连花清瘟联合美罗培南对耐药菌株的体外抑菌实验
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摘要
目的评价连花清瘟联合美罗培南对临床分离菌株及耐药菌株的体外抑菌活性。方法配制连花清瘟浸膏粉溶液,采用96孔板微量肉汤稀释法,对金黄色葡萄球菌、大肠埃希菌、铜绿假单胞菌进行体外抑菌实验。采用微量棋盘稀释法,测定连花清瘟、美罗培南对耐碳青霉烯类铜绿假单胞菌(CR-PA)、耐碳青霉烯类鲍氏不动杆菌(CR-AB)的体外抑菌浓度,计算抑菌指数(FIC)并进行比较。结果连花清瘟对金黄色葡萄球菌、大肠埃希菌、铜绿假单胞菌的最小抑菌浓度(MIC)分别为2、128、64mg/ml,最低杀菌浓度(MBC)分别为8、128、128mg/mL;联合用药后,能够提高CR-AB对连花清瘟和美罗培南的敏感性,其中有协同效果的组合浓度分别为连花清瘟16mg/ml、美罗培南16μg/ml。结论连花清瘟对临床常见致病菌均有抑菌作用。连花清瘟联合美罗培南对CR-AB有协同作用,可为临床治疗耐药菌感染提供依据。
OBJECTIVE To evaluate the antibacterial activity of Lianhuaqingwen combined with meropenem against clinical isolates and drug-resistant strains in vitro.METHODS Solution of Lianhuaqingwen extract powder was prepared and diluted with 96-well plate microbroth method.The bacteria inhibition of Staphylococcus aureus,Escherichia coli and Pseudomonas aeruginosa was studied in vitro.The antibacterial concentration of Lianhuaqingwen and meropenem against carbapenems-resistant P aeruginosa and carbapenems-resistant Acinetobacter baumannii in vitro was determined by microchisboard dilution method,and the antibacterial index(FIC)was calculated and compared.RESULTS The minimum inhibitory concentration(MIC)of Lianhuaqingwen against S aureus,E coli and P aeruginosa was 2,128 and 64 mg/ml,and the minimum bactericidal concentration(MBC)was 8,128 and128 mg/ml,respectively.The sensitivity of carbapenems-resistant A baumannii to Lianhuaqingwen and meropenem was increased with the combination of 16 mg/ml Lianhuaqingwen and 16 ug/ml meropenemy.CONCLUSIONLianhuaqingwen has antibacterial effect on common pathogenic bacteria.Lianhuaqingwen combined with meropenem has a synergistic effect on carbapene-resistant A baumannii,which can provide a basis for clinical treatment of drug-resistant bacterial infection.
OBJECTIVE To evaluate the antibacterial activity of Lianhuaqingwen combined with meropenem against clinical isolates and drug-resistant strains in vitro.METHODS Solution of Lianhuaqingwen extract powder was prepared and diluted with 96-well plate microbroth method.The bacteria inhibition of Staphylococcus aureus,Escherichia coli and Pseudomonas aeruginosa was studied in vitro.The antibacterial concentration of Lianhuaqingwen and meropenem against carbapenems-resistant P aeruginosa and carbapenems-resistant Acinetobacter baumannii in vitro was determined by microchisboard dilution method,and the antibacterial index(FIC)was calculated and compared.RESULTS The minimum inhibitory concentration(MIC)of Lianhuaqingwen against S aureus,E coli and P aeruginosa was 2,128 and 64 mg/ml,and the minimum bactericidal concentration(MBC)was 8,128 and128 mg/ml,respectively.The sensitivity of carbapenems-resistant A baumannii to Lianhuaqingwen and meropenem was increased with the combination of 16 mg/ml Lianhuaqingwen and 16 ug/ml meropenemy.CONCLUSIONLianhuaqingwen has antibacterial effect on common pathogenic bacteria.Lianhuaqingwen combined with meropenem has a synergistic effect on carbapene-resistant A baumannii,which can provide a basis for clinical treatment of drug-resistant bacterial infection.
引文
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[22]王艺竹,王宏涛,韩雪等.连花清瘟胶囊水提物对耐甲氧西林金黄色葡萄球菌细菌生物膜的影响[J].中华医院感染学杂志,2015,25(4):727-790.
[23]Balasubramanian D,Kumari H,Mathee K.Pseudomonas aeruginosa AmpR:all acute-chronic switch regulator[J].Pathog Dis,2015,73(2):1-14.
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[25]毛得斌.铜绿假单胞菌对碳青霉烯类抗菌药耐药性机制研究进展[J].临床合理用药,2017,10(18):161-163.
[26]闫玲,顾兵,张丽等.耐碳青霉烯类鲍曼不动杆菌的耐药机制[J].实用医学杂志,2018,34(15):2594-2599.
[2]Hu FP,Guo Y,Zhu DM,et al.Resistance trends among clinical isolates in China reported from CHINET surveillance of bacterial resistance,2005-2014[J].Clin Microbiol Infect,2016,22(Suppl 1):s9-s14.
[3]Qin X,Yang Y,Hu F,et al.Hospital clonal dissemination of Enterobacter aerogenes producing carbapenemase KPC-2in a Chinese teaching hospital[J].J Med Microbiol,2014,63(Pt2):222-228.
[4]Petty LA,Henig O,Patel TS,et al.Overview of meropenem-vaborbactam and newer antimicrobial agents for the treatment of carbapenem-resistant Enterobacteriaceae[J].Infect Drug Resist,2018,11:1461-1472.
[5]陈新谦,金有豫,汤光.新编药物学[M].北京:人民卫生出版社,2003:74-75.
[6]Lomovskaya O,Sun D,Rubio-Aparicio D,et al.Vaborbactam:spectrum of beta-lactamase inhibition and impact of resistance mechanisms on activity in Enterobacteriaceae[J].Antimicrob Agents Chemother,2017,61(11):e01443-17.
[7]Tattersall T,Wright H,Redmond A.Meropenem-induced liver injury and beta-lactam cross-reactivity[J].BMJ Case Rep,2018,11(1):e227124.
[8]Si L,Li P,Liu X,et al.Chinese herb medicine against Sortase A catalyⅫl transformations,a key role in gram-positive bacterial infection progress[J].J Enzyme Inhib Med Chem,2016,31(supl):184-96.
[9]Nortier JL,Martinez MCM,Schmeiser HH,et al.Urothelial carcinoma associated with the use of a Chinese herb(Aristolochia fangchi)[J].New Engl J Med,2000,342(23):1686-1692.
[10]叶春娟,张帆,朱育银.连花清瘟胶囊对流行性感冒合并支气管肺炎的作用[J].中国实验方剂学杂志,2013,19(24):329-331.
[11]赵明敬,赵晓琴,赵威.连花清瘟胶囊治疗急性上呼吸道感染的临床效果评价[J].中华医院感染学杂志,2015,25(4):839-841.
[12]Ping F,Li Z,Zhang F,et al.Effects of Lianhua Qingwen on pulmonary oxidative lesions induced by fine particulates(PM2.5)in Rats[J].Chin Med Sci J,2016,31(4):233-238.
[13]Dong L,Xia JW,Gong Y,et al.Effect of lianhuaqingwen capsules on airway inflammation in patients with acute exacerbation of chronic obstructive pulmonary disease[J].Evid Based Complement Alternat Med,2014,2014:637969.
[14]Clinical and Laboratory Standards Institute.Performance standards for antimicrobial susceptibility testing;twentyfourth informational supplement[S].Wayne,Pa:CLS,2015.
[15]张卓然.临床微生物学和微生物检验[M].北京:人民卫生出版社,2006:501-502.
[16]Jia W,Wang C,Wang Y,et al.Qualitative and quantitative analysis of the major constituents in Chinese medical preparation Lianhua-Qingwen capsule by UPLC-DAD-QTOF-MS[J].Scientific World Journal,2015,2015:731765.
[17]Wang CH,Zhong Y,Zhang Y,et al.A network analysis of the Chinese medicine Lianhua-Qingwen formula to identify its main effective components[J].Mol Biosyst.2016,12(2):606-613.
[18]吴以岭.络病学[M].北京:中国科学技术出版社,2004:298.
[19]田建霞,陈晓香,王继苹.连花清瘟胶囊联合维生素D治疗慢性阻塞性肺疾病对CAT、mMRC评分和Th17/Treg细胞因子平衡的影响[J].现代中西医结合杂志,2018,27(32):3554-3557.
[20]Niu QQ,Chen Y,Liu Y,et al.Efficacy and safety of Lianhua Qingwen capsule for influenza:a systematic review[J].Zhongguo Zhong Yao Za Zhi,2017,42(8):1474-1481.
[21]雷洪涛,刘敏彦,欧阳竟峰,等.连花清瘟胶囊抗金黄色葡萄球菌生物膜研究[J].中国实验方剂学杂志,2013,19(22):161-164.
[22]王艺竹,王宏涛,韩雪等.连花清瘟胶囊水提物对耐甲氧西林金黄色葡萄球菌细菌生物膜的影响[J].中华医院感染学杂志,2015,25(4):727-790.
[23]Balasubramanian D,Kumari H,Mathee K.Pseudomonas aeruginosa AmpR:all acute-chronic switch regulator[J].Pathog Dis,2015,73(2):1-14.
[24]Tiwari V,Roy R,Tiwari M.Antimicrobial active herbal compounds against Acinetobacter baumannii and other pathogens[J].Front Microbiol,2015,6:618-628.
[25]毛得斌.铜绿假单胞菌对碳青霉烯类抗菌药耐药性机制研究进展[J].临床合理用药,2017,10(18):161-163.
[26]闫玲,顾兵,张丽等.耐碳青霉烯类鲍曼不动杆菌的耐药机制[J].实用医学杂志,2018,34(15):2594-2599.