清开灵注射液提取物及清开灵注射液与抗生素联合对含blaNDM-1超级细菌的抑菌效果

Antimicrobial Effects of Qingkailing Injection Extract and Combination Therapy of Qingkailing Injection and Antibiotics on Bacteria Carrying blaNDM-1 Resistance Gene

目的体外初步研究清开灵注射液主成分提取液和清开灵注射液与抗生素联合用药分别对含产新德里金属β-内酰胺酶-1(New Delhi metallo-β-lactamase1,NDM-1)基因的耐药细菌(blaNDM-1细菌)的抑菌性。方法采用琼脂稀释法和K-B法对清开灵注射液主成分板蓝根、金银花、栀子、黄芩苷4种药物提取液和清开灵注射液与抗生素联合用药分别对耐药超级细菌进行抑菌实验。并测定各提取液的最小抑菌浓度(MIC)值。结果清开灵主成分提取液对含blaNDM-1基因的耐药细菌均有不同程度的抑制效果,其中以黄芩苷为最好,对含blaNDM-1基因的耐药菌不动杆菌属/乙酸钙不动杆菌(WD)、鲍曼不动杆菌(WX)、嗜麦芽寡养单胞菌(WJ)和大肠杆菌pGEX-4T-NDM-1/DH5α(GST-NDM-1)的MIC分别为0.015、0.020、0.005、>0.020g/mL,而各提取液的MIC值的大小依次为黄芩苷、金银花、栀子、板蓝根;清开灵注射液与抗生素联合用药后,对含blaNDM-1基因多重耐药菌的抑菌效果非常明显,大大提高了各类抗生素单独用药的抑菌能力,其中以与青霉素类(青霉素G、美洛西林、哌拉西林/他唑巴坦、氨苄西林/舒巴坦)效果最好,抑菌效果提高10倍左右,其他抗生素类药物抑菌效果都有不同程度的提高。结论清开灵注射液主成分提取液和清开灵注射液与抗生素联合用药对含blaNDM-1耐药基因细菌都有很好的抑菌效果,此研究为药物开发及对blaNDM-1超级耐药细菌的用药和治疗提供了理论依据。

Objective To research the bacteriostatic effects of Qingkailing Injection Extract （QKLIE） and combination therapy of Qingkailing Injection （QKLI） and antibiotics on bacteria carrying New Delhi metallo-β-lactamase 1 （NDM-1） blaNDM-1 resistance gene, and to determine their minimal inhibitory concentrations （MIC）. Methods The antimicrobial experiments of QKLIE （Radix Isatidis, baicalin, gardenia, honeysuckle） and combination therapy of QKLI and antibiotics were performed by using the agar dilution method and K-B method. The MIC was determined from each extract. Results There were different degrees of inhibitory effects on resistant bacteria carrying blaNDM-1 by extracts from main components of QKLI. Of them, the inhibitory effect of baicalin was the best and the MIC of the resistant bacteria was 0.015 g/mL to WD, 0.020 g/mL to WX, 0.005 g/mL to WJ, and more than 0.020 g/mL to pGEX- 4T-NDM-1/DH5α （GST-NDM-1）, respectively. The MIC value of each extract was sequenced from high to low as baicalin, honeysuckle, gardenia, and Radix Isatidis. Furthermore, combination therapy of QKLI and antibiotics greatly enhanced the antimicrobial activity of each antibiotics when used alone, showing very obvious antibacterial effects on multidrug resistant bacteria carrying blaNDM-1 gene. Of them, the optimal effects were obtained when combined with penicillins （penicillin G, mezlocillin, piperacillin/tazobactam, ampicillin/sulbactam）, with the antibacterial effects improved by 10 folds. The antibacterial effects of other kinds of antibiotics were improved to some extent. Conclusions QKLIE and combination therapy of QKLI and antibiotics showed better bacteriostatic effects on resistant bacteria carrying blaNDM-1 gene. This study provided theoretical bases for drug development, medication and treatment for super-resistant bacteria carrying blaNDM-1.