The Characteristics Of Pseudomonas Aeruginosa Pneumonia Syndrome And The Antibacterial Activity Of Fuzheng Jiedu Huayu Recipe On MDRPA In Vitro

BackgroundPseudomonas aeruginosa pneumonia is a serious infectious disease with high incidence and many risk factors.The resistance of Pseudomonas aeruginosa is rapid and has a wide range of drug resistance.The diagnosis and accurate anti-infective treatment of Pseudomonas aeruginosa pneumonia often lags behind,while the high level broad-spectrum antibiotics are expensive and have obvious side effects,which increases the pain and economic burden to the patients and their families.The treatment of exogenous diseases in traditional Chinese medicine has its mature theory system and rich clinical practice.Clinical integration-of traditional Chinese and western medicine will be the development trend of the society and the times.Therefore,it is necessary to study the characteristics of TCM syndromes of Pseudomonas aeruginosa pneumonia,and to explore the mechanism of Chinese medicine in the treatment of drug-resistant bacteria infection.Objective1.To investigate the clinical confirmed cases of Pseudomonas aeruginosa pneumonia,to record the basic information of the patients,the basic diseases,the characteristics of drug resistance of pathogens and the data of four diagnoses of TCM,and to summarize the characteristics of TCM syndromes of Pseudomonas aeruginosa pneumonia.The syndromes of drug resistant strains PAP and sensitive strains PAP were distinguished.2.Taking Fuzheng jiedu Huayu Decoction as the research object,the most common multi-drug resistant Pseudomonas aeruginosa Pseudomonas aeruginosa(MDRPA),which is the most common multi-drug resistant Pseudomonas aeruginosa,was used as an in vitro bacteriostasis test,The ultrastructure changes of MDRPA after intervention by Fuzheng jiedu Huayu Decoction were observed and the bacteriostatic mechanism of Fuzheng jiedu Huayu Decoction was disodcussed.Method1.To record and summarize the data of the fourth diagnosis of Pseudomonas aeruginosa pneumonia in Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine and fill out the case questionnaire.The results of drug sensitivity test in sputum culture were divided into sensitive PAP and drug resistant PAP,and the differences of clinical manifestations between the two groups were summarized.2.Observation of the bacteriostatic effect of different doses of serum containing medicine of Fuzheng jiedu Huayu Decoction on MDRPA in vitro by tube dilution method and K-B disk diffusion method.The ultrastructural changes of MDRPA after intervention by Fuzheng jiedu Huayu Decoction were observed by transmission electron microscope.Results1 Clinical partAmong 133 cases of PAP,82 cases were male,51 cases were female,64 cases were drug resistant PAP,69 cases were sensitive PAP.The clinical symptoms of PAP patients were cough and white matter mucus,and phlegm heat obstruction of lung was the most common type of TCM syndrome.Drug resistant PAP and sensitive PAP were most common in 75-84 years old.Pathogens were found to be drug-resistant strains with darker complexion and yellowish brown stool.2 Experimental part2.1 Tube dilution methodThe minimal concentration of the reagent in the test tube without turbidity is the MIC of the reagent under the condition that the bacteria in the positive control tube multiply in large numbers and the negative control tube grows aseptically.(1)The MIC value of Fuzheng jiedu Huayu Decoction suspension to MDRPA was 0.2 g/ml.(2)The MIC value of imipenem to MDRPA was 16?g/ml.The MIC values of imipenem combined with blank serum,imipenem combined with 0.5 times of drug serum,imipenem combined with 1 times drug serum,imipenem combined with 2 times drug serum were still 16?g/ml.(3)The MIC value of imipenem combined with 4 times drug serum group and imipenem combined 8 times drug serum group was 8?g/ml.ConclusionClinical part:? The clinical symptoms of Pseudomonas aeruginosa pneumonia are fever,cough,expectoration,sputum white stickiness and so on.Cough,phlegm white matter stickiness is most common.Age is concentrated in 75-84 years.Phlegm and heat obstruction of the lung syndrome is the most common.? Sensitive PAP in patients over 75 years old was significantly lower than that in drug resistant patients.There were significant differences in fever,facial obscurity,sputum viscosity,anorexia,loose stools,mental retardation and sleepiness between patients with drug resistant PAP and sensitive PAP.Experimental part:Imipenem combined with 4 times drug serum of Fuzheng jiedu Huayu Decoction or 8 times drug serum of Fuzheng jiedu Huayu Decoction can reduce the MIC value of one gradient of imipenem.The bacteriostatic effect of serum containing medicine of Fuzheng jiedu Huayu Decoction combined with imipenem was more obvious than that of imipenem alone.At the same time,the serum of Fuzheng jiedu Huayu prescription may slow down or decrease the release of MDRPA endotoxin.