Te kikorangi metilīni me Bartonella: ngā kitenga taiwhanga me ngā herenga o ngā taunakitanga haumanu

He kupu kotahi e whakamahia ana mō te rīhi whakatipu me te tūroro, arā, te pokenga, engari he rerekē ngā ariā. I te rīhi, ko te pokenga he tatau i ngā kāhui huakita i runga i te agar. I te tūroro, he huakita kei roto i ngā pūtau me ngā ia toto, he rongoā e rere ana mā te toto me ngā kiko, ā, he pūnaha ārai mate e mahi ana i tētahi wāhanga o te mahi. Ki te whakapoauautia ēnei mea e rua, ka tīmata tētahi tau whakamīharo nō te taiwhanga ki te āhua rite ki tētahi maimoatanga. Ki te wehea tonutia, ka kitea taua tau mō tōna tino tikanga: he take kia mahia te whakamātau e whai ake nei.

Ko taua wehewehenga te tino kaupapa o tēnei arotake mō te kikorangi metilīni me Bartonella. E rua ngā rangahau taiwhanga nō te rōpū rangahau kotahi i whakamātau i te kikorangi metilīni ki a Bartonella henselae i ngā āhuatanga kāore e tipu ana. I pūrongo ngā mea e rua i te kaha o te mahi i roto i te karāhe me te kirihou. Kāore tētahi i whakamātau ki te tangata.

He aha ngā kairangahau e whakamātau ai i te wā tū pūmau

Ko te nuinga o ngā whakamātautau paturopi e whakamahi ana i ngā pūtau e tipu ana. Kāore taua tauira e kapo i tētahi āhuatanga uaua ake: ngā pūtau kua mutu te wehewehe, ā, e manawanui ana ki ngā rongoā e patu ana i ō rātou pūtau whanaunga e tipu ana.

Ka taea e Bartonella te noho tonu i roto i te tinana, tae atu ki roto i ngā pūtau toto whero me ngā pūtau o te paparanga o roto o ngā ia toto. Nō reira, i ui te rōpū ko ēhea rongoā kua whakaaetia e taea ai te patu i a B. henselae i muri i tōna urunga ki te wā tū pūmau. Kāore te MIC iti mō ngā pūtau e tipu ana i matapae i te patunga o ngā pūtau kei te wā tū pūmau. He tino iti te MIC o rifampin, engari he ngoikore tana patu i ngā pūtau tū pūmau; ko ngā pūhui he teitei ake ō rātou uara MIC, he pai kē te patu i aua pūtau. Ko ngā kaipānui e hiahia ana ki tētahi tikanga whānui mō te pānui i tēnei momo pepa ka kite i taua tikanga i te aratohu pānui rangahau mō te kikorangi metilīni.

Te tātari tuatahi: Li me ōna hoa mahi, 2019

I whakamahia e te tātari wā tū pūmau o 2019 i Antibiotics tētahi riaka kotahi, arā, B. henselae JK53, i whakatipuria ki te matū whakatipu Schneider me te 10 percent wē toto kukune kau, i te 37 C me te 5 percent CO2. Ko te nuinga o ngā whakatipu kotahi rā te pakeke he pūtau marara e wehewehe ana. I whakaarotia ngā whakatipu e rima rā te pakeke, tata ki te 10 to the 8th wae hanga kāhui huakita mō ia mL, kei te wā tū pūmau, ā, he huinga pūtau e kitea ana i roto.

Ko te whakamātautau ko SYBR Green I me te propidium iodide, i whakatauritea ki ngā ranunga o ngā pūtau ora me ngā pūtau i patua ki te isopropanol. Nā te kaha o te tae o te kikorangi metilīni, i whakaūngia ngā kitenga whaihua mā te karu whārahi, kātahi mā ngā tatauranga kāhui huakita i runga i te agar toto, arā, te paearu mutunga pakari ake.

I roto i ngā rongoā 1,581 kua whakaaetia, i te 50 micromolar, i waiho e te kikorangi metilīni he 16 percent e ora ana e ai ki te pūrere pānui pereti, ā, he 25 percent e ai ki te karu whārahi. Ko tā daptomycin he 21 percent, ko tā ētahi azole he 22 ki te 27 percent, ko tā gentamicin he 32 percent, ko tā erythromycin he 66 percent, ko tā ciprofloxacin he 74 percent. He kaha ake te āhua o pyrvinium pamoate ki te pūrere pānui, engari kāore i taea te ine mā te karu whārahi nā tōna ake kōrekoreko.

Mō B. henselae e tipu ana, ko te MIC o te kikorangi metilīni he 0.08 ki te 0.16 micrograms per mL. Mō ngā pūtau tū pūmau e rima rā te pakeke, i te 5 micrograms per mL, i heke te tatau kāhui huakita kia kore he kāhui e kitea i muri i te kotahi rā o te pānga ki te rongoā, e rite ana ki a daptomycin me pyrvinium pamoate i ō rāua kukūtanga i whakamātauria. I whakamahia te 10 micrograms per mL i tētahi whakamātau motuhake i te patunga i roto i te wā. He taumata pānga taiwhanga ēnei, ehara i te horopeta, ā, koia tonu te whakamārama a te pepa. Ko tētahi uara kukūtanga mōrahi i te wē toto tangata, tata ki te 3.9 micrograms per mL, i whakahuahia i te pepa hei horopaki whakamārama anake. E whakamārama ana te tirohanga whānui ki te nekehanga o te kikorangi metilīni i roto i te tinana he aha e kore ai te tau mō te wē toto e pānuitia hei tau mō te kiko.

E rua ngā herenga e mārama ana i te pepa. Kāore he tauira kiriata koiora, kāore hoki he whakamātautau huinga kikorangi metilīni. Ko ngā huinga pūtau e rima rā te pakeke he pūtau i whakahuihui ki roto i te whakatipu wai tū pūmau, ehara i te whakamātau kiriata koiora kua whakamanatia. I tono ngā kaituhi kia mahia he rangahau kararehe, he rangahau huinga rongoā, he rangahau kiriata koiora, me ngā whakamātautau ki ētahi atu momo Bartonella.

Ngā huinga me ngā pūtau nō te kiriata koiora: Zheng me ōna hoa mahi, 2020

I mau tonu te rangahau whai muri o 2020 i BMC Microbiology ki taua riaka me taua matū whakatipu, engari i huri ki ngā whakatipu tū pūmau e ono rā te pakeke, ā, i tāpiri i ngā mea e rua kāore i te pepa tuatahi: ngā huinga rongoā e rua me tētahi tauira pūtau nō te kiriata koiora.

Mō ngā rongoā takitahi, i te taumata ōrite o te 5 micrograms per mL mō te 24 hāora, i waiho e te kikorangi metilīni he 3.2 times 10 to the 4th wae hanga kāhui huakita mō ia mL, i te mea ko te tatauranga o te rōpū whakataurite tata ki te 2.8 times 10 to the 10th. He iti ake ngā kāhui i waiho e ciprofloxacin, gentamicin me nitrofurantoin i taua wā tonu. He rerekē tēnei i te hua o 2019, i reira kāore he kāhui i kitea i taua taumata kua tohua i muri i te kotahi rā. He rerekē te pakeke, te kiato me te whāwhā o ngā whakatipu, nō reira i taea te tukurua te ahunga o te patunga, engari kāore tōna nui i ōrite. Ko tēnei rerekētanga i waenga i ngā whakamātau tētahi take e wehe ai ngā arowhai paerewa mō te haumaru me ngā pāhekoheko i te kaha taiwhanga me te pānga haumanu.

Ko te tātari huinga te wāhanga e tino whakahuahia ana. I whakaritea ia wāhanga ki te 5 micrograms per mL. Kāore he kāhui huakita tū pūmau i kitea i te 24 hāora mō te huinga azithromycin me te kikorangi metilīni, me te huinga rifampin me te kikorangi metilīni; i pērā hoki ngā huinga ciprofloxacin e rua. Ko aua huinga e whā anake i pērā i roto i ngā takirua 25 i whakamātauria. Kāore i mahia he tātaritanga ōkawa mō te whakapakari tahi o ngā rongoā, nō reira ko te kupu tika he huinga whai mahi i raro i ēnei āhuatanga, ehara i te whakapakari tahi kua whakaūngia.

I whakamātau te rangahau kiriata koiora i ngā pūtau i tangohia mai i tētahi kiriata koiora hou kua wāwāhia, ehara i te kuhunga ki roto i tētahi kiriata koiora pakeke e mau tonu ana. I whakatipuria ngā whakatipu mō te rima rā, ka waimehatia ki roto i ngā pereti kōhao mō te rima rā anō, ka whakaūngia mā te whakapoke crystal violet, kātahi ka waruhia i mua i te pānga ki te rongoā. I te 5 micrograms per mL, i heke te tatau mā te kikorangi metilīni anake ki te 2.3 times 10 to the 2nd i te rā 6, ā, i roto tēnei i ngā hua pai rawa o ngā rongoā takitahi, engari kāore i eke ki te kore. I eke ngā huinga kikorangi metilīni e rua ki te kore i te rā 6, ā, i pērā hoki ngā huinga ciprofloxacin e rua.

I tohu ngā kaituhi i ngā herenga ka kitea hoki e te kaipānui tūpato: he kiriata koiora hou kua waruhia, kaua ko te kiriata koiora tawhito e mau tonu ana; kotahi te kukūtanga ngāwari mō ngā rongoā katoa, kaua ko ia rongoā i tōna ake taumata mōrahi e hāngai ana ki te ao tūturu; ko ētahi takirua kua kōwhiria anake, e hāngai ana ki a azithromycin, ki a rifampin rānei; kotahi te riaka; kāore he kararehe; kāore he tūroro. I whakaarohia he rangahau huinga rongoā e toru ā muri ake, engari kāore i pūrongotia he hua.

Te whakataurite i te hoahoa rangahau

Ko te ripanga te kaupapa o tēnei tuhinga i tōna āhua poto. Ko ngā mea katoa kei te taha mauī o te tīwae whakamutunga he rangahau whakatipu. Kāore he mea i tētahi o ngā pepa e rua e uru ana ki te tīwae whakamutunga.

Ehara a Bartonella i a Borrelia

E whakahua ana ngā pepa e rua i a Borrelia burgdorferi, te huakita tōrino o te mate Lyme, nā te mea i ahu mai te whakamātautau tae i ngā rangahau o mua mō te wā tū pūmau o Borrelia i taua taiwhanga anō, i reira i kitea hoki te kikorangi metilīni me daptomycin hei matū whai mahi. He horopaki whaihua taua hītori, ā, he pūtake hapa noa hoki.

Kāore he whakamātau i tētahi o ngā pepa Bartonella e whakamātau ngātahi ana i a Borrelia me Bartonella. He rerekē ngā rauropi, he rerekē ngā matū whakatipu, he rerekē ngā kukūtanga, ā, ko te whakapae mō te pānga o te kikorangi metilīni ki te kiriuhi o Bartonella i kīia he whakaaro me rangahau tonu. Kaua ngā hua e whakawhitia i tētahi momo ki tētahi atu, ā, kāore tētahi pepa e tautoko ana i ngā kerēme whānui mō ngā pirinoa. Nā tēnei take ka wehe tonu te whakataurite o ngā pūtau manawanui o Borrelia me Bartonella i ngā tuhinga rangahau mō ēnei mea e rua.

He aha ngā whakatipu e kore ai e huri hei kawa maimoatanga

Ka mārama te hiahia ki te rapu i tētahi kawa mō te kikorangi metilīni me Bartonella. Ko ēnei pepa te take me titiro taua rerenga hei tohu whakatūpato, kaua hei rārangi hoko.

Tuatahi, ko te 5 micrograms per mL i roto i tētahi kōhao pereti ehara i te whakahaunga rongoā. Kāore he kōrero e hono ana mō te ngongo, te tohatoha, te here ki ngā pūmua, te kuhunga ki roto i ngā pūtau, te āhei rānei o te tinana ki te whakamanawanui. I kōwhiria e ngā kaituhi taua taumata hei toharite āwhiwhi mō ngā taumata mōrahi o ngā paturopi, ā, i kī rātou me whakamahi ngā rangahau ā muri ake i ia rongoā i tōna ake taumata e hāngai ana ki te ao tūturu.

Tuarua, ko te kore kāhui huakita he tohu kāore he kāhui i raro i aua tikanga whakatipu pereti, ehara i te tohu he kiko kore huakita. Ko ngā pūtau manawanui, ngā huakita o roto i ngā pūtau, me ngā herenga tango tauira kei waho katoa i te pereti agar.

Tuatoru, ka kore pea e whai hua, ka tūkino rānei i te tinana ngā huinga e whakakore ana i ngā huakita o tētahi kōhao pereti. He takirua taiwhanga a azithromycin me te kikorangi metilīni, me rifampin me te kikorangi metilīni, i ngā taumata pānga taiwhanga. Ki te kore he rangahau nekehanga rongoā i roto i ngā kararehe, me ngā raraunga tangata nō ngā rangahau whai whakahaere, kāore he horopeta, kāore he roanga, kāore hoki he ōwehenga painga ki te mōrea. Me kōrero ki tētahi mātanga haumanu te tangata e whai whakaaro ana ki ngā kōwhiringa, ā, me arotake hoki āhea e hiahiatia ai te tirotiro hauora mō te whakamahi i te kikorangi metilīni, i mua i te whakatau i runga i ngā raraunga rīhi.

Ko te whakatau whāiti e tautokona ana e ēnei pepa ko tēnei: he mahi ka taea te tukurua tō te kikorangi metilīni ki a B. henselae JK53 kāore e tipu ana i waho i te rauropi ora, tae atu ki ngā huinga rongoā e rua i te taiwhanga, ā, nō te rangahau o 2020 ngā hua kaha rawa mō ngā huinga me ngā pūtau nō te kiriata koiora. Ko ngā mea katoa atu, tae atu ki te whai tikanga o taua mahi mō te bartonellosis o te tangata, kāore anō kia whakamātauria.