庆大霉素联合阿奇霉素抗淋球菌的体外研究
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摘要
目的探讨庆大霉素与阿奇霉素体外抗淋球菌的联合作用。方法选取2017-08～2018-01山西医科大学第二医院皮肤性病门诊收集的27株淋球菌临床株,琼脂稀释法分别测庆大霉素、阿奇霉素对淋球菌的最小抑菌浓度(MIC),琼脂棋盘稀释法测联合作用下庆大霉素、阿奇霉素对淋球菌的最小抑菌浓度(MIC),并计算部分抑菌浓度指数(FICI),判断庆大霉素与阿奇霉素体外抗淋球菌的联合作用。结果庆大霉素MIC均值为4. 444 mg/L,MIC值范围为4. 000-8. 000 mg/L;阿奇霉素MIC均值为0. 149 mg/L,MIC值范围为0. 060-0. 500 mg/L。FICI均值为2. 35,范围在0. 75-4. 00之间,庆大霉素联合阿奇霉素体外抗淋球菌表现为相加作用。结论庆大霉素与阿奇霉素体外抗淋球菌表现为相加作用,未发现拮抗作用,可见庆大霉素与阿奇霉素联合使用可以用于抗淋球菌。
Objective To investigate the combined effect of gentamicin with azithromycin against Neisseria gonorrhoeae( NG) in vitro.Methods A total of 27 strains of Neisseria gonorrhoeae( NG) were collected from the sexually transmitted disease( STD) clinic of the Second Hospital of Shanxi Medical University from August 2017 to January 2018. The agar dilution method was used to determine the minimum inhibitory concentrations( MICs) of gentamicin and azithromycin against NG isolates. The agar checkerboard dilution method was used to determine the MICs of gentamicin and azithromycin against NG under combined action. Fractional inhibitory concentration index( FICI) was calculated to evaluate the in vitro combined effect of gentamicin and azithromycin against NG isolates. Results The mean MICs of gentamicin and azithromycin were 4. 444 mg/L( 4. 000-8. 000 mg/L) and 0. 149 mg/L( 0. 060-0. 500 mg/L),respectively. The FICI ranged from 0. 75 to 4. 00,and gentamicin and azithromycin showed an additive effect against the above NG isolates.Conclusion Gentamicin and azithromycin show an additive effect against NG in vitro,so they can be used to resist Neisseria gonorrhoeae under combined action.
Objective To investigate the combined effect of gentamicin with azithromycin against Neisseria gonorrhoeae( NG) in vitro.Methods A total of 27 strains of Neisseria gonorrhoeae( NG) were collected from the sexually transmitted disease( STD) clinic of the Second Hospital of Shanxi Medical University from August 2017 to January 2018. The agar dilution method was used to determine the minimum inhibitory concentrations( MICs) of gentamicin and azithromycin against NG isolates. The agar checkerboard dilution method was used to determine the MICs of gentamicin and azithromycin against NG under combined action. Fractional inhibitory concentration index( FICI) was calculated to evaluate the in vitro combined effect of gentamicin and azithromycin against NG isolates. Results The mean MICs of gentamicin and azithromycin were 4. 444 mg/L( 4. 000-8. 000 mg/L) and 0. 149 mg/L( 0. 060-0. 500 mg/L),respectively. The FICI ranged from 0. 75 to 4. 00,and gentamicin and azithromycin showed an additive effect against the above NG isolates.Conclusion Gentamicin and azithromycin show an additive effect against NG in vitro,so they can be used to resist Neisseria gonorrhoeae under combined action.
引文
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[2]Centers for Disease Control and Prevention(CDC).Update to CDC’s sexually transmitte diseases treatment guidelines,2010:oral cephalosporins no longer a recommended treatment for gonococcal infections[J].MMWR Morb Mortal Wkly Rep,2012,61(31):590-594.
[3]Centers for Disease Control and Prevention(CDC).Gonococcal infections-2015 sexually transmitted diseases treatment guidelines[EB/OL].https://www.cdc.gov/std/tg2015/gonorrhea.htm.
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[7]The European Committee on Antimicrobial Susceptibility Testing.Breakpoint tables for interpretation of MICs and zone diameters.Version 8.0,2018[EB/OL].http://www.eucast.org.
[8]Pereira R,Cole MJ,Ison CA.Combination therapy for gonorrhoea:in vitro synergy testing[J].J Antimicrob Chemother,2013,68(3):640-643.
[9]于瑞星,尹跃平,戴秀芹,等.头孢曲松和阿奇霉素体外抗淋球菌联合作用研究[J].中华皮肤科杂志,2017,50(5):364-366.
[10]杨波,胡丽华,赵建妹.德清地区2013-2016年淋球菌耐药监测结果分析[J].中国公共卫生管理,2018,34(4):497-499.
[11]朱邦勇,李甘泉,梁铭,等.广西地区淋病患者淋病奈瑟菌对七种抗生素的耐药监测[J].中国皮肤性病学杂志,2018,32(9):1052-1056.
[12]Singh V,Bala M,Bhargava A,et al.In vitro synergy testing of gentamicin,an old drug suggested as future treatment option for gonorrhoea,in combination with six other antimicrobials against multidrug-resistant Neisseria gonorrhoeae strains[J].Sex Transm Dis,2018,45(2):127-131.
[13]王鑫,苏晓红,蒋娟.淋球菌对头孢菌素耐药的治疗应对措施[J].中华皮肤科杂志,2016,49(5):367-371.
[14]Kirkcaldy RD,Weinstock HS,Moore PC,et al.The efficacy and safety of gentamicin plus azithromycin and gemifloxacin plus azithromycin as treatment of uncomplicated gonorrhea[J].Clin Infect Dis,2014,59(8):1083-1091.
[2]Centers for Disease Control and Prevention(CDC).Update to CDC’s sexually transmitte diseases treatment guidelines,2010:oral cephalosporins no longer a recommended treatment for gonococcal infections[J].MMWR Morb Mortal Wkly Rep,2012,61(31):590-594.
[3]Centers for Disease Control and Prevention(CDC).Gonococcal infections-2015 sexually transmitted diseases treatment guidelines[EB/OL].https://www.cdc.gov/std/tg2015/gonorrhea.htm.
[4]叶顺章.淋病实验室诊断[M]//叶顺章,王千秋,王荷英,等.性传播疾病的实验室诊断.2版.北京:北京科学出版社,2009:95-97.
[5]Brown LB,Krysiak R,Kamanga G,et al.Neisseria gonorrhoeae antimicrobial susceptibility in Lilongwe,Malawi,2007[J].Sex Transm Dis,2010,37(3):169-172.
[6]Mann LM,Kirkcaldy RD,Papp JR,et al.Susceptibility of Neisseria gonorrhoeae to gentamicin-gonococcal isolate surveillance project,2015-2016[J].Sex Transm Dis,2018,45(2):96-98.
[7]The European Committee on Antimicrobial Susceptibility Testing.Breakpoint tables for interpretation of MICs and zone diameters.Version 8.0,2018[EB/OL].http://www.eucast.org.
[8]Pereira R,Cole MJ,Ison CA.Combination therapy for gonorrhoea:in vitro synergy testing[J].J Antimicrob Chemother,2013,68(3):640-643.
[9]于瑞星,尹跃平,戴秀芹,等.头孢曲松和阿奇霉素体外抗淋球菌联合作用研究[J].中华皮肤科杂志,2017,50(5):364-366.
[10]杨波,胡丽华,赵建妹.德清地区2013-2016年淋球菌耐药监测结果分析[J].中国公共卫生管理,2018,34(4):497-499.
[11]朱邦勇,李甘泉,梁铭,等.广西地区淋病患者淋病奈瑟菌对七种抗生素的耐药监测[J].中国皮肤性病学杂志,2018,32(9):1052-1056.
[12]Singh V,Bala M,Bhargava A,et al.In vitro synergy testing of gentamicin,an old drug suggested as future treatment option for gonorrhoea,in combination with six other antimicrobials against multidrug-resistant Neisseria gonorrhoeae strains[J].Sex Transm Dis,2018,45(2):127-131.
[13]王鑫,苏晓红,蒋娟.淋球菌对头孢菌素耐药的治疗应对措施[J].中华皮肤科杂志,2016,49(5):367-371.
[14]Kirkcaldy RD,Weinstock HS,Moore PC,et al.The efficacy and safety of gentamicin plus azithromycin and gemifloxacin plus azithromycin as treatment of uncomplicated gonorrhea[J].Clin Infect Dis,2014,59(8):1083-1091.