Anaerobic bacteria and intrahepatic stones: detections of Clostridium sp. and Bacteroides fragilis

Ｉｎｔｒａｈｅｐａｔｉｃｓｔｏｎｅｓｏｒｈｅｐａｔｏｌｉｔｈｉａｓｉｓａｒｅｓｔｏｎｅｓｏｃｃｕｒｒｉｎｇｗｉｔｈｉｎｔｈｅｉｎｔｒａｈｅｐａｔｉｃｂｉｌｅｄｕｃｔｓａｂｏｖｅｔｈｅｂｉｆｕｒｃａｔｉｏｎｏｆｔｈｅｒｉｇｈｔａｎｄｌｅｆｔｈｅｐａｔｉｃｄｕｃｔｓ 1,2 　Ｔｈｅｆｏｒｍａｔｉｏｎｏｆｂｒｏｗｎｐｉｇｍｅｎｔｓｔｏｎｅｓｉｎｖｏｌｖｅｓｄｅｃｏｎｊｕｇａｔｉｏｎｏｆｃｏｎｊｕｇａｔｅｄｂｉｌｉｒｕｂｉｎａｎｄｐｒｅｃｉｐｉｔａｔｉｏｎｏｆｆｒｅｅｂｉｌｉｒｕｂｉｎｗｉｔｈｃａｌｃｉｕ…     

30例大肠癌粘膜厌氧菌分析

经纤维结肠镜取３０例大肠癌的癌灶粘膜行定性、定量厌氧菌培养。菌群分析显示类杆菌属和梭菌属检出率分别达７３．３％和８３．３％，其中脆弱类杆菌在类杆菌属中占５１．４％；产气荚膜梭菌在梭菌属中占３８．６％。较高的检出率表明这两种厌氧菌与大肠粘膜的关系较为密切，对大肠癌的致癌过程可能产生一定的影响。     

肠道菌群结构改变与妊娠期糖尿病的关系研究

背景　妊娠期糖尿病（GDM）在近年妊娠期疾病中所占比例日益增加,其高发病率为我国母婴健康和公共卫生事业带来了巨大危害。目前研究提示人类肠道菌群的结构改变与相关代谢性疾病密切相关,越来越多的证据提示肠道菌群结构和相对比例的改变可能是糖尿病、肥胖等疾病的高危因素。目的　探究肠道球形梭菌和多形拟杆菌水平改变与GDM发生之间的关系。方法　本研究为巢式病例对照研究。选取2018-03-01至2019-03-30于新疆医科大学第一附属医院就诊的1 034例妊娠妇女,在其首次就诊于本院并确认妊娠时纳入观察队列,之后每4周返回医院行随访并完成产检,当确诊GDM时为最后一次随访。将确诊为GDM的受试者作为病例组,依据病例组受试者年龄、孕周、时间等相关信息进行1∶1匹配对照组受试者。比较对照组和病例组一般资料,入组时、妊娠20周、诊断GDM时球形梭菌、多 形拟杆菌水平。分析病例组不同时间点球形梭菌及多形拟杆菌与空腹血糖间的相关性。结果　1 034例观察队列中,28例受试者中途退出,5例受试者失访,故共计1 001例受试者完成随访,其中90例（8.99％）被诊断为GDM,即病例组。对照组与病例组年龄、受教育程度、糖尿病家族史发生率、腹围、多囊卵巢综合征发生率、高血压发生率比较,差异无统计学意义（P>0.05）。两组入组时球形梭菌、多形拟杆菌水平比较,差异无统计学意义（P>0.05）;病例组妊娠20周、诊断GDM时球形梭菌、多形拟杆菌水平高于对照组（P<0.05）。病例组妊娠20周、诊断GDM时球形梭菌、多形拟杆菌水平高于入组时（P<0.05）;对照组在病例组诊断GDM对应的时间点的多形拟杆菌水平高于入组时和妊娠20周时（P<0.05）。病例组诊断GDM时球形梭菌、多形拟杆菌与诊断GDM时空腹血糖呈正相关（r值分别为0.435、0.342,P值分别为<0.001、0.001）。结论　球形梭菌与多形拟杆菌的结构改变可能是导致GDM发病的原因之一。     

54例女童阴道厌氧菌分析

本文报告54名3～5(11/12)岁正常女童阴道厌氧菌培养结果。54例培养均阳性。共分离出153株32种厌氧菌,分离率从高至低依次为拟杆菌(96.3％)、消化链球菌(59.3％)、消化链球菌(14.8)、小韦荣球菌(13％)、放线菌{9·3％)和梭杆菌(5·6％)。最多见的菌种是双路拟杆菌、锐利拟杆菌、脆弱拟杆菌、狄氏拟杆菌和真口腔拟杆菌,其次是黑色消化球菌不解糖消化链球菌、厌氧消化链球菌、小韦荣球菌和产生消化链球菌。提示这些厌氧菌是女童阴道正常菌群。厌氧菌在女童外阴阴道感染的病原学意义尚有待研究。     

冠心病患者肠道菌群的特征

  目的   分析云南冠心病人群肠道菌群结构和多样性特征，探究不同类型冠心病人群之间，及与无冠脉病变人群肠道菌群结构差异。   方法   共采集急性心肌梗死患者67名（A组）、不稳定型心绞痛患者91名（B组）、稳定型心绞痛患者47名（C组）、冠脉无异常者64名（D组）、冠状动脉粥样硬化患者37名（E组），提取粪便DNA，根据细菌16srRNA v3-v4序列设计特异性引物，进行PCR扩增，使用Illumina HiSeq PE250进行测序，测序结果进行物种组成统计，Alpha多样性，组间差异分析，最终得到样品物种信息。   结果   各组间肠道菌群结构存在差异（P < 0.05）。与D组相比，A组的梭杆菌增多，B组的拟杆菌减少，变形杆菌、放线菌增多，C组的拟杆菌减少，变形杆菌、梭杆菌增多，E组变形杆菌增多（ P < 0.05）。Alpha多样性发现显示急性心肌梗死患者组的Alpha多样性高于其他组（ P < 0.05）。   结论   冠状动脉粥样硬化患者、稳定型心绞痛患者、不稳定型心绞痛患者、急性心肌梗死患者与对照组肠道菌群的结构、多样性不同，他们存在不同程度的肠道菌群失调。      

The use of a new glycopeptide antibiotic, teicoplanin, in the treatment of bacterial endocarditis

Teicoplanin, a new glycopeptide antibiotic, has been used to treat twelve patients with bacterial endocarditis due to Gram-positive organisms. Teicoplanin has activity against Gram-positive bacteria similar to vancomycin but therapeutic levels are maintained by a single daily dose, given as an intravenous bolus. Of six patients with native valve infections, two cases, due to viridans streptococci, were successfully treated with teicoplanin alone and two others, caused by Streptococcus faecalis, were cured by combinations including teicoplanin. One of these patients sustained high tone hearing loss during treatment. The remaining two patients were drug addicts with endocarditis due to Staphylococcus aureus which recurred despite repeated multiple therapy. Of six prosthetic valve infections, antibiotic combinations including teicoplanin cured three cases, caused by streptococci. Infection persisted or treatment was curtailed in three cases of Staphylococcus epidermidis endocarditis. In this small open study, teicoplanin appeared as effective as vancomycin in the treatment of endocarditis but had the considerable advantage of ease of administration.     

两色金鸡菊醇提物对2型糖尿病小鼠肠道菌群的影响

【摘要】目的研究2型糖尿病动物模型与正常ICR小鼠肠道菌群的差异和两色金鸡菊醇提物对小鼠肠道菌群的影响,探讨两色金鸡菊醇提物,肠道菌群和2型糖尿病(T2DM)之间的可能联系。方法收集模型组（A）,两色金鸡菊醇提物高剂量组1.8g/kg（B）, 两色金鸡菊醇提物中剂量组1.2g/kg(C), 二甲双胍对照组0.2g/kg（D）,空白对照组(E)粪便样本,采用16S rDNA实时荧光定量PCR技术检测粪便样本中球形梭菌与多形拟杆菌的水平;运用Pearson分析方法,对目标菌属水平与各组小鼠的空腹血糖( FBG)做相关性分析。结果1.与正常组比较,模型组中球形梭菌与多形拟杆菌水平均增高(p=0.017,p=0.002)。2.两色金鸡菊醇提物高剂量组与模型组相比,球形梭菌与多形拟杆菌的水平下降,且有统计学差异（2周:p=0.027,p=0.006;4周：p=0.007,p=0.012）。3.球形梭菌水平、多形拟杆菌水平均与FBG水平呈正相关。结论两色金鸡菊醇提物对2型糖尿病小鼠肠道菌群存在着一定的影响且与其血糖水平存在相关性。     

Aortitis due to metastatic gas gangrene

Clostridium septicum bacteremia and its association with hematologic malignancy and colorectal cancer have been well recognized. Panwalker, in a recent review, discussed clostridial sepsis and other unusual infections associated with colorectal tumors, including streptococcal bovis and Bacteroides. He reports the coexistence of colorectal cancer and metastatic Clostridium septicum infections at multiple sites. We describe a case in which a patient with an occult cecal carcinoma develops Clostridium septicum sepsis and thoracic aortitis secondary to metastatic gas gangrene. This dramatic and unusual complication has not previously been documented. The necessity of colonic evaluation with Clostridium septicum bacteremia is discussed.     

Vancomycin and teicoplanin: something old, something new.

OBJECTIVE: To compare and contrast the pharmacology, activity and clinical efficacy of two glycopeptide antibiotics, vancomycin and teicoplanin. DATA SOURCES: English language literature search using MEDLINE, Index Medicus, relevant textbooks and product information literature. STUDY SELECTION: Over 200 publications were examined extending back to the period of initial Phase I trials with vancomycin. DATA EXTRACTION AND SYNTHESIS: Many publications covered similar ground and came to the same conclusions. In these instances one or two of the best pieces were chosen as cited reference material. Conflicting results and conclusions are discussed and an attempt is made to interpret the findings. CONCLUSION: Vancomycin and teicoplanin show differences in activity both in vitro and in vivo. Vancomycin is superior against coagulase-negative staphylococci and reliable dosage regimens are available. Teicoplanin, however, needs to be given in significantly larger doses than initially thought necessary to maximise clinical efficacy. Teicoplanin has a lower incidence of side effects but in clinical practice this advantage is small. Vancomycin remains the glycopeptide of choice for the treatment of infections due to Gram-positive bacteria.     

宏基因组测序技术在发热患者咽部微生物菌群研究中的应用

目的 通过宏基因组高通量测序分析,研究不同发热患者咽部微生物菌群多样性。方法 采用随机法选取2020年1—4月石家庄市五所医院发热门诊就诊21例发热患者作为实验组,选取同期10例健康人作为对照组,采集咽拭子样本并提取核酸,应用Illumina测序平台进行宏基因组测序并进行微生物菌群分析。结果 实验组共获得 1 716 802 816条优质序列,鉴定出4 079个物种,归属于97个门,951个属。实验组和对照组咽部微生物菌群分析显示,在门水平上,梭杆菌门和厚壁菌门在对照组中升高,拟杆菌门在实验组中升高;在纲水平上,梭杆菌纲和梭菌纲在对照组中升高,拟杆菌纲在实验组中升高;在目水平上,拟杆菌目在实验组中升高;在科水平上,瘤胃菌科在对照组中升高,拟杆菌科、理研菌科、阿克曼氏菌科、红细菌科和火色杆菌科在实验组中升高;在属水平上,拟普雷沃菌属、拟杆菌属、理研菌属、副拟杆菌属等在实验组中升高,瘤胃球菌属在对照组中升高;在种水平上,紫单胞菌科细菌（Porphyromonadaceae bacterium KA00676）、两个拟杆菌属（Bcteroidales bacterium Barb7, Bcteroidales SP. CAG:702）、五个普雷沃氏菌（CAG:617、CAG:755、CAG:732、CAG:924、CAG:1031）、卟啉单胞菌KLE1280、甲烷囊菌属的PtaU1.Bin060等在实验组中升高。实验组差异物种有消化链球菌、拟杆菌、科马加泰杆菌、明串珠菌、支原体、假棒状杆菌等。耐药基因主要为β-内酰胺酶类。结论 发热患者咽部有复杂的微生物菌群结构,本研究表明咽部菌群结构会对机体发热有显著影响。     

抗脆弱类杆菌和产气荚膜杆菌McAb池在外科感染快速诊断中的应用

目的 制备抗脆弱杆菌和抗产气荚膜杆菌单克隆抗体池,并用于快速诊断及时指导临床治疗。方法 采用间接免疫荧光抗体染色法（IFA）和免疫酶标抗体染色法（ELA）对我院1998～1999年191例外科感染患者的标本进行细菌学检测,并与常规培养法进行比较。结果 3种方法从191份标本中分别检出脆弱类杆菌53株（27.7%）和55株（28.8%）以及25株（13.1%）;检出产气荚膜杆菌12株（6.3%）和11株（5.8%)以及6株（3.1%）。IFA和ELA法2种厌氧菌检出率明显高于CM法。但IFA和ELA法之间检出率差异无显著性。结论 自制脆弱类杆菌和抗产气荚膜杆菌的McAb池,检测平时常见的脆弱类杆菌和战时常见的产气荚膜杆菌,敏感性高,简便,快速、便于推广。     

双歧杆菌对大鼠肠道菌群的影响

观察Wistar大鼠口服短双歧杆菌5周后,粪中双歧杆菌、乳酸杆菌、梭状芽胞杆菌和大肠杆菌的数量呈现增多,而拟杆菌和肠球菌的数量明显减少、分别由服前的7.11和8.09降到5.16和6.03Log 10~N CFU/g粪。体外试验中,短双歧杆菌分别同拟杆菌、乳酸杆菌和梭状芽胞杆菌共同培养时,结果与前述试验结果相同,而同肠球菌和大肠杆菌共同培养时,结果则相反。提示在食物中补充双歧杆菌,可调整宿主肠道菌群。     

类风湿关节炎合并肺间质疾病患者Treg/Th17免疫失衡与肠道菌群变化的关系

目的 探讨类风湿关节炎（RA）合并肺间质疾病（ILD）患者调节性T细胞（Treg细胞）/辅助性T细胞（Th17细胞）免疫失衡与肠道菌群变化的关系。方法 选取2021年6月-2022年6月于石家庄市人民医院收治的RA患者100例为研究对象,纳入RA组。根据临床症状、X射线及胸部HRCT检查评估结果,将RA组分为RA-ILD组39例和NO-ILD组61例。收集两组患者基线资料;检测Treg/Th17细胞及相关因子;对粪便DNA样本16S rRNA V3-V4区域进行生物信息学分析;使用Spearman相关性分析检验RA-ILD患者肠道菌群丰度与Treg/Th17相关性。结果 与NO-ILD组相比,RA-ILD组的Shannon指数、Observed_species指数及Chao1指数均明显较低,类杆菌属(Bacteroides)、嗜血杆菌属(Haemophilus)、梭状芽孢杆菌属(Acuformics-Prevot)、厚壁菌门(Firmicutes)、真杆菌属(Eubacterium)、乳杆菌属(Lactobacillus)、韦荣球菌属(Veilonella)相对丰度均明显较低,拟杆菌门(Bacteridetes)、变形菌门(Proteobactena)、戈登菌属(Ciordonaspp)、放线菌门(Actinobacteri)、普雷沃菌属(Prerotella)相对丰度均明显较高,Treg细胞比例及Treg/Th17明显较低,IL-23、IL-17水平及Th17细胞比例明显较高,差异均有统计学意义（〖WTBX〗P〖WTBZ〗<0.05）。Treg/Th17与类杆菌属、嗜血杆菌属、韦荣球菌属、真杆菌属、厚壁菌门、乳杆菌属的相对丰度呈明显正相关（均P<0.05）,与普雷沃菌属、变形菌门、梭状芽胞杆菌属、放线菌门、戈登菌属、拟杆菌门呈明显负相关（均P<0.05）。结论 RA合并ILD患者存在Treg/Th17细胞比例失衡,而肠道菌群失衡可能是其失衡的主要原因     

In vitro susceptibility testing of Aspergillus spp. against voriconazole, itraconazole, posaconazole, amphotericin B and caspofungin

Background During recent years, the incidence of serious infections caused by opportunistic fungi has increased dramatically due to alterations of the immune status of patients with hematological diseases, malignant tumors, transplantations and so forth. Unfortunately, the wide use of triazole antifungal agents to treat these infections has lead to the emergence of Aspergillus spp. resistant to triazoles. The present study was to assess the in vitro activities of five antifungal agents （voriconazole, itraconazole, posaconazole, amphotericin B and caspofungin） against different kinds of Aspergillus spp. that are commonly encountered in the clinical setting. Methods The agar-based Etest MIC method was employed. One hundred and seven strains of Aspergillus spp. （5 species） were collected and prepared according to Etest Technique Manuel. Etest MICs were determined with RPMI agar containing 2% glucose and were read after incubation for 48 hours at 35℃. MIC50, MIC90 and MIC range were acquired by Whonet 5.4 software. Results The MIC90 of caspofungin against A. fumigatus, A. flavus and A. nidulans was 0.094 μg/ml whereas the MIC90 against A. niger was 0.19μg/ml. For these four species, the MIC90 of caspofungin was the lowest among the five antifungal agents. For A. terrus, the MIC90 of posaconazole was the lowest. For A. fumigatus and A. flavus, the MIC90 in order of increasing was caspofungin, posaconazole, voriconazole, itraconazole, and amphotericin B. The MIC of amphotericin B against A. terrus was higher than 32 μg/ml in all 7 strains tested. Conclusions The in vitro antifungal susceptibility test shows the new drug caspofungin, which is a kind of echinocandins, has good activity against the five species of Aspergillus spp. and all the triazoles tested have better in vitro activity than traditional amphotericin B.     

非产毒艰难梭菌对艰难梭菌感染BALB/c小鼠的防治作用

目的观察非产毒艰难梭菌对艰难梭菌感染的防治效果。方法用艰难梭菌产毒株人工感染BALB/c小鼠,感染前后分别用非产毒艰难梭菌进行预防与治疗,以小鼠的死亡数、盲肠内容物上清液的细胞毒性和盲肠黏膜的病理变化为观察指标,判断非产毒艰难梭菌对艰难梭菌感染的防治效果。结果非产毒艰难梭菌不能预防艰难梭菌的感染,但在艰难梭菌感染后能明显降低盲肠黏膜的病理损伤。结论非产毒艰难梭菌对感染艰难梭菌的BALB/c小鼠有一定的治疗作用。     

慢性乙型肝炎以及肝硬化患者肠道微生物研究

目的：探讨慢性乙型肝炎以及肝硬化患者的肠道菌群变化及其与细胞因子、肝功能之间的关系。方法选取30例健康志愿者、50例肝炎后肝硬化患者以及50例慢性乙型肝炎患者,采用实时荧光定量 PCR 法检测粪便中九种肠道菌群含量,比较三组间肠道菌群变化;同时采用 ELISA 法检测慢性乙型肝炎患者血清中细胞因子如白介素-17A(IL-17)、白介素-1β( IL-1β)、白介素-6( IL-6)、干扰素-α( INF-α)、CXC 趋化因子(CXCL-13)的浓度,分析肠道菌群与细胞因子以及肝功能之间的关系。结果与健康对照组相比,慢性乙型肝炎以及肝硬化患者体内的双歧杆菌、乳酸杆菌、拟杆菌属以及瘤胃球菌属含量减少;肠杆菌科细菌、肠球菌、梭菌属、白色念珠菌以及普雷沃氏菌含量明显增加。慢性乙型肝炎患者体内的肠杆菌科细菌与凝血酶原时间(PT)呈正相关性,肠球菌与谷丙转氨酶(ALT)、谷草转氨酶(AST)呈正相关性;双歧杆菌与 AST、碱性磷酸酶(AKP)以及 HBV DNA水平呈负相关性,普雷沃氏菌属与 AST、AKP 以及 PT 呈负相关性,拟杆菌属与 AST 和 PT 呈负相关性,瘤胃球菌属与白蛋白(ALB)呈负相关性。另外,9种肠道菌群中只有肠球菌与 IL-17A 呈正相关性。结论慢性乙型肝炎以及肝硬化患者体内存在不同程度的肠道菌群失调,其中乙肝患者体内过度繁殖的肠球菌与 IL-17A 协同参与肝脏炎症反应过程,以致于肝功能受损呈恶性循环状态。     

The identification and antimicrobial susceptibility of anaerobic bacteria from pneumonic cattle lungs

One hundred and forty-four lungs obtained postmortem from cattle with pneumonia were cultured for anaerobic bacteria. Forty-five lungs yielded 73 anaerobic isolates belonging to 20 species. The number of isolations of anaerobes from acute fibrinous or suppurative bronchopneumonias (32.5%) was slightly lower than from similar chronic bronchopneumonias (36.5%). Anaerobes were not recovered from 15 lungs showing macroscopic changes not of bacterial origin, nor from 13 healthy lungs. The predominant genera isolated were Bacteroides, Peptococcus, Fusobacterium and Clostridium. The most common species were P. indolicus (15 isolates), B. asaccharolyticus (nine), F. necrophorum (six), C. perfringens (four) and B. fragilis (four). There was a significant correlation between the presence of Corynebacterium pyogenes (p less than 0.001) or Escherichia coli (p less than 0.01) and the presence of anaerobes in the lungs. The isolated anaerobic bacteria were generally susceptible to ampicillin, penicillin G, cefoxitin, cephalothin, clindamycin, chloramphenicol, erythromycin, tetracycline and metronidazole. The B. fragilis and C. perfringens isolates showed multiple antibiotic resistance, and five P. indolicus isolates were resistant to tetracycline.     

玻璃体腔注射替考拉宁对正常兔眼视网膜的影响

目的观察玻璃体腔注射不同剂量替考拉宁对正常兔眼视网膜的毒性作用。方法 24只健康日本大耳白兔,随机分为4组,每组6只,均以右眼为实验眼。A组:替考拉宁0.5 mg;B组:替考拉宁1.0 mg;C组:替考拉宁2.0 mg;D组(对照组):灭菌生理盐水,注射体积为0.1ml。注射后观察各实验眼眼前节及眼后节情况,注射后第14和第28 d分批处死动物,取眼球标本做组织病理切片,在光学显微镜下观察视网膜组织结构的变化。结果①注射后A组、B组和D组各实验眼眼前节均未见明显炎症反应,C组中2/6实验眼有轻度炎症表现。②注射后A组、B组和D组各实验眼眼后节均未见明显异常改变,C组实验眼眼后节有显著改变。③B组和C组的组织病理切片光镜检查出现不同程度的病理改变,并以C组引起的视网膜细胞损害最为严重。结论玻璃体腔注射替考拉宁0.5 mg不会产生视网膜毒性,可能是较为安全的眼内注射剂量。     

替考拉宁对耐甲氧西林金黄色葡萄球菌和敏感菌药敏实验的研究

目的 探讨耐甲氧西林金黄色葡萄球菌(MRSA )和敏感葡萄球菌(MSSA)临床分离株对替考拉宁药物的敏感性.方法 金黄色葡萄球菌临床分离株18株,采用PCR检测耐药 mecA基因,琼脂稀释法测定替考拉宁对金黄色葡萄球菌体外MIC值.结果 9/18株为MRSA,9/18株为MSSA对替考拉宁均为敏感.替考拉宁对MRSA和...     

炎症性肠病与艰难梭菌感染的相关性

目的:检测湖北省武汉市地区炎症性肠病(IBD)患者艰难梭菌感染率,探讨IBD与艰难梭菌感染的相关性.方法:纳入2010年9月至2011年12月在武汉大学中南医院确诊的56例IBD患者作为IBD组,包括36例溃疡性结肠炎(UC)和20例克罗恩病(CD),收集其粪便标本及临床资料,包括IBD诊断、疾病活动性、分型及病变累及部位等.纳入同时期体检的40例健康成年人作为对照组.采用EIA法检测研究对象粪便中艰难梭菌毒素A&B,分析IBD临床资料与艰难梭菌感染的相关性.结果:IBD组中共检出6例阳性(10.71％),对照组未检出阳性.UC患者艰难梭菌感染率低于CD患者(P＜0.05),处于疾病活动期的IBD患者艰难梭菌感染率显著高于缓解期患者(P＜0.01),初发型IBD患者艰难梭菌感染率高于非初发型患者(P＜0.01),结肠受累者艰难梭菌感染率显著高于非结肠受累者(P＜0.01).结论:与健康成年人相比,IBD患者艰难梭菌感染率明显升高,活动期及结肠受累的IBD患者可能更易感染艰难梭菌.