药学毕业论文--β内酰胺类抗生素对产esbl肺炎克雷伯菌小鼠肺炎疗效研究

《药学毕业论文--β内酰胺类抗生素对产esbl肺炎克雷伯菌小鼠肺炎疗效研究》由会员上传分享，免费在线阅读，更多相关内容在学术论文-天天文库。

1、β内酰胺类抗生素对产ESBL肺炎克雷伯菌小鼠肺炎疗效研究作者：裴迎华张杰马越李景云【摘要】目的评价几种β内酰胺类抗生素对不同的产超广谱β内酰胺酶(ESBL)肺炎克雷伯菌动物肺炎模型的疗效。方法选择临床分离的2株对实验用抗生素敏感的产ESBL肺炎克雷伯菌建立小鼠肺炎模型。根据细菌分为GX6998和Tian29两组，于感染后6h给药。对照组腹腔注射生理盐水0.5ml；治疗组分别给予头孢哌酮/舒巴坦、头孢他啶、头孢吡肟和哌拉西林/三唑巴坦。连续治疗72h后，根据细菌计数结果评价疗效。结果体外药敏试验表明Tian29对4种抗生素的

2、MIC值均大于GX6998，但仍在敏感范围内。4种抗生素治疗后，各组病死率均显著减低。GX6998组中4种抗生素均可显著降低肺组织匀浆的细菌计数(P<0.01)。Tian29组中头孢哌酮/舒巴坦、头孢他啶可以显著降低肺组织匀浆的细菌计数(P<0.05)；头孢吡肟和哌拉西林/三唑巴坦也可使组织匀浆的细菌计数减少，但与对照组比较差异无显著性(P>0.05)。比较同一种抗生素对2株细菌的清除作用发现，4种抗生素对GX6998的清除作用均强于Tian29(P<0.01)。结论13体外敏感的广谱β内酰胺类抗生素和

3、β内酰胺酶抑制剂复合制剂治疗产ESBL肺炎克雷伯菌感染均可显著降低动物模型的死亡率，减少肺组织匀浆细菌计数。但如果细菌对抗生素的MIC升高，将会影响治疗效果。【关键词】超广谱β内酰胺酶；β内酰胺类抗生素；肺炎克雷伯菌；药效学ABSTRACTObjectiveToevaluatetheefficacyofseveralβlactamsagainstESBLproducingKlebsiellapneumoniaepneumoniainamousemodelofpeneumonia.MethodsTwoclinicalKle

4、bsiellapneumoniaestrainssusceptibletotheexperimentalantimicrobialagents,KlebsiellapneumoniaeGX6998andTian29,weredividedintotwogroupsformousepneumoniainfectionrespectively.Aftersixhourinfection,micewereintraperitoneallyinjectedwith0.5ml0.9%NaClforcontrol;micewereintr

5、aperitoneallyinjectedwithceftazidime,cefepime,cefoprazoneplussulbactamandpiperacillinplustazobactamrespectivelyfortrial.Seventytwohourslater,therapyefficacieswereevaluatedwithbacterialcounts.ResultsAllthetrialgroupshadsignificantlylowermortalitythancontrolgroups(P&l

6、t;0.05).Comparedwiththecontrolgroups,inGX6998infectedgroups,thebacterialamountswithallthetestingagentsweresignificantlydecreased(P<0.01);inTian29infectedgroup,thebacterialamounts13withcefoprazoneplussulbactamandceftazidimeweresignificantlydecreased(P<0.05);in

7、cefepimeandpiperacillinplustazobactamgroups,bacterialamountswerereducedwithoutsignificantdifferencewiththatofthecontrolgroup(P>0.05).ConclusionThecombinationsofbroadspectrumβlactamsandβlactamasesinhibitorcouldreducethemortalityandbacterialamountsinmousepneumoni

8、amodelwhichweresusceptibletoESBLsproducingKlebsiellapneumoniastrains.However,theclinicalefficacywouldbereducedwhentheMICincreased.