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2019年1月至2020年12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.