嗜麦芽窄食单胞菌耐药性分析

目的:分析嗜麦芽窄食单胞菌的耐药性以指导临床合理用药。方法:对经VITEK系统鉴定出101株嗜麦芽窄食单胞菌进行自动化药敏试验和纸片扩散法药敏试验,同时对长期难治性嗜麦芽窄食单胞菌感染患者每间隔1周进行1次药敏试验。结果:在所有临床标本中从痰液分离的嗜麦芽窄食单胞菌最多(75％),其次是洁尿(10％),该菌对亚胺培南天然耐药,氨苄西林、阿莫西林/棒酸、头孢唑啉、呋喃妥因、头孢呋辛为100％耐药。丁胺卡那、氨曲南、头孢美唑、头孢曲松、头孢噻肟、庆大霉素敏感率在20％以下,对左氧氟沙星、复方新诺明、头孢他啶、头孢哌酮/舒巴坦(舒普深)耐药率分别为18.92％、22.86％、13.95％、2.50％。结论:嗜麦芽窄食单胞菌为医院感染的重要病原菌,对大多数抗生素耐药,头孢哌酮/舒巴坦(舒普深)为其首选药物;嗜麦芽窄食单胞菌对仅有的几个敏感药物也易产生药物诱导性耐药。     

下呼吸道医院感染嗜麦芽窄食单胞菌的耐药性分析

目的 探讨下呼吸道医院感染嗜麦芽窄食单胞菌对抗菌药物的耐药性,指导临床医师合理使用抗菌药物.方法 采用纸片扩散法检测60株嗜麦芽窄食单胞菌对12种抗菌物的敏感性.结果 嗜麦芽窄食单胞菌对抗菌药物敏感性高的分别为复方新诺明(95.0%)、米诺环素(93.3%)、环丙沙星(65.0%)、头孢哌酮/舒巴坦(65.0%),而亚胺培南耐药率为100%.结论 嗜麦芽窄食单胞菌对复方新诺明、米诺环素等较敏感,对其他抗菌药物耐药情况严重,应加强监测与控制,预防嗜麦芽窄食单胞菌医院感染暴发流行.     

嗜麦芽窄食单胞菌的临床分布及耐药性分析

目的调查我院住院患者嗜麦芽窄食单胞菌的临床分布及耐药性变迁,为临床医师合理使用抗菌药物提供依据。方法收集2014年1月至2016年12月我院住院患者送检的各类标本分离出的嗜麦芽窄食单胞菌,采用VITEK-2系统进行细菌鉴定和药敏试验,并对阳性标本的耐药性进行分析。结果共检出嗜麦芽窄食单胞菌207株,感染嗜麦芽窄食单胞菌的易感人群以中老年患者为主;主要分离自痰标本,占60.4%,其次是尿和全血,分别占13.0%和7.7%;主要来源于重症监护病房和神经内科病房,分别占16.4%和13.5%。在CLSI判定标准规定的针对嗜麦芽窄食单胞菌的几种抗菌药物中,耐药率较低的抗菌药物为复方新诺明和左氧氟沙星,敏感率分别为89.4%、72.5%。结论住院患者嗜麦芽窄食单胞菌的耐药率高,治疗难度大,感染的易感人群主要以中老年患者为主,临床医生应根据药敏试验结果合理选用抗菌药物,避免多重耐药嗜麦芽窄食单胞菌菌株的产生和流行。     

56株嗜麦芽窄食单胞菌的耐药性分析

目的：调查嗜麦芽窄食单胞菌的耐药状况，指导临床合理用药。方法：采用K-B纸片扩散法进行药物敏感试验，结果按美国国家临床实验室标准委员会(NCCLS)2000年版标准判定。结果与结论：嗜麦芽窄食单胞菌对多种抗生素高度耐药，而喹诺酮类和氨基糖苷类抗生素对嗜麦芽窄食单胞菌相对较为敏感，可作为该菌感染的首选药物。     

37株嗜麦芽窄食假单孢菌下呼吸道感染药敏分析

目的：探讨嗜麦芽窄食假单孢菌的耐药性。方法：对我院2000年至2001年37株嗜麦芽窄食假单孢菌对12种抗菌药物的耐药性进行分析。结果：37株嗜麦芽窄食假单孢菌对三代头孢菌素，亚胺培南100％耐药，对复方新诺明耐药率55％，对环丙沙星耐药率22％为最低。结论：嗜麦芽窄食假单孢菌耐药率高，加强重点科室的监测，采取有效的消毒隔离措施，指导临床合理使用抗生素。     

嗜麦芽窄食单胞菌呼吸道感染耐药性分析

目的：分析我院2008～2009年呼吸科嗜麦芽窄食单胞菌感染患者病原菌的耐药性及抗菌药物的选择,为合理应用抗菌药物提供依据。方法：对20例感染嗜麦芽窄食单胞菌的呼吸科住院患者药敏结果进行临床分析。结果：20株嗜麦芽窄食单胞菌对左氧氟沙星、哌拉西林/他唑巴坦等敏感率较高,对亚胺培南、氨曲南100%耐药。结论：高龄、严重基础疾病、侵入性操作等是嗜麦芽窄食单胞菌呼吸道感染的高危因素,根据药敏试验结果选择抗菌药物,减少易感因素,加强基础疾病的治疗,切断传播途径,避免交叉感染,是治疗和防止嗜麦芽窄食单胞菌感染的重要措施。     

2例嗜麦芽窄食单胞菌与多种耐药菌混合感染的抗菌药物使用分析

列举2例嗜麦芽窄食单胞菌与多种耐药菌混合感染的病例, 并对其在嗜麦芽窄食单胞菌出现前后抗菌药物使用情况进行分析. 针对病例的治疗过程, 分析鉴别嗜麦芽窄食单胞菌是定植菌还是致病菌的判定方法 , 对混合菌感染, 提出了切实可行的临床治疗对策. 详尽叙述了针对嗜麦芽窄食单胞菌与多种耐药菌混合感染治疗的判断思考过程, 以及使用抗菌药物的品种、剂量、注意事项等细节, 可为临床合理应用抗菌药物治疗嗜麦芽窄食菌感染提供参考.     

121株嗜麦芽窄食单胞菌的耐药分析

目的 分析临床分离的嗜麦芽窄食单胞菌的耐药性,为嗜麦芽窄食单胞菌感染的临床用药提供依据.方法 采用纸片法测量临床分离到的121株嗜麦芽窄食单胞菌对11种抗菌药物的敏感性.结果 121株嗜麦芽窄食单胞菌对多种常用抗菌药物呈现多重耐药,但对复方新诺明、头孢哌酮舒巴坦、环丙沙星耐药率低,分别为25.1%、22.3%、22.7%.结论 嗜麦芽窄食单胞菌已成为呼吸道医院内感染的的致病菌之一.对嗜麦芽窄食单胞菌引起的感染应尽早进行病源学检查,选择合适的抗菌药物.     

环丙沙星对革兰阴性杆菌抗菌活性连续4年的监测研究

目的了解环丙沙星对革兰阴性杆菌的耐药性变迁,指导临床合理用药。方法2002—2005年每年度一定时间段内连续收集150～200株病房内分离的不重复革兰阴性杆菌,采用E试验测定细菌对11种抗菌药物的最低抑菌浓度（MIC）,用WHONET 5．4软件进行统计分析。结果4年来共收集665株革兰阴性杆菌,主要菌种依次为鲍曼不动杆菌142株（21．35％）、大肠埃希菌134株（20．15％）、肺炎克雷伯菌128株（19．25％）、铜绿假单胞菌111株（16．69％）、嗜麦芽窄食单胞菌42株（6．32％）、阴沟肠杆菌41株（6．17％）。所测的抗菌药物敏感性均呈下降趋势,亚胺培南敏感率最高（75％）,其次为阿米卡星（72％）。环丙沙星敏感率从2002年的62％下降至41％,其中鲍曼不动杆菌的耐药性增加非常显著,从2002年的25％上升至2005年的75％,大肠埃希菌的耐药率均维持在较高水平（75％～86％）,肺炎克雷伯菌、铜绿假单胞菌至2005年仍分别有58％和69％的菌株敏感,阴沟肠杆菌的耐药率也较高（平均为46％）,嗜麦芽窄食单胞菌的耐药率平均为17％,但有24％的菌株为中介。结论环丙沙星对革兰阴性杆菌敏感性呈下降趋势,对不同的菌种抗菌活性有较大差异,应结合药物敏感试验结果合理使用药物。     

2004-2005年天津地区非发酵革兰阴性菌耐药性分析

目的：了解2004年1月-2005年12月天津地区临床分离非发酵革兰阴性杆菌的耐药状况。方法：使用纸片扩散法对天津地区5所三级甲等医院从临床分离的4064株非发酵革兰阴性杆菌进行抗菌药物敏感试验，数据分析采用WHONET5．3软件。结果：2年间天津地区临床分离非发酵革兰阴性杆菌的分离率已占革兰阴性杆菌的38．4％，并有增高趋势。从构成比来看，以铜绿假单胞菌、不动杆菌和嗜麦芽窄食单胞菌为主，2005年铜绿假单胞菌对亚胺培南敏感率70．7％，亚胺培南对鲍曼不动杆菌保持较高的抗菌活性（96．6％），其他非发酵菌对亚胺培南耐药率达50％以上。2个酶抑制复合制剂头孢哌酮／舒巴坦、哌拉西林／他唑巴坦（除外嗜麦芽窄食单胞菌）对非发酵菌的耐药率均在30％以下。左氧氟沙星对非发酵菌保持较高的抗菌活性。结论：非发酵菌感染呈上升趋势。地区性细菌耐药性分析有利于早期经验治疗时抗菌药物的选择。     

Efficacy of gut lavage,hemodialysis, and hemoperfusion in the therapy of paraquat or diquat intoxication

Clinical and in vitro investigations were carried out to test the efficacy of gut lavage, hemodialysis, and hemoperfusion in the treatment of poisoning with paraquat or diquat. In a patient suffering from diquat intoxication 130 times more diquat was removed by gut lavage 30 h after ingestion than was removed by complete aspiration of the gastric contents.Determination of in vitro clearances for paraquat and diquat by hemodialysis showed that, at serum concentrations of 1–2 ppm, such as are frequently encountered in poisoning in man, toxicologically relevant quantities of herbicide cannot be removed from the body. At a concentration of 20 ppm, on the other hand, hemodialysis proved to be effective, the clearance being 70 ml/min at a blood flow rate of 100 ml/min. The efficacy of hemoperfusion with coated activated charcoal was on the whole better. Especially at concentrations around 1–2 ppm, the clearance values for hemoperfusion were some 5–7 times higher than those for hemodialysis.In a patient suffering from paraquat poisoning, both hemodialysis as well as hemoperfusion were carried out. The in vitro results could be confirmed: At serum concentrations of paraquat less than 1 ppm no clearance could be obtained by hemodialysis while by hemoperfusion with activated charcoal quite high clearance values were measured and the serum level dropped down to zero.

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Zusammenfassung Klinische Untersuchungen und Laboratoriumsversuche wurden durchgeführt, um die Wirksamkeit von Darmspülung, Hämodialyse und Hämoperfusion bei Paraquat- und Deiquat-Vergiftungen zu prüfen.Bei einem Patienten wurde 30 Std nach Deiquat-Aufnahme durch Darmspülung 130mal mehr Deiquat entfernt als durch vollständige Aspiration des Mageninhaltes. In vitro-Versuche ergaben, daß bei Blutserumkonzentrationen von 1–2 ppm, die bei Vergiftungen oft gemessen werden, durch Hämodialyse keine toxikologisch relevanten Paraquat- oder Deiquat-Mengen entfernt werden können. Dagegen erwies sich die Hämodialyse bei 20 ppm und einer Blutumlaufgeschwindigkeit von 100 ml/min mit einer Clearance von 70 ml/min als wirksam. Die Hämoperfusion mit beschicheter Aktivkohle war in diesen Versuchen aber eindeutig überlegen, denn insbesondere bei Konzentrationen um 1–2 ppm waren die Clearance-Werte 5–7mal höher als bei der Hämodialyse.Die in vitro-Ergebnisse wurden bei einem Patienten mit einer Paraquat-Vergiftung bestätigt: Bei Konzentrationen unter 1 ppm war die Hämodialyse wirkungslos, während durch Hämoperfusion relativ hohe Clearance-Werte erreicht wurden, so daß der Serumspiegel rasch unter die Nachweisgrenze abfiel.

     

In vitro studies on sterically stabilized liposomes (SL) as enzyme carriers in organophosphorus (OP) antagonism

This study describes a new approach for organophosphorous (OP) antidotal treatment by encapsulating an OP hydrolyzing enzyme, OPA anhydrolase (OPAA), within sterically stabilized liposomes. The recombinant OPAA enzyme was derived from Alteromonas strain JD6. It has broad substrate specificity to a wide range of OP compounds: DFP and the nerve agents, soman and sarin. Liposomes encapsulating OPAA (SL)* were made by mechanical dispersion method. Hydrolysis of DFP by (SL)* was measured by following an increase of fluoride ion concentration using a fluoride ion selective electrode. OPAA entrapped in the carrier liposomes rapidly hydrolyze DFP, with the rate of DFP hydrolysis directly proportional to the amount of (SL)* added to the solution. Liposomal carriers containing no enzyme did not hydrolyze DFP. The reaction was linear and the rate of hydrolysis was first order in the substrate. This enzyme carrier system serves as a biodegradable protective environment for the recombinant OP-metabolizing enzyme, OPAA, resulting in prolongation of enzymatic concentration in the body. These studies suggest that the protection of OP intoxication can be strikingly enhanced by adding OPAA encapsulated within (SL)* to pralidoxime and atropine.     

Aquatic Insects and Trace Metals: Bioavailability,Bioaccumulation, and Toxicity

Abstract

The uptake of metals from food and water sources by insects is thought to be additive. For a given metal, the proportions taken up from water and food will depend both on the bioavailable concentration of the metal associated with each source and the mechanism and rate by which the metal enters the insect. Attempts to correlate insect trace metal concentrations with the trophic level of insects should be made with a knowledge of the feeding relationships of the individual taxa concerned. Pathways for the uptake of essential metals, such as copper and zinc, exist at the cellular level, and other nonessential metals, such as cadmium, also appear to enter via these routes. Within cells, trace metals can be bound to proteins or stored in granules. The internal distribution of metals among body tissues is very heterogeneous, and distribution patterns tend to be both metal and taxon specific. Trace metals associated with insects can be both bound on the surface of their chitinous exoskeleton and incorporated into body tissues. The quantities of trace meals accumulated by an individual reflect the net balance between the rate of metal influx from both dissolved and particulate sources and the rate of metal efflux from the organism. The toxicity of metals has been demonstrated at all levels of biological organization: cell, tissue, individual, population, and community. Much of the literature pertaining to the toxic effects of metals on aquatic insects is based on laboratory observations and, as such, it is difficult to extrapolate the data to insects in nature. The few experimental studies in nature suggest that trace metal contaminants can affect both the distribution and the abundance of aquatic insects. Insects have a largely unexploited potential as biomonitors of metal contamination in nature. A better understanding of the physico-chemical and biological mechanisms mediating trace metal bioavailability and exchange will facilitate the development of general predictive models relating trace metal concentrations in insects to those in their environment. Such models will facilitate the use of insects as contaminant biomonitors.     

Pharmacological treatment of COVID-19: an opinion paper

The precocity and efficacy of the vaccines developed so far against COVID-19 has been the most significant and saving advance against the pandemic. The development of vaccines has not prevented, during the whole period of the pandemic, the constant search for therapeutic medicines, both among existing drugs with different indications and in the development of new drugs. The Scientific Committee of the COVID-19 of the Illustrious College of Physicians of Madrid wanted to offer an early, simplified and critical approach to these new drugs, to new developments in immunotherapy and to what has been learned from the immune response modulators already known and which have proven effective against the virus, in order to help understand the current situation.     

Alzheimer’s disease – current trends in basic and clinical research. Highlights from the 16th ECNP

Advances in the molecular biological knowledge of neuronal nicotinic acetylcholine receptors (nAChRs) have led to a growing interest by the pharmaceutical industry in the development of novel compounds that selectively modulate nAChR function. The ability of (-)-nicotine, an activator of nAChRs, to enhance attentional aspects of cognition in animals and humans, to exert neuroprotective and anxiolytic-like effects, and presumably to mediate the negative correlation between smoking and Alzheimer's (and Parkinson's) Disease, has focused interest on the potential therapeutic utility of modulators of nAChR function for treatment of some of the deficits associated with these progressive, neurodegenerative conditions. Numerous compounds are known which activate nAChRs and which might serve as lead compounds toward the development of such agents. The pharmacologic diversity of neuronal nAChR subtypes suggests the possibility of developing selective compounds which would have more favourable side-effect profiles than existing agents. This broader class of agents, collectively called cholinergic channel modulators (ChCMs), is anticipated to encompass compounds which would have more favourable side-effect profiles than existing agents, which generally exhibit low selectivity. This selectivity may be achieved by preferentially activating some subtypes of nAChRs (i.e., Cholinergic Channel Activators, ChCAs) or inhibiting the function of other subtypes (Cholinergic Channel Inhibitors, ChCIs). An overview of the biology of nAChRs and the rationale for the use of ChCMs for the treatment of dementia related to neurodegenerative diseases are presented, followed by a discussion of lead compounds and compounds under consideration for clinical evaluation.     

Steroidal sapogenin contents in some domestic plants

In order to find out the values of the steroid resources for the future use. the compositions and contents of steroidal sapogenins from 13 domestic plants have been investigated. As a result,Dioscorea nipponica, D. quinqueloba andSmilax china were found to have large amount of diosgenin. And pennogenin inTrillium kamtschaticum andParis verticillata, yuccagenin inAllium fistulosum, hecogenin inAgave americana and neochlorogenin inSolanum nigum were appeared to be major steroidal sapogenins.