Methylene blue ndi Bartonella: zomwe zapezeka m’labotale ndi malire a umboni wa kafukufuku wa odwala

Mbale yokulitsira mabakiteriya ndi wodwala zingafotokozedwe ndi mawu amodzi akuti matenda, koma tanthauzo lake silofanana. M’mbale, matenda amawerengedwa ngati magulu a mabakiteriya omwe amamera pa agar. M’thupi la wodwala, pamakhala mabakiteriya mkati mwa maselo ndi mitsempha, mankhwala akuyenda m’magazi ndi m’minofu, komanso chitetezo cha m’thupi chikugwira mbali ina ya ntchitoyo. Mukasokoneza zinthu ziwirizi, chiwerengero chochititsa chidwi cha m’labotale chimayamba kuoneka ngati njira yochizira. Mukazisiyanitsa, chiwerengero chomwecho chimakhala chimene chilidi: chifukwa chochitira kuyesera kotsatira.

Kusiyanitsa kumeneku ndi cholinga chonse cha ndemanga iyi yokhudza methylene blue ndi Bartonella. Kafukufuku wa m’labotale awiri ochokera ku gulu limodzi la ofufuza anayesa methylene blue pa Bartonella henselae yomwe sinali kuchulukana. Onse awiri ananena kuti inali ndi mphamvu zambiri m’ziwiya za galasi ndi pulasitiki. Palibe amene anayesa munthu.

Chifukwa chake ofufuza amayesa gawo losachulukana

Mayesero ambiri a mankhwala opha mabakiteriya amagwiritsa ntchito maselo omwe akuchulukana. Njira imeneyo imaphonya vuto lovuta kwambiri: maselo omwe asiya kugawikana ndipo amapirira mankhwala omwe amapha maselo anzawo omwe akuchulukana.

Bartonella ingakhalebe m’thupi, kuphatikizapo mkati mwa maselo ofiira a magazi ndi maselo ophimba mkati mwa mitsempha. Choncho gululi linafunsa kuti ndi mankhwala ati ovomerezeka omwe angaphe B. henselae ikalowa m’gawo losachulukana. MIC yotsika pa maselo omwe akuchulukana sinalosere kuphedwa kwa maselo omwe sali kuchulukana. Rifampin inali ndi MIC yotsika kwambiri koma siinaphe bwino maselo osachulukana, pamene zinthu zokhala ndi MIC yapamwamba zinawapha bwino. Owerenga omwe akufuna njira yodziwira mmene angawerengere kafukufuku wamtunduwu adzaipeza m’kalozera wowerengera kafukufuku wa methylene blue.

Kuwunika koyamba: Li ndi anzake, 2019

Kuwunika kwa 2019 kwa gawo losachulukana mu Antibiotics kunagwiritsa ntchito mtundu umodzi, B. henselae JK53, wokulitsidwa mu chakudya cha Schneider chokhala ndi 10 percent ya seramu yochokera m’magazi a mwana wa ng’ombe asanabadwe, pa 37 C ndi 5 percent CO2. Zokulitsidwa kwa tsiku limodzi zinali makamaka maselo omwazikana omwe anali kugawikana. Zokulitsidwa kwa masiku asanu, zokhala ndi pafupifupi 10 yokwezedwa ku mphamvu ya 8 ya mayunitsi opanga magulu a mabakiteriya pa mL, zinatengedwa ngati zili m’gawo losachulukana ndipo zinali ndi magulu ophatikizana ooneka.

Njira yoyezera inagwiritsa ntchito SYBR Green I ndi propidium iodide, ndipo inakonzedwa pogwiritsa ntchito zosakaniza za maselo amoyo ndi maselo ophedwa ndi isopropanol. Popeza methylene blue ili ndi mtundu wamphamvu, zotsatira zomwe zinasonyeza kuti inagwira ntchito zinatsimikiziridwa ndi maikulosikopu kenako ndi kuwerengera magulu a mabakiteriya pa agar yokhala ndi magazi, yomwe inali njira yokhwima kwambiri yotsimikizira zotsatira.

Pa mankhwala 1,581 ovomerezeka omwe anayesedwa pa 50 micromolar, methylene blue inasiya 16 percent ya maselo amoyo poyezedwa ndi chipangizo chowerengera m’mbale, ndi 25 percent poyang’aniridwa ndi maikulosikopu. Daptomycin inasiya 21 percent, mankhwala angapo a gulu la azole anasiya 22 mpaka 27 percent, gentamicin 32 percent, erythromycin 66 percent, ndipo ciprofloxacin 74 percent. Pyrvinium pamoate inaoneka yamphamvu kwambiri pa chipangizo chowerengera, koma sinathe kuwerengedwa ndi maikulosikopu chifukwa cha kuwala kwake kwa fluorescence.

Pa B. henselae yomwe ikuchulukana, MIC ya methylene blue inali 0.08 mpaka 0.16 micrograms per mL. Pa maselo omwe anali m’gawo losachulukana kwa masiku asanu, pogwiritsa ntchito 5 micrograms per mL, magulu a mabakiteriya anachepa mpaka kusapezeka pambuyo pa tsiku limodzi la kuwakhudza ndi mankhwalawo. Izi zinafanana ndi daptomycin ndi pyrvinium pamoate pa milingo yomwe inayesedwa. Kuyesera kwina koyezera kupha mabakiteriya pakapita nthawi kunagwiritsa ntchito 10 micrograms per mL. Iyi ndi milingo yomwe maselo anakumana nayo m’labotale, osati mlingo wopatsa munthu, ndipo nkhani ya kafukufukuyo imafotokoza choncho. Mlingo wapamwamba wa m’madzi a m’magazi a munthu, pafupifupi 3.9 micrograms per mL, womwe watchulidwa m’nkhaniyo, uli mmenemo monga chidziwitso cha kumbuyo chokha. Ndemanga ya mmene methylene blue imayendera ndi kusinthidwa m’thupi imafotokoza chifukwa chake chiwerengero cha m’madzi a m’magazi sichiyenera kutengedwa ngati chiwerengero cha m’minofu.

Nkhani ya kafukufukuyo imafotokoza momveka bwino malire awiri. Panalibe chitsanzo cha biofilm ndipo panalibe kuyesa methylene blue yophatikizidwa ndi mankhwala ena. Magulu ophatikizana a masiku asanu anali maselo osonkhana m’chakudya chamadzimadzi m’gawo losachulukana, osati kuyesera kwa biofilm kotsimikiziridwa. Olembawo anapempha kuti pakhale kafukufuku wa nyama, wa mankhwala ophatikizidwa, wa biofilm, komanso mayesero pa mitundu ina ya Bartonella.

Mankhwala ophatikizidwa ndi maselo ochokera mu biofilm: Zheng ndi anzake, 2020

Kafukufuku wotsatira wa 2020 mu BMC Microbiology unagwiritsa ntchito mtundu ndi chakudya chomwecho, koma unasamukira ku zokulitsidwa kwa masiku asanu ndi limodzi zomwe zinali m’gawo losachulukana. Unawonjezeranso zinthu ziwiri zomwe sizinali mu kafukufuku woyamba: mankhwala awiri ophatikizidwa ndi chitsanzo cha maselo ochokera mu biofilm.

Pa mankhwala amodzi omwe anayesedwa onse pa 5 micrograms per mL kwa maola 24, methylene blue inasiya 3.2 kuchulukitsa 10 yokwezedwa ku mphamvu ya 4 ya mayunitsi opanga magulu a mabakiteriya pa mL, poyerekeza ndi chitsanzo chosapatsidwa mankhwala chomwe chinali pafupifupi 2.8 kuchulukitsa 10 yokwezedwa ku mphamvu ya 10. Ciprofloxacin, gentamicin, ndi nitrofurantoin zinasiya magulu ocheperapo panthawi yomweyo. Izi zikusiyana ndi zotsatira za 2019, pamene mlingo womwewo sunasiye magulu opezeka pambuyo pa tsiku limodzi. Zaka za zokulitsidwazo, kuchuluka kwa maselo, ndi mmene anagwiritsidwira ntchito zinali zosiyana, choncho kupha mabakiteriya kunabwerezedwa koma kuchuluka kwa omwe anaphedwa sikunafanane. Kusiyana kumeneku pakati pa mayesero ndi chifukwa chimodzi chomwe kuwunika kwanthawi zonse kwa chitetezo ndi kugwirizana kwa mankhwala kumasiyanitsa mphamvu ya m’labotale ndi zotsatira zake pa odwala.

Kuwunika kwa mankhwala ophatikizidwa ndi mbali yomwe imatchulidwa kwambiri. Mankhwala onse ophatikizidwawo anaikidwa pa 5 micrograms per mL. Azithromycin yophatikizidwa ndi methylene blue komanso rifampin yophatikizidwa ndi methylene blue sizinasiye magulu opezeka a mabakiteriya osachulukana pa maola 24. Momwemonso, zophatikiza ziwiri zomwe zinali ndi ciprofloxacin sizinasiye magulu opezeka. Pa zophatikiza 25 zomwe zinayesedwa, ndi zinayi zokhazi zomwe zinachita zimenezi. Panalibe kusanthula mwadongosolo kuti mankhwalawo amalimbikitsana, choncho mawu oyenera ndi akuti mankhwala ophatikizidwa omwe anagwira ntchito pansi pa mikhalidwe imeneyi, osati kulimbikitsana kotsimikiziridwa.

Kuyesera kwa biofilm kunayesa maselo otengedwa mu biofilm yatsopano yomwe inasokonezedwa, osati kulowa kwa mankhwala mu biofilm yakale yomwe inali yosawonongeka. Mabakiteriya anakulitsidwa kwa masiku asanu, anachepetsedwa kuchuluka n’kuikidwa m’mbale zokhala ndi mabowo kwa masiku enanso asanu, ndipo biofilm inatsimikiziridwa ndi utoto wa crystal violet. Kenako inakwangulidwa musanayikidwe mankhwala. Pa 5 micrograms per mL, methylene blue yokha inachepetsa kuchulukako kufika pa 2.3 kuchulukitsa 10 yokwezedwa ku mphamvu ya 2 pofika tsiku 6. Inali imodzi mwa mankhwala amodzi omwe anagwira ntchito bwino kwambiri, koma sinachepetse kufika pa ziro. Zophatikiza zonse ziwiri za methylene blue zinafika pa ziro pofika tsiku 6, monganso zophatikiza zonse ziwiri za ciprofloxacin.

Olembawo anatchula malire omwe wowerenga mosamala angaonenso: biofilm yatsopano yokwangulidwa m'malo mwa yakale yosawonongeka, mlingo umodzi wosankhidwa kuti ukhale wosavuta pa mankhwala onse m'malo mwa mlingo wapamwamba womwe ungakwaniritsidwe pa mankhwala aliwonse, zophatikiza zosankhidwa zokha zomwe zinali ndi azithromycin kapena rifampin, mtundu umodzi, palibe nyama, komanso palibe odwala. Kafukufuku wam’tsogolo wa mankhwala atatu ophatikizidwa anaperekedwa ngati lingaliro, osati ngati zotsatira zomwe zinali zitapezeka kale.

Kuyerekezera mmene kafukufuku anakonzedwera

Tebuloli likufotokoza mwachidule mfundo ya nkhaniyi. Chilichonse kumanzere kwa ndime yomaliza ndi ntchito yokulitsa mabakiteriya m’labotale. Palibe chilichonse m’nkhani zonse ziwirizi chomwe chili m’ndime yomalizayo.

Bartonella si Borrelia

Nkhani zonse ziwiri zimatchula Borrelia burgdorferi, bakiteriya wooneka ngati ulusi wopindapinda amene amayambitsa matenda a Lyme. Zimatero chifukwa njira yoyezera pogwiritsa ntchito utoto inachokera ku kafukufuku wakale wa Borrelia m’gawo losachulukana m’labotale yomweyo, momwe methylene blue ndi daptomycin zinapezekanso kuti zinagwira ntchito. Mbiri imeneyi imathandiza kumvetsa nkhaniyi, koma imayambitsanso zolakwika zambiri.

Palibe kuyesera m’nkhani iliyonse ya Bartonella komwe kumayesa Borrelia limodzi ndi Bartonella kuti ziyerekezedwe. Tizilomboti ndi tosiyana, chakudya chokulitsira ndi chosiyana, milingo ndi yosiyana, ndipo lingaliro lakuti methylene blue imakhudza nembanemba ya Bartonella linatchulidwa ngati lingaliro losatsimikiziridwa lofunika kafukufuku wina. Zotsatira siziyenera kusamutsidwa kuchokera ku mtundu umodzi kupita ku wina, ndipo palibe nkhani iliyonse yomwe imathandiza kunena zinthu zambiri zokhudza tizilombo todalira zamoyo zina. Kuyerekezera maselo a Borrelia ndi Bartonella omwe amatha kupirira mankhwala kumasiyanitsa kafukufuku wa tizilombo tiwiriti pa chifukwa chimenechi.

Chifukwa chake zokulitsidwa m’labotale sizingasandulike ndondomeko yochizira

N’zomveka kuti anthu akufufuza ndondomeko yochizira Bartonella pogwiritsa ntchito methylene blue. Kafukufuku ameneyu ndi chifukwa chake mawu amenewo ayenera kutengedwa ngati chizindikiro chochenjeza m'malo mwa mndandanda wa zinthu zogula.

Choyamba, 5 micrograms per mL m’bowo la mbale yoyesera si malangizo opatsa wodwala mankhwala. Sizifotokoza mmene mankhwalawo amalowera m’thupi, kufalikira, kumangirirana ndi mapuloteni, kulowa mkati mwa maselo, kapena kupiririka ndi thupi. Olembawo anasankha mlingowu ngati chiwerengero chapakati choyerekeza cha milingo yapamwamba ya mankhwala opha mabakiteriya, ndipo ananena kuti kafukufuku wam’tsogolo ayenera kugwiritsa ntchito mlingo womwe ungakwaniritsidwe wa mankhwala aliwonse.

Chachiwiri, magulu a mabakiteriya akakhala ziro zimangotanthauza kuti palibe magulu omwe amera pansi pa mikhalidwe imeneyo ya kuika pa agar, osati kuti minofu ilibe mabakiteriya. Maselo opirira mankhwala, mabakiteriya omwe ali mkati mwa maselo, ndi malire a kutenga zitsanzo zonse sizifotokozedwa ndi mbale ya agar.

Chachitatu, mankhwala ophatikizidwa omwe amachotsa mabakiteriya onse m’bowo la mbale angalephere kapena kuvulaza m’thupi. Azithromycin yophatikizidwa ndi methylene blue ndi rifampin yophatikizidwa ndi methylene blue ndi zophatikiza za m’labotale pa milingo ya m’labotale. Popanda kafukufuku wa mmene mankhwala amayendera ndi kusinthidwa m’thupi la nyama komanso deta ya mayesero oyendetsedwa bwino pa anthu, palibe mlingo wopatsa munthu, nthawi yogwiritsira ntchito, kapena muyeso wa phindu poyerekeza ndi chiopsezo. Aliyense amene akuganizira njira zosiyanasiyana ayenera kukambirana ndi katswiri wa zachipatala komanso kuwerenga za nthawi yomwe kugwiritsa ntchito methylene blue kumafunika kuyang’aniridwa ndi achipatala, asanafike pa mfundo iliyonse kuchokera ku deta ya m’mbale.

Mfundo yokhayo yokhala ndi malire yomwe kafukufuku ameneyu amathandiza ndi iyi: methylene blue imagwira ntchito mobwerezedwanso pa B. henselae JK53 yosachulukana kunja kwa thupi, kuphatikizapo m’mayesero a m’labotale ophatikiza mankhwala awiri. Zotsatira zamphamvu kwambiri za mankhwala ophatikizidwa ndi maselo ochokera mu biofilm zinachokera ku kafukufuku wa 2020. Zina zonse, kuphatikizapo ngati kugwira ntchito kumeneko kuli kofunika pa bartonellosis ya anthu, sizinayesedwebe.