎春4

英文作者:Sheng Wei1 Ye Meijuan1 Lu Bingqing2, Cheng Tao3 Ling Yingchun4

单位:1浙江省金华市第二医院药剂科,金华321000;2浙江省金华市第二医院老年一病区,金华321000;3浙江省金华市第二医院兰溪院区院长办公室,金华321000;4浙江省绍兴市第七人民医院检验科,绍兴312000

英文单位:1Department of Pharmacy the Second Hospital of Jinhua Zhejiang Province Jinhua 321000 China; 2Geriatric Ward 1 the Second Hospital of Jinhua Zhejiang Province Jinhua 321000 China; 3President′s Office Lanxi District of the Second Hospital of Jinhua Zhejiang Province Jinhua 321000 China; 4Department of Laboratory Shaoxing Seventh People′s Hospital Zhejiang Province Shaoxing 312000 China

关键词:肺炎克雷伯菌;亚胺培南;头孢他啶;产KPC-2酶;药物敏感试验

英文关键词:Klebsiellapneumoniae;Imipenem;Ceftazidime;KPC-2enzymeproducing;Drugsensitivitytest

  • 摘要:
  • 目的  探讨亚胺培南联合头孢他啶对产KPC-2酶肺炎克雷伯菌的体外抗菌效果。方法  回顾性分析浙江省金华市第二医院20191月至202012月收治的150例产KPC-2酶肺炎克雷伯菌感染患者的临床资料,送检标本中共分离出产KPC-2酶的肺炎克雷伯菌150株,分析检出菌株的标本分布情况、药物敏感试验结果、KPC基因型筛查结果以及亚胺培南联合头孢他啶的最低抑菌浓度值。结果  150株产KPC-2酶肺炎克雷伯菌检出标本来源为痰液84株(56.0%)、尿液43株(28.7%)、分泌物11株(7.3%)、血液9株(6.0%)、腹腔积液3株(2.0%);菌株对亚胺培南的耐药率为48.7%73/150),对头孢他啶的耐药率为100%150/150),对二者联合的耐药率为22.7%34/150);均为携带blaKPC-2基因型。亚胺培南与头孢他啶联合的分级抑菌浓度指数<0.5,两种药物存在协同作用。结论  亚胺培南联合头孢他啶对产KPC-2酶肺炎克雷伯菌具有明显的体外抗菌效应,为临床治疗产KPC-2酶肺炎克雷伯菌感染增加了一种用药选择。

  • Objective To investigate the antibacterial effect of imipenem combined with ceftazidime on KPC-2 enzyme producing Klebsiella pneumoniae in vitro. Methods From January 2019 to December 2020, Clinical data of 150 patients with KPC-2 enzyme producing Klebsiella pneumoniae infection treated in the Second Hospital of Jinhua, Zhejiang Province  were retrospectively analyzed. A total of 150 strains of KPC-2 enzyme producing Klebsiella pneumoniae were isolated. The sample distribution, drug sensitivity test Results , KPC genotype screening Results  and the minimum inhibitory concentration of imipenem combined with ceftazidime were analyzed. Results Among 150 strains of KPC-2 enzyme producing Klebsiella pneumoniae  were detected, including 84 strains (56.0%)of sputum, 43 strains (28.7%) of urine, 11 strains (7.3%) of secretion, 9 strains (6.0%) of blood and 3 strains (2.0%) of peritoneal effusion. The resistance rate to imipenem was 48.7%(73/150), the resistance rate to ceftazidime was 100%(150/150), and the resistance rate to the combination of the two was 22.7%(34/150). All of the strains carried blaKPC-2 genotype; the combined minimum inhibitory concentration value of the two drugs was <0.5, and the two drugs had synergistic effect. Conclusion Imipenem combined with ceftazidime has obvious antibacterial effect on KPC-2 enzyme producing Klebsiella pneumoniae in vitro, which increases a choice for clinical treatment of KPC-2 enzyme producing Klebsiella pneumoniae infection.

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