糖尿病患者尿路感染的病原菌特点和药敏分析

目的探讨糖尿病患者尿路感染病原菌的分布以及药敏分析,以指导临床治疗。方法对152例糖尿病伴尿路感染患者的尿进行病原学检测和药敏试验。结果 152例患者中共分离出病原菌株100例,检出率65.79%,以女性居多,占88.00%。其中革兰阴性菌57例,革兰阳性菌36例,真菌7例,标本中大肠埃希菌检出率最高,占43.00%(43/100);大肠埃希菌中,以氨苄西林(90.70%)、左旋氧氟沙星(62.79%)、头孢唑啉(58.14%)的耐药率较高。与非产ESBLs菌相比,产ESBLs大肠杆菌头孢呋辛酯、头孢呋辛钠、头孢噻肟、头孢唑啉以及头孢他啶的耐药率明显升高。结论糖尿病尿路感染以女性多见,其病原菌以大肠埃希菌为主,对ES-BLs的监测较为重要,临床上尽量根据细菌药敏结果调整抗生素,避免抗生素滥用。     

118例糖尿病伴尿路感染患者清洁中段尿标本中细菌培养结果及其对抗菌药物的耐药性探究

目的:探究糖尿病伴尿路感染患者清洁中段尿标本中致病菌的分布及其对抗菌药物的耐药性。方法:选取医院2018年9月—2019年9月间收治的糖尿病伴尿路感染患者118例资料,统计其采集患者清洁中段尿细菌培养及药敏试验结果,探究其尿液中病原菌及菌属的分布,分析不同病原菌对抗菌药物的耐药性和治疗效果及预后。结果:118例糖尿病伴尿路感染患者尿液中,分离出病原菌139株,其中革兰阴性菌88株(63.31%)、革兰阳性菌47株(33.81%)和真菌4株(2.88%);革兰阴性菌中以大肠埃希菌为主(79.55%);革兰阳性菌中以肠球菌及凝固酶阴性葡萄球菌为主,凝固酶阴性葡萄球菌占42.55%;革兰阴性菌对亚胺培南、头孢哌酮-舒巴坦耐药率较低;革兰阳性菌对万古霉素、呋喃妥因的耐药率较低;临床可根据药敏试验结果调整抗菌药物用药后的治疗率显著提高。结论:糖尿病伴尿路感染患者尿液中病原菌以革兰阴性菌居多,其中尤以大肠埃希菌为主,临床应根据病原菌检出情况及药敏试验结果合理选用抗菌药物,以提高糖尿病伴尿路感染的治愈率。     

糖尿病尿路感染的病原菌分布及耐药性分析

目的分析糖尿病泌尿系统感染的病原菌分布及耐药性。方法收集517例2型糖尿病患者的中段尿液标本,分离病原菌并做药敏试验。结果有50例患者发生泌尿系统感染,占517例2型糖尿病患者得9.67%。共分离出54株病原菌,4例患者为双重感染占10.2%,均为复合真菌感染。革兰阴性菌35株(64.8%),革兰阳性菌15株(27.8%),真菌4株(7.4%)。最多的病原菌为大肠埃希菌占31.5%。结论糖尿病患者并发泌尿系统感染率较高,临床医师应该了解并掌握2型糖尿病患者尿路感染病原菌分布特点及其耐药性,以为患者制定合适的治疗方案。     

743株尿路感染患者病原菌的分布及其耐药性分析

目的:分析尿路感染患者病原菌的分布及其对抗菌药物的耐药性,为临床合理使用抗菌药物提供参考。方法:选取2016年1月—2018年12月间收治的尿路感染患者中段尿样本1 537例,统计其中段尿样本尿菌培养结果,分析结果中病原菌的分布及其对抗菌药物的耐药性。结果:1 537例尿路感染患者中段尿样本中分离出743株病原菌(检出率为48.34%),其中革兰阴性菌513株(占69.04%),革兰阳性菌189株(占25.44%)和真菌41株(占4.42%);主要革兰阴性菌对美罗培南的耐药率均较低,其中鲍曼不动杆菌、铜绿假单胞菌、大肠埃希菌和奇异变形杆菌对阿米卡星的耐药率较低,肺炎克雷伯菌和奇异变形杆菌对头孢曲松和依替米星的耐药率较低;主要革兰阳性菌对左氧氟沙星的耐药率较低,金黄色葡萄球菌对四环素和利福平的耐药率也较低,粪肠球菌对庆大霉素和阿奇霉素的耐药率较低。结论:医院收治的尿路感染患者所感染的病原菌以革兰阴性菌为主,并且仅对少数抗菌药物具有较低的耐药率,临床用药可参考其药敏结果,合理使用抗菌药物,以减少致病菌对抗菌药物耐药性的发生。     

149株糖尿病患者伴口腔颌面部多间隙感染病原菌的分布及其耐药性分析

目的:分析糖尿病患者伴口腔颌面部多间隙感染的病原菌分布与耐药性。方法:选取2016年12月—2017年12月间收治的糖尿病伴口腔颌面部多间隙感染患者120例资料,分析其病原菌的分布及特征以及对抗菌药物的耐药情况。结果:120例患者中检出149株病原菌,其中革兰阳性菌为主(88株占59.06%),主要以金黄色葡萄球菌为最高(45株占51.14%);革兰性阴性菌56株占37.58%,主要以肺炎克雷伯菌为主(27株占48.21%),明显高于其他类菌株(真菌5株占3.36%)(P<0.05);且不同病原菌对不同的抗生素存在不同的耐药性。结论:糖尿病患者伴口腔颌面部感染病原菌种类较多,以革兰阳性菌为主,由于糖尿病患者感染致病菌对药物的耐药性较高,所以应当配合病原学检测,更有目的性的进行治疗。     

分析糖尿病合并尿路感染患者尿液的细菌培养与药物敏感试验

目的探讨糖尿病合并尿路感染患者尿液的细菌培养与药物敏感试验的结果,以期为临床用药提供参考依据。方法选取我院70例糖尿病合并尿路感染患者的临床资料,收治时段在2015年3月至2016年8月,所有患者均实施细菌培养与药物敏感试验。结果糖尿病患者检出70株病原菌,其中革兰阴性杆菌为42株;革兰阳性球菌共20株,真菌8株;另外,革兰阴性杆菌对亚胺培南的耐药率较低(3.1%),对氨芐西林的耐药率最高(76.9%);革兰阳性球菌的耐药中青霉素耐药率(75.0%)和克林霉素的耐药率(64.2%)较高。结论对于糖尿病合并尿路感染者应先实施清洁中段尿细菌培养以及药敏试验,后根据试验的结果给予对应的抗生素治疗。     

我院肾内科2011-2013年住院患者尿路感染病原菌分布及耐药性分析

目的:了解我院肾内科住院患者尿路感染的病原菌分布特点及病原菌耐药现状,为临床选用抗菌药物提供参考。方法:对我院肾内科2011-2013年471例住院患者尿路感染的病原菌分布和抗菌药物耐药性进行回顾性分析。结果:471例患者中,3例为2种病原菌感染,1例为3种病原菌感染,分离出476株病原菌,其中革兰阴性(G-)菌301株(63.24%),革兰阳性(G+)菌136株(28.57%),真菌39株(8.19%)。产超广谱β-内酰胺酶(ESBLs)的阳性菌44株,占总菌株数的9.24%,占G-菌的14.62%;耐甲氧西林金黄色葡萄球菌(MRSA)24株,占总菌株数的5.04%,占G+菌的17.65%。对G+菌敏感性较高的药物有利奈唑胺和万古霉素等,对G-菌敏感性较高的药物有头孢哌酮/舒巴坦、亚胺培南和哌拉西林/他唑巴坦等。结论:我院肾内科住院患者尿路感染以G-菌为主,大肠埃希菌为主要致病菌,耐药性较高;敏感性较好的药物有头孢哌酮/舒巴坦、亚胺培南、哌拉西林/他唑巴坦、阿米卡星等。     

前列腺癌患者术后发生医院感染的病原菌分布与危险因素分析

目的：分析前列腺癌患者术后发生医院感染的病原菌分布与危险因素,为前列腺癌患者术后感染的防治提供参考。方法：选取2019年12月—2022年12月丰城市人民医院行手术治疗的82例前列腺癌患者作为研究对象,分析术后医院感染发生情况与病原菌分布特点,并通过多因素回归分析探究发生术后医院感染的危险因素。结果：82例前列腺癌患者中,23例发生医院感染(感染率为28.05%),其中尿路感染15例(占65.22%),呼吸系统感染6例(占26.09%),切口感染2例(占8.70%);23例医院感染患者标本中共培养出31株病原菌,其中革兰阴性菌21株(占67.74%),革兰阳性菌10株(占32.26%);合并糖尿病、未预防使用抗菌药物、前列腺体积≥45 cm³、术前导尿、手术时间≥1 h、留置尿管时间≥5 d、住院时间>7 d与患者发生医院感染相关(P<0.05);Logistic多因素分析结果显示,合并糖尿病(OR=3.019)、未预防使用抗菌药物(OR=1.937)、前列腺体积≥45 cm³(OR=2.694)、术前导尿(OR=2.162)、手...     

某院102例重症细菌性肺炎患儿的病原菌分布及其耐药性分析

目的:探究医院102例重症细菌性肺炎患儿的病原菌分布及其耐药特点,为临床治疗重症肺炎提供参考.方法:选取2019年6月—2020年6月医院收治的102例重症细菌性肺炎患儿作为研究对象,在其确诊重症肺炎24 h内采集下呼吸道分泌物及2 mL静脉血进行细菌培养及药敏试验,统计患者病原菌的来源、分布,并分析主要革兰阴性菌、主要革兰阳性菌的耐药情况.结果:102例重症细菌性肺炎患儿标本检测出151株病原菌,其中痰液检出112株(占74.17％),血液检出73株(占48.34％);151株病原菌含92株革兰阴性菌、59株革兰阳性菌,分别占60.93％、39.07％;革兰阴性菌中前3位的分别为肺炎克雷伯菌36株(占23.84％)、大肠埃希菌18株(占11.92％)、鲍曼不动杆菌12株(占7.95％),革兰阳性菌前3位的分别为肺炎链球菌23株(占15.23％)、金黄色葡萄球菌16株(占10.60％)、溶血性链球菌12株(占7.95％);药敏结果显示,革兰阴性菌对亚胺培南、阿米卡星的耐药率低,肺炎克雷伯菌、大肠埃希菌对环丙沙星的耐药率较低;革兰阳性菌对利奈唑胺、万古霉素的耐药率低.结论:重症细菌性肺炎患儿的病原菌以革兰阴性菌为主,以肺炎克雷伯菌最为常见,检出病原菌对常见抗菌药物呈普遍耐药现象,临床应根据药敏试验结果制定适宜用药方案.     

我院慢性阻塞性肺疾病急性加重期患者痰培养的病原菌分布及耐药性分析

目的:了解我院慢性阻塞性肺疾病急性加重期(AECOPD)患者痰培养的病原菌分布及耐药性,为临床合理用药提供参考。方法:收集我院2010年12月-2014年12月AECOPD患者痰液进行培养,对分离出的307株病原菌进行鉴定和药敏试验,数据采用SPSS 17.0软件进行统计、分析。结果:307株病原菌中,革兰阳性菌17株(占5.54%),革兰阴性菌247株(占80.46%),真菌43株(占14.00%);常见的病原菌是铜绿假单胞菌(33.22%)、鲍曼不动杆菌(19.54%)、嗜麦芽窄食假单胞菌(9.77%)、肺炎克雷伯菌(7.82%)和白色念珠菌(6.84%)等。铜绿假单胞菌和鲍曼不动杆菌多药耐药情况严重;检出产超广谱β-内酰胺酶肺炎克雷伯菌10株,检出率为41.67%;金黄色葡萄球菌中未检出万古霉素、替考拉宁、利奈唑胺耐药株,耐甲氧西林金黄色葡萄球菌检出率为50.00%。结论:AECOPD患者感染病原菌以革兰阴性菌为主,常见病原菌耐药性严重,临床应加强病原菌耐药监测,并结合药敏试验结果合理使用抗菌药物。     

Quantitative in vivo and in vitro sex differences in artemisinin metabolism in rat

1. The pharmacokinetics of the antimalarial compound artemisinin were compared in the male and female Sprague-Dawley rat after single dose i.v. (20 mg.kg) or i.p. (50 mg.kg) administration of an emulsion formulation. 2. Plasma clearance of artemisinin was 12.0 (95% confidence interval: 10.4, 13.0) l.h. kg in the male rat and 10.6 (95% CI: 7.5, 15.0) l.h. kg in the female rat suggesting high hepatic extraction in combination with erythrocyte uptake or clearance. Artemisinin half-life was 0.5 h after both routes of administration in both sexes. Values for plasma clearance and half-lives did not statistically differ between the sexes. 3. After i.p. administration artemisinin AUCs were 2-fold higher in the female compared with male rat (p 0.001). Artemisinin disappearance was 3.9-fold greater in microsomes from male compared with female livers and it was inhibited in male microsomes by goat or rabbit serum containing antibodies against CYP2C11 and CYP3A2 but not CYP2B1 or CYP2E1. 4. The unbound fraction of artemisinin in plasma was lower (p 0.001) in plasma obtained from the male (8.8 2.0%) compared with the female rat (11.7 2.2%). 5. The possibility of a marked sex difference, dependent on the route of administration, has to be taken into account in the design and interpretation of toxicological studies of artemisinin in this species.     

Quantitative in vivo and in vitro sex differences in artemisinin metabolism in rat

1. The pharmacokinetics of the antimalarial compound artemisinin were compared in the male and female Sprague-Dawley rat after single dose i.v. (20 mg x kg(-1)) or i.p. (50 mg x kg(-1)) administration of an emulsion formulation. 2. Plasma clearance of artemisinin was 12.0 (95% confidence interval: 10.4, 13.0) 1 x h(-1) x kg(-1) in the male rat and 10.6 (95% CI: 7.5, 15.0) 1 x h(-1) x kg(-1) in the female rat suggesting high hepatic extraction in combination with erythrocyte uptake or clearance. Artemisinin half-life was approximately 0.5 h after both routes of administration in both sexes. Values for plasma clearance and half-lives did not statistically differ between the sexes. 3. After i.p. administration artemisinin AUCs were 2-fold higher in the female compared with male rat (p < 0.001). Artemisinin disappearance was 3.9-fold greater in microsomes from male compared with female livers and it was inhibited in male microsomes by goat or rabbit serum containing antibodies against CYP2C11 and CYP3A2 but not CYP2B1 or CYP2E1. 4. The unbound fraction of artemisinin in plasma was lower (p < 0.001) in plasma obtained from the male (8.8 +/- 2.0%) compared with the female rat (11.7 +/- 2.2%). 5. The possibility of a marked sex difference, dependent on the route of administration, has to be taken into account in the design and interpretation of toxicological studies of artemisinin in this species.     

Interindividual variability in metabolic activation in humans in vivo

In assessing interindividual variability in metabolic activation, the toxic metabolite is often too unstable for conventional analysis. Possible alternatives include a stable product of the reactive metabolite e.g. cysteinyl derivatives of N-acetyl-4-benzoquinoneimine, the toxic metabolite of paracetamol, adducts with DNA or protein, and indirect measurement of the activity of the enzyme(s) producing the active metabolite. An example of the last approach is the use of furafylline, a highly specific inhibitor of human CYP1A2, to determine the extent of the metabolic activation of the cooked food mutagens PhIP and MeIQx. The extent of inhibition, determined from levels of unchanged amine in urine, is an indirect measure of the activity of the activation pathway. Further refinement of this approach, allied to improved measures of the biological process of interest should prove of value in evaluating interindividual variability and its role in the risk assessment process.     

Theophylline kinetics in peripheral tissues in vivo in humans

Several biochemical and cellular effects have been described for methylxanthines under in vitro conditions. However, it is unknown, whether threshold concentrations required to exert these effects are attained in target tissues in vivo. We therefore employed the microdialysis technique for measuring theophylline concentrations in peripheral tissues under in vivo conditions.Following in vitro and in vivo calibration, microdialysis probes were inserted into the medial vastus muscle and into the periumbilical subcutaneous adipose layer of healthy volunteers. Following single oral dose administration of 300 mg or i.v. infusion of 240 mg theophylline, in vivo time courses of theophylline concentrations were monitored in tissues and plasma. Major pharmacokinetic parameters (c_max, t_max, AUC) were calculated for plasma and tissue time courses. The mean AUC_tissue /AUC_plasma-ratio was 0.56 (p.o.) and 0.55 (i.v.) for muscle and 0.55 (p.o.) and 0.72 (i.v.) for subcutaneous adipose tissue.We conclude that microdialysis provides important information on the distribution and the tissue pharmacokinetics of theophylline.Abbreviations FPIA Fluorescence polarisation immuno assay - AUC Area under the curve - t_max Time to peak concentration - c_max Peak concentration     

休克时血中氧自由基的变化

本实验测定10名休克患者血浆和红细胞的丙二醛(MDA)、血浆总抗的氧化活性(AOA)的含量。结果表明:休克病人红细胞膜和血浆 MDA 含量(4.298±0.722;5.348±0.834)与对照组(3.235±0.682;4.356±1.081)比较明显增高(P<0.05);血浆 AOA(39.65±7.858)与对照组(48.21±10.81)比较明显降低(P<0.01)。提示:休克时,患者机体内自由基反应增强是引起组织细胞损伤的原因之一。     

Changes in angiopoietin expression in glomeruli involved in glomerulosclerosis in rats with daunorubicin-induced nephrosis

AIM: To study the potential pathological role of endogenous angiopoietins in daunorubicin-induced progressive glomerulosclerosis in rats. METHODS: Seventy male Wistar rats were allocated randomly into a daunorubicin group (DRB; n=40) or a control group (n=30). The rats in the DRB group were injected with DRB (15 mg/kg), in their tails. Subsequently, at intervals of 1, 2, 4, 6, 8, and 12 weeks, 5 male Wistar rats in each group were chosen randomly for 24 h urinary protein quantitative measurements (24 h UPQM), and determination of plasma tumor necrosis factor alpha (TNF-alpha), angiopoietin-1 (Ang1), and angiopoietin-2 (Ang2) levels. Kidney sections were examined by electron microscopy, Periodic Acid Schiff (PAS) staining, immunohistochemical staining and in situ hybridization histochemistry. RESULTS: As glomerulosclerosis progressed in the DRB group, expression of Ang1 mRNA and protein in glomeruli decreased and expression of TNF-alpha protein, Ang2 mRNA and protein in glomeruli increased. Expression of Ang1 mRNA and protein in glomeruli were negatively correlated with 24 h UPQM, Fn protein expression, and mean area of extracellular matrix (MAECM). In comparison, expression of Ang2 mRNA and protein in glomeruli were positively correlated with 24 h UPQM, Fn protein expression and MAECM; furthermore, there was a positive correlation between plasma Ang2 and 24 h UPQM. Plasma TNF-alpha and expression of TNF-alpha in glomeruli were positively correlated with expression of Ang2 mRNA and protein in glomeruli. There was a negative correlation between Ang1 protein expression and Ang2 protein expression in glomeruli. CONCLUSION: During DRB-induced glomerulosclerosis, podocyte injury led to a shift in the balance of Ang1 and Ang2 in glomeruli. Increased TNF-alpha in plasma and glomeruli may upregulate Ang2 expression in glomeruli. Elevated Ang2 in both plasma and glomeruli may mediate protein permeability through the glomerular filtration barrier. Moreover, local expression of Ang2 may facilitate the progress of glomerulosclerosis by upregulating a component expression of extracellular matrix.     

Trichinellosis in immigrants in Switzerland

We describe a case of trichinellosis diagnosed at the Division of Infectious Diseases, Hospital of Lugano, in January 2009. This case was associated with a cluster of cases and was traced to the consumption of contaminated meat after a wild boar hunt in Bosnia.