| In recent years, the problem of antibiotic resistance has attracted glo bal wide attention on account of massive applications,the "super bacteria" even sounds the alarm to human. Because of the irrational use of extended spectrum beta-lactam antibiotics,such as the third generation cephalosporin, the bacteria produce ESBLs,which are mediated by plasmid. ESBLs are the der ivant of serine ptotease, which can hydrolyze cephalosporin,penicillins, mono bactams, but not efficient to Carbapenems and Cephamycins. Meanwhile, the ESBL s-producing strains are always the carrier of drug-resistant genes like Qui nolones, Aminoglycosides,sulfonamides,finally, these genes lead to multidrug resistance through rearrangement in different strains by plasmid, integron or transposonSince the first ESBLs-producing K. pneumoniae was found in Germany in1983, the ESBLs-producing strains appeared continually in the followed20yea rs. The percentage of ESBLs-producing K. pneumoniae was23%in35ICUs of Eu rope in1994, the tracing research of most of those ICUs during1997～1998showed that, there was not an obvious change in the rate of ESBLs, but the re sistant rate of piperacillin/tazobactam (PIP/TAZ) rose from31%to63%rapid ly (P<0.001), of which the resistance were high levels. ESBLs were mainly pr oduced by Enterobacteriaceae species, especially E. coli and K. pneumoniae. CHI NET surveillance of bacterial resistance in China indicated the average rat e of ESBLs in Klebsiel la (K. pneumoniae and K.oxytoca) was41.4%, which was fr om the survey of clinical isolates in14hospitals distributed in different areas. The bacterial surveillance of Beijing University of Chinese Medicin e Third Affiliated Hospital from May1,2010to April30,2011showed that, th e percentage of ESBLs-producing K.pneumoniae had reached to56.1%, it was a grim situation,and also brought serious problems of medical treatment and infection control.Objecive:To verify the bacteriostasis against drug-resistant bacteria o f Chinese medicine according to the study of bacteriostasis in vitro of Chi nese medicine Tanreqing injection against ESBLs-producing K. pneumoniae,and investigate the effect of the combination of Chinese medicine and antibioti c so as to provide more evidence to screen effective Chinese medicine,moreo ver, it lays the foundation to the cell experiment,animal experiment and the clinical study, it is helpful to find out the mechanism of the herb’s effect in vivo.Methods:Identify the bacteria and perform the drug sensitive test by VI TEK32; according to CLSI,carry out the confirmatory test to the suspicious strains by disc diffusion method,and do the bacteriostatic test of Tanreqin g injecion,Tanreqing combined Tazocin (PIP/TAZ),Tanreqing combined Ceftazidi me.Results:The MICs of Tanreqing injection, Tazocin,Ceftazidime were750μ;/ml,28.125μg/ml,7.813μg/ml respectively.The simultaneous use of Tanreqing and Tazocin against ESBLs-producing K. pneumoniae could decrease the dose of Tazocin for1～2times when the concen tration of Tanreqing injection was0.00μl/ml～1.758μl/ml.It could decreas e the dose of Tazocin for5times when adding Tazocin after Tanreqing for6hours on condition that the concentration of Tanreqing injection was above450μl/ml.The simultaneous use of Tanreqing and Ceftazidime against ESBLs-produci ng K.pneumoniae could decrease the dose of Ceftazidime for1time when the concentration of Tanreqing injection was0.007μl/ml-0.027p μl/ml. It could d ecrease the dose of Ceftazidime for2times when adding Ceftazidime after T anreqing for6hours and the concentration of Tanreqing injection was400μ l/ml,and at least3times in case the concentration of Tanreqing injection was above450μl/ml.Conclusion:Tanreqing injection had the function of bacteriostasis, no ma tter the simultaneous use of Tanreqing and Tazocin or interval for6hours, it could improve the bacteriostatic activity of Tazocin against ESBLs-produ cing K. pneumoniae, so did Ceftazidime.Meanwhile, the bacteriostatic activity of Tazocin was stronger than Ceftazidime. |
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