腹泻粪便中小肠结肠炎耶尔森菌检验的价值结果分析

目的对腹泻粪便中小肠结肠炎耶尔森菌检验的价值结果进行分析。方法随机选取2012年7月至12月间的腹泻患者423例,采取培养法以及RT-PCR进行小肠结肠炎耶尔森菌肠炎检验,对两种检测方式的疾病检出率进行比较分析。结果培养法及RT-PCR对小肠结肠炎耶尔森菌的疾病检出均有积极意义,且采取RT-PCR进行小肠结肠炎耶尔森菌肠炎检验使得疾病检出率更高,P<0.05。结论对腹泻粪便中小肠结肠炎耶尔森菌检验时,采取RT-PCR,使得检出率更高,值得临床积极推广     

腹泻粪便中小肠结肠炎耶尔森菌检验的价值结果分析

目的探讨不同检测方法检验腹泻粪便中耶尔森菌感染者的临床价值。方法取50例于2014年5月至2015年5月我单位接收的腹泻患者,均符合感染性腹泻诊断标准(WS271-2007),采集患者新鲜粪便,分别采用RT-PCR法和培养法对样本中耶尔森菌感染情况进行检测,观察检测结果。结果 RT-PCR法对小肠结肠炎耶尔森菌的检出率较培养法显著要高(P<0.05),具有统计学差异。结论 RTPCR检测法对腹泻粪便中小肠结肠炎耶尔森菌的检出效果更好,以便及时予以抗感染治疗,改善患者预后。     

57例新生儿坏死性小肠结肠炎临床分析

目的研究新生儿坏死性小肠结肠炎发病特点,严重程度的高危因素。方法将笔者所在医院2007年1月～2012年1月收治的57例新生儿坏死性小肠结肠炎临床资料作一回顾性分析。结果约90%NEC发生于胎龄<36周患儿,早产儿、感染、动脉导管未闭、红细胞增多、非母乳喂养为NEC高危因素。结论 NEC好发于早产儿,穿孔率高,病死率高,临床表现不典型,早期诊断困难,降低NEC死亡率关键在于预防NEC发生。     

新生儿坏死性小肠结肠炎危险因素分析

目的：探讨新生儿坏死性小肠结肠炎（necrofizingen terocolitis。NEC）的发病吲索，为该病防治提供依据。方法：对NEC9种危险因素进行调查，对资料用Logistic回归法进行统计学分析和处理。结果：资料分析显示胎龄、出生体重、窒息、感染、母围生期危险因素、快速超量高渗喂养6个因素为NEC的危险因素，母乳喂养是保护因素。结论：该病的发生与多种危险因素有关，NEC的防治关键在于提高对本病的认识，对具有影响NEC发生因素的患儿，采取综合预防措施，有利于降低发病率。     

福州地区肺炎克雷伯氏菌和大肠埃希氏菌的药敏监测

目的监测福州地区肺炎克雷伯氏菌和大肠埃希氏菌对14种常用抗生素的药敏情况，为临床合理选用抗生素提供依据。方法收集2001年3月-10月福州地区4家医院分离的肺炎克雷伯氏菌和大肠埃希氏菌426株，用K-B琼脂扩散法作药敏试验；用表型确认试验检测超广谱β-内酰胺酶(ESBLs)。结果在14种抗生素中，敏感性最高的是亚胺培南(100％)、头孢哌酮／舒巴坦(100％)、哌拉西林／三唑巴坦(99．53％)、头孢吡肟(94．37％)和头孢美唑(91．08％)，敏感性最低的是阿莫西林(12．68％)、哌拉西林(48．83％)和环丙沙星(50．70％)；除头孢他啶外，第三代头孢菌素对肺炎克雷伯氏菌和大肠埃希氏菌的耐药率均在30％以上；产ESBLs菌检出率为33．33％(142／426)；除亚胺培南、头孢哌酮／舒巴坦、哌拉西林／三唑巴坦和头孢美唑外，产ESBLs菌对其它10种抗生素的耐药率均显著高于非产ESBLs菌。结论亚胺培南、头孢哌酮／舒巴坦、哌拉西林／三唑巴坦、头孢吡肟和头孢美唑的敏感性最高，产ESBLs是肺炎克雷伯氏菌和大肠埃希氏菌产生耐药的主要机制之一，临床实验室有必要常规检测肺炎克雷伯氏菌和大肠埃希氏菌是否产ESBLs。     

新生儿坏死性小肠结肠炎23例分析

现将我们诊治２３例新生儿坏死性小肠结肠炎（ＮＥＣ）分析报道如下。１ 临床资料１．１ 一般资料：自１９９５年１月～１９９９年６月我们诊治ＮＥＣ２３例,均符合文献诊断标准［１］。其中早产儿占７３．９％（,有,窒息缺氧１９例占８２．６％,开奶时间＜３天１８例占７８．９％,人工喂养１６例占６９．５％,有感染因素１１例占４７．８％。１．２ 治疗及转归：治疗综合予禁食、胃肠减压、静脉营养及控制感染等综合措施;转归：治愈１３例占５６．５％,死亡７例及因病情危重而放弃治疗在院外死亡３例共占４３．５％。２ 讨论 资料…     

新生儿坏死性小肠结肠炎危险因素分析

目的探讨新生儿坏死性小肠结肠炎（NEC）的危险因素及其在NEC发病中起到的作用。方法 2003年1月至2007年12月在广州医学院第三附属医院新生儿科住院确诊为NEC的32例患儿为病例组,同期在本院产科出生的32例健康新生儿为对照组。归纳出可能引起NEC的早产、窒息、孕高征等19个疑似危险因素,用SPSS13.0软件进行Logistic回归分析。通过Logistic分析,筛选出有统计学意义的危险因素。结果最终筛选出NEC的危险因素有3个,分别为早产、窒息、非母乳喂养因素,其他因素被回归方程排除。OR值分别为：19.474、12.966和16.245。结论本次回归分析显示,早产因素在三者中的OR值最高达19.474,引起NEC的风险最大。但母亲的孕期健康状况作为一个间接诱因也不能忽视。因此做好围产期保健,减少早产儿及低体重儿的出生,防止窒息的发生,提倡母乳喂养是预防NEC的关键。     

Susceptibility of Polish clinical strains of Yersinia enterocolitica serotype O3 to antibiotics

A total of 199 clinical strains of Yersinia enterocolitica serotype O3, biotype 4 were tested for their susceptibility to antibiotics (158 strains carried the virulence plasmid pYV and 41 strains did not). A total of 114 isolates were tested by a standard disk diffusion method for 21 antibiotics. Almost all strains tested were resistant to ampicillin and cefazolin and susceptible to amoxycillin/clavulanate, cefaclor, cefamandole, cefuroxime, cefotaxime, ceftriaxone, aztreonam, imipenem, gentamicin, amikacin, netilmicin, tetracycline, doxycycline, chloramphenicol, ciprofloxacin, sulphamethoxazole, trimethoprim, co-trimoxazole and furazolidone. In addition, minimal inhibitory concentrations of 15 antibiotics were determined by the agar dilution method for all 199 strains (158 carrying plasmid pYV and 41 strains that did not). Third-generation cephalosporins such as cefotaxime and ceftriaxone and a fluoroquinolone (ciprofloxacin) were the most active antimicrobial agents tested followed by aztreonam, imipenem, trimethoprim, tetracycline, gentamicin, chloramphenicol, amoxycillin/clavulanate, cefaclor, cefuroxime, amikacin, furazolidone and sulphamethoxazole. The present study demonstrated a high susceptibility of clinical strains of Y. enterocolitica to most of the tested antibiotics. In general there was no significant difference between susceptibility to antibacterial agents of strains with or without plasmid pYV.     

Toxigenic Properties of Yersinia enterocolitica Biotype 1A

Yersinia (Y.) enterocolitica, an etiological agent of yersiniosis, is a bacterium whose pathogenicity is determined, among other things, by its ability to produce toxins. The aim of this article was to present the most important toxins that are produced by biotype 1A strains of Y. enterocolitica, and to discuss their role in the pathogenesis of yersiniosis. Y. enterocolitica biotype 1A strains are able to synthesize variants of thermostable YST enterotoxin and play a key role in the pathogenesis of yersiniosis. Biotype 1A strains of Y. enterocolitica also produce Y. enterocolitica pore-forming toxins, YaxA and YaxB. These toxins form pores in the cell membrane of host target cells and cause osmotic lysis, which is of particular importance in systemic infections. Insecticidal toxin complex genes have been detected in some clinical biotype 1A strains of Y. enterocolitica. However, their role has not yet been fully elucidated. Strains belonging to biotype 1A have long been considered non-pathogenic. This view is beginning to change due to the emerging knowledge about the toxigenic potential of these bacteria and their ability to overcome the defense barriers of the host organism.     

高毒力肺炎克雷伯菌实验室鉴定方法的研究进展

摘要：高毒力肺炎克雷伯菌(hypervirulent Klebsiella pneumoniae, hvKP)具有独特的表型特征和基因型特征，常导致严重的感染。然而，国际上仍无统一的hvKP定义标准，造成不同研究选择的hvKP评价方案不尽相同，基于流行病学分析和感染的快速诊断等多方需求，目前迫切需要关于hvKP的客观鉴定方法。本文从hvKP的表型、毒力基因、毒力评估方面对其实验室鉴定方法进行综述，希望对hvKP的防控提供参考。     

Drug sensitivity of Yersinia enterocolitica and Yersinia pseudotuberculosis]

Drug-sensitivity of 70 strains of Y. enterocolitica and 24 of Y. pseudotuberculosis including reference strains and isolates from men or animals were determined by the agar plate-dilution method. All the strains of Y. enterocolitica were relatively resistant to penicillins and cephalosporins, while all of Y. pseudotuberculosis were sensitive to both of the agents. Most of the strains of both species excluding 13 resistant ones were sensitive to streptomycin. The resistant strains, however, were sensitive to other aminoglycoside antibiotics, i.e. kanamycin, paromomycin, gentamicin, tobramycin, dibekacin and amikacin. All of the strains were sensitive to chloramphenicol. Most of the strains excluding 3 resistant ones were highly sensitive to tetracycline. The resistant strains were also resistant to doxycycline and methacycline but not to minocycline. All of them were resistant to erythromycin, to lincomycin and to novobiocin. Most of them excluding 7 resistant strains were sensitive to sulfisoxazole. All of them were sensitive to nalidixic acid, piromidic acid, and also to dihydroxymethylfuratrizine. A new synthetic agent, fosfomycin showed a relatively wide range of activity to the strains, but none of resistant strains were noticed. These resistant strains were all found in the isolates from men and animals but not in reference strains. Among these resistant strains, resistance patterns were as follows; TC, SM, SA in 3 of Y. enterocolitica, SM, SA in 3 of Y. enterocolitica and in 1 of Y. pseudotuberculosis, and SM in 3 of the both species, respectively. As for polypeptide antibiotics, polymyxin B and colistin, some strains of the both species showed an uncontinous susceptibility, i.e. inhibited growth at a certain lower concentration but growth at a higher concentration.     

Involvement of phospholipase C in Yersinia enterocolitica heat stable enterotoxin (Y-STa) mediated rise in intracellular calcium level in rat intestinal epithelial cells.

In response to Yersinia enterocolitica heat stable enterotoxin (Y-STa) intracellular calcium level was increased with a prolong sustained phase in presence of calcium chloride in extracellular environment in rat intestinal epithelial cells. Chelation of extracellular calcium with EGTA (extracellular calcium chelator) and suspension of cells in calcium free buffer demonstrated a rapid but transient rise in calcium level, which suggested that Y-STa induced rise in intracellular calcium concentration was the combination of both intracellular calcium store depletion and calcium influx from extracellular environment. Moreover, in response to Y-STa phosphoinositide specific phospholipase C activity and inositol tri phosphate (IP3) level was increased and U73122, a phospholipase C inhibitor could completely inhibit Y-STa induced calcium rise. However, treatment of rat enterocytes with dantrolene IP3, a mediated calcium release inhibitor from intracellular store resulted partial inhibition of Y-STa induced rise in intracellular calcium level. Similar observation was noted with IP3 receptor antagonist 2ABP (2-amino-ethoxydiphenylborate). These results suggested that beside phospholipase C IP3 pathway, phospholipase C might have an independent role in Y-STa induced calcium influx. Rise in phospholipase Cgamma isoform activity in response to Y-STa suggested that gamma isoform of phospholipase C might have a role in Y-STa mediated rise in intracellular calcium level.     

Campylobacter enteritis and Yersinia enterocolitica infection in New Zealand.

A three-month survey was undertaken to determine the incidence of Campylobacter jejuni and Yersinia enterocolitica in diarrhoeal disease and acute abdominal disease in Palmerston North. C. jejuni was isolated from five domiciliary patients and one hospitalised patient with acute diarrhoea but there were no isolations from patients suffering from acute abdominal disease. The isolation rates for C. jejuni in domiciliary and hospitalised patients with acute diarrhoea were 7.8 percent and 1.7 percent respectively. Y. enterocolitica was not isolated.     

呼和浩特市89株肺炎链球菌携带耐药及毒力基因特征分析

目的 探究呼和浩特地区住院患者分离肺炎链球菌抗生素耐药基因及携带毒力基因分布情况,了解儿童株和成人株之间的差异。方法 收集内蒙古医科大学附属医院2010年10月-2016年4月临床患者分离89株肺炎链球菌,采用PCR技术检测其携带耐药和毒力基因表达情况,分别统计分析其在儿童及成人分布不同。结果 89株肺炎链球菌耐药基因pbp2a、pacE阳性率为100%;pbp2b、pbp3、teM、ermB、gyrB和parC阳性率在90%以上;tetM、teO基因阳性率分别为51.7%、36.0%。pbp1a和tet基因在儿童分离株和成人分离株之间有差异(χ2=5.107和22.984, P=0.01)。毒力基因stkP、nanA和piaA阳性率为100%;pcsB、phtD、pneumolysin、lytA、pspA和psaA基因阳性率均在90%以上;bacteriocin和clpP基因检测率较低,分别为79.8%和68.5%;cps2A基因在儿童株和成人株之间有差异(P=0.031)。结论 肺炎链球菌儿童分离株耐药基因携带率低于成人分离株,但毒力基因携带率明显高于成人分离株,不同人群肺炎链球菌菌分离株的生物学特征差异及其机制有待进一步研究。     

Protective effect of Oxadin on experimental Yersinia enterocolitica infection in rats

The effect of Oxadin (a new Bulgarian antimicrobial chemotherapeutic agent) on some parameters of non-specific immune response was investigated in a rat model of infection. After mimicking natural Yersinia enterocolitica systemic infection the number and functional activity of blood leucocytes and peritoneal macrophages were compared between groups of animals treated with Oxadin before and after infection. A significant immunostimulating effect of Oxadin was found in both experimental groups but was better expressed when administered before Yersinia infection. Bactericidal response of peritoneal macrophages (killing ability) and phagocytic activity of polymorphonuclear leucocytes from animals treated with Oxadin and thereafter infected with Yersinia enterocolitica were significantly activated during the first week of study. These findings correlated with the enhanced number of both types of phagocytic cells and the higher glycolytic activity of peritoneal macrophages.