摘要
目的 探讨黄连素联合万古霉素对难辨梭菌(Clostridium difficile, CD)体外分离株的抗菌效果,以期为临床CD感染相关性疾病的治疗提供新思路。方法 选取35株临床分离CD菌株,应用琼脂稀释法进行万古霉素(浓度范围为0.0625~4 mg/L)或黄连素(浓度范围为8~512 mg/L)对CD的单一药敏或联合药敏试验,统计单一用药和联合用药情况。结果 35株CD临床分离菌株均对黄连素和万古霉素敏感,对黄连素和万古霉素的药物敏感性范围分别为128 mg/L^512 mg/L和0.25 mg/L^2 mg/L,50%最低药物抑制浓度(MIC50)值分别为512 mg/L和0.25 mg/L,90%最低药物抑制浓度(MIC90)值分别为>512 mg/L和1 mg/L。不同浓度的黄连素分别与0.0625~4 mg/L的万古霉素联合,协同作用最强的是128 mg/L黄连素和1 mg/L万古霉素联合(占比5.71%),相加作用最强的是64 mg/L黄连素和0.5 mg/L万古霉素联合(占比25.71%),无关作用最强的是8 mg/L黄连素分布联合0.0625 mg/L万古霉素(占比97.14%),未发现黄连素联合万古霉素出现拮抗作用的菌株(χ2=9.85,P=0.003)。结论 黄连素可增加万古霉素对CD的抗菌活性,具有临床联合用药价值。
Objective To explore the antimicrobial effect of berberine combined with vancomycin on isolated Clostridium difficile(CD)strains in vitro,in order to provide some new ideas for the treatment of CD-related diseases.Methods Thirty-five clinical isolated CD strains were selected for single or combined susceptibility tests of vancomycin(concentration range 0.0625~4 mg/L)or berberine(concentration range 8~512 mg/L)to CD by agar dilution method,the drug sensitivity result of single and combined drugs were analysed.Results All 35 CD strains were sensitive to berberine and vancomycin,where the sensitivity ranges of berberine and vancomycin were 128 mg/L to 512 mg/L and 0.25 mg/L to 2 mg/L,respectively.The 50%minimum inhibitory concentration(MIC50)values were 512 mg/L and 0.25 mg/L,and the 90%minimum inhibitory concentration(MIC90)values were>512 mg/L and 1 mg/L,respectively.Different concentrations of berberine combined with 0.0625-4 mg/L vancomycin respectively,the strongest synergistic effect was 128 mg/L berberine combined with 1 mg/L vancomycin(accounting for 5.71%),the strongest additive effect was 64 mg/L berberine combined with 0.5 mg/L vancomycin(accounting for 25.71%),the strongest irrelevant effect was 8 mg/L berberine combined with 0.0625 mg/L vancomycin(accounting for 97.14%),no antagonistic effect of berberine and vancomycin was found(χ2=9.85,P=0.003).Conclusions Berberine can increase the antimicrobial activity of vancomycin against CD,and has the synergistic value for clinical medication.
作者
王刚
张延京
张金仿
Wang Gang;Zhang Yanjing;Zhang Jinfang(Department of Clinical Laboratory,Capital Medical University Affiliated Beijing Friendship Hospital,Beijing 100050,China)
出处
《中华实验和临床病毒学杂志》
CAS
CSCD
2019年第6期622-625,共4页
Chinese Journal of Experimental and Clinical Virology
关键词
难辨梭菌
万古霉素
黄连素
Clostridium difficile
Vancomycin
Berberine
