Study On The Effect Of Honokiol On Fungal Activity

Objective: Retrospective analysis of the status of fungal resistance in cases with deep fungal infection in our hospital,at the same time,study the effects of honokiol on the activity of Candida albicans to provide new ideas for clinical antifungal treatment.Methods: Collect all cases of deep fungal infections in our hospital from January 1,2017 to December 31,2018,and analyze the patient's age,department distribution,and drug sensitivity test results to understand the resistance of patients in our hospital to fungal infections status quo.Status of drug resistance.For the in vitro experiment,the microdilution method in the M27-A2 protocol issued by the Clinical and Laboratory Standards Institute(CLSI)was used to perform the in vitro drug sensitivity test.The trial was divided into the honokiol alone group,the fluconazole alone group and the honokiol combined with fluconazole group.The final concentration range of the two drug-only groups was 128 ug / ml-0.25 ug / ml,and the concentration range of the combined drug group was 64 ug / ml-0.125 ug / ml.The final concentration of the bacteria suspension(0.5-2.5)× 103 CFU / ml was used as the standard,and the cells were cultured in a 35 ° C incubator for 48 hours.The growth of the test strain on the drug-sensitive plate was visually observed under sufficient light conditions.(Ie,100%inhibition)The minimum drug concentration in each test well is used as the MIC(Minimal Inhibitory Concentration,MIC)value.The Fractional Inhibitory Concerntration Index(FICI)was used to evaluate drug-drug interactions.Evaluation methods: FICI?0.5 considered synergistic;0.5 <FICI?1 considered additive;1 <FICI?2considered no Correlation;FICI> 2 is considered to have antagonism.Results: Statistical analysis of 504 cases of deep fungal infection in our hospital: 1.There were 315 cases(62.5%)in men and 189 cases(37.50%)in women;409 cases(81.15%)in the elderly patient group,92 cases(18.25%)in the middle-aged patient group and 3 cases(0.60%)in the juvenile patient group).2.Strain source: 369 cases of sputum(73.21%),47 cases of blood(9.33%),35 cases of urine(6.94%),19 cases ofdrainage fluid(3.77%),and 18 cases of sterile body fluid(3.57%).3.Distribution of departments: 166 cases(32.94%)in the emergency department(including emergency ICU),113 cases(22.42%)in the critical care department,80 cases(15.87%)in the respiratory department,34 cases(6.75%)in general surgery,and 36 cases in Shenyang(7.14%)and so on.4.Types of strains: 311 cases(61.71%)of Candida albicans,74 cases(14.68%)of Candida albicans,58 cases(11.51%)of Candida tropicalis,44(8.73%)of Candida nearly smooth,6 cases of yeast(1.19%),6 cases of Aspergillus(1.19%),and 5cases of other fungi(0.99%).5.Drug sensitivity results: Candida albicans showed high sensitivity to five antifungal drugs,fluconazole,voriconazole,amphotericin B,itraconazole,and 5-fluorocytosine;fluconazole was effective against Yeast is highly sensitive.Amphotericin B is highly sensitive to all yeasts.In vitro and magnolol and fluconazole alone and combined drug sensitivity test results on Candida albicans showed:The range of MIC value of honokiol alone group:8-16 ug / ml,geometric mean(G)is 11.31 ug / ml;The range of MIC value of fluconazole alone group: 1-4ug / ml,G is 2ug / ml;The MIC values of the combination group were:MIC and honokiol were 0.125-16 ug / ml(1.41 ug / ml),and MIC fluconazole was0.125-2 ug / ml(0.5 ug / ml).The geometric mean of the MIC value in the combination group was significantly lower than that in the single group.The FICI value of the combination of the two was 0.37,indicating that the two drugs have synergistic antifungal effect.Conclusion:1.The elderly population is a high prevalence of deep fungal infections.The emergency department,the intensive medicine department and the respiratory medicine department are the high incidence departments of deep fungal infections.2.Candida albicans infections are most common in deep fungal infections.Fluconazole is highly sensitive to Candida other than Candida klebsiella.Amphotericin B is highly sensitive to all yeasts.Candida albicans showed high sensitivity to five antifungal drugs,fluconazole,voriconazole,amphotericin B,itraconazole,and 5-fluorocytosine.3.Both honokiol and fluconazole have synergistic activity against Candida albicans.