| Surgical infection(SSI)is the most common nosocomial infection in surgery.It is reported that about 1.9%of post-operative patients in the United States have SSI,and that in Europe SSI ranks second in hospital acquired infections.The incidence of SSI may be higher in developing countries.Surgical site infection ranks among the top three nosocomial infections in China.Gram-negative bacteria and Gram-positive bacteria are the main pathogens.The results showed that 58.04%of the common pathogenic bacteria in orthopaedic surgical site infection were Gram-negative bacteria,mainly Escherichia coli.38.22%Gram-positive bacteria,mainly Staphylococcus aureus,and 3.74%fungi.Infection is accompanied by the overuse of clinical antibiotics,drug-resistant pathogens are common,resulting in poor efficacy of antibiotics.Research shows that the non-standard use of antibiotics leads to the general resistance of bacteria to common antibiotics in clinic.The resistance rate of Staphylococcus aureus to penicillin is 98%;that of Staphylococcus epidermidis to penicillin is 92%;that of Pseudomonas aeruginosa to compound neomycin is 87%;and that of Escherichia coli to piperacillin is 80%.The emergence of extensively drug-resistant bacteria and superbacteria has posed great challenges to human anti-infective treatment.Antibiotics and disinfectants are two commonly used antibiotics at present.Although their bacteriostasis and bactericidal mechanisms are different,relevant studies have shown that low concentration disinfectants and antibiotics have similar mechanisms of action.It is found that when bacteria are resistant to antibiotics,they will become resistant to antibiotics of the same mechanism and cross-resistance to low-concentration disinfectants.In addition,when bacteria are resistant to low-concentration disinfectants,they will also become resistant to antibiotics.Modern studies have found that traditional Chinese herbal medicines have significant antimicrobial effects and are not easy to produce bacterial resistance,especially compound preparations.More and more attention has been paid to the pharmacological study of the Bacteriostasis of Chinese herbal medicines and the clinical application of Chinese herbal prescriptions.Clearing heat,detoxifying and drying dampness recipe in our department consists of rhubarb,Coptis chinensis,phellodendron.Sophora flavescens,dandelion,digitalis,Cnidium monnieri,Radix Rehmanniae and fresh peel.It has been used in clinic for more than 20 years to prevent foot surgical infection and treat foot skin infections,erysipelas and tinea pedis.Rhubarb and Phellodendron amurense are commonly used antipyretic,detoxicating and Dampness-drying drugs in TCM clinic They have antimicrobial activity and are commonly used in conjunction with each other.They can inhibit bacteria at low concentration and kill bacteria at high concentration.Rhubarb.Coptis chinensis and Phellodendron chinensis all have a broad spectrum of bacteriostasis.which can inhibit Gram-positive.Gram-negative bacteria and fungi,but have a strong inhibition on bacteria,especially Gram-positive bacteria.Modern pharmacological studies have shown that Sophora flavescens has a significant inhibitory effect on Staphylococcus epidermidis.Alkaloids in Sophora flavescens extract can reduce bacterial content.Flavonoids may play a bacteriostaticrole by destroying bacterial cell membranes and cell walls.The bacteriostatic effect of avonoids is positively correlated with the concentration.The ethanol extracts of fresh peel and Fructus Cnidii have bactericidal effect.Han Lu's experiment showed that the three extraction methods of Fructus Scutellariae,including ethanol extraction.Decoction and impregnation,had antimicrobial effects on Botrytis cinerea,Capsicum wilt fungus and Cucumber Fusarium wilt fungus,and the impregnation method had the best antimicrobial effect.Studies have shown that many antipyretic and detoxifying herbs and their compounds have inhibitory effects on bacterial growth,and can enhance human immunity and interfere with the emergence of bacterial resistance to antibiotics.Therefore,traditional Chinese medicine has a broad prospect in clinical application of antimicrobial agents.At present,the pharmacological research on the Bacteriostasis of this prescription is still vacant.The lack of scientific data on the effective concentration and medication time for clinical use hinders the further development and application of this prescription.ObjectiveTo understand the distribution of bacterial spectrum in foot and analyze the characteristics of pathogenic bacteria in foot.To observe the bacteriostatic effect of No.1 Foot Washing Formula on common foot pathogens and provide experimental basis for its clinical application.MethodBy collecting the foot specimens of patients before routine operation and those infected after ankle operation,the distribution of common bacterial spectrum in foot was analyzed.According to the characteristics of bacterial flora,standard strains of Staphylococcus aureus(ATCC25923),Escherichia coli(ATCC25922).Pseudomonas aeruginosa(ATCC27853).Candida albicans(ATCC14053)and Streptococcus pyogenes(ATCC)were selected.Staphylococcus epidermidis(16K4038)and Staphylococcus epidermidis(19615)were the experimental strains.According to the composition of "Clearing heat,detoxifying and drying dampness recipe".1 gram powder equivalent to 4.37 gram dry powder of Chinese medicine and 1 g/ml Decoction of Chinese medicine were prepared.After diluting the suspension to 105CFU/mL,the suspension was mixed with the doubly diluted suspension of Chinese medicine dry powder,and then cultured in incubator to observe the bacteriostatic effect and obtain the minimum bacteriostatic concentration of Chinese medicine dry powder for different bacteria.The bacteriostatic effect of different dosage forms of Chinese medicine on the same bacteria at the same concentration was compared and analyzed.Result1.In Vitro Bacteriostasis Test of Compound Dry Powder of Traditional Chinese MedicineDuring the experiment,there was no bacterial growth in the blank control group.which indicated that there was no cross-contamination of bacteria during the whole experiment.Different bacteria had different susceptibility to traditional Chinese medicine.Staphylococcus epidermidis(16K4038)was collected from clinical specimens.The strains were identified by microbial identification instrument.This strain and Pseudomonas aeruginosa(ATCC27853)had the highest susceptibility to traditional Chinese medicine.(ATCC14053)had the lowest sensitivity to traditional Chinese medicine.The results of minimum bacteriostatic concentration of Chinese herbal compound on bacteria were as follows:MIC value of Chinese herbal medicine on Staphylococcus epidermidis(16K4038)was 0.015625g/ml,Chinese herbal medicine had no bacteriostatic effect on Candida albicans(ATCC 14053),MIC value of Chinese herbal medicine on Escherichia coli(ATCC25922)was 0.125 g/ml.MIC value of Chinese herbal medicine on Staphylococcus aureus(ATCC25923)was 0.03125 g/ml,and Chinese herbal medicine on Pseudomonas aeruginosa(ATCC278).The MIC value of 53 was 0.015625g/ml,and that of traditional Chinese medicine for Streptococcus pyogenes(ATCC19615)was 0.03125g/ml.2.In Vitro Bacteriostasis of Different Forms of Compound Traditional Chinese MedicineGram-positive bacteria,Staphylococcus aureus(ATCC25923)and Gram-negative bacteria,Escherichia coli(ATCC25922),which are sensitive to compound Chinese herbal medicines were selected.Comparing the bacteriostasis effect of compound Chinese medicine dry powder and water decoction at different concentration,the results showed that the same concentration of compound Chinese medicine dry powder had better bacteriostasis effect on Staphylococcus aureus(ATCC25923)and Gram-negative bacteria Escherichia coli(ATCC25922)than compound Chinese medicine water decoction.ConclusionIn vitro bacteriostasis experiment,the Clearing heat,detoxifying and drying dampness recipe has different degrees of inhibition on Gram-positive bacteria such as Staphylococcus aureus,Staphylococcus epidermidis,Streptococcus pyogenes and Gram-negative bacteria such as Pseudomonas aeruginosa and Escherichia coli,and its bacteriostasis effect is proportional to the concentration of traditional Chinese medicine;its bacteriostasis effect on Candida albicans is not obvious,but its bacteriostasis effect is the same.Samples were in direct proportion to the concentration of traditional Chinese medicine.Therefore,we should pay attention to the relationship between drug concentration and curative effect in clinical application of traditional Chinese medicine.In addition,by comparing the bacteriostatic effect of dry powder suspension and decoction of "Clearing heat,detoxifying and drying dampness recipe" in vitro,the results showed that the bacteriostatic effect of different dosage forms was different,and the influence of dosage forms on clinical efficacy should be paid attention to in the development. |
PDF Full Text Request