鱼腥草联合亚胺培南对碳青霉烯耐药铜绿假单胞菌杀菌效果的体外研究  

Vitro Study on the Bactericidal Effect of Houttuynia Cordata Combined with Imipenem Against Carbapenem Resistant Pseudomonas Aeruginosa

作　　者：黄秋兰 钱巧慧 范德平 刘红绸 薛娜丽 高守霞 马莹玮 周嘉平 HUANG Qiu-lan;QIAN Qiao-hui;FAN De-ping;LIU Hong-chou;XUE Na-li;GAO Shou-xia;MA Ying-wei;ZHOU Jia-ping(Department of Clinical Laboratory,Shanghai Jiading Dsitrict Nanxiang Hospital,Shanghai 201802,China;Department of Traditional Chinese Medicine,Shanghai Jiading Dsitrict Nanxiang Hospital,Shanghai 201802,China;Department of Teaching&Training,Shanghai Health and Science School Affiliated Zhoupu Hospital,Shanghai 201318,China)

机构地区：[1]上海市嘉定区南翔医院检验科,上海201802 [2]上海市嘉定区南翔医院中医科,上海201802 [3]上海健康医学院附属周浦医院教学培训部,上海201318

出　　处：《现代检验医学杂志》2021年第3期118-121,共4页Journal of Modern Laboratory Medicine

基　　金：上海市嘉定区科学技术委员会基金(JDKW-2018-W18)。

摘　　要：目的探究鱼腥草联合亚胺培南对碳青霉烯耐药铜绿假单胞菌(carbapenem resistant pseudomonas aeruginosa,CRPA)的体外杀菌效果,为合理使用抗生素、预防和控制医院感染提供参考。方法样本取自上海市某医院收治患者送检的痰、尿、创面等液体标本中分离到的50株CRPA,观察单药使用亚胺培南、鱼腥草及二者联合使用时对铜绿假单胞菌(PA)的最低抑菌浓度(MIC)、分级抑菌浓度(FIC)指数和对浮游菌的时间杀菌曲线。结果亚胺培南单用的MIC_(50)(32 mg/L)和MIC_(90)(128 mg/L)均高于鱼腥草单用(MIC_(50)2 mg/L,MIC_(90)4 mg/L)及两者联合使用(MIC_(50)0.25 mg/L,MIC_(90)1 mg/L),且鱼腥草单用的MIC_(50)和MIC_(90)均高于两者联合使用。分级抑菌浓度指数显示12株(24.0%)亚胺培南和鱼腥草联用后呈现协同作用,30株(60.0%)表现相加作用,8株(16.0%)表现无相关作用,未发现拮抗作用。随机选取2株菌株观察浮游菌的时间杀菌曲线,单独使用亚胺培南6~12h后,菌株均出现细菌恢复生长的现象;鱼腥草联合亚胺培南使用时,菌株的浮游菌数量降低均>6log CFU/L,且24h时均无细菌生长现象。结论鱼腥草联合亚胺培南优于单药亚胺培南的抗CRPA效率。Objective To explore the bactericidal effect in vitro of houttuynia cordata combined with imipenem on Carbapenem resistant Pseudomonas aeruginosa(CRPA)for the rational use of antibiotics,prevention and control of nosocomialinfections.Methods Fifty CRPA strainsisolated from liquid specimens such as sputum,urine,and wounds of patients from Shanghai,were collected from January 2019 to March 2020.The minimum inhibitory concentration(MIC),partial inhibitory concentration index(FIC),and time sterilization curve for planktonic bacteria of imipenem,houttuynia cordata alone and the combination of both were analyzed.Results The MIC_(50) and MIC_(90) of imipenem alone(MIC_(50)32 mg/L,MIC_(90)128 mg/L)were higher than those of houttuynia cordata single-use(MIC_(50)1 mg/L,MIC_(90)4 mg/L)and the combination of imipenem and houttuynia cordata(MIC_(50)0.25 mg/L,MIC_(90)1 mg/L),and the MIC_(50) and MIC_(90) of houttuynia cordata alone were higher than that of imipenem.The hierarchical inhibitory concentration index showed that 12(24.0%)strains of imipenem combined with Houttuynia cordata showed synergistic effect,30 strains(60.0%)showed additive effect,8 strains(16.0%)showed no correlation effect,and no antagonistic effect was found.Two strains were randomly selected to observe the time sterilization curve of planktonic bacteria.It was found that the number of planktonic bacteria was less than 6 logCFU/L after 24h,and there was no bactericidal effect.After using imipenem alone for 6~12h,the bacteria resumed growth was showed.When houttuynia cordata combined with imipenem was used,the number of planktonic bacteria decreased by more than 6 logCFU/L,and there was no bacterial growth at 24 hours.Conclusion The anti CRPA efficiency of Houttuynia cordata combined with imipenem was better than that of single drug imipenem.

关 键 词：铜绿假单胞菌 亚胺培南 鱼腥草 最低抑菌浓度 

分 类 号：R378.991[医药卫生—病原生物学] R446.5[医药卫生—基础医学]