小建中胶囊对幽门螺杆菌体外抑菌作用的研究

目的探讨小建中胶囊浸膏液在体外对幽门螺杆菌(Helicobacter pylori,Hp)是否存在抑菌作用及其最低抑菌浓度(Minimum inhibitory concentration,MIC)。方法国际标准菌株NCTC11637和临床分离的4例多药耐药菌株及3例敏感菌株作为实验菌株。采用打孔法测定小建中胶囊对幽门螺杆菌体外是否有抑菌作用,并用琼脂稀释法测定小建中胶囊浸膏液对Hp菌株的MIC值。结果小建中胶囊对Hp标准菌株和临床分离的敏感及耐药菌株体外均有抑菌作用,其MIC值为0.78~1.56 mg/m L,且对抗生素耐药和敏感菌株之间无差别。结论小建中胶囊在体外对Hp有抑菌作用,有望用于Hp相关性疾病的治疗。     

聚乙烯亚胺单独及与三种抗菌药物联用对白念珠菌的体外抗菌活性

目的评估多支链的阳离子高分子聚合物——聚乙烯亚胺(PEI)单独及与三种不同类别的常规抗菌药物(两性霉素B、氟康唑和多黏菌素B)联合使用对白念珠菌(MY7245和MY7238)的两种临床分离物的抗真菌活性。方法通过体外实验测定不同分子质量聚乙烯亚胺单独及与三种不同类别的常规抗菌药物联合使用对两株白念珠菌的最小抑菌浓度和杀灭时间,确定PEI单独及联合使用的体外抗真菌活性。结果分子量在2～745ku范围内的PEI均对这两种白念珠菌产生很好的抗真菌活性,且分子量小的PEI比分子量大的PEI的抗菌作用更显著。与单独作用的PEI相比,分子量较大的PEI与常规药物联合使用时可产生较强的协同作用。在体外致死研究实验中可以看到,PEI-两性霉素B和PEI-氟康唑结合物可以提高抑菌作用,但PEI-多黏菌素B结合物却拮抗抑菌作用。结论PEI单独与联合使用均对白念珠菌产生很好的抗菌效果。     

In – Vitro activity of Desmostachya bipinnata (L.) Stapf successive extracts against Helicobacter pylori clinical isolates

Helicobacter pylori are well acknowledged as a major cause of gastrointestinal ailments and gastric cancers. Therefore, the present study aimed to investigate the potential in vitro activity of Desmostachya bipinnata against H. pylori, focusing on the determination of the most active extract responsible for the anti-helicobacter activity to produce new active drug from natural source.Desmostachya bipinnata total alcohol and successive extracts were in vitro tested against H. pylori. All extracts showed promising anti Helicobacter pylori activities. The most effective extract was diethyl ether extract, it showed 75% growth inhibition of the clinical Isolates bacterial Helicobacter pylori, in addition it showed high count reduction on the selected organisms in the different concentrations used (2xMIC, MIC & ½ MIC) compared with the untreated controls as well as the other extracts (chloroform, ethyl acetate and n-butanol). The oral median lethal dose (LD₅₀) of the alcohol extract of the plant by doses up to 5000?mg/kg didn’t showed any mortality or morbidity, in addition no side effects were recorded on both liver and kidney functions this means that the extract was safe for use.     

三黄泻心汤三味药联合抗生素对幽门螺杆菌的体外抑菌实验研究

目的探讨组成三黄泻心汤的大黄、黄连、黄芩对幽门螺杆菌(Hp)的抑制作用,研究三味中药两两联合、每味中药分别与克拉霉素(CLR)、左氧氟沙星(LEV)、甲硝唑(MTZ)联合对Hp的增敏效果。方法菌株ATCC43504做质控及实验菌株,以药敏纸片法探讨三味中药对Hp的抑制作用;琼脂二倍稀释法检测实验药物(大黄、黄连、黄芩、CLR、LEV、MTZ)单独及联合使用对Hp菌株ATCC43504的最小抑菌浓度(MIC),计算抑菌浓度指数(FICI),确定联合抑菌效果,判断联合用药时实验药物敏感性的变化。结果黄连、大黄、黄芩的抑菌环直径:22 mm、18 mm、10 mm;MIC值:0.625 mg/ml、1.25 mg/ml、5 mg/ml;黄连与黄芩、黄连与CLR、黄连与MTZ、黄芩与MTZ联合的FICI≤0.5,呈协同作用,其余组合为相加作用,未见拮抗作用。菌株ATCC43504为抗生素MTZ的耐药菌株,联合用药时MTZ的MIC大于耐药折点,菌株依然对MTZ耐药。结论中药联合较单药有更强的抑制Hp能力。中药大黄、黄连、黄芩与抗生素联合用药能一定程度上提高抗生素敏感性。三黄泻心汤组方及三味中药可以与抗生素联合应用于根除Hp。     

头孢唑林联合舒巴坦对90株产酶菌的体外抗菌活性

用液体培养基试管二倍稀释法测定头孢唑林联合舒巴坦对常见临床分离产酶菌的最低抑菌浓度（ＭＩＣ），并与头孢唑林进行比较。９０株产酶菌中金葡球菌２０株、表葡球菌４株、大肠埃希氏菌３５株、克雷伯氏菌２５株、其它６株，产酶菌鉴定采用ｎｉｔｒｏｃｅｆｉｎ试棒。结果９０株产酶菌中３４株（３７．８％）对头孢唑林耐药（ＭＩＣ≥３２ｍｇ／Ｌ），而仅有１９株（２１．１％）对头孢唑林／舒巴坦（２１）耐药，两者比较有显著差异（Ｐ＜０．０５）。头孢唑林／舒巴坦（２１）对其中６５．６％菌株显示出协同或累加抗菌作用，与头孢唑林比较，ＭＩＣ降至其１／２～１／２８，其中包括２５株耐头孢唑林菌株。此外，对３５株产酶菌株测试，头孢唑林／舒巴坦（２１）较头孢唑林／舒巴坦（１１）显示出更强的体外抗菌活性。     

左氧氟沙星替代克拉霉素治疗幽门螺杆菌感染110例临床观察

目的 探讨左氧氟沙星替代克拉霉素治疗幽门螺杆菌（Hp）感染的临床效果.方法 选取2010年1月～2012年1月本院收治的经胃镜检查活检快速尿激酶检测Hp阳性及14C呼气试验证实为Hp感染者220例,将其按照随机数字表法分为治疗组和对照组各110例,治疗组给予奥美拉唑20 mg,每日2次,饭前口服,左氧氟沙星0.5 g、阿莫西林1.0 g,每日2次,饭后半小时口服,连服2周.对照组给予奥美拉唑20 mg,每日2次,饭前口服,克拉霉素0.5 g、阿莫西林1.0 g,每日2次,饭后半小时口服,连服2周.停药后1、3个月复查Hp.经14C呼气试验阴性者为根治.结果 治疗组110例中,Hp根除103例,根除率为93.64％;对照组110例中,Hp根除86例,根除率为78.18％;两组Hp根除率差异有统计学意义（x2=10.85,P＜0.05）.治疗组不良反应发生率为9.1％,对照组不良反应发生率为10.0％,两组差异无统计学意义（P＞0.05）.结论 左氧氟沙星替代克拉霉素治疗Hp感染效果显著,不良反应轻微,值得临床推广使用.     

抗菌药物联合中药单体对泛耐药鲍曼不动杆菌生物被膜的影响

摘要：目的 研究4种抗菌药物(亚胺培南、美罗培南、多黏菌素B和替加环素) 和3种中药单体(黄芩苷、盐酸小檗碱和槲皮素二水物)对泛耐药鲍曼不动杆菌(XDRAB)生物被膜形成能力的影响,并探讨以上组合用药对XDRAB的协同抗生物被膜效应。方法 收集2018-2019年成都医学院第一附属医院的不同科室的临床标本分离的9株XDRAB,采用比浊法测定4种抗菌药物、3种中药单体在1 MIC、1/2 MIC、1/4 MIC、1/8 MIC、1/16 MIC对9株XDRAB 24 h内的生长情况;结晶紫棋盘染色法检测工作浓度下亚胺培南、美罗培南、替加环素、多黏菌素B、黄芩苷、盐酸小檗碱和槲皮素二水物单用对生物被膜的抑制作用和组合联用的协同抗生物被膜效应。结果 亚胺培南(4 μg/mL)、美罗培南(2 μg/mL)、多黏菌素B(0.25 μg/mL)、替加环素(0.0625 μg/mL)、黄芩苷(128 μg/mL)、盐酸小檗碱(32 μg/mL)、槲皮素二水物(64 μg/mL)的浓度时24 h内不抑制细菌的生长,以此浓度为基础倍比稀释,设置高、中、低三个浓度梯度;与模型对照组相比,4种抗菌药物、3种中药单体、在高浓度下单用、联用均可以明显抑制XDRAB生物被膜的形成(P＜0.05),联合用药效果均优于单独用药(P＜0.05),表现为不同程度的协同抗生物被膜作用,其中替加环素与黄芩苷的9个浓度组合均能够显著抑制XDRAB生物被膜的形成,0.015625 μg/mL替加环素与32 μg/mL黄芩苷与的浓度组合下,药物剂量最小。结论 4种抗菌药物亚胺培南、美罗培南、多黏菌素B、替加环素,3种中药单体黄芩苷、槲皮素二水物、盐酸小檗碱单用及联用时对XDRAB的生物被膜形成均具有不同程度的抑制作用,联合用药均表现为不同程度的协同抗生物被膜效应。     

In vitro activities of beta-lactam antibiotics alone and in combination with sulbactam against Gram-negative bacteria

The resistance rates of ampicillin/sulbactam 2:1 against imipenem-susceptible and -resistant Acinetobacter baumannii were 23.5 and 30%, respectively. Ceftazidime/sulbactam combination showed significant reduction of resistant rates against Enterobacter cloacae, A. baumannii, ESBL Klebsiella pneumoniae. MIC₉₀ of cefoperazone against E. cloacae, Serratia marcescens, A. baumannii and ESBL K. pneumoniae were >128 mg/l. Addition of sulbactam enhanced the antimicrobial activities significantly. When imipenem was combined with sulbactam, the resistant rates against imipenem-resistant A. baumanni were significantly reduced. Cefepime/sulbactam combination was active against imipenem-resistant A. baumanni. The resistance rates of aztreonam/sulbactam combination against E. cloacae, imipenem-sensitive and resistant A. baumannii, ESBL K. pneumoniae were lowered significantly. The cefotaxime/sulbactam combination showed a significant improvement of activities against E. cloacae, S. marcescens, A. baumannii and ESBL K. pneumoniae.     

头孢哌酮/舒巴坦(2:1,1:1)联合米诺环素对亚胺培南耐药鲍曼不动杆菌的体外抗菌作用

目的 评价头孢哌酮/舒巴坦(2:1,1:1)与米诺环素(四环素类抗生素)联合用药,对39株临床分离的亚胺培南耐药的鲍曼不动杆菌的体外抗菌效应.方法 将不同浓度2种抗菌药用棋盘法设计,用琼脂稀释法测定不同浓度组合的抗菌药对菌株的最低抑菌浓度(MIC),并计算部分抑菌浓度指数(FICI),判定标准:HCI≤0.5为协同作用;0.54为拮抗作用.结果 2种不同配比的头孢哌酮/舒巴坦同米诺环素联用后,HCI均于0.5～4.0,未观察到协同作用,亦无拮抗作用;2种组合的HCI分布情况相当.结论 2种不同配比的头孢哌酮/舒巴坦同米诺环素联合对本组亚南培南耐药的鲍曼不动杆菌表现为无相关作用.     

Combined effect of sulbactam/cefoperazone and other antibiotics against clinical isolates of multi-resistant strains. II. In vitro combined effects of sulbactam/cefoperazone with imipenem/cilastatin, cefuzonam, flomoxef, amikacin or tobramycin

We evaluated combined effects of sulbactam/cefoperazone (SBT/CPZ) with each of imipenem/cilastatin (IPM), cefuzonam, flomoxef, amikacin (AMK) and tobramycin (TOB) against 324 clinical strains. Through this study, we obtained the following results. 1. Against Serratia marcescens and Enterobacter cloacae, good synergism was obtained by combining SBT/CPZ with IPM, AMK, or TOB. 2. Against Pseudomonas aeruginosa, good synergism was obtained by combining SBT/CPZ with AMK or TOB. 3. When SBT/CPZ was used in combination with IPM, antagonism was observed among about 45% of strains of P. aeruginosa.     

Combined effect of sulbactam/cefoperazone and other antibiotics against clinical isolates of multi-resistant strains. I. Effect of sulbactam against beta-lactams resistant strains and in vitro combined effect of sulbactam/cefoperazone with each of piperacillin, latamoxef, ceftazidime, fosfomycin and doxycycline

We evaluated relationships between production of beta-lactamase and their resistances to beta-lactams, effect of sulbactam (SBT), a beta-lactamase inhibitor, against beta-lactam resistant strains, and combined effect of sulbactam/cefoperazone (SBT/CPZ) with other antibiotics against multi-resistant strains. Through these studies, we obtained the following results. 1. Most of the strains resistant to beta-lactams were beta-lactamase producers. 2. Relationships between the production of beta-lactamase and their resistances to beta-lactams indicate that their resistances generally were the highest in producers of both penicillinase (PCase) and cephalosporinase (CEPase), moderate in producers of either PCase or CEPase, and the lowest in beta-lactamase non-producers. Most of highly-resistant strains of MRSA appeared to be beta-lactamase non-producers though some exceptions were observed among methicillin-resistant Staphylococcus aureus (MRSA), Serratia marcescens and Pseudomonas aeruginosa. 3. SBT showed good effect against PCase producers, moderate effect against producers of both PCase and CEPase, little effect against CEPase producers, and no effect against beta-lactamase non-producers. 4. Results of combined effect of SBT/CPZ with other antibiotics indicated that good synergism was obtained by combining SBT/CPZ with fosfomycin (FOM) or piperacillin against multi-resistant strains of Proteus spp., Enterobacter cloacae, and S. marcescens, by combining SBT/CPZ with ceftazidime (CAZ) or FOM in methicillin-sensitive S. aureus and by combining SBT/CPZ with CAZ in P. aeruginosa. 5. Better synergism was obtained with the higher concentrations of antibiotics.