临床分离鲍曼不动杆菌的分布特征及耐药谱变迁

目的研究临床分离鲍曼不动杆菌的分布特征及耐药性的变迁,为临床科学合理使用抗生素提供参考。方法通过回顾性调查方法,对某医院临床标本分离出的鲍曼不动杆菌分布特点和2002-2010年期间该菌耐药性变迁进行分析。结果在调查期间该医院从感染病人的标本中共检出鲍曼不动杆菌2 161株,分离率为4.5%;标本来源以痰液为主,占83.7%。鲍曼不动杆菌感染分布较高的科室是重症监护室、呼吸内科和脑外科;感染部位分布以呼吸道为主。鲍曼不动杆菌对替卡西林、哌拉西林和复方氨苄西林的耐药率最高,并呈逐年上升趋势;对其他类型抗菌药物的耐药率从2002年以来也处于上升趋势。本医院分离的鲍曼不动杆菌对头孢哌酮/舒巴坦和多粘菌素E等抗菌药物都比较敏感。结论该医院2002年以来临床标本鲍曼不动杆菌分离率及其耐药率均呈上升趋势,提示对该菌应加强监测和药敏试验,以便更科学合理使用抗菌药物。     

某院围手术期抗菌药物使用现状调查

目的了解医院骨科清洁手术围手术期抗菌药物使用现状,加强抗菌药物合理使用。方法通过回顾性调查,结合抗菌药物专项整治活动,对某医院骨科50例清洁手术抗菌药物使用情况进行调查与分析。结果该医院骨科清洁手术围手术期抗菌药物使用率为98%,术前预防用药为94%,在术前2 h内用药占92%。一代头孢菌素使用率为63.27%,青霉素为16.33%,其余为二、三代头孢菌素;70%以上为单联用药。结论该医院骨科清洁切口手术围手术期抗菌药物使用比较合理,显示出此次抗菌药物专项整治活动取得初步成效,需要进一步巩固抗菌药物合理应用整治成果。     

Ⅰ类切口围手术期抗菌药物应用干预研究

目的规范Ⅰ类切口围手术期抗菌药物预防应用管理,建立系列干预措施。方法采用现场调查方法对本医院外科Ⅰ类切口围手术期抗菌药物预防应用干预前后结果进行评价和分析。结果专项整改前该医院外科I类手术围手术期抗菌药物预防性使用率为98.4%,第三代头孢类药物使用率为37%,基本不使用第一代头孢。实施干预措施后,围手术期抗菌药物使用率为85.9%,第三代头孢使用率为9.6%,第一代头孢使用率为61.8%。无手术中追加用药现象。结论通过专项整改,Ⅰ类切口围手术期抗菌药物的应用得到规范,抗菌药物使用的合理性有明显提高。     

螺旋CT对眼眶骨折的诊断价值

目的 探讨螺旋CT对眼眶骨折的诊断价值.方法 对眼眶骨折的80例患者螺旋CT资料进行回顾性分析.结果 眼眶骨折的直接CT征象为眶壁骨质连续性中断、粉碎、凹陷及曲度失常;上颌窦腔出现“泪滴征”是诊断眼眶下壁骨折的特异性间接征象,眼外肌明显嵌顿及眼球内陷和牵拉试验阳性是手术治疗的指征.结论 螺旋CT扫描能全面、准确地诊断眼...     

磷霉素与9种抗菌药物分别联用对不动杆菌的体外抗菌活性研究

[目的]研究磷霉素与其它9种临床常用抗菌药物分别联合应用对47株不动杆菌的体外抗菌活性.[方法]收集痰标本中分离出的不动杆菌47株,将磷霉素与其它9种抗菌药物在体外单独以及联合应用,采用琼脂二倍稀释法,测定最低抑菌浓度(MIC)、计算部分抑菌浓度(FIC)指数,评价磷霉素与其它9种抗菌药物分别联合应用的体外抗菌活性.[...     

Chemical basis of the synergism and antagonism in microbial communities in the nests of leaf-cutting ants

Leaf-cutting ants cultivate the fungus Leucoagaricus gongylophorus, which serves as a major food source. This symbiosis is threatened by microbial pathogens that can severely infect L. gongylophorus. Microbial symbionts of leaf-cutting ants, mainly Pseudonocardia and Streptomyces, support the ants in defending their fungus gardens against infections by supplying antimicrobial and antifungal compounds. The ecological role of microorganisms in the nests of leaf-cutting ants can only be addressed in detail if their secondary metabolites are known. Here, we use an approach for the rapid identification of established bioactive compounds from microorganisms in ecological contexts by combining phylogenetic data, database searches, and liquid chromatography electrospray ionisation high resolution mass spectrometry (LC-ESI-HR-MS) screening. Antimycins A(1)-A(4), valinomycins, and actinomycins were identified in this manner from Streptomyces symbionts of leaf-cutting ants. Matrix-assisted laser desorption ionization (MALDI) imaging revealed the distribution of valinomycin directly on the integument of Acromyrmex echinatior workers. Valinomycins and actinomycins were also directly identified in samples from the waste of A. echinatior and A. niger leaf-cutting ants, suggesting that the compounds exert their antimicrobial and antifungal potential in the nests of leaf-cutting ants. Strong synergistic effects of the secondary meta-bolites produced by ant-associated Streptomyces were observed in the agar diffusion assay against Escovopsis weberi. Actinomycins strongly inhibit soil bacteria as well as other Streptomyces and Pseudonocardia symbionts. The antifungal antimycins are not only active against pathogenic fungi but also the garden fungus L. gongylophorus itself. In conclusion, secondary metabolites of microbial symbionts of leaf-cutting ants contribute to shaping the microbial communities within the nests of leaf-cutting ants.     

Diagnosis of ventilator-associated respiratory infections (VARI): microbiologic clues for tracheobronchitis (VAT) and pneumonia (VAP)

Intubated patients are at risk of bacterial colonization and ventilator-associated respiratory infection (VARI). VARI includes tracheobronchitis (VAT) or pneumonia (VAP). VAT and VAP caused by multidrug-resistant (MDR) pathogens are increasing in the United States and Europe. In patients with risk factors for MDR pathogens, empiric antibiotics are often initiated for 48 to 72 hours pending the availability of pathogen identification and antibiotic sensitivity data. Extensive data indicate that early, appropriate antibiotic therapy improves outcomes for patients with VAP. Recognizing and treating VARI may allow earlier appropriate therapy and improved patient outcomes.     

下呼吸道感染病原菌分布及耐药性分析

目的：探讨下呼吸道感染病原菌分布及耐药状况,为治疗下呼吸道感染疾病提供可靠依据,指导临床合理用药。方法：对下呼吸道感染病人痰培养分离出的1203株病原菌及药敏试验结果进行回顾性分析。结果：下呼吸道感染病原菌中铜绿假单胞菌检出率最高,为301株（25%）;其次为肺炎克雷伯菌268株（22.3%）、鲍曼不动杆菌186株（15.5%）、大肠埃希菌116株（9.6%）、金黄色葡萄球菌111株（9.2%）;对亚胺培南的耐药率：大肠埃希菌最低为0、肺炎克雷伯菌为0.9%。铜绿假单胞菌和鲍曼不动杆菌的耐药率较高,未发现耐万古霉素金黄色葡萄球菌。结论：下呼吸道感染主要病原菌为铜绿假单胞菌和肺炎克雷伯菌,对头孢类和喹诺酮类药物的耐药率明显较高,临床应依据药敏报告结果合理选用抗菌药物。     

香港海鸥形菌对理化生因子抵抗力的实验研究

目的 了解香港海鸥形菌(LH)对理化生因子的抵抗力.方法 用紫外线、高温、干燥、pH、常用多种化学消毒剂及部分抗菌药物处理两株分离于病人的香港海鸥形菌,定量观察其生长情况.结果 温度≥56℃即可灭活香港海鸥形菌;紫外线照射30s杀灭率>90%,照射20 min可完全灭菌;菌株在pH>8.5或<5.0条件下不能存活,最适...