Tanreqing Injection Esbls-producing Escherichia Coli Resistant To Impact

The Escherichia coli (E. coli) was the most common community acquired and hospital acquired pathogen. Among them, the infection caused by the extended-spectrum beta-lactamase (ESBLs) producing E. coli took the first place. ESBLs producing E. coli can hydrolyze penicillin, and the first, second, third generation and part of the fourth generation cephalosporin. Part of the strains can also resist aminoglycoside and fluoroquinolones antibiotics. So the infection caused by it was treated by less antibiotics, and the effect was often not ideal which increased mortality. This made the treatment difficult, made treatment fee increase, and also brought heavier social economic burden.It was reported that some formulas had certain antibacterial effect on some bacteria in vivo, especially achieved good curative effect in the therapy of some drug-resistant bacteria infection diseases. And some Chinese medicine had stronger antimicrobial effect on some drug-resistant bacteria. So it is possible to give method for the current grim drug-resistant bacteria problems by further research on antibacterial effect on Chinese medicine.This paper mainly included literature review, monitoring drug resistance of main bacteria in Dongfang hospital in 2010 and experimental research.1 Literature reviewThe literature review introduced the research progress of traditional Chinese medicine antibacterial function, Tanreqing, and E. coli producing ESBLs.2 Monitoring drug resistance of main bacteria in Dongfang hospital in 2010 Objective:To investigate the detection rate of main bacteria and the drug resistance of bacteria to antibiotics in Dongfang hospital of Beijing university of Chinese medicine in 2010.Methods:According to certain regulations, to isolate and culture bacteria. according to CLSI,to identify and do drug susceptibility test by VITEK-32.Results:From January to December of 2010,3489 strains were isolated in Dongfang hospital, the top five respectively were:E. coli, Pseudomonas aeruginosa, Staphylococcus aureus, Acinetobacter calcoaceticus-baumanii complex and Klebsiella pneumonia, and the detection rates were 17.71%,17.25%,12.81%, 10.66%,8.94% respectively. The detection rates of ESBLs producing E. coli and ESBLs producing Klebsiella pneumoniae respectively were 68.12% and 41.03%, and the rate of MRSA was 91.95%. The resistance rate of E.coli to imipenem was 1.62% and that of E.coli to meropenem was 5%. The resistanc rates of E. coli to piperacillin/tazobactam and cefoperazone/sulbactam respectively were 17% and 16%. To ceftazidime, cefota-xime and cefepime, the rates were more than 75%. To cefoxitin, the rate was 26%. It remained high sensitive to amikacin with only 15% of antimicrobial resistance. The rate to Levof loxacin was 68%. The resistance rates of Pseudomonas aeruginosa to imipenem and meropenem respectively were 36% and 46%. The rates to piperacillin/tazobactam and cefoperazone/sulbactam were 27%,44% respecttively. The rates to ceftazidime, cefepime were 55% and 68% respectively, to amikacin was 14% and to levof loxacin was 50%. The resistance rate of Staphylococcus aureus to vancomycin was 0.22%, to nitrofurantoin, cotrimoxazole, rifampin, tetracycline, gentamicin were 25%,40%,74%,76% and 89% respectively. The resistance rates of Acinetobacter calcoaceticus-baumanii complex to imipenem and meropenem were 73%,70% respectively, to piperacillin/tazobactam and cefoperazone/sulbactam were 62%,73% respectively, to ceftazidime was 84%, to amikacin was 69%, and to levof loxacin was 74%. The resistance rates of Klebsiel la pneumoniae to imipenem and meropenem were 4%,11% respectively, to piperacillin/tazobactam and cefoperazone/sulbactam were 41%,31% respectively.Conclusion:E. coli took the first place among the bacteria isolated from the hospital in 2010. The detection rate of ESBLs producing E.coli reached up to 68.12%, the resistance rates of E. coli to many antibiotics were higher on average and multiple drug-resistant strains appeared which brought greater difficulties in clinical treatment. The hospital had to face the problem that how to choose the antibiotics to treat the infections caused by E.coli. Furthermore, the situations in Pseudomonas aeruginosa, Staphylococcus aureus, Acinetobacter calcoaceticus, and Klebsiella pneumoniae were not optimistic.3 Experiment researchObjective:To study the impact of Tanreqing injection on ESBLs, discussing the mechanism of it. It was the basic for further study to antibacterial mechanism of Chinese medicine, and giving possible method for the current grim drug-resistant bacteria problems.Methods:To take ESBLs producing E.coli from the clinical laboratory which identified by VITEK-32. To adopt two-folded dilution method to determine MIC of Tanreqing injection to E.coli producing ESBLs. To measure inhibition zone diameters of Tanreqing injection with different concentrations effecting on E. coli producing ESBLs by disc diffusion method. To use spectrophotometry to determine the ESBLs activity of E.coli affected by Tanreqing.Results:The MIC of Tanreqing to 10 ESBLs producing E.coli strains were 31.25μl/ml-125μl/ml. The MIC of Tanreqing to strains 1,2,5,6,8 and 9 were 62.5μl/ml. To select the six strains to do drug sensitive test and determine the ESBLs activity.Affected by Tanreqing, the inhibition zone diameters of ceftazidime, cefoperazone, cefotaxime of strains 1,6 and 8 were increased and their antibiotics sensitivity were enhanced, statistically significantly (P<0.05). The inhibition zone diameters of cefotaxime and cefoperazone of strain 5 were increased, and its sensitivity to cefotaxime and cefoperazone were enhanced, statistically significantly (P<0.05). The inhibition zone diameter of ceftazidime of strain 9 was increased, and its sensitivity to ceftazidime was enhanced, statistically significantly (P<0.05). The inhibition zone diameters of three kinds antibiotics of strains 2 and 8 were not increased and their sensitivity were not enhanced (P>0.05).Affected by Tanreqing, ESBLs activity of strainsl,5,6 and 9 decreased statistically significantly(P<0.05), ESBLs activity of the strains 2,8 did not reduce (P>0.05).Conclusion:Tanreqing inhibited the ESBLs activity of some E. coli strains and enhanced their sensitivity to some antibiotics; Tanreqing had no inhibition on the ESBLs activity of some E. coli strains, and also did not strengthen their sensitivity to antibiotics; Tanreqing may had different impact on different ESBLs of E. coli. Tanreqing had no impact on ESBLs activity of some strains, but increased their sensitivity to some antibiotics. There may be other mechanism for Tanreqing to strengthen antibiotics sensitivity of drug-resistant strains.