I-methylene blue ne-Bartonella: okutholwe elabhorethri nemingcele yobufakazi basemtholampilo

Isitsha sokukhulisa amagciwane nesiguli kusebenzisa igama elifanayo, ukutheleleka, kodwa leli gama alisho into efanayo kuzo zombili. Esitsheni, ukutheleleka kuyisibalo samakoloni ku-agar. Esigulini, kungamagciwane angaphakathi kwamaseli nasemithanjeni, imithi ehamba egazini nasezicutshini, kanye namasosha omzimba enza ingxenye yomsebenzi. Uma kudidaniswa lokhu okubili, inani elimangalisayo laselabhorethri liqala ukubukeka njengendlela yokwelapha. Uma kuhlukaniswa, lona lelo nani liba yilokho eliyikho: isizathu sokwenza ucwaningo olulandelayo.

Lokho kuhlukanisa kuyinhloso yonke yalokhu kubuyekezwa kwe-methylene blue ne-Bartonella. Izifundo ezimbili zaselabhorethri ezenziwe iqembu elilodwa labacwaningi zahlola i-methylene blue ku-Bartonella henselae ezimweni lapho ingakhuli khona. Zombili zabika ukusebenza okunamandla ezitsheni zengilazi nezepulasitiki. Asikho esayihlola kumuntu.

Kungani abacwaningi behlola isigaba sokungakhuli

Ukuhlolwa okuningi kwemithi elwa namagciwane kusebenzisa amaseli akhulayo. Leyo ndlela iphuthelwa isimo esinzima kakhulu: amaseli aseyekile ukuhlukana futhi abekezelela imithi ebulala amanye amaseli ohlobo olufanayo asakhulayo.

I-Bartonella ingahlala emzimbeni, kuhlanganise nangaphakathi kwamaseli abomvu egazi namaseli olwelwesi lwangaphakathi lwemithambo. Ngakho iqembu labuza ukuthi yimiphi imithi egunyaziwe engabulala i-B. henselae ngemva kokuba isingene esigabeni sokungakhuli. I-MIC ephansi kumaseli akhulayo ayizange ibikezele ukubulawa kwamaseli asesigabeni sokungakhuli. I-rifampin yayine-MIC ephansi kakhulu kodwa yayingawabulali kahle amaseli angakhuli, kuyilapho izinhlanganisela zamakhemikhali ezinamanani e-MIC aphezulu ziwabulala kahle. Abafundi abafuna indlela ejwayelekile yokufunda iphepha elinjengaleli bazoyithola kumhlahlandlela wokufunda ucwaningo lwe-methylene blue.

Ukuhlola kokuqala: u-Li nozakwabo, 2019

Ukuhlolwa kwesigaba sokungakhuli kwango-2019 ku-Antibiotics kwasebenzisa uhlobo olulodwa, i-B. henselae JK53, olwakhuliswa endaweni yokukhulisa i-Schneider ene-10 percent yeseramu yombungu wenkomo, ku-37 C kanye ne-5 percent CO2. Amasiko amagciwane anosuku olulodwa ayenamaseli amaningi ahlakazekile ahlukanayo. Amasiko anezinsuku ezinhlanu, anamayunithi akha amakoloni acishe abe ngu-10 emandleni esi-8 nge-mL ngayinye, athathwa njengasesigabeni sokungakhuli futhi ayenamaqoqo abonakalayo.

Ukuhlola kwasebenzisa i-SYBR Green I ne-propidium iodide, kwalinganiswa kusetshenziswa izingxube zamaseli aphilayo nalawo abulawe nge-isopropanol. Njengoba i-methylene blue inombala ogqamile, izinto ezabonisa ukusebenza zaqinisekiswa ngesibonakhulu bese kuqinisekiswa ngokubala amakoloni ku-agar enegazi, okuyisilinganiso somphumela esiqinile kakhulu.

Emithini egunyaziwe engu-1,581 eyahlolwa ku-50 micromolar, i-methylene blue yashiya ukusinda okungu-16 percent ngokomshini ofunda amapuleti nokungu-25 percent ngokwesibonakhulu. I-daptomycin yathola u-21 percent, ama-azole amaningana athola u-22 kuya ku-27 percent, i-gentamicin u-32 percent, i-erythromycin u-66 percent, ne-ciprofloxacin u-74 percent. I-pyrvinium pamoate yabonakala inamandla kakhulu emshinini ofundayo kodwa ayikwazanga ukukalwa ngesibonakhulu ngenxa yokukhanya kwayo kwe-fluorescence.

Ku-B. henselae ekhulayo, i-MIC ye-methylene blue yayingu-0.08 kuya ku-0.16 micrograms per mL. Kumaseli angakhuli anezinsuku ezinhlanu, ku-5 micrograms per mL, isibalo samakoloni sehla kwaze kwangabe kusatholakala amakoloni ngemva kosuku olulodwa lokuchayeka. Lokhu kwafana ne-daptomycin ne-pyrvinium pamoate emazingeni okuhlushwa ayehloliwe. Ukuhlola okuhlukile kokubulawa kwamagciwane ngokuhamba kwesikhathi kwasebenzisa u-10 micrograms per mL. Lawo ngamazinga okuchayeka aselabhorethri, hhayi imithamo, futhi iphepha liwasho kanjalo. Inani elicashuniwe lezinga eliphakeme kuplazma yomuntu, eliseduze no-3.9 micrograms per mL, livela ephepheni njengolwazi lwesizinda kuphela. Ukubuka konke ngokumuncwa, ukusatshalaliswa nokukhishwa kwe-methylene blue emzimbeni kuchaza ukuthi kungani inani elikuplazma lingeke lithathwe njengenani elisezicutshini.

Iphepha lisho ngokucacile imingcele emibili. Kwakungekho imodeli ye-biofilm futhi kwakungekho ukuhlolwa kwezinhlanganisela ze-methylene blue. Amaqoqo ezinsuku ezinhlanu ayengamaqoqo esikweni lamagciwane eliwuketshezi asesigabeni sokungakhuli, hhayi ucwaningo lwe-biofilm oluqinisekisiwe. Ababhali bacele ucwaningo ngezilwane, ngezinhlanganisela, nge-biofilm, kanye nokuhlolwa kwezinye izinhlobo ze-Bartonella.

Izinhlanganisela namaseli athathwe ku-biofilm: u-Zheng nozakwabo, 2020

Ucwaningo olulandelayo lwango-2020 ku-BMC Microbiology lwagcina uhlobo olufanayo nendawo efanayo yokukhulisa kodwa lwasebenzisa amasiko esigabeni sokungakhuli anezinsuku eziyisithupha. Lwengeza izinto ezimbili ezazingekho ephepheni lokuqala: izinhlanganisela zemithi emibili kanye nemodeli yamaseli athathwe ku-biofilm.

Lapho kuhlolwa imithi ngayinye ezingeni elifanayo elingu-5 micrograms per mL amahora angu-24, i-methylene blue yashiya amayunithi akha amakoloni angu-3.2 ophindwe ngo-10 emandleni esi-4 nge-mL ngayinye, uma kuqhathaniswa neqembu lokulawula elalicishe libe ngu-2.8 ophindwe ngo-10 emandleni e-10. I-ciprofloxacin, i-gentamicin ne-nitrofurantoin zashiya amakoloni ambalwa kakhulu ngaleso sikhathi. Lokhu kuhlukile emiphumeleni yango-2019, lapho izinga elifanayo elishiwo lingashiyanga amakoloni atholakalayo ngemva kosuku olulodwa. Ubudala besiko, ukuminyana kwalo, nendlela elaphathwa ngayo kwakuhlukile. Ngakho ukubulawa kwamagciwane kwaphindeka ngokuthi kwenzeka, kodwa ubukhulu bako babungafani. Lolu shintsho phakathi kokuhlola okukodwa nokulandelayo lungesinye sezizathu zokuthi ukuhlola okujwayelekile kokuphepha nokusebenzisana kwemithi kuphathe amandla aselabhorethri njengento ehlukile emtheleleni wasemtholampilo.

Ukuhlolwa kwezinhlanganisela kuyingxenye ecashunwa kakhulu. Ingxenye ngayinye yagcinwa ku-5 micrograms per mL. Kokubili i-azithromycin ne-methylene blue kanye ne-rifampin ne-methylene blue akushiyanga amakoloni atholakalayo asesigabeni sokungakhuli emahoreni angu-24. Kwenzeka okufanayo ngezinhlanganisela zombili ze-ciprofloxacin, futhi yilezo ezine kuphela kwezingu-25 ezahlolwa ezakwenza lokhu. Akuzange kwenziwe ukuhlaziywa okusemthethweni kokuthi ukusebenza kwemithi ndawonye kudlula yini ukusebenza okulindelekile kwemithi ngayinye. Ngakho igama elifanele lithi inhlanganisela esebenzayo ngaphansi kwalezi zimo, hhayi ukusebenza ngokubambisana okuqinisekisiwe.

Ucwaningo lwe-biofilm lwahlola amaseli athathwe ku-biofilm esencane ephazanyisiwe, hhayi ukungena kwemithi ku-biofilm evuthiwe engakaphazanyiswa. Amasiko akhuliswa izinsuku ezinhlanu, ahlanjululwa afakwa emapuletini anemigodi ezinye izinsuku ezinhlanu, aqinisekiswa ngokufakwa umbala nge-crystal violet, abe esekhuhlwa ngaphambi kokuchayekwa emithini. Ku-5 micrograms per mL, i-methylene blue iyodwa yehlisa isibalo saba ngu-2.3 ophindwe ngo-10 emandleni esi-2 ngosuku lwe-6, okwakuphakathi kwemiphumela engcono kakhulu yemithi ngayinye, kodwa hhayi uziro. Zombili izinhlanganisela ze-methylene blue zafinyelela kuziro ngosuku lwe-6, njengoba kwenzeka nasezinhlanganisweni zombili ze-ciprofloxacin.

Ababhali baphawula imingcele efanayo naleyo umfundi oqaphelayo angayibona: i-biofilm esencane ekhuhlwe esikhundleni sendala engaphazanyisiwe; izinga elilodwa elilungele ukuhlola yonke imithi esikhundleni sokuhlola umuthi ngamunye ezingeni lawo eliphakeme elingafinyelelwa ngokoqobo; izinhlanganisela ezikhethiwe kuphela ezisekelwe ku-azithromycin noma ku-rifampin; uhlobo olulodwa; kungabikho zilwane; kungabikho ziguli. Kwaphakanyiswa ucwaningo olulandelayo lwemithi emithathu, kodwa aluzange lubikwe.

Ukuqhathaniswa kwezindlela izifundo ezaklanywa ngazo

Ithebula lifingqa iphuzu lalesi sihloko. Konke okungakwesokunxele sekholomu yokugcina kuwumsebenzi wamasiko amagciwane. Akukho kunoma yiliphi iphepha okungena kukholomu yokugcina.

I-Bartonella akuyona i-Borrelia

Womabili amaphepha akhuluma nge-Borrelia burgdorferi, igciwane eliyispirochete elibangela isifo se-Lyme, ngoba ukuhlola ngodayi kwavela emsebenzini wangaphambilini wesigaba sokungakhuli se-Borrelia kuleyo labhorethri. Kulowo msebenzi, i-methylene blue ne-daptomycin nazo zazibonise ukusebenza. Lowo mlando uwulwazi lwesizinda oluwusizo futhi uvame ukuba umthombo wamaphutha.

Akukho ukuhlola kunoma yiliphi iphepha le-Bartonella okuhlola i-Borrelia kanye ne-Bartonella eceleni komunye. Amagciwane ahlukile, izindawo zokuwakhulisa zihlukile, amazinga okuhlushwa ahlukile, futhi umthelela ocatshangwayo we-methylene blue olwelwesini lwe-Bartonella wachazwa njengokuqagela okudinga olunye ucwaningo. Imiphumela akufanele idluliselwe kwezinye izinhlobo, futhi alikho kulawa maphepha elisekela izimangalo ezibanzi ngezinambuzane eziphila ngokuncika kwezinye izinto eziphilayo. Ngenxa yalesi sizathu, ukuqhathaniswa kwamagciwane aphikelelayo e-Borrelia nawe-Bartonella kugcina imibhalo yocwaningo yalezi zinhlobo ezimbili ihlukene.

Kungani amasiko amagciwane engaphenduki uhlelo lokwelapha

Kuyaqondakala ukuthi abantu bafuna uhlelo lokusebenzisa i-methylene blue ku-Bartonella. Lawa maphepha ayisizathu sokuthi lelo binzana kufanele lithathwe njengophawu lokuxwayisa esikhundleni sohlu lokuthenga.

Okokuqala, u-5 micrograms per mL emgodini wepuleti akuwona umyalelo wokwelashwa. Lelo nani alinalo ulwazi lokumuncwa, ukusatshalaliswa, ukubophezela kumaprotheni, ukungena ngaphakathi kwamaseli, noma ukubekezelelwa ngumzimba. Ababhali balikhetha njengesilinganiso esilinganiselwe samazinga aphakeme emithi elwa namagciwane, base bethi ucwaningo oluzayo kufanele lusebenzise umuthi ngamunye ezingeni lawo elingafinyelelwa ngokoqobo.

Okwesibili, amakoloni anguziro asho ukuthi awekho amakoloni ngaphansi kwalezo zimo zokuwakhulisa epuletini, hhayi ukuthi izicubu azisenamagciwane. Amagciwane aphikelelayo, amagciwane angaphakathi kwamaseli, nemingcele yokuthatha amasampula konke akubhekwa yipuleti le-agar.

Okwesithathu, izinhlanganisela eziqeda amagciwane emgodini wepuleti zingase zingasebenzi noma zilimaze emzimbeni. I-azithromycin ne-methylene blue kanye ne-rifampin ne-methylene blue ziyizinhlanganisela zaselabhorethri emazingeni okuchayeka aselabhorethri. Ngaphandle kwedatha yokumuncwa nokusatshalaliswa kwemithi ezilwaneni kanye nedatha elawulwayo yabantu, akukho mthamo, akukho sikhathi sokusebenzisa, futhi asikho isilinganiso senzuzo uma iqhathaniswa nobungozi. Noma ubani ocabangela izindlela angazikhetha kufanele axoxe ngazo nochwepheshe wezokwelapha futhi afunde ukuthi kunini lapho ukusetshenziswa kwe-methylene blue kudinga ukuqondiswa kwezokwelapha, ngaphambi kokufinyelela noma yisiphi isiphetho ngedatha yezitsha.

Isiphetho esilinganiselwe esisekelwa yilawa maphepha yilesi: i-methylene blue inokusebenza okuphindekayo ku-B. henselae JK53 engakhuli ngaphandle komzimba, kuhlanganise nasezinhlanganisweni zemithi emibili zaselabhorethri. Imiphumela enamandla kakhulu yezinhlanganisela neyamaseli athathwe ku-biofilm ivela ocwaningweni lwango-2020. Konke okunye, kuhlanganise nokuthi lokho kusebenza kunokubaluleka yini ku-bartonellosis yabantu, akukahlolwa.