PDF(Sci-hub)
Abstract：
Pseudomonas aeruginosa is related to nosocomial infections, and it tends to become resistant during or after antimicrobial treatment. The ability to develop carbapenems resistance makes it difficult to treat. P. aeruginosa infections are often associated with high mortality, morbidity and treatment costs. A group of Chinese experts drafted a consensus for treatment of extensively drug-resistant Gram-negative bacilli (XDR-GNB) including extensively drug-resistant P. aeruginosa (XDR-PA). In this study, we studied the antibacterial activities of different antibiotic combinations against six carbapenems-resistant P. aeruginosa (CRPA) strains in vitro, and the results indicated that the combination of ceftazidime with cefoperazone-sulbatam was the best combination with excellent synergistic rate (100%). Besides, some combinations exhibited better effects than using antibiotics alone, reducing the MICs of both drugs significantly, such as ceftazidime/piperacillin-tazobactam and ceftazidime/aztreonam etc. However, there are also some combinations that showed no additional or synergistic effects, suggesting that not all combinations recommended by the guideline have the same effect against resistant P. aeruginosa. Our study screened out some effective combinations against six CRPA strains which might help to prevent the spread of antibiotic resistance through improving antibiotic effectiveness. SIGNIFICANCE AND IMPACT OF THE STUDY: This study measured the synergistic interactions between various antibiotics in vitro recommended by Chinese consensus statement against carbapenems-resistant Pseudomonas aeruginosa. The results of this study provide valuable evidence that some combinations may be a promising option for clinical treatment.
摘要：
铜绿假单胞菌与医院感染有关,在抗菌治疗期间或之后，它往往会产生耐药性。发展碳青霉烯类耐药性的能力使其难以治疗。铜绿假单胞菌感染通常与高死亡率相关，发病率和治疗费用。一组中国专家起草了广泛耐药的革兰氏阴性杆菌（XDR-GNB）包括广泛耐药的铜绿假单胞菌（XDR-PA）的治疗共识。在这项研究中,我们研究了不同抗生素组合对6株耐碳青霉烯类铜绿假单胞菌(CRPA)的体外抗菌活性,结果表明，头孢他啶与头孢哌酮-舒巴坦的组合是最佳组合，具有良好的协同率（100％）。此外,一些组合显示出比单独使用抗生素更好的效果，显著降低两种药物的中等收入国家，如头孢他啶/哌拉西林他唑巴坦和头孢他啶/氨曲南等。然而,也有一些组合没有显示出额外或协同作用，这表明并非所有指南推荐的组合对耐药铜绿假单胞菌都有相同的效果。我们的研究筛选出了一些针对6种CRPA菌株的有效组合，这可能有助于通过提高抗生素的有效性来防止抗生素耐药性的传播。研究的意义和影响：这项研究测量了中国针对耐碳青霉烯类铜绿假单胞菌的共识声明推荐的各种抗生素之间的体外协同相互作用。这项研究的结果提供了有价值的证据，表明某些组合可能是临床治疗的有希望的选择。
