丹参酮与万古霉素联合应用对MRSA的抑制作用

Inhibitory Effect of Tanshinone with Vancomycin on Methicillin-Resistant Staphylococcus Aureus

目的探讨丹参酮及其与万古霉素、β-内酰胺类抗菌药物联用对耐甲氧西林金黄色葡萄球菌(MRSA)的体外抑制作用。方法从临床送检的标本中鉴定筛选出20株MRSA。采用微量稀释法分别测定丹参酮、万古霉素、苯唑西林、氨苄西林、头孢唑林对MRSA的最低抑菌浓度MIC(minimal inhibitory concentration)。采用试管棋盘稀释法分别测定丹参酮与万古霉素、苯唑西林、氨苄西林、头孢唑林联合使用时对MRSA的MIC,计算联合指数(FIC)。结果丹参酮对MRSA的MIC与对甲氧西林敏感的金黄色葡萄球菌(MSSA)即标准株ATCC29213的MIC比较差异无统计学意义。丹参酮与万古霉素在体外联合使用时万古霉素的MIC为(0.23±0.27)μg/ml,与单用万古霉素对MRSA的MIC[(0.71±0.42)μg/ml]比较差异有统计学意义(P<0.001)。FIC平均为0.75,呈相加作用。上述β-内酰胺类抗菌药物与丹参酮合用的FIC均大于1.0,呈无关作用。结论丹参酮对MRSA有抑制作用。丹参酮与万古霉素联合使用具有相加作用。丹参酮与苯唑西林、氨苄西林、头孢唑林联合使用则呈无关作用。本研究结果提示丹参酮有望成为治疗MR-SA感染的辅助用药,为MRSA感染的患者提供一治疗新思路。

Objective To investigate the inhibitory effect of Tanshinone combined with or without Vancomycin,Oxacillin,Ampicillin, Cephazolin respectively on methicillin-resistant staphylococcus aureus （MRSA） in vitro. Methods 20 clinical isolates of MRSA were selected by the Kirby-Bauer method. The minimal inhibitory concentration（MIC） of TanshiJnone, Vancomycin, Oxacil- lln, Amplcillin, Cephazolin were detected by the tube dilution respectively. The combined MICs of Tanshinone with Vancomycin, Oxacillin,Ampicillin and Cephazolin were detected by the dilution respectively. The fractional inhibitory concentration（FIE） was calculated. Results There was no statistically significance between the MIC of Tanshinone to MRSA and that of Tanshinone to MSSA：ATCC29213. There was significant difference between the MIC of Vancomycin [ （0.71±0.42）μg/ml] and that of Vancomycin with Tanshinone [ （ 0. 23 ± 0. 27 ） μ/ml ] （ P 〈 0. 001 ）. The average FIC of Tanshinone with Vancomycin was 0. 75 and showed additive effects but not with Oxacillin, Ampicillin and Cephazolin. Conclusions The growth of MRSA can be inhibited by Tanshinone in vitro. The synergic inhibitory effect of Tanshinone on MRSA was found when with Vancomycin but not with Oxacillin, Ampicillin and Cephazolin. Tanshinone can be used as a supplement in the treatment of patients with MRSA infection.