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1.
Rice LB 《Mayo Clinic proceedings. Mayo Clinic》2012,87(2):198-208
The widespread use of antibiotics has resulted in a growing problem of antimicrobial resistance in the community and hospital settings. Antimicrobial classes for which resistance has become a major problem include the β-lactams, the glycopeptides, and the fluoroquinolones. In gram-positive bacteria, β-lactam resistance most commonly results from expression of intrinsic low-affinity penicillin-binding proteins. In gram-negative bacteria, expression of acquired β-lactamases presents a particular challenge owing to some natural spectra that include virtually all β-lactam classes. Glycopeptide resistance has been largely restricted to nosocomial Enterococcus faecium strains, the spread of which is promoted by ineffective infection control mechanisms for fecal organisms and the widespread use of colonization-promoting antimicrobials (especially cephalosporins and antianaerobic antibiotics). Fluoroquinolone resistance in community-associated strains of Escherichia coli, many of which also express β-lactamases that confer cephalosporin resistance, is increasingly prevalent. Economic and regulatory forces have served to discourage large pharmaceutical companies from developing new antibiotics, suggesting that the antibiotics currently on the market may be all that will be available for the coming decade. As such, it is critical that we devise, test, and implement antimicrobial stewardship strategies that are effective at constraining and, ideally, reducing resistance in human pathogenic bacteria. 相似文献
2.
3.
Hershey AD 《Current pain and headache reports》2005,9(5):341-344
Pediatric headache is a common health problem in children, with a significant headache reported in more than 75% by the age
of 15 years. Pediatric migraine occurs in up to 10.6% of children between the ages of 5 and 15 years and in up to 28% of adolescents
between the ages of 15 and 19 years. Given this high frequency, the impact of this disease on the lives of these children
and their parents can be quite significant. This impact can be assessed with disease-specific disability and impairment as
well as disease non-specific effects on quality of life. The goal of evaluation should be recognition of this impact, whereas
the goal of management should be effective treatment that minimizes the impact of this disorder in the short term and for
the life of the patient. 相似文献
4.
5.
Laurent Poirel Thierry Naas Patrice Nordmann 《Antimicrobial agents and chemotherapy》2010,54(1):24-38
Class D β-lactamase-mediated resistance to β-lactams has been increasingly reported during the last decade. Those enzymes also known as oxacillinases or OXAs are widely distributed among Gram negatives. Genes encoding class D β-lactamases are known to be intrinsic in many Gram-negative rods, including Acinetobacter baumannii and Pseudomonas aeruginosa, but play a minor role in natural resistance phenotypes. The OXAs (ca. 150 variants reported so far) are characterized by an important genetic diversity and a great heterogeneity in terms of β-lactam hydrolysis spectrum. The acquired OXAs possess either a narrow spectrum or an expanded spectrum of hydrolysis, including carbapenems in several instances. Acquired class D β-lactamase genes are mostly associated to class 1 integron or to insertion sequences.Class D β-lactamases, also known as oxacillinases or OXA-type β-lactamases (OXAs), are active-serine-site enzymes like Ambler class A and class C β-lactamases, differing from class A and C enzymes in amino acid structure, whereas class B β-lactamases are metalloenzymes with a Zn2+ ion(s) in the active site (4, 71, 78). Even though class D includes mostly enzymes with higher hydrolysis rates for cloxacillin and oxacillin than for benzylpenicillin (hence the name oxacillinases), not all class D β-lactamases have this characteristic. Most of the class D enzymes belong to group 2d of the Bush functional classification scheme for β-lactamases (23). Among the four β-lactamase molecular classes, class D β-lactamases are the most diverse enzymes (107). This diversity is observed at both the genetic and biochemical levels, with enzymes possessing either a narrow or expanded spectrum of hydrolysis. In addition, several class D β-lactamases have an expanded spectrum of activity resulting from point mutations.Although many class D β-lactamase genes are embedded into class 1 integrons, recent reports indicated that other specific genetic structures, including insertion sequences and transposons, may be associated with class D β-lactamase genes. Numerous class D β-lactamase genes have been identified as a source of acquired resistance in gram-negative bacteria, but recent studies have shown that class D β-lactamases are also naturally produced in clinically significant pathogens and environmental species (107).This review focuses on the diversity and substrate profiles of class D β-lactamases, their sources, and the genetics of acquisition of the corresponding genes. All the class D β-lactamases for which a sequence is available in the GenBank databases are listed in Table Table11.
Open in a separate windowaThe nomenclature is in accordance with that provided by G. Jacoby on the Lahey website (http://www.lahey.org/Studies/other.asp#table1). Lacking variants (in boldface) are those for which a number has been assigned on this website but for which no information is yet available.bA, acquired; N, natural.c+, the oxacillinase gene was found to be associated with an integron-borne gene cassette; −, the gene is not associated with an integron-borne gene cassette.dExperimentally obtained pI values (when available) versus calculated values. Theoretical values were calculated using software found at the ExPASy proteomics tools website (http://www.expasy.ch/tools/) and the amino acid sequences of the mature proteins only. Peptide cleavage site identification was performed with SignalP (http://www.cbs.dtu.dk/services/SignalP/), and pI computing was performed with the Compute pI/Mw tool (http://www.expasy.ch/tools/pi_tool.html).eUP, unpublished. 相似文献
TABLE 1.
Features of oxacillinasesNamea | Alternate name | OXA group | Type | Original host | A or Nb | Associated mobile element | Gene GC content (%) | Isoelectric pointd | GenBank accession no.e | Referencef | ||
---|---|---|---|---|---|---|---|---|---|---|---|---|
Transposon or insertion sequence | Integronc | Exptl | Theoretical | |||||||||
OXA-1 | OXA-30 | Narrow spectrum | E. coli | A | Tn2603 | + | 34.4 | 7.4 | 7.7 | J02967 | 113 | |
OXA-2 | OXA-2 | Narrow spectrum | S. Typhimurium | A | + | 50 | 7.7 | 9.1 | X07260 | 97 | ||
OXA-3 | OXA-2 | Narrow spectrum | K. pneumoniae | A | Tn1411 | + | 50 | 7.1 | 8.1 | L07945 | 142 | |
OXA-4 | OXA-35 | Narrow spectrum | E. coli | A | Tn1409 | + | 7.5 | AY162283 | 142 | |||
OXA-5 | Narrow spectrum | P. aeruginosa | A | Tn1406 | + | 40.2 | 7.6 | 8.4 | X58272 | 32 | ||
OXA-6 | Narrow spectrum | P. aeruginosa | A | 7.7 | UP | |||||||
OXA-7 | OXA-10 | Narrow spectrum | E. coli | A | + | 40.6 | 7.7 | 9.3 | X75562 | 145 | ||
OXA-8 | ||||||||||||
OXA-9 | Narrow spectrum | K. pneumoniae | A | Tn1331 | + | 49.5 | 6.9 | 7.1 | M55547 | 155 | ||
LCR-1 | Narrow spectrum | P. aeruginosa | A | Tn1412 | − | 52 | 6.5 | 7.1 | X56809 | 32 | ||
OXA-10 | Narrow spectrum | P. aeruginosa | A | Tn1404 | + | 42.1 | 6.1 | 7.0 | U37105 | 70 | ||
OXA-11 | OXA-10 | ES-OXA | P. aeruginosa | A | + | 42 | 6.4 | 6.3 | Z22590 | 60 | ||
OXA-12 | Narrow spectrum | A. jandaei | N | − | 62.3 | 8.6 | 8.4 | U10251 | 139 | |||
AmpS | Narrow spectrum | A. hydrophila | N | − | 63 | 7.9 | 7.1 | X80276 | 165 | |||
OXA-13 | OXA-10 | Narrow spectrum | P. aeruginosa | A | + | 41.2 | 8.0 | 8.7 | U59183 | 99 | ||
OXA-14 | OXA-10 | ES-OXA | P. aeruginosa | A | + | 42.1 | 6.2 | 6.3 | L38523 | 38 | ||
OXA-15 | OXA-2 | ES-OXA | P. aeruginosa | A | + | 50 | 8.7 | 9.3 | U63835 | 36 | ||
OXA-16 | OXA-10 | ES-OXA | P. aeruginosa | A | + | 42.1 | 6.2 | 6.3 | AF043100 | 39 | ||
OXA-17 | OXA-10 | ES-OXA | P. aeruginosa | A | + | 42.1 | 6.1 | 7.0 | AF060206 | 37 | ||
OXA-18 | ES-OXA | P. aeruginosa | A | ISCR19 | − | 61.2 | 5.5 | 5.9 | U85514 | 118 | ||
OXA-19 | OXA-13 | ES-OXA | P. aeruginosa | A | + | 41.2 | 7.6 | 8.4 | AF043381 | 98 | ||
OXA-20 | Narrow spectrum | P. aeruginosa | A | + | 45.1 | 7.4 | 9.0 | AF024602 | 108 | |||
OXA-21 | OXA-3 | Narrow spectrum | A. baumannii | A | + | 50.1 | 7.0 | 8.1 | Y10693 | 162 | ||
OXA-22 | Narrow spectrum | R. pickettii | N | − | 65.5 | 7.0 | 6.4 | AF064820 | 112 | |||
OXA-23 | CHDL | A. baumannii | A | Tn2006/Tn2007 | − | 38 | 6.7 | 7.0 | AJ132105 | 42 | ||
OXA-24 | OXA-40 | CHDL | A. baumannii | A | − | 34.4 | 8.6 | 9.0 | AJ239129 | 19 | ||
OXA-25 | OXA-40 | CHDL | A. baumannii | A | − | 34.4 | 8.0 | 8.5 | AF201826 | 1 | ||
OXA-26 | OXA-40 | CHDL | A. baumannii | A | − | 34.4 | 7.9 | 9.0 | AF201827 | 1 | ||
OXA-27 | OXA-23 | CHDL | A. baumannii | A | − | 38 | 6.8 | 8.0 | AF201828 | 1 | ||
OXA-28 | OXA-13 | ES-OXA | P. aeruginosa | A | + | 41.2 | 8.1 | 8.7 | AF231133 | 125 | ||
OXA-29 | Narrow spectrum | L. gormanii | N | − | 36.6 | 9.0 | 9.4 | AJ400619 | 49 | |||
OXA-30 | OXA-1 | Narrow spectrum | E. coli | A | + | 34.4 | 7.3 | 6.8 | AF255921 | 148 | ||
OXA-31 | OXA-1 | ES-OXA | P. aeruginosa | A | + | 34.4 | 7.5 | 6.8 | AF294653 | 9 | ||
OXA-32 | OXA-2 | ES-OXA | P. aeruginosa | A | + | 50 | 7.7 | 9.0 | AF315351 | 124 | ||
OXA-33 | OXA-40 | CHDL | A. baumannii | A | − | 34.4 | 8.6 | 9.0 | AY008291 | |||
OXA-34 | OXA-2 | ES-OXA | P. aeruginosa | A | + | 50 | 8.9 | AF350424 | UP | |||
OXA-35 | OXA-10 | ES-OXA | P. aeruginosa | A | + | 41.2 | 8.0 | 8.7 | AF315786 | 8 | ||
OXA-36 | OXA-2 | ES-OXA | P. aeruginosa | A | + | 49.4 | 9.2 | AF300985 | UP | |||
OXA-37 | OXA-20 | Narrow spectrum | A. baumannii | A | + | 44.8 | 7.4 | 8.9 | AY007784 | 109 | ||
OXA-38 | ||||||||||||
OXA-39 | ||||||||||||
OXA-40 | CHDL | A. baumannii | A | − | 34.4 | 8.6 | 9.0 | AF509241 | 65 | |||
OXA-41 | ||||||||||||
OXA-42 | Narrow spectrum | B. pseudomallei | N | − | 66.3 | 9.2 | 9.3 | AJ488302 | 111 | |||
OXA-43 | Narrow spectrum | B. pseudomallei | N | − | 65.9 | 9.2 | 9.3 | AJ488303 | 111 | |||
OXA-44 | ||||||||||||
OXA-45 | ES-OXA | P. aeruginosa | A | ISCR5 | − | 61.8 | 8.8 | 9.4 | AJ519683 | 153 | ||
OXA-46 | Narrow spectrum | P. aeruginosa | A | + | 47.1 | 7.8 | 8.7 | AF317511 | 57 | |||
OXA-47 | OXA-1 | Narrow spectrum | K. pneumoniae | A | + | 34.1 | 7.4 | 6.8 | AY237830 | 127 | ||
OXA-48 | CHDL | K. pneumoniae | A | Tn1999 | − | 44.5 | 7.2 | 8.0 | AY236073 | 127 | ||
OXA-49 | OXA-23 | CHDL | A. baumannii | A | − | 38 | 6.0 | AY288523 | UP | |||
OXA-50 | Narrow spectrum | P. aeruginosa | N | − | 64.8 | 8.6 | 9.0 | AY306130 | 54 | |||
OXA-51 | OXA-Ab1 | CHDL | A. baumannii | A | − | 39.3 | 7.0 | 8.0 | AJ309734 | 22 | ||
OXA-52 | ||||||||||||
OXA-53 | OXA-2 | ES-OXA | S. Agona | A | + | 50.2 | 6.9 | 7.2 | AY289608 | 103 | ||
OXA-54 | CHDL | S. oneidensis | N | − | 46.6 | 6.8 | 6.7 | AY500137 | 126 | |||
OXA-55 | CHDL | S. algae | N | − | 53.8 | 8.6 | 8.6 | AY343493 | 68 | |||
OXA-56 | Narrow spectrum | P. aeruginosa | A | + | 40.7 | 6.5 | 8.7 | AY445080 | 25 | |||
OXA-57 | Narrow spectrum | B. pseudomallei | N | − | 66 | 9.3 | AJ631966 | 73 | ||||
OXA-58 | CHDL | A. baumannii | A | − | 37.4 | 7.2 | 7.2 | AY665723 | 130 | |||
OXA-59 | Narrow spectrum | B. pseudomallei | N | − | 65.9 | 9.3 | AJ632249 | 73 | ||||
OXA-60 | Narrow spectrum | R. pickettii | N | − | 64.9 | 5.1 | 5.4 | AF525303 | 55 | |||
OXA-61 | Narrow spectrum | C. jejuni | N | − | 27.4 | 9.1 | AY587956 | 2 | ||||
OXA-62 | CHDL | P. pnomenusa | N | − | 65.3 | >9.0 | 9.5 | AY423074 | 144 | |||
OXA-63 | Narrow spectrum | B. pilosicoli | N | − | 24.9 | 6.0 | AY619003 | 94 | ||||
OXA-64 | OXA-Ab2 | OXA-51 | CHDL | A. baumannii | N | − | 39.6 | 8.0 | AY750907 | 21 | ||
OXA-65 | OXA-Ab3 | OXA-51 | CHDL | A. baumannii | N | − | 39.2 | 8.8 | AY750908 | 21 | ||
OXA-66 | OXA-Ab4 | OXA-51 | CHDL | A. baumannii | N | − | 39.4 | 9.0 | AY750909 | 21 | ||
OXA-67 | OXA-Ab5 | OXA-51 | CHDL | A. baumannii | N | − | 39 | 8.0 | DQ491200 | UP | ||
OXA-68 | OXA-Ab6 | OXA-51 | CHDL | A. baumannii | N | − | 39 | 7.1 | AY750910 | 21 | ||
OXA-69 | OXA-Ab7 | OXA-51 | CHDL | A. baumannii | N | − | 39.3 | 8.4 | 8.6 | AY750911 | 66 | |
OXA-70 | OXA-Ab8 | OXA-51 | CHDL | A. baumannii | N | − | 39.3 | 9.0 | AY750912 | 21 | ||
OXA-71 | OXA-Ab9 | OXA-51 | CHDL | A. baumannii | N | − | 39.7 | 8.0 | AY750913 | 21 | ||
OXA-72 | OXA-40 | CHDL | A. baumannii | A | − | 36.4 | 8.8 | EF534256 | 166 | |||
OXA-73 | OXA-23 | CHDL | K. pneumoniae | A | − | 37.6 | 8.0 | AY762325 | UP | |||
OXA-74 | OXA-10 | Unknown | P. aeruginosa | A | − | 41.9 | 6.5 | 7.0 | AJ854182 | 46 | ||
OXA-75 | OXA-Ab10 | OXA-51 | CHDL | A. baumannii | N | − | 38.7 | 8.6 | AY859529 | 66 | ||
OXA-76 | OXA-Ab11 | OXA-51 | CHDL | A. baumannii | N | − | 39.3 | 9.2 | AY949203 | 66 | ||
OXA-77 | OXA-Ab12 | OXA-51 | CHDL | A. baumannii | N | − | 39.2 | 8.6 | AY949202 | 66 | ||
OXA-78 | OXA-Ab13 | OXA-51 | CHDL | A. baumannii | N | − | 39.2 | 8.9 | AY862132 | UP | ||
OXA-79 | OXA-Ab14 | OXA-51 | CHDL | A. baumannii | N | − | 39.5 | 9.0 | EU019534 | 47 | ||
OXA-80 | OXA-Ab15 | OXA-51 | CHDL | A. baumannii | N | − | 39.3 | 9.0 | EU019535 | 47 | ||
OXA-81 | ||||||||||||
OXA-82 | OXA-Ab16 | OXA-51 | CHDL | A. baumannii | N | − | 39.4 | 9.0 | EU019536 | 158 | ||
OXA-83 | OXA-Ab17 | OXA-51 | CHDL | A. baumannii | N | − | 39.5 | 9.0 | DQ309277 | 158 | ||
OXA-84 | OXA-Ab18 | OXA-51 | CHDL | A. baumannii | N | − | 39.4 | 9.0 | DQ309276 | 158 | ||
OXA-85 | Narrow spectrum | F. nucleatum | N | − | 24.6 | 5.3 | 6.1 | AY227054 | 164 | |||
OXA-86 | OXA-Ab19 | OXA-51 | CHDL | A. baumannii | N | − | 38.8 | 8.0 | DQ149247 | 159 | ||
OXA-87 | OXA-Ab20 | OXA-51 | CHDL | A. baumannii | N | − | 38.9 | 8.0 | DQ348075 | 159 | ||
OXA-88 | OXA-Ab21 | OXA-51 | CHDL | A. baumannii | N | − | 39.2 | 9.2 | DQ392963 | 75 | ||
OXA-89 | OXA-Ab22 | OXA-51 | CHDL | A. baumannii | N | − | 38.4 | 7.0 | 8.6 | DQ445683 | 94 | |
OXA-90 | OXA-Ab23 | OXA-51 | CHDL | A. baumannii | N | − | 39.2 | 8.6 | EU433382 | UP | ||
OXA-91 | OXA-Ab24 | OXA-51 | CHDL | A. baumannii | N | − | 39 | 8.0 | DQ519083 | 75 | ||
OXA-92 | OXA-Ab25 | OXA-51 | CHDL | A. baumannii | N | − | 39.3 | 8.6 | DQ335566 | 156 | ||
OXA-93 | OXA-Ab26 | OXA-51 | CHDL | A. baumannii | N | − | 39.3 | 8.0 | DQ519087 | 75 | ||
OXA-94 | OXA-Ab27 | OXA-51 | CHDL | A. baumannii | N | − | 39.3 | 8.9 | DQ519088 | 75 | ||
OXA-95 | OXA-Ab28 | OXA-51 | CHDL | A. baumannii | N | − | 39.5 | 8.6 | DQ519089 | 75 | ||
OXA-96 | OXA-58 | CHDL | A. baumannii | A | − | 37.5 | 7.2 | DQ519090 | 75 | |||
OXA-97 | OXA-58 | CHDL | A. baumannii | A | − | 37.8 | 7.2 | EF102240 | 129 | |||
OXA-98 | OXA-Ab29 | OXA-51 | CHDL | A. baumannii | N | − | 39.2 | 8.6 | AM279652 | UP | ||
OXA-99 | OXA-Ab30 | OXA-51 | CHDL | A. baumannii | N | − | 39.4 | 8.0 | DQ888718 | UP | ||
OXA-100 | ||||||||||||
OXA-101 | OXA-10 | Unknown | C. freundii | A | + | 40.7 | 8.8 | AM412777 | UP | |||
OXA-102 | OXA-23 | CHDL | A. radioresistens | N | − | 38 | 5.8 | Unknown | 123 | |||
OXA-103 | OXA-23 | CHDL | A. radioresistens | N | − | 38 | 5.8 | Unknown | 123 | |||
OXA-104 | OXA-Ab31 | OXA-51 | CHDL | A. baumannii | N | − | 39.3 | 8.6 | EF581285 | 47 | ||
OXA-105 | OXA-23 | CHDL | A. radioresistens | N | − | 38 | 7.0 | Unknown | UP | |||
OXA-106 | OXA-Ab32 | OXA-51 | CHDL | A. baumannii | N | − | 39.3 | 8.9 | EF650032 | 47 | ||
OXA-107 | OXA-Ab33 | OXA-51 | CHDL | A. baumannii | N | − | 39.3 | 8.6 | EF650033 | 47 | ||
OXA-108 | OXA-Ab34 | OXA-51 | CHDL | A. baumannii | N | − | 39 | 8.5 | EF650034 | 47 | ||
OXA-109 | OXA-Ab35 | OXA-51 | CHDL | A. baumannii | N | − | 39.3 | 9.0 | EF650035 | 47 | ||
OXA-110 | OXA-Ab36 | OXA-51 | CHDL | A. baumannii | N | − | 39.3 | 8.6 | EF650036 | 47 | ||
OXA-111 | OXA-Ab37 | OXA-51 | CHDL | A. baumannii | N | − | 39.4 | 7.1 | EF650037 | 47 | ||
OXA-112 | OXA-Ab38 | OXA-51 | CHDL | A. baumannii | N | − | 39.4 | 8.6 | EF650038 | 47 | ||
OXA-113 | OXA-Ab39 | OXA-51 | CHDL | A. baumannii | N | − | 39.3 | 8.0 | EF653400 | 106 | ||
OXA-114 | Narrow spectrum | A. xylosoxidans | N | − | 70.4 | 8.6 | 9.0 | EU188842 | 41 | |||
OXA-115 | OXA-Ab40 | OXA-51 | CHDL | A. baumannii | N | − | 39.3 | 9.0 | EU029998 | UP | ||
OXA-116 | OXA-Ab41 | OXA-51 | A. baumannii | N | − | 39.3 | 8.6 | EU220744 | UP | |||
OXA-117 | OXA-Ab42 | OXA-51 | A. baumannii | N | − | 39.2 | 8.6 | EU220745 | UP | |||
OXA-118 | Narrow spectrum | B. cepacia | A | + | 49.3 | 7.3 | AF371964 | 33 | ||||
OXA-119 | Narrow spectrum | Uncultured bacterium | A | + | 49.4 | 6.7 | AY139598 | 150 | ||||
OXA-120 | ||||||||||||
OXA-121 | ||||||||||||
OXA-122 | ||||||||||||
OXA-123 | ||||||||||||
OXA-124 | ||||||||||||
OXA-125 | ||||||||||||
OXA-126 | ||||||||||||
OXA-127 | ||||||||||||
OXA-128 | OXA-10 | CHDL | A. baumannii | N | + | 39.1 | 8.0 | EU375515 | 52a | |||
OXA-129 | OXA-Ab43 | OXA-5 | Unknown | S. Bredeney | A | + | 39.9 | 9.1 | AM932669 | 95 | ||
OXA-130 | OXA-Ab44 | OXA-51 | A. baumannii | N | − | 39.1 | 8.5 | EU547445 | UP | |||
OXA-131 | OXA-Ab45 | OXA-51 | A. baumannii | N | − | 39.4 | 9.0 | EU547446 | UP | |||
OXA-132 | OXA-Ab46 | OXA-51 | A. baumannii | N | − | 39.3 | 8.0 | EU547447 | UP | |||
OXA-133 | OXA-23 | CHDL | A. radioresistens | N | − | 39.3 | 6.1 | EU571228 | 123 | |||
OXA-134 | CHDL | A. lwoffii | N | − | 46.2 | 5.3 | UP | |||||
OXA-135 | ||||||||||||
OXA-136 | OXA-63 | Narrow spectrum | B. pilosicoli | N | − | 25.1 | 5.3 | EU086830 | 96 | |||
OXA-137 | OXA-63 | Narrow spectrum | B. pilosicoli | N | − | 24.9 | 5.7 | EU086834 | 96 | |||
OXA-138 | ||||||||||||
OXA-139 | ||||||||||||
OXA-140 | ||||||||||||
OXA-141 | OXA-2 | ES-OXA | P. aeruginosa | A | + | 49.9 | 9.1 | EF552405 | UP | |||
OXA-142 | OXA-10 | ES-OXA | P. aeruginosa | A | + | 42 | 6.3 | EU358785 | UP | |||
OXA-143 | CHDL | A. baumannii | A | − | 34.4 | 8.7 | UP | |||||
OXA-144 | ||||||||||||
OXA-145 | OXA-10 | ES-OXA | P. aeruginosa | A | + | 41.1 | 8.7 | FJ790516 | UP | |||
OXA-146 | ||||||||||||
OXA-147 | OXA-10 | ES-OXA | P. aeruginosa | A | 41 | 8.1 | FJ848783 | UP |
6.
7.
Background:Hypertension,diabetesaremainriskfactorsofcardiovasculardiseases.Manydatashows:hypertensionmorbidityrateofdiabetespatientsisapparentlyhigherthanthatofnon-diabetespeople.Inforeigncountry,hypertensionmorbidityrateofdiabetespatientsreaches40%~80%.Inourcountry,surveyof220thousandpeoplein1994showedthathypertensionmorbidityrateofdiabetespatientsis55.4%.insulinresistanceiscommonpathogeneticfoundationofhypertensionandtype2diabetes.Inpreviousreports,therewasli… 相似文献
8.
Tiffany R. Keepers Marcela Gomez Chris Celeri Wright W. Nichols Kevin M. Krause 《Antimicrobial agents and chemotherapy》2014,58(9):5297-5305
Avibactam, a non-β-lactam β-lactamase inhibitor with activity against extended-spectrum β-lactamases (ESBLs), KPC, AmpC, and some OXA enzymes, extends the antibacterial activity of ceftazidime against most ceftazidime-resistant organisms producing these enzymes. In this study, the bactericidal activity of ceftazidime-avibactam against 18 Pseudomonas aeruginosa isolates and 15 Enterobacteriaceae isolates, including wild-type isolates and ESBL, KPC, and/or AmpC producers, was evaluated. Ceftazidime-avibactam MICs (0.016 to 32 μg/ml) were lower than those for ceftazidime alone (0.06 to ≥256 μg/ml) against all isolates except for 2 P. aeruginosa isolates (1 blaVIM-positive isolate and 1 blaOXA-23-positive isolate). The minimum bactericidal concentration/MIC ratios of ceftazidime-avibactam were ≤4 for all isolates, indicating bactericidal activity. Human serum and human serum albumin had a minimal effect on ceftazidime-avibactam MICs. Ceftazidime-avibactam time-kill kinetics were evaluated at low MIC multiples and showed time-dependent reductions in the number of CFU/ml from 0 to 6 h for all strains tested. A ≥3-log10 decrease in the number of CFU/ml was observed at 6 h for all Enterobacteriaceae, and a 2-log10 reduction in the number of CFU/ml was observed at 6 h for 3 of the 6 P. aeruginosa isolates. Regrowth was noted at 24 h for some of the isolates tested in time-kill assays. These data demonstrate the potent bactericidal activity of ceftazidime-avibactam and support the continued clinical development of ceftazidime-avibactam as a new treatment option for infections caused by Enterobacteriaceae and P. aeruginosa, including isolates resistant to ceftazidime by mechanisms dependent on avibactam-sensitive β-lactamases. 相似文献
9.
Background
There is growing public and legislative body support for the medical use of cannabis products, for example, for chemotherapy-induced nausea and vomiting (CINV), in Germany.Methods
A comprehensive literature search until November 2015 was conducted in MEDLINE, DARE and Cochrane libraries for systematic reviews of randomized controlled trials (RCTs) comparing herbal or pharmaceutical cannabinoids (CB) versus placebo or conventional antiemetics for CINV. Outcomes were reduction of CINV for efficacy, drop-out rates due to adverse events for tolerability, and serious adverse events for safety. The methodology quality of the systematic reviews was evaluated by the tool assessment of multiple systematic reviews (AMSTAR).Results
Six systematic reviews of RCTs included the pharmaceutical CBs dronabinol, levonantradol, and nabilone or whole plant extract (e.g., nabiximol) compared with placebo or conventional antiemetics. There was moderate quality evidence on the efficacy of CBs compared to placebo and conventional antiemetics for CINV. There was moderate quality evidence that pharmaceutical CBs were less tolerated and less safe than placebo and conventional antiemetics in CINV. One RCT examining whole plant extract was included into the systematic reviews. No RCT was found comparing CBs with neurokinine?1 receptor antagonists.Conclusions
With safe and effective antiemetics available, CBs cannot be recommended as first- or second-line therapy for CINV. Some guidelines recommend pharmaceutical CBs as third-line treatment in the management of breakthrough nausea and vomiting. Due to the lack of RCT data and safety concerns, herbal cannabis cannot be recommended for CINV.10.
Joshua W. Cohen Tanya D. Ivanova Brenda Brouwer Kimberly J. Miller Dianne Bryant S. Jayne Garland 《Archives of physical medicine and rehabilitation》2018,99(4):713-719
Objective
To investigate the extent to which physical performance measures of strength, balance, and mobility taken at discharge from inpatient stroke rehabilitation can predict health-related quality of life (HRQoL) and community reintegration after 6 months.Design
Longitudinal study.Setting
University laboratory.Participants
Adults (N=75) recruited within 1 month of discharge home from inpatient stroke rehabilitation.Interventions
Not applicable.Main Outcome Measures
36-Item Short Form Health Survey (SF-36) for HRQoL and Subjective Index of Physical and Social Outcome (SIPSO) for community reintegration. Physical performance measures were the 6-minute walk test, timed Up and Go (TUG) test, Berg Balance Scale, Community Balance and Mobility Scale, and isokinetic torque and power of hip, knee, and ankle on the paretic and nonparetic sides. Other prognostic variables included age, sex, stroke type and location, comorbidities, and motor FIM score.Results
Separate stepwise linear regressions were performed using the SF-36 and SIPSO as dependent variables. The total paretic lower limb torque and 6-minute walk test predicted the SF-36 Physical Component Summary (adjusted R2=.30). The total paretic lower limb torque and TUG test predicted the SIPSO physical component (adjusted R2=.47). The total paretic lower limb torque significantly predicted the SF-36 Mental Component Summary, but the adjusted R2 was low (.06). Similarly, the TUG test significantly predicted the SIPSO social component, but again the adjusted R2 was low (.09).Conclusions
Measures of physical performance including muscle strength and mobility at discharge can partially predict HRQoL and community reintegration 6 months later. Further research is necessary for more accurate predictions. 相似文献11.
Furnham A 《Complementary Therapies in Medicine》2000,8(4):266-275
This study looked at the relationship between ratings of the perceived effectiveness of 24 methods for telling the future, 39 complementary therapies (CM) and 12 specific attitude statements about science and medicine. A total of 159 participants took part. The results showed that the participants were deeply sceptical of the effectiveness of the methods for telling the future which factored into meaningful and interpretable factors. Participants were much more positive about particular, but not all, specialties of complementary medicine (CM). These also factored into a meaningful factor structure. Finally, the 12 attitude to science/medicine statements revealed four factors: scepticism of medicine; the importance of psychological factors; patient protection; and the importance of scientific evaluation. Regressional analysis showed that belief in the total effectiveness of different ways of predicting the future was best predicted by beliefs in the effectiveness of the CM therapies. Although interest in the occult was associated with interest in CM, participants were able to distinguish between the two, and displayed scepticism about the effectiveness of methods of predicting the future and some CM therapies. 相似文献
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Nigel Hartley 《Progress in Palliative Care》2016,24(1):6-8
Public health approaches to palliative care must appreciate that health professionals are part of communities, and the importance of partnerships should not be ignored – despite the inherent challenges. The true partners in a public health approach towards the end of life are of course, dying people, their families and friends, and members of the communities within which they are living and dying. However, we ignore important partnerships with nurses, doctors, and other healthcare professionals at our peril. This paper situates hospices within the broader community and uses vignette's to highlight approaches to community engagement and the challenges of partnership. 相似文献
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Florian Uhle Benjamin G. Chousterman Robert Grützmann Thorsten Brenner 《Expert review of anti-infective therapy》2016,14(10):917-927
Introduction: Sepsis is a major cause of death worldwide but its orchestrating components remain incompletely understood. On the one hand, development of sepsis results from an infectious focus that cannot be controlled by the immune system, but on the other, responding immune cells that can eliminate the infection inflict damage to the host by contributing to complications such as endothelial leakage, septic shock, and multiorgan failure.
Areas covered: In this review we give a comprehensive overview of how sepsis occurs, which exogenous and endogenous factors might affect the immune-pathophysiological course of sepsis and finally how this knowledge translates into up-to-date definitions and therapeutic approaches.
Expert commentary: Although new immunological mechanisms altering the course of sepsis have been identified recently, future research needs to address the limitations of experimental approaches, redirect the research focus into translational approaches, and finally evaluate personalized treatment strategies. 相似文献
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Background:Therearemanysurgerymethodstoevacuatehematomwhencerebralhemorrhage,buttheyalsocancausesomesecondaryinjuries,whichareharmfultoearlyrehabilitation.WeusecombinationofTCMandwesternmedicaltherapytoevacuatehematomandafterdynamicobserving,analyzeitseffectsonex-tremitiesfunction,andamentia.Objective:ToanalyzetheeffectsofcombinationofTCMandwesternmedicinetherapyinthetreatmentofevacuationofhematom,extremitiesfunction,andamentia.Unit:DepartmentofNeurologyofAffiliatedHospitalof… 相似文献