71株白念珠菌临床分离株微卫星基因分型

目的 建立高效、快速、简便的白念珠菌临床分离株三重保守基因微卫星分型技术。方法 以煮沸法处理的71株白念珠菌野生株为模板，三色荧光分别标记保守基因CDC3、EF3和HIS3微卫星序列引物，PCR扩增，产物行聚丙烯酰胺凝胶电泳。由基因扫描分析软件获取片段的精确长度，Genotyper软件行基因分型。结果 71株白念珠菌野生株行CDC3、EF3和HIS3基因分型分别获得5、10、8种等位基因，7、8、9种基因型，三位点联合分析共获得14种菌株基因型。结论 白念珠菌多重保守基因微卫星分型能从基因水平快速、高效的对临床分离株进行分型，对白念珠菌的流行病学研究有重要价值。     

白色念珠菌对人口腔黏膜上皮角质细胞的作用研究

目的研究白色念珠菌对人口腔黏膜上皮角质细胞的作用机制。方法将培养的口腔黏膜上皮角质细胞分别加入孢子型白色念珠菌(孢子组)和菌丝型白色念珠菌(菌丝组),另将单独培养的口腔黏膜上皮角质细胞作为阴性对照组。比较各组对口腔黏膜上皮角质细胞的黏附作用,并观察白色念珠菌对口腔黏膜上皮角质细胞的凋亡和增殖作用。结果菌丝组黏附指数(7.63±1.39)显著高于孢子组(3.47±1.04),差异有统计学意义(P<0.05);菌丝组凋亡率[(3.49±0.4)%]显著高于孢子组[(2.07±0.15)%]和阴性对照组[(1.98±0.07)%],差异有统计学意义(P<0.05),而孢子组和阴性对照组凋亡率相比差异无统计学意义(P>0.05)。菌丝组G0/G1期细胞比例[(38.17±7.83)%]显著低于孢子组[(49.47±11.41)%]和阴性对照组[(57.71±9.39)%],差异有统计学意义(P<0.05);S期[(8.54±4.03)%]、G2/M期[(20.18±9.59)%]细胞比例上升,且显著高于孢子组[(6.47±2.73)%、(10.71±3.19)%]和阴性对照组[(5.35±2.11)%、(12.38±4.35)%],差异有统计学意义(P<0.05);PI[(42.79±18.73)%]明显高于孢子组[(28.67±8.79)%]和阴性对照组[(26.87±7.64)%],差异有统计学意义(P<0.05),而孢子组和阴性对照组PI相比差异无统计学意义(P>0.05)。结论白色念珠菌能够导致口腔黏膜上皮角质细胞发生凋亡和增殖周期改变。     

Time of catheter removal in candidemia and mortality

Background

The impact of central venous catheter (CVC) removal on the outcome of patients with candidemia is controversial, with studies reporting discrepant results depending on the time of CVC removal (early or any time during the course of candidemia).

热带假丝酵母菌临床分离株毒力表型特征研究

目的 描述临床分离的热带假丝酵母菌培养不同时间的天冬氨酰蛋白酶活性(蛋白酶活性)、磷脂酶活性和溶血活性,并分析不同感染部位分离菌的蛋白酶活性和溶血活性差异。方法 将分离自不同感染部位的热带假丝酵母菌鉴定后分别接种在牛血清蛋白培养基、卵黄琼脂培养基和羊血琼脂培养基上,培养不同时间(24、48和72 h)后检测蛋白酶活性、磷脂酶活性和溶血活性。结果 热带假丝酵母菌培养24、48和72 h时均具有蛋白酶活性和溶血活性,但未表现出磷脂酶活性;热带假丝酵母菌在48 和72 h时的蛋白酶活性高于其在24 h时的活性,在72 h范围内,溶血活性随培养时间延长持续增长;分离自不同感染部位的热带假丝酵母菌的蛋白酶活性(P=0.368)和溶血活性(P=0.985)差异无统计学意义。结论 我国热带假丝酵母菌临床分离株培养不同时间具有蛋白酶活性和溶血活性,但无磷脂酶活性。     

Evaluating Epidemiology and Improving Surveillance of Infections Associated with Health Care,United States

The Healthcare-Associated Infections Community Interface (HAIC), launched in 2009, is the newest major activity of the Emerging Infections Program. The HAIC activity addresses population- and laboratory-based surveillance for Clostridium difficile infections, candidemia, and multidrug-resistant gram-negative bacilli. Other activities include special projects: the multistate Healthcare-Associated Infections and Antimicrobial Use Prevalence Survey and projects that evaluate new approaches for improving surveillance. The HAIC activity has provided information about the epidemiology and adverse health outcomes of health care–associated infections and antimicrobial drug use in the United States and informs efforts to improve patient safety through prevention of these infections.     

18例早产儿真菌败血症临床特点

目的对某院早产儿真菌败血症的临床特点进行分析,为临床诊治提供参考。方法对该院2011年1月—2013年12月18例早产儿真菌败血症的临床资料进行回顾性分析。结果 18例早产儿胎龄为27~36周,出生体重为1 050~3 100 g,其中极低出生体重儿(VLBWI)8例;均有广谱抗菌药物用药史,感染前均长时间静脉营养,10例机械通气,2例经外周静脉穿刺中心静脉置管(PICC)。临床表现以呼吸暂停、抽搐、喂养困难、反应差等为主;出现症状时间为出生后3 h~52 d。13例(72.22%)早产儿血白细胞(WBC)计数异常,12例(66.67%)血小板(PLT)100×109/L,18例(100.00%)C反应蛋白(CRP)均增高,平均CRP浓度为(41.90±26.77)mg/L。感染病原菌以假丝酵母菌属为主,共17例(94.44%),其中包括近平滑假丝酵母菌7例,白假丝酵母菌5例,白假丝酵母菌生物变种4例,无名假丝酵母菌1例。用氟康唑及两性霉素B治疗,15例治愈(83.33%),2例好转(11.11%),1例死亡(5.56%)。结论早产儿真菌败血症以假丝酵母菌感染为主,临床缺乏特异性表现,应严密观察具有高危因素的早产儿临床症状,定期检测血常规及CRP等指标,及时给予抗真菌药物治疗,有助于取得良好的治疗效果。     

耐两性霉素B的近平滑与热带假丝酵母菌的体外诱导及耐药分子机制研究

目的：体外诱导近平滑假丝酵母菌（ CP）、热带假丝酵母菌（ CT）对两性霉素B（ AMB）的耐药株,检测其中的耐药基因表达情况。方法 AMB体外构建耐药株,用实时荧光定量PCR法检测耐药基因的表达水平。结果 CP、CT 野生株经体外 AMB 浓度递增法诱导后,形成耐药株最低抑菌浓度（ MIC,≥8μg? mL－1）;CYP51A、CYP51B、CDR1、CDR2、MDR1及MDR2基因在野生株中低水平表达,在耐药株中表达水平明显升高,差别有统计学意义（ P ＜0．05）;CYP51A、CYP51B、CDR1、CDR2、MDR1及MDR2的表达量在CPAMB耐药株中分别是其野生株的136．92,16．33,2．07,14．84,4．07,2．38倍;在CT AMB耐药株中分别是其野生株的8．83,2．98,3．00,2．40,2．30,3．57倍。结论 CP、CT对AMB耐药与CYP51A、CYP51B、CDR1、CDR2、MDR1及MDR2基因过度表达有关。     

特比萘酚联合氟康唑对念珠菌及新生隐球菌的体外药敏试验

目的研究特比萘酚（FCZ）和氟康唑（TBNF）对念珠菌及新生隐球菌体外联合药敏试验中的相互作用，为临床用药提供实验室依据。方法参照美国国家临床实验室标准化委员会（NCCLS）提出的标准（M27-A方案）采用棋盘微量稀释法对10株念珠菌和18株新生隐球菌进行了特比萘酚和氟康唑的体外联合药敏试验。结果联合用药时FCZ的最低抑菌浓度（MIC）几何均值从单用药时的5.124降至0.672，差异有显著性（t=5.558，P〈0.001）;TBNF从2.26降至0.291，差异有显著性（t=6.552，P〈0.001）。两种药物联用有协同或相加作用，联合抑菌指数（FICI）的平均值为0.629。结论特比萘酚和氟康唑对致病酵母菌主要表现为协同相加作用。     

Do Fish Thrombocytes Play an Immunological Role? Their Cytoenzymatic Profiles and Function During an Accidental Piscine Candidiasis in Aquarium

Fish (F) thrombocytes (THRs) from healthy trouts were studied in terms of cytoenzyme expression. FTHRs were positive to acid periodic of shiff (PAS) and acid phosphatase (ac. phos.) without tartaric acid (? TA) stainings, as well to alkaline phosphatase. However, when compared with autologous macrophages (MØs), they were negative to naphthol cloroacetate esterase (AS-D), α-naphthyl acetate esterase (Anae), peroxidase (perox) and control ac. phos. with tartaric acid (+ TA) stainings, thus indicating a lack of typical lysosomial enzymes. This evidence supports the notion that FTHRs are not true digesting cells. Quite interestingly, trouts and human MØs were positive for PAS, AS-D, Anae, and perox stainings, thus confirming that cellular cytochemistries are maintained across evolution as their phagocytic functions. Additionally, blood films from trouts, accidentally infected with Candida albicans in aquarium, were morphologically analyzed. Actually, FTHRs interact with erythrocytes, potentiating the formation of rosettes around a central MØ. Polymorph nuclear cells and lymphocytes are present in these cellular aggregates, thus suggesting that FTHRs may represent a link between innate and adaptive immunity.