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1.
目的 了解临床分离多重耐药鲍曼不动杆菌和铜绿假单保菌Ⅰ类整合子与插入序列共同区1(ISCR1)的分布情况.方法 2010年1月至2013年12月共收集我院126株多重耐药鲍曼不动杆菌和89株多重耐药铜绿假单胞菌,采用PCR法扩增Ⅰ类整合酶、Ⅰ类整合子基因盒、ISCR1、ISCR1可变区.Ⅰ类整合基因盒和ISCR1可变区的PCR产物分别用HinfⅠ、RasⅠ进行酶切,相同类型酶切图谱的PCR产物随机挑取一例进行测序,测序结果在GenBank中用BlastN进行核酸序列同源性搜索.结果 在多重耐药鲍曼不动杆菌中,检出79例Ⅰ类整合酶,67例Ⅰ类整合子基因盒阳性,含有6种类型;59例ISCR1阳性,其中9例ISCR1可变区阳性.在89株多重耐药铜绿中,检出41例Ⅰ类整合酶,36例Ⅰ类整合子基因盒阳性,含有10种类型;9例ISCR1阳性,其中4例ISCR1可变区阳性.有8株鲍曼不动杆菌和2株铜绿假单胞菌同时携带Ⅰ类整合子和ISCR1可变区结构.结论 在多重耐药铜绿假单胞菌和鲍曼不动杆菌中,Ⅰ类整合子和ISCR1分布较广.  相似文献   

2.
林瑜 《中国热带医学》2012,12(6):673-676
目的 检测临床多重耐药铜绿假单胞菌的整合子,并进行结构及定位分析.方法 PCR扩增耐药基因和整合子、电泳胶回收DNA片段并进行序列比对分析.结果 在一株多重耐药铜绿假单胞菌(PAVim2)中检测到双整合子,其中一个为Ⅰ类整合子,一个为Tn402样的Ⅰ类整合子,两者基因结构为5'CS-IntI-sul1-3'CS和5'CS-IntI-Vim2-Rh506.结论 双整合子结构的发现为铜绿假单胞菌多重耐药研究有临床意义.  相似文献   

3.
目的 研究产金属酶铜绿假单胞菌携带Ⅰ类整合予及其基因盒的情况.方法 收集铜绿假单胞菌68临床株,进行金属酶IMP-1、VIM基因的PCR检测,选取阳性株再作第Ⅰ类整合酶基因的PCR检测,然后选取整合酶基因阳性株进行Ⅰ类整合子相关基因盒的PCR检测.结果 PCR检测出68株铜绿假单胞菌中的1株同时含有IMP-1基因和Ⅰ类整合子基因盒;55株含有VIM基因,其中26株含有Ⅰ类整合酶基因,在这26株中只有18株含有Ⅰ类整合子基因盒,根据电泳条带可分为5种类别.结论 首次在中国西南地区发现产IMP-1并同时带有Ⅰ类整合子的铜绿假单胞菌.Ⅰ类整合子在产金属酶铜绿假单胞菌中分布广泛,基因盒携带率为69.2%,对细菌的耐药性传播具有重要意义.  相似文献   

4.
目的:探讨我院临床分离多重耐药铜绿假单胞菌的β-内酰胺酶相关基因及Ⅰ类整合子(int Ⅰ 1和qacE△1-sul1)的携带情况,为临床抗感染治疗和控制医院感染提供依据.方法:采用K-B法对临床分离的铜绿假单胞;进行药敏试验,选出34株多重耐药菌株,用PCR法检测其相关耐药基因16种.结果:在34株多重耐药铜绿假单胞菌...  相似文献   

5.
大肠埃希菌多重耐药与Ⅰ类整合子的关系   总被引:2,自引:0,他引:2  
目的 监测大肠埃希菌临床分离株的耐药性,了解大肠埃希菌中Ⅰ类整合子的流行情况和分子特性.方法 临床分离114株大肠埃希菌经全自动细菌分析系统鉴定并检测耐药性,应用PCR法扩增质粒DNA上Ⅰ类整合子,对PCR产物进行酶切分析和DNA测序.将序列结果在GenBank中搜索,确定Ⅰ类整合子可变区基因盒的种类和排列.结果 细菌耐药率>50%,且大多为多重耐药菌(耐受3种以上抗生素).在58株细菌的质粒DNA上检测到Ⅰ类整合子序列,大小约600~3 500 bp,各含1~3个Ⅰ类整合子.整合子中最常见的基因盒为dfrl7(甲氧苄啶耐药基因)与aadA5(链霉素、壮观霉素耐药基因),最主要的基因盒排列为dfrl7-aadA5.绝大多数携带甲氧苄啶耐药基因盒的菌株对复方新诺明耐受,大多数携带链霉素、壮观霉素耐药基因盒的菌株对链霉素不敏感.结论 目前临床分离的大肠埃希菌耐药性强,并广泛存在Ⅰ类整合子.菌株携带基因盒和耐药表型之间有较好的对应关系,基因盒介导了细菌耐药性.细菌的多重耐药率与Ⅰ类整合子的阳性率相关.  相似文献   

6.
目的了解分离于青岛骨伤医院临床标本的铜绿假单胞菌对15种常用抗生素的耐药率;明确整合子基因盒结构及其在耐药基因播散中的作用。方法采用微量肉汤稀释法检测70株铜绿假单胞菌的对15种常用抗生素耐药率;采用煮沸法提取70株铜绿假单胞菌基因组DNA;PCR扩增Ⅰ、Ⅱ、Ⅲ类整合子基因,通过测序分析其所携带耐药基因。结果 70株铜绿假单胞菌对头孢哌酮/舒巴坦(CPZ/SB)耐药率为1.43%,对其他抗生素的耐药性在20.00%~67.14%之间;检出Ⅰ类整合子阳性28株(40.0%),包括aacA4、aadA1、catB8和dfrA17四种基因盒。未检测到Ⅱ、Ⅲ类整合子。Ⅰ类整合子阳性菌株对头孢吡肟、哌拉西林、哌拉西林/他唑巴坦等10种抗生素的耐药率明显高于整合子阴性菌株。结论铜绿假单胞菌对常用抗生素的耐药性因临床株而异,其中Ⅰ类整合子阳性的菌株耐药率高,提示该整合子在铜绿假单胞菌多重耐药中发挥重要作用。  相似文献   

7.
目的:探讨产超广谱β-内酰胺酶(ESBLs)志贺菌多重耐药与整合子的关系,研究其耐药机制。方法:圆盘扩散方法检测抗菌药物敏感性,改良三维试验对可疑产ESBLs志贺菌进行检测,多重PCR检测、、类整合子,并对整合子进行DNA测序以确定携带的耐药基因盒。结果:在10株产ESBLs志贺菌中全部检出类整合子,其可变区含有dfrA17-aadA5基因盒。结论:本地区产ESBLs志贺菌全部含有类整合子,分别编码磺胺类和氨基糖苷类多重耐药性。  相似文献   

8.
铜绿假单胞菌整合子携带的金属β内酰胺酶研究进展   总被引:1,自引:0,他引:1  
王志锐  李力 《医学综述》2007,13(4):294-297
铜绿假单胞菌是条件致病菌,近年来该菌的多重耐药菌株日益增多,尤其是在该菌中发现整合子可以携带很多耐药基因如金属β-内酰胺酶基因等。本文就铜绿假单胞菌中整合子携带的金属β-内酰胺酶基因IMP、VIM、SPM和GIM的研究进展作一综述。  相似文献   

9.
目的确定铜绿假单胞菌不同基因型与抗菌谱的联系,以追踪院内感染中铜绿假单胞菌菌株在分子水平上的相关性。方法对2002年1月~2004年12月自该院住院患者各种标本中分离获得216株铜绿假单胞菌,用脉冲场凝胶电泳分析耐亚胺培南铜绿假单胞菌的同源性;液体稀释法测定携带blaIMP基因铜绿假单胞菌菌株的最小抑菌浓度,纸片扩散法检测亚胺培南敏感株和耐药株对10种常用抗菌药物的耐药性。结果分离的铜绿假单胞菌主要来自呼吸道标本,对常用抗菌药物的耐药率高,多重耐药现象严重。携带blaIMP基因与不携带blaIMP基因的铜绿假单胞菌对亚胺培南的耐药性差异有显著性,未携带blaIMP基因的铜绿假单胞菌菌株在PFGE上表现出不同的分型,而携带blaIMP基因的10株中9株具有相同的PFGE分型。结论blaIMP基因在铜绿假单胞菌的耐药机制中起主要作用,了解铜绿假单胞菌的耐药现状,有利于为临床合理用药提供依据,抗生素的合理使用可减少细菌耐药性的产生,降低医院感染的发病率。  相似文献   

10.
目的 了解我院临床分离的鲍曼不动杆菌的整合子携带情况,以及整合子与鲍曼不动杆菌的耐药相关性分析.方法 用VITEK2 Compact全自动微生物分析系统及纸片扩散法检测临床分离的鲍曼不动杆菌对常用22种抗生素的敏感性.PCR扩增整合酶基因检测鲍曼不动杆菌携带整合子情况,同时对整合子可变区进行扩增及测序以其了解整合子耐药基因盒携带耐药基因的情况.结果 鲍曼不动杆菌呈多重耐药性.鲍曼不动杆菌对CPZ/SB耐药率为1.2%,对替加环素(15.4%)、左旋氧氟沙星(34.4%)、亚胺培南(54.3%)、比阿培南(49.4%)、阿米卡星(59%),对其他抗生素均在71%以上.104株中有73株菌株含Ⅰ类整合子(阳性率为70.2%),未有Ⅱ、Ⅲ类整合子扩增阳性菌株,且Ⅰ类整合子阳性株的耐药性均高于阴性株.Ⅰ类整合子基因盒序列分析表明我院鲍曼不动杆菌Ⅰ类整合子携带aacA4、catB8和aadA1 3种耐药基因.结论 我院分离的鲍曼不动杆菌主要携带Ⅰ类整合子,且与多重耐药性密切相关.  相似文献   

11.
Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P< 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P< 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.  相似文献   

12.
Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P < 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (>0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P <0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P < 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.  相似文献   

13.
Objective: To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods: SD rats served as both donors and recipients. 4℃ sodium lactate Ringer's was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava (IVC) inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results: Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion: This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.  相似文献   

14.
Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.  相似文献   

15.
Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.  相似文献   

16.
A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care(~'4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.  相似文献   

17.
Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.  相似文献   

18.
Journal of Nanjing Medical University (English Edition) JNMU, sponsored by Nanjing Medical University, was established in 1987. It is a bimonthly comprehensive English medical journal published locally and abroad.Since 2007, Journal of Nanjing Medical University (English Edition )was granted Elsevier the full publishing and distribution rights worldwide for the Electronic Edition, excluding the People's Republic of China.  相似文献   

19.
目的:评价使用安心颗粒对急诊经皮冠状动脉介入术(PPCI)术后生活质量的影响.方法:将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组(术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次)和对照组(仅接受基础药物治疗).所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表(MIDAS)、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果:入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异(P>0.05);出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低(P<0.05);组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低(P<0.05).两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血(P>0.05).两组发生轻度血小板减少症的患者数比较无差异(P>0.05).结论:PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.  相似文献   

20.
Objective To measure Derpl and Blot5 allergen levels in asthmatics' homes in Hongkong.Methods Seventy houses were enrolled for a mite indoor environment study. Dust samples were obtained from two sites of each patients' house: bed and floor. Derpl and Blot5 levels were quantified by a two-site monoclonal antibody-based ELISA technique.Results The levels of Derpl allergens found in bed (geometric mean (GM) 3.43 μg/g of dust; 95%CI, 1.89-4.96 μg/g)and on the floor (GM 1.12 μg/g of dust; 95%CI, 0.71-1.53 μg/g) indicated significant differences (P=0.005). However, the levels of Blot5 allergens found in bed (GM 19.00 μg/g of dust; 95%CI, 0.89-38.90 μg/g) and on the floor (GM 6.14 μg/g of dust; 95%CI, 0.40-11.90 μg/g) showed no statistically significant difference. In addition, in regards to the exposure index for Derpl and Blot5 allergens found in bed and on the floor, 17.6% in bed and 8.6% on the floor had levels of Blot5 ≥ 10 μg/g of dust, higher than those obtained for Derp1 (7.2% and 0% in bed and on the floor respectively, P< 0.05); higher percentages in bed and on the floor (25.0% and 35.7%) were observed for levels of Blot5 =0 μg/g of dust as compared with Derpl in bed and on the floor (4.3% and 14.5% respectively, P< 0.05).Conclusions Derpl and Blot5 are the major allergens found in this regional study, Blot5 is a more potent allergen in Hongkong, probably reflecting the high level of exposure to Blomia tropicalis (Bt). Bt and Dermatophagoides pteronyssinus (Dp) allergens should be included for precise diagnosis and effective immuno-therapeutic treatment of mite allergy in Hongkong.  相似文献   

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