Removal of lead from aqueous solution by Acinetobacter calcoaceticus

A bacterial strain tolerant to the presence of 400 ppm lead was isolated from digested sewage sludge. The organism was identified as Acinetobacter calcoaceticus var: anitraus (98% confidence). Both viable and formalin-inactivated bacterial cells could remove Pb from an aqueous solution. The Pb-binding ability of inactivated cells was compared with that of a commercial ion-exchange resin. Amberlite IR-120. The metal-binding ability of A. calcoaceticus followed the sequence Pb greater than or equal to Cu greater than or equal to Cr greater than or equal to (Cd, Ni, and Zn) greater than or equal to Co. The ability of the inactivated cells to remove Pb was pH sensitive, and the adsorption process was slightly affected at high temperature (70 degrees C). The adsorption and desorption process worked equally well with A. calcoaceticus embedded in a polyacrylamide gel matrix.     

脑脊液乳酸脱氢酶检测在脑膜炎诊断中的临床意义

目的探讨脑脊液乳酸脱氢酶（LDH）检测在鉴别细菌性脑膜炎和病毒性脑膜炎的临床应用价值。方法采用速率法检测48例细菌性脑膜炎、45例病毒性脑膜炎以及对照组40例脑脊液LDH和血清LDH的浓度。结果细菌性脑膜炎患者LDH浓度明显高于病毒性脑膜炎患者以及正常对照组（P〈0．05）;而病毒性脑膜炎患者脑脊液LDH浓度与对照组相比差异无统计学意义（P〉0．05）。细菌性脑膜炎血清LDH与病毒性脑膜炎比较差异无统计学意义（P〉0．05）。结论脑脊液LDH检测可作为细菌性脑膜炎和病毒性脑膜炎的鉴别诊断,对于临床药物的选择具有重要的指导意义。     

Community-acquired Acinetobacter calcoaceticus var anitratus pneumonia.

Two patients had community-acquired Acinetobacter calcoaceticus var anitratus pneumonia. Both patients were alcoholic and one was cirrhotic. One patient died and the other received two weeks of gentamicin therapy and survived. Misinterpretation of the sputum Gram stain delayed diagnosis and institution of proper therapy in both cases. In addition to organisms sensitive to penicillins such as Neisseria or Haemophilus, Acinetobacter must be considered in the differential diagnosis of community-acquired Gram-negative coccobacillary pneumonia.     

The use of the bromine partition test in the diagnosis and prognosis of tuberculous meningitis

The bromine partition test was successfully used to differentiate cases of proven tuberculous meningitis from patients with aseptic and non-tuberculous meningitis. Forty patients, 22 males and 18 females aged 5 to 30 years (mean 13.5 +/- 6.2), were included in the study. Nineteen patients were confirmed to have tuberculous meningitis, 12 had aseptic meningitis, and 9 bacterial meningitis. All patients received 0.6 mci/kg of bromine 82 administered through a nasogastric tube as ammonium bromide dissolved in 5 ml of isotonic sodium chloride. The serum to CSF bromine ratio was then calculated 48 hours after the dose. The test was then repeated 8 days later in patients with bacterial meningitis and 8, 90, and 180 day later in patients with tuberculous meningitis. The test was very useful in quickly differentiating cases of aseptic from bacterial and tuberculous meningitis and was also a useful prognosticator in patients with severe tuberculous meningitis.     

间接ELISA检测无菌性脑膜炎患儿的埃可病毒特异性IgM抗体

目的：研究检测患儿脑脊液和血清标本的特异性IgM在诊断埃可病毒感染的无菌性脑膜炎的实用价值。方法：采用埃可病毒混合抗原包被酶标板,用间接ELISA方法检测脑脊液和血清标本的特异性IgM抗体。结果：在临床诊断为无菌性脑膜炎患儿的78份脑脊液和203份血清标本中分别有14份（17.9%）和48份（23.6%）阳性,而36份细菌性脑膜炎和30份脑外伤患者脑脊液仅1份阳性;细菌性脑膜炎、正常成人血清均为阴性。结论：本方法快速、简便、可靠,适合于临床早期诊断,而脑脊液标本IgM抗体的检测在诊断埃可病毒感染的无菌性脑膜炎可能更为准确。     

Community-acquired bacteraemic Acinetobacter pneumonia with survival.

A 65 year old man was admitted with segmental consolidation of the left upper lobe after having stayed in a hotel for 2 days. He deteriorated rapidly on conventional antibiotic therapy and required ventilatory support. Acinetobacter calcoaceticus var. anitratus was grown from the sputum and blood cultures, which was treated with a combination of anti-pseudomonal agent, aminoglycoside and cotrimoxazole. He made a slow but remarkable recovery from the pneumonia. Acinetobacter is a rare potentially fatal cause of community-acquired pneumonia.     

脑膜异常强化的MRI诊断

目的：分析不同病变的脑膜异常强化MRI表现,探讨脑膜异常强化模式的形态与病因间的关系。方法对资料完整、MRI增强扫描显示脑膜异常强化的27例患者进行回顾性分析。结果27例患者中脑膜癌病11例（其中软脑膜强化模式9例,包括结节样强化4例、线样强化4例、结节样和线样强化并存的混合型强化1例,全脑膜强化模式、混合型强化2例）;感染性脑膜炎9例（其中细菌性脑膜炎5例,包括软脑膜强化模式、线样强化4例,全脑膜强化模式、线样强化1例,并伴有硬膜下脓肿、颅骨骨髓炎,结核性脑膜炎3例,均为软脑膜强化模式,2例为线样强化,1例为结节样强化并伴有脑内多发结核结节,病毒性脑膜炎1例,为软脑膜强化模式、局限性线样强化）;自发性低颅压综合征2例（硬脑膜强化模式、为弥漫均匀的线样强化）;慢性硬膜下血肿4例和慢性硬膜下血肿伴硬膜下积液1例（硬脑膜强化模式、线样强化）。结论不同病变所致脑膜异常强化,其强化模式及形态具有一定的特点,MRI能为疾病的诊断提供重要信息。     

重庆地区老年人洛菲不动杆菌下呼吸道感染的耐药性变迁

目的 了解老年人下呼吸道院内感染洛菲不动杆菌的耐药性变迁特点.方法 收集2003～2007年本院老年患者院内下呼吸道感染洛菲不动杆菌,进行菌株鉴定和药敏试验,按NCCLS标准判断.结果 洛菲不动杆菌分离率超过鲍曼不动杆菌.2003~2007年洛菲不动杆菌对13种抗菌药物的耐药率呈逐年上升趋势.该菌对亚胺培南最敏感,耐药率仅为0.0%~4.4%;其次对阿米卡星和氨苄西林/舒巴坦,耐药率为0.0%~8.9%;对环丙沙星的耐药率为3.1%~17.4%;对哌拉西林、氨曲南、头孢噻肟、头孢曲松、头孢他啶、头孢吡肟和复方新诺明具有较高的耐药率,为43.5%～65.2%.结论 老年人下呼吸道院内感染洛菲不动杆菌分离率高,耐药性呈增加趋势,部分菌株呈高度多重耐药.     

Bacterial meningitis in children under five years of age in Western Australia

OBJECTIVES: To describe the epidemiology and the associated mortality and serious neurological sequelae of bacterial meningitis in children under five years of age in Western Australia, and to consider the potential impact of a Haemophilus influenzae type b vaccine on this group of children. DESIGN: A retrospective survey, using multiple sources of case ascertainment. PATIENTS: All children in Western Australia from one month to five years of age who developed bacterial meningitis, over a five-year period (from 1984 to 1988 inclusive). MAIN OUTCOME MEASURES: Episodes of bacterial meningitis, deaths associated with bacterial meningitis, and sensorineural deafness (requiring hearing aids) and cerebral palsy following bacterial meningitis. RESULTS: Two hundred and seventy episodes of bacterial meningitis were identified; 200 occurred in non-Aboriginal children and 70 in Aboriginal children. There were 16 meningitis-associated deaths (case fatality rate, 5.9%), 7 children developed profound sensorineural deafness and a further 7 children developed cerebral palsy after bacterial meningitis. H. influenzae type b caused nearly 70% of the cases of childhood bacterial meningitis. The annual incidence rate of H. influenzae meningitis was significantly greater in Aboriginal children (150 episodes per 100,000 children under five years of age per year) than in non-Aboriginal children (27 episodes per 100,000), and the mean age of onset of H. influenzae meningitis was significantly lower in Aboriginal children (6.8 months) than in non-Aboriginal children (19.8 months). CONCLUSIONS: Any conjugate H. influenzae type b vaccine should be effective when administered to non-Aboriginal children in the first six months of life, but only the most immunogenic vaccines (for example, the vaccine known as PRP-OMP) are likely to be effective in Aboriginal infants.     

空间环境诱导屎肠球菌突变株LCT-EF18的蛋白组学分析

目的 对搭载神舟八号飞船的屎肠球菌进行突变株筛选,并鉴定和分析差异表达的蛋白质。方法 利用Biolog 生化反应板从搭载神舟八号飞船飞行后屎肠球菌中筛选突变株,提取突变株蛋白质并进行SDS-PAGE 电泳检测,用BCA 法测定总蛋白浓度后,采用同重同位素相对与绝对定量（isobaric tags for relative and absolute quantitation,iTRAQ） 方法分析空间环境诱变屎肠球菌突变株和地面对照株之间的差异表达蛋白,并进行统计、分析和注释。结果 通过Biolog 表型筛选获得空间环境诱导屎肠球菌突变株LCT-EF20,该菌株能利用肌酐和L- 苹果酸,而不能利用对羟基苯乙酸。差异蛋白组学分析发现了124 个蛋白质表达的改变,其中50 个蛋白表达上调,74 个蛋白表达下调。结论 太空环境可改变屎肠球菌的生物学特性,并影响大量蛋白质的表达,差异表达蛋白主要分布在代谢相关过程。     

Haemophilus influenzae meningitis in school-aged children

The relative frequency of meningitis caused by Haemophilus influenzae in school-age children was determined by reviewing etiologic diagnoses in children 6 to 15 years old admitted to four hospitals from 1974 to 1978. Sixty-five (45%) of 145 patients had aseptic meningitis and 29 (20%) had bacterial meningitis. Thirty-two (22%) of the patients had received antibiotic therapy before diagnosis, and 19 (13%) could not be classified. Six (21%) of the 29 patients with bacterial meningitis had H influenzae meningitis. Although aseptic disease was the most common type of meningitis, initial antibiotic therapy for presumed bacterial meningitis in school-aged children should include adequate coverage for H influenzae.     

TNF-α和IL-1β在细菌性脑膜炎患儿血清中的表达及其临床意义

目的 观察急性期细菌性脑膜炎和病毒性脑炎患儿血清中肿瘤坏死因子α（TNF-α）、白细胞介素-1β（IL-1β） 的水平变化及临床意义.方法 收集在本院治疗的细菌性脑膜炎患儿27例,病毒性脑炎患儿23例的血清,采用双抗体酶联免疫吸附法（ELISA） 检测各组对象血清中TNF-α和IL-1β的表达水平.结果 细菌性脑膜炎组血清TNF-α水平明显高于病毒性脑炎组（P 〈 0.05）.结论 血清TNF-α与IL-1β的检测可以用于对细菌性脑膜炎患儿的诊断.     

由细菌性脑膜炎的治疗引发的哲学思考

目的 探讨细菌性脑膜炎有效辅助治疗措施。方法 运用现代医学知识，以创造性思维突破常规，多因素多环节不同水平干扰发病过程。结果 创造性思维可寻找有效的辅助治疗措施。结论 在细菌性脑膜炎的治疗中正确运用哲学观点，充分发挥创造性思维能力，可降低本病的死亡率和后遗症的发生率，促进人类健康生存，提高生活质量。     

应用ROC曲线评价中性粒细胞CD64诊断儿童化脓性脑膜炎的价值

目的应用受试者工作特征曲线(ROC曲线)评价中性粒细胞CD64诊断儿童化脓性脑膜炎的价值.方法选取40例经脑脊液证实的化脓性脑膜炎儿童患者,所有患者均检测中性粒细胞的CD64、CD11b及血常规.选取20例健康体检患儿,并测试中性粒细胞的CD64、CD11b.结果 CD64、CD11b诊断化脓性脑膜炎的ROC曲线下面积分别是0.880,0.853;CD64、CD11b诊断化脓性脑膜炎的最佳阈值为1.30,15.85;CD64、CD11b诊断化脓性脑膜炎的灵敏度分别为88.3%、70.4%、特异度分别为90.4%、75.9%;化脓性脑膜炎患者中性粒细胞CD64、CD11b与白细胞计数无相关性(P>0.05).结论 ROC曲线评价显示中性粒细胞CD64对化脓性脑膜炎具有较高的诊断准确度,CD64是诊断化脓性脑膜炎理想的敏感指标.     

Dexamethasone use in adult meningococcal meningitis

The use of dexamethasone in the management of bacterial meningitis in adults remains controversial. This report illustrates the case of a 27-year-old male with severe meningococcal meningitis and meningococcemia who completely recovered after receiving antibiotics and dexamethasone. In adults with suspected bacterial meningitis, especially in high risk cases, the adjunctive use of dexamethasone may be beneficial.     

支气管扩张患者病原菌的分布及耐药性分析

目的分析支气管扩张患者病原菌的分布及耐药情况。方法对我院2004—2007年住院的106例支气管扩张患者进行痰一般致病菌培养及药物敏感分析。结果106例患者病原菌检出阳性48例(45.2%),共分离出细菌49株,铜绿假单胞菌33株(67.4%),鲍曼不动杆菌8株(16.3%),肺炎克雷伯杆菌4株(8.3%),斯氏假单胞菌1株(2%),洛菲不动杆菌1株(2.0%),大肠埃希氏菌1株(2.0%),白色念珠菌1株(2.0%)。结论支气管扩张患者病原菌铜绿假单胞菌排在首位,提示合理选用抗菌药物对减少耐药菌的产生有重要作用。     

A common source outbreak of Acinetobacter pulmonary infections traced to Wright respirometers.

Over a 30-day period, Acinetobacter calcoaceticus var. antiratus was the responsible pathogen for hospital-acquired pneumonia in 10 patients, and resulted in the colonization of the upper respiratory tract in an additional 9 patients. Wright respirometers contaminated by this organism were shown to be the common source for the outbreak as indicated by the recovery of a single serotype (8J), the inability to recover Acinetobacter from any other environmental source, and the demonstration that moisturized Wright respirometers are capable of "aerosolizing" fluids containing Acinetobacter.     

河北省2009-2010年细菌性脑膜炎哨点监测病例分析

目的初步了解河北省细菌性脑膜炎流行病学特征和病原情况。方法选择6家哨点医院,开展细菌性脑膜炎病例流行病学调查和实验室病原检测。结果 2009-2010年哨点医院共报告细菌性脑膜炎病例134例,死亡1例。发病以15岁以下散居儿童和学生为主,男性多于女性,本地病例占1/2左右,冬春季节和7~8月为发病高峰,病例以轻型和不典型为主。从96例病例脑脊液标本中分离出Sp 1株,Hib 1株,其他菌5株。96例病例标本的Real-time PCR检测Sp阳性4例,Hib阳性2例,阴性90例。结论哨点医院报告病例数较少,病原检测阳性率低,需进一步分析查找原因。     

细菌性脑膜炎患儿脑脊液中兴奋性氨基酸的变化及临床意义

目的　探讨细菌性脑膜炎患儿脑脊液中谷氨酸和天门冬氨酸的含量及临床意义。方法　根据细菌性脑膜炎的诊断标准选择 40例细菌性脑膜炎患儿作为细菌性脑膜炎组, 另选择 16例非神经系统疾病的患儿作对照组, 均于入院当天做腰穿留取脑脊液置-30℃冰箱保存待测。用高效液相色谱法测定脑脊液中谷氨酸和天门冬氨酸的含量。结果　细菌性脑膜炎患儿脑脊液中谷氨酸和天门冬氨酸的含量与对照组比较, 差别有显著性意义 (P均 <0。 05)。结论　细菌性脑膜炎的病理生理过程中存在着兴奋性氨基酸的兴奋毒性。兴奋性氨基酸的受体拮抗剂的应用有可能成为一种重要的治疗细菌性脑膜炎的新方法。     

树鼩粪便细菌分离培养与鉴定

目的 了解人工饲养树鼩粪便菌群多样性,为树鼩的正常饲养繁殖和微生物质量控制标准化提供依据。方法 随机采集10份树鼩粪便样品,利用有氧及厌氧培养基进行细菌分离培养,提取细菌基因组DNA后PCR扩增16SrRNA基因并测序鉴定。结果 本实验从树鼩粪便样品中,经有氧培养分离鉴定出25株、12种细菌,经厌氧培养分离鉴定出25株、10种细菌,包括变形杆菌属、肠球菌属、埃希菌属、志贺菌属、葡萄球菌属、气单胞菌属、拉恩氏菌属、拉乌尔菌属、微小杆菌属、链球菌属、明串珠菌属。结论 树鼩肠道好氧菌及厌氧菌具有丰富的种属多样性,普通变形杆菌群、费格森埃希菌群和屎肠球菌群可能是树鼩肠道的主要寄生菌群。