胆源性胰腺炎与胆道感染的关系

目的　研究胆石性胰腺炎病人胆道感染情况。方法　观察 4 9例病人临床、生化指标和胆汁细菌学检查。结果　年龄、血糖和ALT 3项指标在胆汁细菌培养阴性组和阳性组中结果明显不同 (P <0 .0 5 )。 2 2例阳性胆汁有 32种细菌 ,包括 1 2种革兰氏阳性细菌、1 8种革兰氏阴性细菌和 2种厌氧菌。最常见的微生物是埃希氏大肠杆菌 (2 5 % ) ,其次是肠球菌 (2 1 .9% )和链球菌 (1 2 .5 % )。结论　急性胆石性胰腺炎与胆汁感染有关 ,应该早期应用抗革兰氏阴性杆菌和革兰氏阳性球菌抗生素     

Comparison of preputial sac and urine cultures in healthy children

The aim of the present study was to examine subpreputial bacteriology and to compare it with the urine cultures of healthy male children. Seventy-two male children were divided into two groups as A and B according to age. In both groups preputial sac and urine cultures were taken simultaneously. Gram (+) enteric cocci were the most common isolated pathogens from the preputial sac in group B. Enterobacter, E. coli and staphylococci species were isolated from the urine cultures of three patients in group B. We could not find any difference between the preputial sac swabs of group A and B patients, but the isolation rate of urine cultures of group A patients was significantly higher than group B (p < 0.05). The findings of the present study support a potential role of the prepuce acting as a reservoir of faecal bacteria in the pathogenesis of UTI in male infants, especially in the first year of life. Improved penile hygiene after the first year of life does not alter the subpreputial bacteriology, but significantly decreases the contamination of urine. This revised version was published online in August 2006 with corrections to the Cover Date.     

慢性鼻-鼻窦炎患者筛窦黏膜的细菌学特征研究

目的：比较伴和不伴鼻息肉的慢性鼻-鼻窦炎（CRS）患者前筛黏膜标本的细菌学特征。方法在鼻内镜手术中获取前筛黏膜标本,进行需氧和厌氧培养。结果本研究共纳入CRS患者135例,其中不伴鼻息肉者65例（A组）,伴鼻息肉者70例（B组）。细菌培养总阳性率为85.2%（115/135）。A组和B组需氧或兼性厌氧细菌培养阳性率分别为87.7%（50/57）和82.9%（48/58）,两组间分布无显著差异（χ2=0.562,P =0.454）。两组患者的黏膜标本以需氧菌和厌氧菌混合感染为主,混合感染率分别为78.9%（45/57）和79.3%（46/58）,且差异无统计学意义（χ2=0.002,P =0.962）;两组最常见需氧菌株均为凝固酶阴性葡萄球菌和棒状杆菌属细菌。A组和B组厌氧菌培养阳性率分别为80.7%（46/57）和81.0%（47/58）,差异无统计学意义（χ2=0.002,P=0.964）;最常见厌氧菌株为丙酸杆菌属细菌和消化链球菌属细菌。结论伴和不伴鼻息肉的CRS患者前筛黏膜标本的细菌学特征无明显差异。     

Three-decade trends in the distribution of organisms causing septic arthritis in native joints: Single-center study of 374 cases

ObjectiveA rise in the incidence of septic arthritis due to methicillin-resistant Staphylococcus aureus (MRSA) has been reported in several parts of the world. Here, our objective was to look for changes over the last 30 years in the distribution and antibiotic susceptibility profiles of organisms responsible for septic arthritis.MethodsWe conducted a single-center retrospective study of all cases of septic arthritis documented by joint specimens and/or blood cultures between 1979 and 2008. Prosthetic joint infections were excluded.ResultsWe enrolled 374 patients, of whom 127, 136, and 111 were included during each decade, respectively. We detected no significant time trends in the proportions of staphylococci (67%, 65%, and 64%), streptococci (14%, 21%, and 17%), or Gram-negative rods (7%, 10%, and 14%). Tuberculosis was more common during the earliest decade (1979–1988, n = 10, 4, 2%; P < 0.05). No significant changes occurred in the proportions of methicillin-resistant staphylococci or MRSA (13%, 11%, 15%). Age and prevalence of risk factors for infection increased over time.ConclusionThe distribution and susceptibility of organisms causing septic arthritis has changed little over time. Our findings do not support the use of broader-spectrum antibiotics when empirical treatment is deemed necessary at our center.     

两种烤瓷冠修复对基牙颈部影响的对比研究

目的：探讨两种金属烤瓷冠的戴入对牙周细菌的影响。方法采用经典细菌培养鉴定及菌落形成单位计数（CFU/mL）的检测方法,对临床病例进行前后自身对照取样。结果2组可疑病原菌修复前无显著差异（P〉0.05）,在修复后1个月、6月和1年A组细菌数均高于B组（P〈0.01）,在1个月至1年B组细菌无明显变化（P〉0.05）,而A组呈递增趋势（P〈0.05）。结论贵金属烤瓷牙长时间戴入对口腔局部龈沟菌群的影响较小。     

2型糖尿病对肺结核临床及影像学特征的影响

目的探讨糖尿病并发肺结核的临床特征及其相关因素。方法选取2003年10月—2004年10月就诊于天津市结核病控制中心和天津市肺科医院的全部新近确诊的2型糖尿病并发肺结核病患者87例（DM—FIB组）；从同一医院同期就诊患者中随机选取88例肺结核病患者（FIB组）作为对照，比较两组临床特征，并运用Logistic回归模型对痰菌阳性、肺部空洞的相关因素进行分析。结果FIB组发生咳嗽、咯痰、中毒症状和咯血的比例（83．o％，62．5％和33．O％）高于DPTB组（66．7％，37．9％和16．1％）；DM—PTB组发生痰菌阳性和空洞（63．2％和56．3％）的比例高于PTB组（34．1％和13．6％），且DM—PTB组病变范围更广泛，双侧肺部受累更常见。痰菌阳性相关因素有并发糖尿病（OR=2．186，95％CI：1．082-4．420）、性格内向（OR=1．582，95％CI：1．063—2．355）和肺部空洞（OR=2．793，95％CI：1．308～5．964）。肺部空洞的相关因素有并发糖尿病（OR=14．199，95％CI：5．376—37．501），咳嗽、痰菌阳性也与肺部空洞存在正关联。结论DM—FIB患者临床症状不典型，而X线表现与PTB患者存在一定差别，应注意鉴别诊断；两病并发会增加痰菌阳性和肺部空洞的危险，应注意观察，避免其作为传染源导致疫情蔓延。     

The clinical application of bacteriological results of antibiotic prophylaxis for appendicectomy

Culture results from intra-operative peritoneal swabs taken in 85 cases of perforated and gangrenous appendicitis at Princess Margaret Hospital for Children (PMH) from January 1982 until December 1984 were analysed. All were given preoperative antibiotic therapy. Sixty-one specimens were culture positive, yielding 134 isolates comprising bacteria from 13 different groups. Escherichia coli (E. coli) was the most common organism cultured, being found in 82% of patients with positive cultures. Six different bacterial groups accounted for 91% of all isolates (122 of 134). The combination of ampicillin, gentamycin, and metronidazole provided the most comprehensive antibiotic cover for all bacteria cultured. This combination was also the least expensive and was associated with a satisfactory clinical outcome.     

同种异体肝移植合并肺部感染细菌学分析

目的：回顾性分析同种异体肝移植合并肺部感染细菌学的特点。方法：对1999年6月至2003年10月收治的22例肝移植病例的术后咽拭子、痰液、血液细菌培养结果进行统计分析。结果：咽拭子、痰液培养阳性率明显高于血液，咽拭子、痰液培养两种方法之问无差别，主要为念珠菌、表皮葡萄球菌、光滑球拟酵母菌、草绿色链球菌、粪链球菌、肺炎克雷伯杆菌。结论：同种异体肝移植合并肺部感染主要以革兰氏阳性球菌和真菌为主。