耐碳青霉烯类肺炎克雷伯菌生物膜形成及多黏菌素B联合替加环素的体外抗菌活性

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中图分类号：R978.1 文献标志码：A

Carbapenem-resistant Klebsiella pneumoniae biofilm formation and in vitro antimicrobial activity of polymyxin B in combination with tigecycline

Liu Jiel and Zhao Jianping² （1 InnerMongoliaClinical MedicalCollege，InnerMongoliaMedical University，Hohhot010050; 2 Department ofLaboratory Medicine， Inner Mongolia People's Hospital，Hohhot 010010）

Abstract Objective To analyze the relationship between the biofilm formation capacity of Klebsiella pneumoniae （KPN）and carbapenem antibiotic susceptibility，and evaluated the antimicrobial efect of polymyxin B（PMB）and tigecycline （TGC） in vitro against clinically isolated carbapenem-resistant Klebsiella pneumoniae （CRKP）.MethodsThe abilityof 66 KPN strains to form biofilm and thecorrelation between KPNbiofilm formation ability and carbapenem susceptibility were analyzed bycrystal violet staining method;the minimum inhibitory concentration of PMB and TGC against 31 clinical isolates was determined by broth dilution and checkerboard dilution，and some inhibitory concentration index was calculated.ResultsThe biofilm formationrate in the 66 KPN strains was 90.91% .The main specimen types of the biofilm-positive strains were sputum （ 60% andbronchial lavage fluid （18.33%） . The ICU （36.67%） was the major distributed department. The production rate of 31 CRKP strains was 90.63% .The35carbapenem-susceptible K. pneumoniae （CSKP） biofilm formation rate was 88.57% .There was no difference in biofilm formation ability between the CRKP and CSKP groups （P>0.05） .The CRKP isolateswere obtained mainly from malepatients.TheICU （64.52%） ）wasalso the major distributed department. The specimens were mainly derived from sputum （51.61%） and bronchial lavage fluid （35.48% ）. 31 CRKP mainly showed additive and synergistic effects，with 67.74% and 22.58% ，respectively，and the combination effect of the two drugs was 9.68% with no antagonistic efect. ConclusionKPN biofilm isolated in this hospital had strong formation capacity and should attact clinical atention; theantibacterial effect of PMBandTGCin vitro was mainly synergistic and aditive to CRKP.

Key WordsKlebsiella pneumoniae; Carbapenemresistant; Biofilm; Polymyxin B; Tigecycline; Drug combination

据报道，肺炎克雷伯菌（Klebsiellapneumoniae，KPN）是全球医院感染相关的主要细菌病原体之一[]。（剩余12599字）