目的 探討多黏菌素聯(lián)合替加環(huán)素（tigecyclin）對多重耐藥鮑曼不動桿菌體外抗菌的效果。方法 收集臨床分離的50株多重耐藥鮑曼不動桿菌，采用微量肉湯稀釋法、棋盤法分別檢測替加環(huán)素、多黏菌素單獨及聯(lián)合使用的最低抑菌濃度（MIC），并計算藥物聯(lián)合使用抑菌濃度（FIC）指數(shù)，利用FIC指數(shù)判定替加環(huán)素和多黏菌素聯(lián)用時對多重耐藥鮑曼不動桿菌體外抗菌的效果。熒光定量PCR檢測外排泵基因表達水平。結果 替加環(huán)素聯(lián)合多黏菌素能顯著降低各自MIC值，表現(xiàn)為協(xié)同作用的菌株占70%，表現(xiàn)為相加作用的占14%，表現(xiàn)為無關作用的占6%，拮抗作用則為10%。對聯(lián)合用藥不敏感的菌株，其外排泵基因（abeB，abeJ，abeG，abeM）表達水平顯著高于敏感型（P<0.05）。結論 替加環(huán)素聯(lián)合多黏菌素可對多重耐藥鮑曼不動桿菌的感染進行治療。

Objective The objective of this study was to evaluate the combination of colistin and tigecycline in vitro antibacterial effect of multidrug resistant baumanus.Methods Collect clinical separation 50 multiple drug-resistant strains of acinetobacter baumannii, trace broth dilution method, board method is used respectively for ring element, polymyxin b alone and combination of the minimum bacteriostatic concentration (MIC), and calculate the drug combination of bacteriostatic concentration (FIC) index, using the FIC index determination for ring element and polymyxin b when the combination of multiple drug resistance of acinetobacter baumannii in vitro antibacterial effect.Results The interaction between colistin and tigecycline, when used in combination, was 70% synergistic, 14% additive, 6% indifferent, and 10% antagonistic. For strains that are not sensitive to combination therapy, the expression level of efflux pump gene (abeB, abeJ, abeG, abeM) was significantly higher than that of sensitive type (P < 0.05).Conclusion Our results suggest that the synergistic effect of the colistin-tigecycline combination is suffcient to make it an optimal treatment choice.