小檗碱体外逆转耐碳青霉烯类铜绿假单胞菌耐药性研究  

Resistance reverse of carbapenem resistant Pseudomonas aeruginosa by berberine in vitro

作　　者：刘心伟 王志盛 许晓娜[2] 张小倩 李永伟[1,2] LIU Xinwei;WANG Zhisheng;XU Xiaona;ZHANG Xiaoqian;LI Yongwei(Department of Clinical Laboratory,Henan Province Hospital of TCM/Second Affiliated Hospital of Henan University of TCM,Zhengzhou,Henan 450002,China;Henan University of TCM,Zhengzhou,Henan 450008,China)

机构地区：[1]河南省中医院/河南中医药大学第二附属医院检验科,河南郑州450002 [2]河南中医药大学,河南郑州450008

出　　处：《国际检验医学杂志》2018年第24期3050-3052,3057,共4页International Journal of Laboratory Medicine

摘　　要：目的评估小檗碱对耐碳青霉烯类铜绿假单胞菌(CRPA)体外抗菌活性和耐药性逆转能力,为小檗碱用于治疗CRPA感染提供依据。方法收集河南省中医院临床微生物实验室2017年1-12月分离的CRPA临床分离株,采用二倍肉汤稀释法检测CRPA对小檗碱的最小抑菌浓度(MIC),评估小檗碱抑菌活性;棋盘法检测小檗碱与哌拉西林等5种抗菌药物的协同抑菌活性;K-B法检测CRPA经小檗碱逆转前后抑菌圈变化,评估小檗碱的耐药性逆转能力。结果 79株CRPA临床分离株对小檗碱的MIC为(1.67±0.55)mg/mL;经小檗碱逆转前后,CRPA对哌拉西林、哌拉西林/他唑巴坦、头孢他啶、亚胺培南和美罗培南的抑菌环直径差异有统计学意义(P<0.05),对头孢吡肟、阿米卡星、环丙沙星和多黏菌素B差异无统计学意义(P>0.05)。结论小檗碱对CRPA具有较好的抑菌活性,与哌拉西林、头孢他啶和亚胺培南具有协同抑菌作用,可逆转CRPA对部分抗菌药物的耐药性,但具体机制有待进一步深入研究。Objective To evaluate antimicrobial activity and resistance reversal ability of berberine to carbapenem-resistant pseudomonas aeruginosa(CRPA)in vitro,and provide basis for the CRPA infection treatment with berberine.Methods Clinical isolates of CRPA from January2017to December2017were collected from clinical microbiology laboratory of Henan Province Hospital of Traditional Chinese Medicine.The broth dilution test was applied to detect the MIC of CRPA to berberine and checkerboard method to detect the synergistic antibacterial activity of berberine with five antibiotics including piperacillin.In order to evaluate the resistance reverse ability of berberine,K-B disc diffusion method was used to detect the changes of the antibacterial circle of CRPA before and after the berberine reverse.Results The MIC of79CRPA clinical isolates to berberine was(1.67±0.55)mg/mL.Before and after the reversal of berberine,CRPA showed statistically significant differences in the diameter of the antibacterial ring between piperacillin,piperacillin/tazobactam,ceftazidime,imipenem and meropenem(P<0.05),and no statistical significance for cefepime,amikacin,ciprofloxacin and polymyxin B(P>0.05).Conclusion Berberine showed good antibacterial activity to CRPA and synergistic antibacterial activity with piperacillin,ceftazidime and imipenem.It also can reverse the resistance of CRPA to some antibiotics,but the exact mechanism needs to be further studied.

关 键 词：小檗碱 碳青霉烯药物 铜绿假单胞菌 药物敏感性试验 耐药性逆转 

分 类 号：R446.5[医药卫生—诊断学]