清热解毒方对耐碳青霉烯类革兰阴性杆菌的抑菌作用

Effect of Qingre Jiedu Prescription on Carbapenem-resistant Gram-negative Bacteria

目的:探讨清热解毒方对临床分离的耐碳青霉烯类革兰阴性杆菌的抑菌作用。方法:应用K-B法和MIC法对临床分离的487株革兰阴性杆菌进行抗生素药敏试验,鉴定出耐碳青霉烯类革兰阴性杆菌;采用琼脂二倍稀释法,观察清热解毒方对代表性耐碳青霉烯类革兰阴性杆菌株铜绿假单胞菌(Pa1、Pa2、Pa3、Pa4)、鲍曼不动杆菌(Ab1、Ab2、Ab3、Ab4)、肺炎克雷伯菌(Kp)、产酸克雷伯菌(Ko)、阴沟肠杆菌(Ecs)的体外抑菌效果。结果:487株革兰阴性杆菌鉴定出耐碳青霉烯类铜绿假单胞菌20株、鲍曼不动杆菌43株、克雷伯杆菌33株、阴沟肠杆菌4株,其他菌株23株;多重耐药鲍曼不动杆菌21株,多重耐药铜绿假单胞菌10株。在62 mg/m L浓度的清热解毒方提取液平皿上未见Pa1、Pa2、Pa3、Pa4及Ab1生长;在125 mg/m L浓度平皿上未见Ab2、Ab3、Ab4和Kp生长,在较高浓度中药平皿上(250和500 mg/m L)未见Ko和Ecs生长。结论:清热解毒方能抑制多种耐碳青霉烯类革兰阴性杆菌,尤其对耐药鲍曼不动杆菌和耐药铜绿假单胞菌抑菌效果佳。这为临床常见耐碳青霉烯类革兰阴性杆菌感染的中药防治提供一定的理论基础。

Objective To observe the effect of Qingre Jiedu Prescription （QJP） on carbapenem-resistant Gram-negative bacteria. Methods Gram-negative bacteria （487 strains） were tested for antimicrobial activity by K-B and MIC methods so as to identify carbapenem-resistant bacteria. The in vitro antimicrobial activity of QJP on carbapenem-resistant Gram-negative bacteria was tested by the two fold agar dilution method, including Pseudomonas aeruginosa （Pa1, Pa2, Pa3, Pa4）, Acinetobacter baumannii （Ab1, Ab2, Ab3, Ab4）, Klebsiella pneumonia （Kp）, Klebsiella oxytoca （Ko） and Enterobacter cloacae （Ecs）. Results Gram-negative bacteria （487strains） were consisted with 20 strains of carbapenem-resistant P. aeruginosa, 43 strains of A. baumannii, 33 strains of K. pneumoniae, 4 strains of E. cloacaeand 23 other strains. There were 21 strains of multidrug resistant A. baumannii and 6 strains of extensively drug-resistant P. aeruginosa. Pa1, Pa2, Pa3, Pa4 and Ab1 were not found on the QJP dish （62 mg/mL）. Ab2, Ab3, Ab4 and Kp were not observed on the QJP dish （125 mg/mL）. And Ko and Ecs were not discovered on the high concentration QJP dish （250 and 500 mg/mL）. Conclusion QJP has in vitro antimicrobial effect on carbapenem-resistant Gram-negative bacillus, especially on drug-resistant A. baumannii and P. aeruginosa. The study provides basis for the prevention and treatment of drug-resistant bacterial infections using traditional Chinese medicine