Abstract | Bakterije roda Enterococcus poznati su uzorčnici infekcija mokraćnog sustava. Vrlo su otponi na razne faktore iz okoline što je glavni razlog njihova opstanka u nepovoljnim okruženjima. Otporni su na brojne antibiotike zbog nekoliko čimbenika virulencije, od kojih je najvažnija sposobnost stvaranja biofilma. Najčešći uzročnici intrahospitalnih infekcija, E. faecium i E. faecalis, smatraju se sekundarnim uropatogenima, a najčešće izazivaju komplicirane infekcije i infekcije mokraćnog sustava stečenih za vrijeme bolničke skrbi. U prisutnosti urinarnog katetera bitan je čimbenik stvaranja biofilma. Mogući su uzročnici infekcija urinarnog trakta, septikemije, abdominalnih infekcija, endokarditisa i infekcija povezanih s intravaskularnim kateterima.
Zbog prirodne otpornosti enterokoka na antibiotike, potrebno je istražiti druge načine liječenja urinarnih infekcija, odnosno vratiti se prirodnom načinu liječenja infekcija mokraćnog sustava. Biljni pripravci obične planike, zimzelene medvjetke te uvin čaja sadrže prirodne tvari poput arbutina i hidrokinona koji pridonose uklanjanju ili smanjenju simptoma urinarnih infekcija. Osim prirodnih tvari, u ovom se radu ispituje i nitroksolin, učinkoviti uroseptik čije se antibakterijsko djelovanje te inhibicija stvaranja biofilma temelji na svojstvima keliranja.
Cilj je ovog istraživanja ispitivanje interakcije hidrokinona i nitroksolina na adheziju uropatogenih izolata enterokoka u in vitro uvjetima metodom šahovnice. Najprije se određuje minimalna inhibitorna koncentracija (MIK) kako bi se odredila vrsta interakcije ispitivanih tvari, a nakon određivanja adhezije ispitat će se i svojstvo anti- adhezije. Najjača antimikrobna aktivnost pokazala se na vrijednostima gdje je MIK za Nitroxolin pri 8 µg/mL, dok je za hidrokinon 1,56 µg/mL. Kombinacija hidrokinona izoliranog iz biljnih pripravaka sa antibiotikom Nitroxolinom pokazuje potencijal primjene u liječenju urinarnih bakterijskih infekcija protiv bakterijskih sojeva E. Faecalis. |
Abstract (english) | Bacteria of the genus Enterococcus are well-known pathogens of urinary tract infections. They are very resistant to various environmental factors, which is the main reason for their survival in unfavorable environments. They are resistant to numerous antibiotics due to several virulence factors, the most important of which is the ability to form biofilms. The most common causes of intrahospital infections, E. faecium and E. faecalis, are considered secondary uropathogens, and most often cause complicated infections and urinary tract infections acquired during hospital care. In the presence of a urinary catheter, it is an important factor in the formation of biofilm. Possible causes are urinary tract infections, septicemia, abdominal infections, and infections associated with intravascular catheters.
Due to the natural resistance of enterococci to antibiotics, it is necessary to investigate other ways of treating urinary infections, that is, to return to the natural way of treating urinary tract infections. Herbal preparations of common plantain, evergreen bearberry, and uvin tea contain natural substances such as arbutin and hydroquinone, which contribute to the elimination or reduction of symptoms of urinary infections. In the alkaline medium of the gastrointestinal tract, E. ramulus, E. casseliflavus, B. distasonis and B. adolescentis metabolize arbutin to hydroquinone. The entire process of bioactivation takes place on the intestinal villi with the help of the β-glucosidase enzyme and intestinal bacteria. The stronger antimicrobial and antioxidant action of hydroquinone contributes to the treatment of urinary infections. Urinary tract bacteria can also create hydroquinone from arbutin. In addition to natural substances, this work also examines nitroxoline, an effective uroseptic whose antibacterial action and inhibition of biofilm formation is based on chelating properties.
The aim of this research is to examine the interaction of hydroquinone and Nitroxolin on the adhesion of uropathogenic isolates of enterococci in in vitro conditions using the Checkerboard assay method. First, the minimum inhibitory concentration (MIC) is determined in order to determine the type of interaction of the tested substances, and after determining the adhesion, the anti-adhesion property will also be tested. The strongest antimicrobial activity was shown at values where the MIC for Nitroxolin is 8 µg/mL, while for hydroquinone it is 1.56 µg/mL. The combination of hydroquinone isolated from herbal preparations with the antibiotic Nitroxolin shows the potential of application in the treatment of urinary intrahospital bacterial infections against bacterial strains of E. faecalis. |