中药对多重耐药铜绿假单胞菌外排泵的作用研究  

Study on the effect of traditional Chinese medicine on efflux pump of multi-drug resistant Pseudomonas aeruginosa

作　　者：王淋荆 曾建明[1] 鲁洋[1] 蓝锴[1] 罗强[1] 林冬玲[1] 张伟铮[1] 陈茶[1] 

机构地区：[1]广东省中医院检验医学部,广东广州510006 [2]广州中医药大学第二临床医学院,广东广州510006

出　　处：《分子诊断与治疗杂志》2017年第6期401-407,共7页Journal of Molecular Diagnostics and Therapy

基　　金：广东省科技计划项目(2014A020212281;2016A020215236);广东省中医院拔尖人才专项(2014KT1491)

摘　　要：目的研究中药与常用抗生素的相互作用和对多重耐药铜绿假单胞菌(multi drug resistant Pseudomonas aeruginosa,MDR-PA)外排泵的作用。方法采用外排泵抑制剂联合纸片扩散法(Kirby-Bauer,K-B)筛选外排泵阳性MDR-PA,并用实时荧光定量PCR(real-time fluorescence quantitative PCR,q PCR)确认外排泵基因高表达菌株。检测10种常用中药对抗生素的作用和对外排泵阳性MDR-PA外排泵基因表达的影响。结果从34株MDR-PA中筛选到5株外排泵阳性菌,q PCR法检测到这5株菌外排泵基因的表达水平是野生型铜绿假单胞菌PAOl的2倍或2倍以上(P<0.05)。黄芩、金银花和夏枯草对环丙沙星有较强的拮抗作用,穿心莲和五倍子对庆大霉素的拮抗作用最强,穿心莲和夏枯草对美罗培南的协同作用最强。穿心莲、金银花、夏枯草和五倍子具有促进外排泵基因表达的作用。结论中药穿心莲、金银花、夏枯草和五倍子可通过促进外排泵基因的表达拮抗抗生素的抗菌作用,临床抗感染治疗时需谨慎使用。Objective To study the effect of traditional Chinese medicine on efflux pump of Pseudomonas aeruginosa with multiple drug resistance（MDR-PA）. Methods Kirby-Bauer（K-B） test and real-time fluorescence quantitative PCR（q PCR） were used to screen positive bacteria of efflux pump in MDRPA. The effect of 10 kinds of traditional Chinese medicine on the role of antibiotics and the expression of efflux pump genes positive MDR-PA were detected. Results 5 strains of efflux pump positive bacteria were screened from 34 strains of MDR-PA, and the expression level of efflux pump gene was 2 times or more than that of wild type Pseudomonas aeruginosa（P〈0.05）. Scutellaria, honeysuckle and prunella have strong antagonism against ciprofloxacin, andrographis paniculata and gallnut have the strongest antagonism against gentamicin, and andrographolide and prunella have the strongest synergistic effect on meropenem.Andrographis paniculata, flos lonicerae, prunella vulgaris and gallnut chinensis have the function of promoting the gene expression of efflux pump. Conclusions Andrographis paniculata, flos lonicerae, prunella vulgaris and gallnut can antagonize the antibiotic effect by promoting the expression of efflux pump gene, and use caution in clinical anti-infection treatment.

关 键 词：铜绿假单胞菌 多重耐药 外排泵 穿心莲 金银花 夏枯草 五倍子 

分 类 号：R446.5[医药卫生—诊断学]