耐甲氧西林表皮葡萄球菌发生率及耐药性检测

目的 了解临床分离表皮葡萄球菌中耐甲氧西林菌株(MRSE)发生率及其耐药情况.方法 对128株表皮葡萄球菌进行头孢西丁纸片扩散法检测耐甲氧西林株,琼脂稀释法进行药敏试验.结果 128株表皮葡萄球菌中,MRSE检出率为79.7%.MRSE对多种抗菌药物耐药,对万古霉索、替考拉宁敏感,耐药率为0;除青霉素类、大环内酯类和糖肽类以外,MRSE对其他抗菌药物的耐药率均高于甲氧西林敏感表皮葡萄球菌(MSSE).结论 MRSE发生率高,耐多药,未发现糖肽类耐药株.     

五倍子水煎剂对124株表皮葡萄球菌(MRSE和MSSE)的体外抗菌活性观察

目的 观察五倍子水煎剂对124株表皮葡萄球菌(methicillin-resistant staphylococcus epidermidis,MRSE和methicillin-sensitivity staphylococcus epidemaidis,MSsE)的体外抗菌活性。方法 采用新的中药抑菌实验方法对五倍子水煎剂进行了体外抗菌活性检测。结果 五倍子对耐甲氧西林的表皮葡萄球菌(MRSE)和甲氧西林敏感表皮葡萄球菌(MSSE)的抗菌活性均较好,其MIC90均为0．203mg/ml(1：1280),其MIC50均为0．051mg/ml(1：10240)。结论 此项研究为临床治疗由表皮葡萄球菌引起的感染,提供了科学依据。     

1999年～2003年我院表皮葡萄球菌耐药性变化的分析

目的:了解1999年～2003年我院表皮葡萄球茵耐药性的变迁情况,为临床合理用药提供参考.方法:收集1999年～2003年我院患者留取的各种标本(痰、尿、血、脓性分泌物等),共分离出242株表皮葡萄球菌.根据药物敏感试验结果来分析其耐药性的变化.结果:本研究显示,耐甲氧西林表皮葡萄菌(MRSE)分离率有上升趋势,其对青霉素类、大环内酯类、喹诺酮类、复方新诺明及庆大霉素高度耐药;对万古霉素高度敏感.甲氧西林敏感表皮葡萄球菌(MSSE)对头孢菌素类、氨基糖苷类、喹诺酮类依然保持较低的耐药率.结论:表皮葡萄球菌的耐药性呈逐年增加的趋势,合理使用抗菌药以延缓细菌耐药性的产生非常重要.     

两种葡萄球菌耐药性的变迁

目的研究5 a内医院内金黄色葡萄球菌和表皮葡萄球菌耐药性的变迁。方法采用回顾性分析方法，对1999年1月～2003年12月分离得到的187株金黄色葡萄球菌和242株表皮葡萄球的耐药性进行分析。药敏试验采用K-B纸片扩散法。结果耐甲氧西林金黄色葡萄球菌(MRSA)和耐甲氧西林表皮葡萄球菌(MRSE)的分离率逐年增高，5 a总分离率分别为67.38%和66.12%；从呼吸道分离的金黄色葡萄球菌和表皮葡萄球菌最多；表皮葡萄球菌的耐药率略低于金黄色葡萄球菌，但其感染率有超过金黄色葡萄球菌的趋势。结论MRSA和MRSE对大部分抗菌药物均已高度耐药，对万古霉素依然高度敏感。临床合理用药水平亟待提高。     

48株耐甲氧西林表皮葡萄球菌对7种头孢菌素的敏感性测定

采用琼脂稀释法对48株耐甲氧西林表皮葡萄球菌(methicillin-resistant Staphy-lococcus epidermidis,简称MRSE)进行了7种头孢菌素的敏感性测定,所有菌株对头孢呋肟和长效头孢菌素敏感(MIC90为8μg/ml),但对头孢氨苄、头孢唑林、头孢噻肟和ceftazidime则很少敏感(敏感菌株百分率分别为39.60％、22.9％、37.5％和35.4％)。所有MRSE对甲氧西林耐药(MIC_(90)>256μg/ml),而去甲万古霉素抗菌作用好。MRSE比MRSA的耐药性更高。     

耐甲氧西林表皮葡萄球菌感染情况调查及药敏分析研究

目的 探讨耐甲氧西林表皮葡萄球菌的感染情况及其耐药性.方法 收集收集2013年7月至2016年4月住院患者的各类送检标本中分离鉴定的表皮葡萄球菌158株,由有经验的检验员采用BIOFOSUN微生物鉴定药敏分析系统对菌株进行鉴定,采用MIC法作抗生素敏感性试验,分析不同科室、不同年龄、不同标本及不同性别中MRSE菌株的分布情况;对院外与院内MRSE的临床特征进行分析;对MRSE在12种抗生素的药敏结果进行分析.结果 在表皮葡萄球菌感染的病例中耐甲氧西林表皮葡萄球菌(MRSE)占79.1％,且男性耐甲氧西林表皮葡萄球菌的检出率高于女性,>60岁的MRSE检出率高于30～60岁和<30岁的检出率,院内感染者检出率高于院外感染者,重症监护室MRSE的检出率为高于其他科室,来源于脓性分泌物标本的MRSE检出率高于血液标本和其他标本,差异均具有统计学意义(P<0.000).院内MRSE感染的患者中存在原发疾病的比例较院外感染的多,检出细菌前2周内服用两种以上抗生素的患者所占比例较院外感染的多,差异均具有统计学意义(P<0.05);MRSE对青霉素、氨苄西林、苯唑西林、头孢唑啉、红霉素及克林霉素的耐药性极强,均超过90.0％,而对环丙沙星、庆大霉素、四环素、利福平、甲氧苄啶/磺胺甲噁唑(SMZ)的耐药性较强,而对万古霉素敏感.结论 耐甲氧西林表皮葡萄球菌在临床上感染情况严重,且普遍存在对普通抗生素的耐药性.     

替考拉宁对葡萄球菌的体外抗菌活性研究

目的 :测定替考拉宁对葡萄球菌的体外抗菌活性。方法 :采用琼脂二倍稀释法测定替考拉宁对 492株葡萄球菌的最低抑菌浓度 (MIC) ,其中金黄色葡萄球菌 3 2 4株 ,表皮葡萄球菌 1 68株。结果 :替考拉宁对葡萄球菌的MIC90 值均为 1mg·L-1,明显低于氧氟沙星、红霉素和苯唑西林 ,与万古霉素相当 ;替考拉宁对甲氧西林耐药金黄色葡萄球菌 (MR SA)和对甲氧西林耐药表皮葡萄球菌 (MRSE)的MIC90 分别为 4mg·L-1和 2mg·L-1,是万古霉素的1 / 2。抗菌活性明显高于氧氟沙星和红霉素。结论 :替考拉宁对葡萄球菌的体外抗菌活性是万古霉素的 2倍 ,明显强于氧氟沙星和红霉素     

我院1999年~2005年耐甲氧西林葡萄球菌的耐药性分析

目的:了解我院耐甲氧西林葡萄球菌(MRS)的耐药现状,为临床合理用药提供依据。方法:将我院1999年~2005年分离的274株葡萄球菌的药敏试验结果,应用WHONET5·3软件进行统计学分析。结果:耐甲氧西林金黄色葡萄球菌(MRSA)和耐甲氧西林表皮葡萄球菌(MRSE)的检出率为48·4%和65·9%,且其检出率逐年升高,MRS的耐药率远比甲氧西林敏感葡萄球菌(MSS)高;未检出对万古霉素耐药的葡萄球菌。结论:医院应加强对MRS的检测,临床应依据药敏结果合理选用抗菌药物治疗感染。     

耐甲氧西林金黄色葡萄球菌耐药分析

目的了解全院临床科室耐甲氧西林金黄色葡萄球菌(MRSA)耐药情况,为呼吸科临床治疗提供抗菌药选用依据。方法对临床分离的28株金黄色葡萄球菌中耐甲氧西林金黄色葡萄球菌(MRSA)的药物敏感报告单进行耐药分析。结果 28株金黄色葡萄球菌中耐甲氧西林金黄色葡萄球菌(MRSA)的检出率为53.57%,MRSA对18种抗菌药物中种耐药率>63.24%,对青霉素类、头孢菌素类以及红霉素100.0%耐药,MRSA对替考拉宁、利奈唑胺100.0%敏感,检测到1株耐万古霉素金黄色葡萄球菌。结论本研究中我院呼吸科MRSA发生率低于国内平均水平,复方新诺明和氯霉素对其仍较敏感,万古霉素出现耐药菌株,替考拉宁、利奈唑胺仍为首选。     

国产头孢硫脒对224株凝固酶阴性葡萄球菌的体外抗菌活性研究

目的观察头孢硫脒对表皮葡萄球菌、溶血葡萄球菌等凝固酶阴性葡萄球菌的体外抗菌活性。方法采用琼脂稀释法对头孢硫脒进行224株表皮葡萄球菌、溶血葡萄球菌等凝固酶阴性葡萄球菌的最低抑菌浓度(MIC)测定。结果头孢硫脒对100株耐甲氧西林的凝固酶阴性葡萄球菌和124株甲氧西林敏感的凝固酶阴性葡萄球菌的MIC50,MIC90分别为0．5、128、≤0．125和2μg／ml。对甲氧西林敏感的表皮葡萄球菌(MSSE)、溶血葡萄球菌(MSSH)和里昂葡萄球菌(MSSL)的MIC90分别为0．5、2．0和2．0μg／ml。结论头孢硫脒对124株甲氧西林敏感的凝固酶阴性葡萄球菌具有较强的抑菌力。     

新生儿感染耐甲氧西林葡萄球菌的药敏分析

目的:探索致新生儿感染的耐甲氧西林葡萄球菌(MRS)流行病学及常见10种抗菌药物敏感性。方法:按《全国临床检验操作规程》鉴定细菌,玻片法血浆凝固酶试验,K－B扩散法药敏试验。结果:分离出葡萄球菌323株,其中金黄色葡萄球菌(SA)55株,耐甲氧西林金葡菌(MRSA)14株(25．5%),表皮葡萄球菌 171株,耐甲氧西林表葡菌(MRSE)102株(59,6%),腐生葡萄球菌97株,耐甲氧西林腐生葡菌(MRSS)52株(53．6%),院内感染株中 MRS所占比例明显高于甲氧西林敏感葡萄球菌(MS),x~2=3.978,P＝0.046。对氨苄西林、青霉素及红霉素总耐药率分别为86.8%、84.6%及68.9%,而对万古霉素及头孢唑啉总耐药率分别仅为6.7%(7/140)及11.3%(26/231),万古霉素对全部SA、甲氧西林敏感表葡菌(MSSE)、甲氧西林敏感腐生葡菌(MSSS)均敏感,MRS对青霉素、氨苄西林、头孢哇啉、头孢呋辛、头孢他啶、庆大霉素、阿米卡星、诺氟沙星及万古霉素的耐药率较MSS明显增高(P＜0.01)。结论:新生儿耐甲氧西林葡萄球菌易引起医院感染,其耐药性明显,值得高度重视．     

临床表葡菌耐药性和氟喹诺酮类药物外排检测研究

分离鉴定临床表葡菌126株,通过Kirby-Bauer法和平皿二倍稀释法测定了126株临床分离表皮葡萄球菌对13种抗菌药物(甲氧西林、卡那霉素、庆大霉素、氨苄西林、四环素、红霉素、克林霉素、磺胺甲口恶唑/甲氧苄啶、利福平、头孢曲松、头孢噻肟、头孢唑林、万古霉素)的耐药水平及78株表葡菌对13种抗菌药物的耐药谱。126株表葡菌中甲氧西林耐药菌(MRSE)为79株,占62.7%。万古霉素对MRSE和MSSE的作用最好,抑菌率均为100%,利福平对MRSE的抑菌作用也较强,抑菌率为83.5%,其次是卡那霉素、四环素和磺胺甲口恶唑/甲氧苄啶。采用平皿二倍稀释法测定78株表葡菌(从126株菌随意挑选)对4种氟喹诺酮类药物(诺氟沙星、氧氟沙星、环丙沙星和司帕沙星)的耐药水平及交叉耐药性。78株表葡菌中,对环丙沙星耐药25株(32.05%);对诺氟沙星耐药34株(43.59%);对氧氟沙星耐药22株(28.21%);对司帕沙星耐药16株(20.51%)。且菌株对此4种药物存在高度交叉耐药性;16株表葡菌在加入利舍平后MIC变小,说明外排泵介导的氟喹诺酮耐药机制普遍存在于临床分离的表葡菌中。但菌株SE7、SE9、SE68的MIC在加入利舍平后增大。说明这些菌株中除主动外排耐药机制外,还存在着其它耐药机制。     

Synthesis and potent antimicrobial activity of some novel 4-(5, 6-dichloro-1H-benzimidazol-2-yl)-N-substituted benzamides

A series of 4-(5, 6-dichloro-1H-benzimidazol-2-yl)-N-substituted benzamides were synthesized and evaluated for antibacterial and antifungal activities against Staphylococcus aureus, methicillin-resistant S. aureus (MRSA), methicillin-resistant S. epidermis (MRSE), Enterococcus faecalis, Escherichia coli and Candida albicans. Certain compounds inhibit bacterial growth with low MIC values (microg/mL). Among them, compounds 10 and 11 exhibited the greatest antibacterial activity with MIC values of 3.12 microg/mL against S. aureus, MRSA and MRSE.     

Post-marketing surveillance of antibacterial activities of cefozopran against various clinical isolates--I. Gram-positive bacteria

As a post-marketing surveillance, the in vitro antibacterial activities of cefozopran (CZOP), an agent of cephems, against various clinical isolates were yearly evaluated and compared with those of other cephems, oxacephems, penicillins, and carbapenems. Changes in the bacterial sensitivity for CZOP were also evaluated with the resistance ratio calculated with breakpoint MIC. Sixteen species (1,913 strains) of Gram-positive bacteria were isolated from the clinical materials annually collected from 1996 to 2000, and consisted of methicillin-susceptible Staphylococcus aureus (MSSA; n = 178), methicillin-resistant S. aureus (MRSA; n = 199), methicillin-susceptible Staphylococcus epidermidis (MSSE; n = 98), methicillin-resistant S. epidermidis (MRSE; n = 164), Staphylococcus haemolyticus (n = 72), Staphylococcus saprophyticus (n = 28), Enterococcus faecalis (n = 206), Enterococcus faecium (n = 91), Enterococcus avium (n = 72), Streptococcus pyogenes (n = 133), Streptococcus agalactiae (n = 138), penicillin-susceptible Streptococcus pneumoniae (PSSP; n = 133), penicillin-intermediate resistant S. pneumoniae (PISP; n = 100), penicillin-resistant S. pneumoniae (PRSP; n = 29), Streptococcus milleri group (n = 135) and Peptostreptococcus spp. (n = 137). CZOP possessed comparable antibacterial activities against MSSA and MSSE to other cephems, and was also effective on MRSE but not on MRSA. An antibacterial activity of CZOP against S. saprophyticus was comparable to or higher than other cephems. CZOP, however, did not indicate an antibacterial activity against S. haemolyticus, just like other cephems. An antibacterial activity of CZOP against E. faecalis was comparable to cefpirome (CPR) and higher than other cephems. No antibacterial activity of CZOP against E. faecium and E. avium was observed, just like other drugs. An antibacterial activity of CZOP against S. pyogenes was as potent as that of cefotiam (CTM), cefepime (CFPM) and CPR, and that against S. agalactiae was also preferable. CZOP and other cephems also had a preferable antibacterial activity against S. milleri group that was most sensitive to benzylpenicillin. An antibacterial activity of CZOP against Peptostreptococcus spp. was preferable but weaker than that of cefazolin, CTM and cefmetazole. The resistance ratio estimated with breakpoint MIC of CZOP was 96.5% in MRSA, 93.1% in PRSP, 60.0% in PISP, 40.3% in S. haemolyticus, 22.3% in E. faecalis, and 15.9% in MRSE. Those resistance ratios were similar to those for CFPM, but E. faecalis showed 90.8% resistance for CFPM. The difference in the resistance ratio of E. faecalis demonstrated that CZOP successfully maintained its antibacterial activity against this species. In conclusion, no remarkable annual change in the antibacterial activities of CZOP against the Gram-positive bacteria was observed. The sensitivities of PISP and PRSP to CZOP, however, was suggested to be decreasing.     

二重实时PCR快速检测耐甲氧西林金黄色葡萄球菌

目的 建立二重实时聚合酶链反应（duplexreal-timePCR）快速检测耐甲氧西林金黄色葡萄球菌（MRSA）。方法 采用二重SYBR Green实时PCR快速检测MRSA的决定基因mecA和金葡菌的种特异性基因nuc，经熔解曲线分析鉴定产物。结果 所有MRSA菌株的熔解曲线均呈现mecA、nuc基因特异性的峰，甲氧西林敏感的金葡菌仅有nuc峰，耐甲氧西林的表葡菌仅有mecA峰，甲氧西林敏感的表葡菌与其他菌种的菌株无特异峰出现；当MRSA菌浓度达10^2cfu／ml时就可检出。在131株金葡菌中，30．53％（40／131）耐药；二重实时PCR扩增mecA基因29．01％（38／131）阳性，nuc基因100％阳性。单引物与二重实时PCR两者阳性扩增符合率为100％。结论 对mecA、nuc基因进行二重实时PCR能准确、快速地鉴定耐甲氧西林的金葡菌和凝固酶阴性的葡萄球菌。     

Post-marketing surveillance of antibacterial activities of cefozopran against various clinical isolates--I. Gram-positive bacteria

As a post-marketing surveillance, the in vitro antibacterial activities of cefozopran (CZOP), an agent of cephems, against various clinical isolates were yearly evaluated and compared with those of other cephems, oxacephems, penicillins, and carbapenems. Changes in the bacterial susceptibility for CZOP were also evaluated with the resistance ratio calculated with breakpoint MIC. Sixteen species (2,363 strains) of Gram-positive bacteria were isolated from the clinical materials annually collected from 1996 to 2001, and consisted of methicillin-susceptible Staphylococcus aureus (MSSA), methicillin-resistant Staphylococcus aureus (MRSA), methicillin-susceptible Staphylococcus epidermidis (MSSE), methicillin-resistant Staphylococcus epidermidis (MRSE), Staphylococcus haemolyticus, Staphylococcus saprophyticus, Enterococcus faecalis, Enterococcus faecium, Enterococcus avium, Streptococcus pyogenes, Streptococcus agalactiae, penicillin-susceptible Streptococcus pneumoniae (PSSP), penicillin-intermediate resistant S. pneumoniae (PISP), penicillin-resistant S. pneumoniae (PRSP), Streptococcus milleri group and Peptostreptococcus spp. The antibacterial activity of CZOP either against MSSA or MSSE was preferable (MIC90: 2 or 0.5 micrograms/mL) and comparable to those of other cephems. CZOP was also effective on MRSE (MIC90: 16 micrograms/mL) but not on MRSA. CZOP and other cephems had low antibacterial activity against S. haemolyticus (MIC90: 64 micrograms/mL). The antibacterial activity of CZOP against S. saprophyticus was comparable to or higher than those of other cephems, but the MIC90 of CZOP in 2001 was higher than those in 1996-2000 (32 vs 1-2 micrograms/mL). The antibacterial activity of CZOP against E. faecalis was comparable to that of cefpirome (CPR; MIC90: 16 micrograms/mL) and higher than those of other cephems. No antibacterial activity of CZOP against E. faecium and E. avium was observed, like other drugs. The antibacterial activity of CZOP against S. pyogenes was as potent as those of cefotiam and CPR (MIC90: < or = 0.063 microgram/mL), and, against S. agalactiae, was also preferable (MIC90: 0.125 microgram/mL). CZOP indicated preferable antibacterial activity either against PSSP, PISP, or PRSP (MIC90: 0.25, 1, or 2 micrograms/mL). The antibacterial activity of CZOP against S. milleri group was also preferable, but the MIC90 of CZOP in 2001 was higher than those in 1996-2000 (4 vs 0.5 micrograms/mL). The antibacterial activity of CZOP against Peptostreptococcus spp. was preferable but weaker than those of cefazolin and cefmetazole. The resistance ratio estimated from breakpoint MIC of CZOP was 95.9% in MRSA, 93.5% in PRSP, 63.3% in PISP, 35.8% in S. haemolyticus, 27.9% in E. faecalis, and 13.3% MRSE. Those resistance ratios were comparable to those for cefepime (CFPM), but E. faecalis showed 91.2% for CFPM. The difference in the resistance ratio of E. faecalis demonstrated that CZOP successfully maintained its antibacterial activity against these species. In correlation of drug susceptibility, 40.3% of PRSP was not inhibited at breakpoint MIC either CZOP or CFPM while 69.2% at breakpoint MIC either CZOP or ceftazidime. In conclusion, the antibacterial activities of CZOP against the Gram-positive bacteria obtained from the 6-year duration study were consistent with the results from the studies performed until the new drug application approval. A decline in the sensitivities of S. saprophyticus, S. milleri group, PISP, and PRSP to CZOP, however, was suggested.