黄连、氯己定与抗生素介导的细菌交叉耐药  

Cross resistance mediated by antibiotics,chlorhexidine and Rhizoma coptidis in bacteria

作　　者：吴东美[1] 陆若辰 陈钰泉 邱杰[1] 邓超澄[1] 谭强[1] WU Dong-mei LU Ruo-chen CHEN Yu-quan QIU Jie DENG Chao-cheng TAN Qiang(Institute of Pharmacy, Traditional Chinese Medicine University of Guangxi, Guangxi Nanning 530001, China)

机构地区：[1]广西中医药大学药学院,广西南宁530001

出　　处：《中国医院药学杂志》2017年第13期1250-1255,共6页Chinese Journal of Hospital Pharmacy

基　　金：广西区自然基金(编号:2014GXNSFAA118176;2012GXNSFAA276037);南宁市科技计划资质项目(编号:20131062);广西中医药大学2016年硕士研究生科研创新重点项目(编号:YJS201608)

摘　　要：目的:研究抗生素、消毒剂(氯己定)和抗菌中药(黄连)能否介导细菌产生交叉耐药。方法:根据国际标准微量肉汤稀释法测定上述药物对金黄色葡萄球菌(Staphylococcus aureus,Sa)的最低抑菌浓度(minimum inhibitory concentration,MIC)。根据抗性结果分析,选择亚致死剂量下的药物浓度连续培养细菌14 d,诱导细菌产生交叉耐药。结果:经环丙沙星(ciprofloxacin,CIP)和庆大霉素(gentamicin,GEN)诱导后细菌没有增加对氯己定(chlorhexidine,CHX)的抗性,但出现了对CHX敏感性提高的现象。分别有1株和4株Sa对黄连水提液(Rhizoma coptidis extract,RCE)和盐酸小檗碱(berberine,BBR)提高了抗性。经四环素(tetracycline,TET)诱导后,对CHX、RCE和BBR产生交叉耐药的Sa菌株分别有3,6,8株。经CHX诱导后,几乎所有菌株都对至少一种抗生素产生了交叉耐药,分别有7株和9株Sa对RCE和BBR抗性提高了4倍以上。经RCE诱导后,对抗生素、CHX和BBR产生交叉耐药的Sa菌株数分别是11,3和14。经BBR诱导后,对抗生素、CHX、RCE产生交叉耐药的Sa菌株数分别是9,2和14。结论:根据实验结果可知,抗生素、消毒剂和抗菌中药能诱导细菌产生交叉耐药,细菌对三者的抑菌机制可能相同。OBJECTIVE To research whether antibiotics,chlorhexidine（CHX）and Rhizoma coptidis extract（RCE）would induce cross resistance in bacteria.METHODS MIC of Staphylococcus aureus（Sa）to drug was determined by geometric micro-dilution in Mueller-Hinton（MHB）broth.The experimental strains were exposed to antibiotics,CHX and RCE at sublethal dose（susceptibility was determined everyday）up to 14 days,respectively.RESULTS The resistance to CHX was not obviously changed after ciprofloxacin（CIP）and gentamicin（GEN）exposure.One and 4 Sa strains became cross resistant to RCE and berberine（BBR）,respectively.There were 3,6 and 8 strains（Sa）with decreased MIC（≥ 4-fold）to CHX,RCE and BBR,correspondingly.After induced by CHX,almost all strains developed cross resistance to not less than one antibiotics.To RCE and BBR,7 and 9 Sa strains increased resistance,respectively.And after induced by RCE,counts of Sa strains became cross resistant to antibiotics,CHX and BBR were 11,3 and 14.After exposure to BBR,9,2 and 14 strains increased resistance（≥4 times of MIC）to antibiotics,CHX and RCE.CONCLUSION Antibiotics,biocides and antimicrobial Chinese herbs can induce cross resistance in bacteria at sublethal dose.The three kinds of drugs may share some same actions of mechanisms against bacteria.

关 键 词：抗生素 氯己定 黄连 细菌 交叉耐药 

分 类 号：R978.1[医药卫生—药品]