Ubururu bwa metilene na Bartonella: ibyavuye muri laboratwari n'imbibi z'ibimenyetso byo mu buvuzi

Igikoresho cy'umuco n'umurwayi bihurira ku ijambo, ubwandu, ariko ntibihurira ku cyo risobanura. Mu gikoresho, ubwandu ni umubare w'amatsinda ya bagiteri akura kuri agar. Mu murwayi, ni bagiteri ziri mu turemangingo no mu mitsi, imiti inyura mu maraso no mu ngingo z'umubiri, n'ubudahangarwa bukora igice cy'akazi. Iyo ibyo byombi byitiranyijwe, umubare utangaje wabonetse muri laboratwari utangira gusa n'uburyo bwo kuvura. Iyo bitandukanyijwe, uwo mubare ugumana icyo usobanura: impamvu yo gukora igerageza rikurikira.

Iryo tandukaniro ni ryo shingiro ryose ry'iri sesengura ry'ubururu bwa metilene na Bartonella. Ubushakashatsi bubiri bwo muri laboratwari, bwakozwe n'itsinda rimwe ry'abashakashatsi, bwapimye ubururu bwa metilene kuri Bartonella henselae iri mu mimerere yo kutiyongera. Bwombi bwagaragaje ko bwakoraga cyane mu bikoresho by'ibirahuri n'ibya pulasitiki. Nta na bumwe bwabupimye ku muntu.

Impamvu abashakashatsi bapima icyiciro cyo kutiyongera

Igerageza ryinshi ry'imiti yica bagiteri rikoresha uturemangingo turi kwiyongera. Iyo ngero ntigaragaza ikibazo gikomeye kurushaho: uturemangingo twahagaritse kwigabanyamo kandi twihanganira imiti yica utundi two mu bwoko bumwe turi kwiyongera.

Bartonella ishobora kuguma mu mubiri, harimo no mu nsoro zitukura z'amaraso no mu turemangingo dutwikiriye imbere mu mitsi y'amaraso. Ni yo mpamvu iryo tsinda ryibajije imiti yemewe ishobora kwica B. henselae imaze kwinjira mu cyiciro cyo kutiyongera. MIC nto ku turemangingo turi kwiyongera ntiyahanuraga ubushobozi bwo kwica uturemangingo turi mu cyiciro cyo kutiyongera. Rifampin yari ifite MIC nto cyane ariko ikica nabi uturemangingo tutiyongera, mu gihe ibinyabutabire byari bifite MIC nini byatwicaga neza. Abasomyi bashaka uburyo rusange bwo gusoma inyandiko nk'iyi babusanga mu mabwiriza yo gusoma ubushakashatsi ku bururu bwa metilene.

Isuzuma rya mbere: Li na bagenzi be, 2019

Isuzuma ryo mu 2019 ry'icyiciro cyo kutiyongera ryasohotse muri Antibiotics ryakoresheje ubwoko bumwe gusa, B. henselae JK53, bwakuze mu ntungamubiri za Schneider zirimo 10 percent bya serumu y'amaraso y'urusoro rw'inka, kuri 37 C hamwe na 5 percent bya CO2. Imico yari imaze umunsi umwe yari igizwe ahanini n'uturemangingo twatatanye turi kwigabanyamo. Imico yari imaze iminsi itanu, irimo hafi 10 ku mpagarike ya 8 y'uturemangingo dushobora kubyara amatsinda ya bagiteri kuri mL, yafashwe nk'iri mu cyiciro cyo kutiyongera kandi yarimo ibitsure bigaragara.

Ikizamini cyakoresheje SYBR Green I hamwe na propidium iodide, bipimwa hakoreshejwe imvange z'uturemangingo tuzima n'utwishwe na isopropanol. Kubera ko ubururu bwa metilene bufite ibara rikomeye, ibyagaragaye ko bikora byagenzuwe hakoreshejwe mikorosikopi, hanyuma hakabarwa amatsinda ya bagiteri kuri agar irimo amaraso, ari cyo gipimo cya nyuma gikomeye kurushaho.

Mu miti 1,581 yemewe yapimwe kuri 50 micromolar, ubururu bwa metilene bwasize 16 percent by'uturemangingo tukiri tuzima hakurikijwe igikoresho gisoma ibyapa by'igerageza, na 25 percent hakurikijwe mikorosikopi. Daptomycin yagize 21 percent, imiti myinshi yo mu itsinda rya azole yagize 22 kugeza kuri 27 percent, gentamicin 32 percent, erythromycin 66 percent, na ciprofloxacin 74 percent. Pyrvinium pamoate yagaragaraga nk'ikora kurushaho ku gikoresho gisoma ibyapa, ariko ntiyashoboraga gupimwa hakoreshejwe mikorosikopi kubera urumuri rwayo rwa fluorescence.

Kuri B. henselae iri kwiyongera, MIC y'ubururu bwa metilene yari 0.08 kugeza kuri 0.16 micrograms per mL. Ku turemangingo twari tumaze iminsi itanu tutiyongera, ubururu bwa metilene kuri 5 micrograms per mL bwatumye umubare w'amatsinda ya bagiteri ugabanuka kugeza aho nta tsinda ryashoboraga kuboneka nyuma y'umunsi umwe tubushyizwemo, kimwe na daptomycin na pyrvinium pamoate ku ngano byapimweho. Irindi gerageza ryakurikiranye iyicwa rya bagiteri uko igihe gihita ryakoresheje 10 micrograms per mL. Izo ni ingano zikoreshwa mu igerageza rya laboratwari, si ingano z'umuti zihabwa umuntu, kandi inyandiko ibivuga uko. Agaciro kavuzwe k'ingano ntarengwa mu gice cy'amazi cy'amaraso y'umuntu, kari hafi 3.9 micrograms per mL, kagaragara muri iyo nyandiko gusa nk'amakuru atanga imiterere rusange y'ikibazo. Incamake y'uko ubururu bwa metilene bwinjira, bukwirakwira kandi bugasohoka mu mubiri isobanura impamvu umubare wo mu gice cy'amazi cy'amaraso udashobora gufatwa nk'umubare wo mu ngingo z'umubiri.

Iyo nyandiko ivuga mu buryo bweruye imbibi ebyiri. Nta ngero ya biofilm yakoreshejwe, kandi nta mvange zirimo ubururu bwa metilene zapimwe. Ibitsure byari bimaze iminsi itanu byari amatsinda mu muco w'amazi uri mu cyiciro cyo kutiyongera, ntabwo byari igerageza rya biofilm ryemejwe ko rikwiriye. Abanditsi basabye ko hakorwa ubushakashatsi ku nyamaswa, ku mvange z'imiti, kuri biofilm, no ku yandi moko ya Bartonella.

Imvange n'uturemangingo twakuwe muri biofilm: Zheng na bagenzi be, 2020

Ubushakashatsi bwakurikiyeho bwo mu 2020 bwasohotse muri BMC Microbiology bwagumanye ubwoko bumwe n'intungamubiri zimwe, ariko bukoresha imico yari imaze iminsi itandatu mu cyiciro cyo kutiyongera, bwongeraho ibintu bibiri bitari mu nyandiko ya mbere: imvange z'imiti ibiri n'ingero y'uturemangingo twakuwe muri biofilm.

Ku miti yakoreshejwe umwe umwe, yose kuri 5 micrograms per mL mu gihe cy'amasaha 24, ubururu bwa metilene bwasize 3.2 gukuba 10 ku mpagarike ya 4 y'uturemangingo dushobora kubyara amatsinda ya bagiteri kuri mL, ugereranyije n'umuco wo kugereranya utashyizwemo umuti wari ufite hafi 2.8 gukuba 10 ku mpagarike ya 10. Ciprofloxacin, gentamicin na nitrofurantoin zasize amatsinda make kurushaho muri icyo gihe. Ibyo bitandukanye n'ibyavuye mu 2019, aho ingano imwe yavuzwe yatumye nta tsinda rishobora kuboneka nyuma y'umunsi umwe. Igihe imico yari imaze, ubucucike bwayo n'uko yakoreshejwe byari bitandukanye; bityo iyicwa rya bagiteri ryarongeye kugaragara, ariko ntiryari ku rugero rumwe. Iri hinduka hagati y'amagerageza ni imwe mu mpamvu isuzuma risanzwe ry'umutekano n'imikoranire y'imiti ritandukanya imbaraga zigaragaye muri laboratwari n'ingaruka zo mu buvuzi.

Isuzuma ry'imvange ni ryo gice kivugwa cyane. Buri muti wo mu mvange washyizwe kuri 5 micrograms per mL. Azithromycin ivanze n'ubururu bwa metilene, na rifampin ivanze n'ubururu bwa metilene, byombi byatumye nta matsinda ya bagiteri yo mu cyiciro cyo kutiyongera ashobora kuboneka nyuma y'amasaha 24. Imvange zombi zirimo ciprofloxacin na zo zabikoze, kandi izo mvange enye ni zo zonyine zabikoze mu mvange 25 zapimwe. Nta sesengura ryemewe ryakozwe ngo ryemeze ko imiti ikorana ikarushaho kongera imbaraga; bityo imvugo ikwiye ni imvange ikora muri iyo mimerere, si imikoranire yemejwe yongera imbaraga.

Igerageza rya biofilm ryapimye uturemangingo twakuwe muri biofilm ikiri nshya yari yamaze gusenywa, ntabwo ryapimye uko imiti yinjira muri biofilm ikuze kandi itarasenywa. Imico yakuze iminsi itanu, ivangwa n'amazi mu byapa birimo utwobo tw'igerageza kugira ngo igabanyirizwe ubucucike, ikomeza gukura indi minsi itanu, yemezwa hakoreshejwe irangi rya crystal violet, hanyuma iraharurwa mbere yo gushyirwamo imiti. Kuri 5 micrograms per mL, ubururu bwa metilene bwonyine bwagabanyije umubare ukagera kuri 2.3 gukuba 10 ku mpagarike ya 2 ku munsi wa 6, bukaba mu miti yakoreshejwe yonyine yakoze neza kurusha indi, ariko ntibwageze kuri zeru. Imvange zombi zirimo ubururu bwa metilene zageze kuri zeru ku munsi wa 6, kimwe n'imvange zombi zirimo ciprofloxacin.

Abanditsi bagaragaje imbibi n'umusomyi witonze yabona: biofilm nshya yaharuwe aho kuba biofilm imaze igihe kandi itarasenywa; ingano imwe yoroshye gukoresha ku miti yose aho gukoresha kuri buri muti ingano ntarengwa ishobora kugerwaho mu mibereho nyakuri; imvange zimwe gusa zatoranyijwe zishingiye kuri azithromycin cyangwa rifampin; ubwoko bumwe gusa; nta nyamaswa; nta barwayi. Ubushakashatsi bwakurikiraho ku mvange z'imiti itatu bwarasabwe, ariko nta bisubizo byabwo byatangajwe.

Kugereranya imiterere y'ubushakashatsi

Iyi mbonerahamwe ikubiyemo igitekerezo cy'ingenzi cy'iyi nyandiko mu buryo buhinnye. Ibiri ibumoso bw'inkingi ya nyuma byose ni ubushakashatsi ku mico. Nta kintu kiri muri izo nyandiko zombi kigera mu nkingi ya nyuma.

Bartonella si Borrelia

Inyandiko zombi zivuga Borrelia burgdorferi, bagiteri imeze nk'umwizingo itera indwara ya Lyme, kubera ko ikizamini gikoresha amarangi cyakomotse ku bushakashatsi bwabanje ku cyiciro cyo kutiyongera cya Borrelia muri laboratwari imwe, aho ubururu bwa metilene na daptomycin na byo byari byaragaragaje ko bikora. Ayo mateka ni amakuru y'ingirakamaro, ariko kandi ni inkomoko ikunze gutera kwibeshya.

Nta gerageza riri muri izo nyandiko zombi kuri Bartonella ripima Borrelia na Bartonella icyarimwe ngo ribigereranye. Ibinyabuzima biratandukanye, intungamubiri ziratandukanye, ingano z'imiti ziratandukanye, kandi ingaruka ubururu bwa metilene bushobora kugira ku gahu k'uturemangingo twa Bartonella zavuzwe nk'igitekerezo kigikeneye ubushakashatsi. Ibisubizo ntibigomba kwimurirwa ku yandi moko, kandi nta nyandiko n'imwe muri izo zombi ishyigikira ibivugwa muri rusange ku binyabuzima by'indiririzi. Kugereranya uturemangingo twa Borrelia na Bartonella dukomeza kubaho nyuma yo guhura n'imiti bitandukanya ubushakashatsi kuri ibyo binyabuzima byombi kubera iyo mpamvu.

Impamvu imico idahinduka amabwiriza yo kuvura

Birumvikana ko abantu bashakisha amabwiriza yo gukoresha ubururu bwa metilene kuri Bartonella. Izi nyandiko ni zo mpamvu iyo mvugo ikwiye gufatwa nk'ikimenyetso cyo kwitonda aho kuba urutonde rw'ibyo kugura.

Icya mbere, 5 micrograms per mL mu kobo k'igerageza si amabwiriza y'umuti wandikiwe umurwayi. Iyo ngano ntirimo amakuru ku kwinjira mu mubiri, gukwirakwira, kwifatanya na poroteyine, kwinjira imbere mu turemangingo, cyangwa uko umubiri uyihanganira. Abanditsi bayihisemo nk'impuzandengo igereranyije y'ingano ntarengwa z'imiti yica bagiteri, kandi bavuga ko ubushakashatsi buzaza bugomba gukoresha buri muti ku ngano yawo ishobora kugerwaho mu mibereho nyakuri.

Icya kabiri, amatsinda zeru asobanura ko nta matsinda yabonetse muri iyo mimerere yo kuyakuza, ntabwo bisobanura ko ingingo z'umubiri nta bagiteri zirimo. Uturemangingo dukomeza kubaho nyuma yo guhura n'imiti, bagiteri ziri imbere mu turemangingo, n'imbibi zo gufata ingero byose biri hanze y'icyapa cya agar.

Icya gatatu, imvange zikuraho bagiteri zose mu kobo k'igerageza zishobora kunanirwa cyangwa guteza ingaruka mbi mu mubiri. Azithromycin ivanze n'ubururu bwa metilene, na rifampin ivanze n'ubururu bwa metilene, ni imvange zo muri laboratwari ku ngano zikoreshwa muri laboratwari. Hatabayeho amakuru y'uko iyo miti yinjira, ikwirakwira kandi igasohoka mu mubiri w'inyamaswa, n'amakuru y'ubushakashatsi bugenzurwa ku bantu, nta ngano yo gutanga yemejwe, nta gihe cyo kuyikoresha cyemejwe, kandi nta gereranya ry'inyungu n'ingaruka rihari. Umuntu wese usuzuma amahitamo akwiye kubiganiraho n'umuganga kandi agasoma igihe gukoresha ubururu bwa metilene bisaba gukurikiranwa n'abaganga, mbere yo gufata umwanzuro uwo ari wo wose ashingiye ku makuru yavuye mu bikoresho by'umuco.

Umwanzuro ufite imbibi izi nyandiko zishyigikira ni uyu: ubururu bwa metilene bugaragaza imikorere ishobora kongera kuboneka mu magerageza kuri B. henselae JK53 itiyongera, hanze y'umubiri, harimo no mu mvange z'imiti ibiri zo muri laboratwari; ibisubizo bikomeye kurusha ibindi ku mvange no ku turemangingo twakuwe muri biofilm bikaba byaravuye mu bushakashatsi bwo mu 2020. Ibindi byose, harimo no kumenya niba iyo mikorere hari icyo imaze ku bwandu bwa Bartonella mu bantu, ntibirapimwa.