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百里香酚、乙二胺四乙酸(EDTA)和万古霉素的两药及三药联合对包括大肠杆菌在内的多重耐药菌的协同相互作用。

Synergistic interactions in two-drug and three-drug combinations (thymol, EDTA and vancomycin) against multi drug resistant bacteria including E. coli.

作者信息

Hamoud Razan, Zimmermann Stefan, Reichling Jürgen, Wink Michael

机构信息

Institute of Pharmacy and Molecular Biotechnology, Heidelberg University, INF 364 Heidelberg, Germany.

Department of Infectious Diseases, Medical Microbiology and Hygiene, Heidelberg University, Heidelberg, Germany.

出版信息

Phytomedicine. 2014 Mar 15;21(4):443-7. doi: 10.1016/j.phymed.2013.10.016. Epub 2013 Nov 18.

Abstract

Combinations of two or more drugs, which affect different targets, have frequently been used as a new approach against resistant bacteria. In our work we studied the antimicrobial activity (MIC, MBC) of individual drugs (the phenolic monoterpene thymol, EDTA and vancomycin), of two-drug interactions between thymol and EDTA in comparison with three-drug interactions with vancomycin against sensitive and resistant bacteria. Thymol demonstrated moderate bactericidal activity (MBC between 60 and 4000μg/ml) while EDTA only exhibited bacteriostatic activity over a range of 60-4000μg/ml. MICs of vancomycin were between 0.125 and 16μg/ml against Gram-positive and between 32 and 128μg/ml against Gram-negative bacteria. Checkerboard dilution and time-kill curve assays were performed to evaluate the mode of interaction of several combinations against Methicillin-resistant Staphylococcus aureus (MRSA NCTC 10442) and Escherichia coli (ATCC 25922). Checkerboard data indicate indifferent interaction against Gram-positive (FICI=1-1.3) and synergy against Gram-negative bacteria (FICI≈0.4), while time kill analyses suggest synergistic effect in different combinations against both types of bacteria. It is remarkable that the combinations could enhance the sensitivity of E. coli to vancomycin 16-fold to which it is normally insensitive. We have provided proof for the concept, that combinations of known antibiotics with modern phytotherapeutics can expand the spectrum of useful therapeutics.

摘要

两种或更多种作用于不同靶点的药物联合使用,已常常被用作对抗耐药菌的一种新方法。在我们的研究中,我们研究了单一药物(酚类单萜百里酚、乙二胺四乙酸(EDTA)和万古霉素)的抗菌活性(最低抑菌浓度(MIC)、最低杀菌浓度(MBC)),比较了百里酚与EDTA的两药相互作用以及与万古霉素的三药相互作用对敏感菌和耐药菌的影响。百里酚表现出中等杀菌活性(MBC在60至4000μg/ml之间),而EDTA仅在60 - 4000μg/ml范围内表现出抑菌活性。万古霉素对革兰氏阳性菌的MIC在0.125至16μg/ml之间,对革兰氏阴性菌的MIC在32至128μg/ml之间。进行棋盘稀释法和时间 - 杀菌曲线分析,以评估几种联合用药对耐甲氧西林金黄色葡萄球菌(MRSA NCTC 10442)和大肠杆菌(ATCC 25922)的相互作用模式。棋盘数据表明对革兰氏阳性菌为无关相互作用(联合抑菌指数(FICI)=1 - 1.3),对革兰氏阴性菌为协同作用(FICI≈0.4),而时间 - 杀菌分析表明不同联合用药对两种类型细菌均有协同效应。值得注意的是,这些联合用药可使大肠杆菌对通常不敏感的万古霉素的敏感性提高16倍。我们已为这一概念提供了证据,即已知抗生素与现代植物疗法的联合使用可以扩大有效治疗药物的范围。

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