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Objective:To study the interaction between Tanreqing injection and commonly used antibiotics against multi-drug resistant Pseudomonas aeruginosa (MDR-PA) and the effect on bacterial efflux pump. Method:Antibiotic susceptibility test was performed with bacteria. Paper diffusion method (Kirby-Bauer, KB) combined with efflux pump inhibitor (50 mg·L-1) was used to measure the diameter of the inhibition zone, and real-time fluorescence quantitative polymerase chain reaction (Real-time PCR) was used to detect gene expression of efflux pump Positive efflux pump strain. KB method was used to observe the changes of Tanreqing (final concentration 3 g·L-1) and antibiotics on the diameter of the zone of inhibition. Strains were co-cultured with Tanreqing and antibiotic sub-inhibitory concentrations for Real-time PCR detection. KB method was used to observe the effect of Tanreqing on the diameter of bacteriostatic ring after the continuous use of efflux pump-positive bacteria. Result:Two MDR-PA efflux pump-positive strains were identified and screened. Tanreqing has synergistic antibacterial effect with aloxicillin, aztreonam, meropenem, ceftazidime, cefoperazone, and Shupushen. In inhibiting the expression levels of bacterial efflux pump genes, the four drugs were compared by the effect: cefoperazone>Tanreqing>ceftazidime>Shupushen. After Tanreqing continued to act on efflux pump-positive strains, it could have a better effect in combination with ceftazidime, cefoperazone, and Shupushen. Conclusion:Tanreqing, ceftazidime, cefoperazone, and Shupushen can reduce the drug resistance of bacteria by down-regulating the expressions of bacterial efflux pump genes, and reducing the clinical dose of antibiotics, and thus play a bacteriostatic effect.
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OBJECTIVE To evaluate the risk factors, therapy and prognosis of multi-drug resistant Pseudomonas aeruginosa infection. METHODS We made retrospective study of multi-drug resistant P. aeruginosa infection cases from Jan 2000 to Dec 2004 proved by samples tests. RESULTS Thirty four cases were infected by multi-drug resistant P. aeruginosa, 29 cases were with hospital infection. Among the 34 cases infected by multi-drug resistant P. aeruginosa, the mortality was 67.7%. There were 34 cases concomitant with 1-5 kinds of underlying diseases. There were 26 cases infected with more than 2 kinds of bacteria. CONCLUSIONS Multi-drug resistant P. aeruginosa infection mostly happens in old men, incorporated with underlying diseases and mixed bacterial infection .
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Objctive To investigate the zymogenic state and drug resistance of multi-drug resistant Pseudomonas aeruginosa (MDRP) for providing a laboratory basis of combined use of drugs against MDRP in clinical practice. Methods All isolates were isolated by routine procedures and identified by VITEK-2 automatic bacterial identification instrument. Following the CLSI instruction, doubling dilution in agar plates was performed for MIC detection. Results MDRP were 22.77% ( 86.96% for sputum) from 101 strains Pseudomonas aeruginosa, which were isolated from clinical specimens. Positive rates of MDRP producing metallo-?-lactmases were 91.3%, positive rates for producing induced Ampc and plasmid Ampc ?-lactamase were 52.17% and 21.74%, respectively. The ratio between Meropenem and Imipenem higher then 1 was 34.78%. The bacterial inhibitory rates of Polymyxin B and Imipenem were zero, that of Amikaein and Ceftaxidime were 4.35%, that of Ciprofloxacin and Cefoperazone/sulbactam were 43.48%, that of Pazufioxacin and Piperacillin/Tazobactam were 21.74% and 26.07%, and that of Meropenem was 47.83%. The combined use of Cefoperazone/sulbactam, Cefpirome, Piperacillin/Tazobactam with Amikacin resulted in bacteriostatic rate of 65.2%, 47.8%, 43.5%, respectively. Conclusoins MDRP is main micro-organism found in respiratory tract specimens. Drug resistance of MDRP is related to multiple drug-resistant mechanisms. Clinicians should first select enzyme inhibitory-drug (Cefoperazone/sulbactam or Piperacillin/Tazohaetam) with Amikacin or Polymyxin B to treat clinical MORP infection, and re-adjust the type of antibiotics rationally according to patients' symptoms, phenotype of the drug-resistant pathogen, the results of drug susceptibility test, and the effect on the patients.