纳米银和抗结核药物对耐药结核分枝杆菌联合作用初探  

Study on the combined effects of nano silver and anti tuberculosis drugs for drug resistance Mycobacterium tuberculosis

作　　者：王春花[1,2] 穆成[1] 王志锐[3] 赵慧[1] 傅衍勇 

机构地区：[1]天津市结核病控制中心结核参比室,天津300041 [2]天津医科大学,天津300070 [3]天津市疾病预防控制中心,天津300011

出　　处：《中国卫生检验杂志》2017年第13期1956-1959,共4页Chinese Journal of Health Laboratory Technology

基　　金：天津市企业博士后创新项目(2013022)

摘　　要：目的研究纳米银和抗结核药物联合作用对耐药结核分枝杆菌的杀菌效果。方法对H37Rv和不同临床分离菌株进行链霉素(SM)、异烟肼(INH)、利福平(RIF)、乙胺丁醇(EMB)、卡那霉素(KM)和氧氟沙星(OFX)6种药物固体药敏试验,选出不同耐药谱菌株。采用液体药敏试验评价SM、INH、RIF、EMB(1.0μg/ml、0.1μg/ml、1.0μg/ml、5.0μg/ml)抗结核药物和终浓度为0.15μg/ml、0.30μg/ml纳米银联合作用对耐药结核菌的作用。结果纳米银在0.15μg/ml低浓度下不能对任何结核菌株进行有效杀灭,而0.30μg/ml及以上浓度均可有效杀灭H37Rv和临床分离的敏感、单耐药、多耐药、耐多药和广泛耐药菌株。0.15μg/ml浓度纳米银与4种一线抗结核药物联合作用不能对结核菌株进行有效杀灭,而0.30μg/ml浓度纳米银联合抗结核药物可有效杀灭耐药结核菌。结论纳米银对结核菌杀灭作用具有浓度依赖性,浓度高于0.30μg/ml纳米银对敏感和耐药结核菌均具有杀灭作用。Objective To study the combined effect of nano silver and anti tuberculosis drugs on the bactericidal effect for drug resistant Mycobacterium tuberculosis. Methods H37 Rv and clinical bacterial strain were conducted for the solid drug sensitivity test to streptomycin（ SM）,isoniazid（ INH）,rifampicin（ RIF）,ethambutol（ EMB）,kanamycin（ KM）,and ofloxacin（ OFX）,and find out the drug-resistant spectrum of clinical bacteria. And liquid drug sensitivity test was used to evaluate the combined effect of SM,INH,RIF,EMB（ 1. 0 μg/ml,0. 1 μg/ml,1. 0 μg/ml,5. 0 μg/ml） and silver nanoparticles（ 0. 15 μg/ml,0. 30 μg/ml） on drug resistant Mycobacterium tuberculosis. Results Silver nanoparticles could not kill Mycobacterium tuberculosis under the concentration of 0. 15 μg/ml. Silver nanoparticles could kill all the Mycobacterium tuberculosis and clinically isolated,susceptible,single drug resistant,multi drug resistant（ MDR） strains and XDR strains above the concentration of0. 30 μg/ml. Silver nanoparticles（ 0. 15 μg/ml） combined with 4 SIRE could not kill Mycobacterium tuberculosis. And silver nanoparticles（ 0. 30 μg/ml） combined with SIRE could kill drug resistant tuberculosis effectively. Conclusion The effect against Mycobacterium tuberculosis depends on the concentration of silver nanoparticles. Drug-resistant and sensitive tuberculosis could be killed by silver nanoparticles with the concentration higher than 0. 30 μg/ml.

关 键 词：纳米银 结核分枝杆菌 耐药 抗结核药 联合作用 

分 类 号：R446.5[医药卫生—诊断学]