Aetiology and outcome in 53 cases of native valve staphylococcal endocarditis

Within the last 30 years the profile of infective endocarditis has altered considerably with regard to microbiological causation, clinical features, and natural history. A contributory factor has undoubtedly been the development of potent antibiotics and their sometimes indiscriminate use. The increase in intravenous drug abuse in urban centres, the use of immunosuppressive agents, and the use of prosthetic heart valves have also all contributed. Although cardiac surgery in the uninfected heart provides a perfect environment for infective endocarditis, the improved design of prosthetic valves and the enhanced long-term survival and decreased immediate operative risk, means that surgery is viewed as the best option in many cases. In a series of 53 cases of staphylococcal endocarditis from a national endocarditis survey, those risk factors which influenced outcome were analysed. Thirty out of 53 patients had predisposing heart disease. Mortality was 39.6%. Statistical analysis revealed that attributable mortality was significantly associated with skin infection, systemic embolisation, and inappropriate therapy. Interestingly, surgical treatment was associated with better outcome.     

一起由金黄色葡萄球菌和路邓葡萄球菌引发食物中毒病原分析

目的 通过一起疑似葡萄球菌引发食物中毒进行葡萄球菌肠毒素检测,并结合检测出致病性葡萄球菌病原学分析,为下一步食物中毒处置提供诊断依据。方法 根据流行病学调查和国家标准《食品微生物学检验》GB4789,对可疑食物及患者呕吐物、肛拭子等进行了几种常见致病原菌分离培养,并直接采用实时荧光PCR方法对金黄色葡萄球菌肠毒素A~E基因进行分型,用全自动微生物鉴定分析仪进行系统生化鉴定,并做血浆凝固酶试验。结果 在食用剩余汉堡中分离出1株金黄色葡萄球菌、2名患者肛拭子中分离出2株金黄色葡萄球菌,1名患者呕吐物中分离1株血浆凝固酶阴性路邓葡萄球菌,利用PCR方法分别对其进行了肠毒素基因分型,结果显示,食用剩余汉堡中1株和2株患者肛拭子的金黄色葡萄球菌肠毒素均为SEA型,为同一型;1株患者呕吐物的路邓葡萄球菌的肠毒素为SEC型。 结论 该起食物中毒主要是由金黄色葡萄球菌产生SEA型肠毒素所导致,血浆凝固阴性路邓葡萄球菌跟金黄色葡萄球菌一样,也能产生肠毒素同样具有致病性作用,提示路邓葡萄球菌不单纯只是人类皮肤共生菌,或许还跟金黄色葡萄球菌同样具有侵袭性、产肠毒素等致病性,在进行公共卫生流行调查诊断时不能被忽视。     

葡萄球菌属的分离及耐药性研究

目的　对 1 974株临床分离的葡萄球菌的耐药性进行研究 ,以观察葡萄球菌属的耐药现状。方法　药敏试验采用纸片扩散法 (K -B法 )。结果　临床分离到的葡萄球菌中 ,MRSA的分离率为 2 0 .8% (66/ 31 7) ,MRCNS的分离率为 66 .9% (1 1 0 9/ 1 657) ,MRSA主要来源于生殖道分泌物、痰、伤口分泌物 ,分别占 2 7.3 % ,2 2 .7% ,1 8.2 % ;血液标本中MRSA和MRCNS分别占总分离数的 0 .2 5 %和 4 .9% ,而MRSA只占 0 .2 5 %。MRSA和MRCNS对红霉素、庆大霉素、氯霉素、克林霉素、环丙沙星、复方磺胺甲恶唑、四环素的耐药率分别为 86 .2 %、47.6 %、50 .8%、61 .3 %、54 .5 %、83 .3 %、66 .1 %和 84.9%、37.5 %、45 .9%、53 .7%、58.2 %、84.9%、67.6 % ;MSCNS中环丙沙星、复方磺胺甲恶唑、四环素、氯霉素的耐药率分别为 33 .0 %、64 .1 %、58.5 %、2 7.8%均高于MSSA的 1 4 .6 %、42 .8%、41 .5 %、1 7.7% ,但对于MSS环丙沙星、庆大霉素、氯霉素、克林霉素有较高的敏感性。结论　重视对葡萄球菌的耐药性监测 ,合理使用抗生素、特别是合理使用糖肽类抗生素是非常必要的。     

耐甲氧西林凝固酶阴性葡萄球菌的耐药性

目的 观察凝固酶阴性葡萄球菌（CNS）对甲氧西林等的耐药性和β-内酰胺酶的产生率,指导临床用药。方法 对本院临床感染标本常规分离鉴定菌株,药敏试验应用K-B纸片扩散法,按NCCLS规定的标准进行,耐甲氧西林凝固酶阴性葡萄球菌（MRCNS）MIC测定应用Vitex微生物自动分析系统,β-内酰胺酶检测采用碘量试管法。结果 CNS95株中MRCNS的分离率为39%,β-内酰胺酶的阳性率为63%,MRCNS的产酶率为95%,以甲氧西林敏感的葡萄球菌（MSCNS）的产酶率为43%;95%株CNS对万古霉素100%敏感,对氨苄青、青霉素、红霉素最低耐药率为85%,对头孢派酮、头孢唑林、舒普深最低敏感率为83%。结论 MRCNS和MSCNS的产酶率与对甲氧西林的耐药性呈正相关,MRCNS与产β-内酰胺酶葡萄球菌间的耐药率无显差异。目前万古霉素和舒普深是治疗MRCNS和产酶CNS的首选抗生素。     

Aspergillus niger endocarditis in an immunocompetent patient: an unusual course

Aspergillus is an opportunistic nosocomial fungus generally associated with a high mortality rate. A niger has been rarely associated with infection, and most cases have occurred in patients who have recently undergone heart surgery or in immunocompromised patients. We present a case of an immunocompetent patient with A niger endocarditis which illustrates the difficulties in diagnosis and the possible insidious course of fungal endocarditis.     

院内外环境分离金黄色葡萄球菌的耐药性及毒素基因检测

目的检测医院及环境样中金黄色葡萄球菌（Staphylococcus aureus,SA）耐药基因及毒素基因,了解其分布情况。方法采用多重聚合酶链反应（multiplex polymeras chain reaction,PCR）技术分别检测耐药基因mecA、femA与毒素基因TSST、PVL。结果 83株金黄色葡萄球菌,仅3株（3.61%）菌检出mecA基因,22株菌（26.50%）检出femA基因,15株菌（18.07%）同时检出mecA与femA基因。医院样本检出12株耐甲氧西林金黄色葡萄球菌（methicillin-resistantStaphylococcus aureus,MRSA）,3株甲氧西林耐药凝固酶阴性的金黄色葡萄球菌（methicillin-resistant and coagulasenegative Staphylococcus aureus,MRCNS）。83株分离自医院及环境样本SA,2株分离自咽拭子的样本检出TSST基因,检出率4.54%（2/44）;1株分离自血液的样本检出PVL基因,检出率2.27%（1/44）,其余菌株未检出毒素基因。结论院内样本中,部分菌株携带mecA基因,环境样本未发现携带mecA菌株,两者存在差异。83株SA菌,毒素基因携带率较低。检测耐药、毒素基因携带率,为临床治疗及院内感染控制,食物中毒溯源提供依据。     

某医院感染葡萄球菌的临床分布及耐药性分析

目的了解耐甲氧西林金葡菌（MRSA）和凝固酶阴性葡萄球菌（MRSE）的临床分布及其耐药性,指导临床合理使用抗菌药物。方法对2012年1月-2013年1月乌鲁木齐市第四人民医院临床分离的146株MRSA和121株 MRSE的临床分布和耐药率进行统计学分析。结果146株 MRSA和121株 MRSE的分布主要以痰标本为主（44．5％和42．9％）,其次为尿液（15．7％和16．5％）。MRSA和 MRSE对苯唑西林和青霉素的耐药率最高,分别为100．00％和92．56％、100．00％和96．70％,其次为红霉素（85．62％和88．43％）,而对万古霉素和利奈唑烷的耐药率为0．00％。结论医院感染 MRSA和 MRSE对所测抗菌药物均有不同程度的耐药,医院应加强对药品的管理和定期进行耐药性检测,指导临床合理用药。     

不同来源血浆对试管法葡萄球菌凝固酶试验的影响

目的探讨试管法葡萄球菌凝固酶试验的最佳血浆及试验持续观察时间并解决假阴性问题，减少其检测的漏检率。方法用枸橼酸钠稀释不同的献血员及普通患者血浆对标准金黄色葡萄球菌菌株进行血浆凝固酶试验。结果分别用献血员、普通患者血浆做此试验在4h、24h、36h观察凝固情况，以献血员血浆较普通患者血浆阳性率较高、假阴性率较低，并且36h结果阳性率最高、假阴性率最低。结论采用不同来源血浆直接影响试管法血浆凝固酶试验的诊断效率，采用献血员血浆明显优于普通患者血浆。     

Antimicrobial drug resistance of Staphylococcus aureus in dairy products

Objective

To evaluate the prevalence of multidrug resistant Staphylococcus aureus (S. aureus) in dairy products.

Methods

Isolation and identification of S. aureus were performed in 3 dairy-based food products. The isolates were tested for their susceptibility to 5 different common antimicrobial drugs.

Results

Of 50 samples examined, 5 (10%) were contaminated with S. aureus. Subsequently, the 5 isolates were subjected to antimicrobial resistance pattern using five antibiotic discs (methicillin, vancomycin, kanamycin, chloramphenicol and tetracycline). Sample 29 showed resistance to methicillin and vancomycin. Sample 18 showed intermediate response to tetracycline. The other samples were susceptible to all the antibiotics tested.

Conclusions

The results provide preliminary data on sources of food contamination which may act as vehicles for the transmission of antimicrobial-resistant Staphylococcus. Therefore, it enables us to develop preventive strategies to avoid the emergence of new strains of resistant S. aureus.     

Antibacterial activity of the essential oils from the leaves of Eucalyptus globulus against Escherichia coli and Staphylococcus aureus

Objective

To examine the in vitro antimicrobial activities of essential oil of the leaves of Eucalyptus globulus (E. globulus).

Methods

The essential oils of this plant were obtained by the hydrodistillation method. The inhibitory effects of this essential oil were tested against Escherichia coli (E. coli) and Staphylococcus aureus (S. aureus) by using agar disc diffusion and dilution broth methods.

Results

The results obtained showed that essential oil of the leaves of E. globulus has antimicrobial activity against gram negative bacteria (E. coli) as well as gram positive bacteria (S. aureus).

Conclusion

The encouraging results indicate the essential oil of E. globulus leaves might be exploited as natural antibiotic for the treatment of several infectious diseases caused by these two germs, and could be useful in understanding the relations between traditional cures and current medicines.     

凝固酶阴性葡萄球菌qacA／B基因检测分析

目的了解凝固酶阴性葡萄球菌（CNS）qacA／B耐消毒剂基因耐药基因存在状况,为临床提供CSN对消毒剂的潜在耐药信息。方法收集临床标本中分离出的CNS,并根据其对头孢西丁的敏感性分为耐甲氧西林凝固酶阴性葡萄球菌（MRCNS）和甲氧西林敏感凝固酶阴性葡萄球菌（MSCNS）两组,采用聚合酶链反应（PCR）检测qacA／B基因,并对组间检出率进行比较。结果38株CNS中qacA／B基因阳性13株（占34．2％）,其中MRCNS35．7％,MSCNS30．0％。结论CNS的qacA／B基因携带率较高,且MRCNS菌株与MSCNS菌株组间携带率无统计学意义。MSCNS携带qacA／B基因为国内首次报道。     

速冻食品中金黄色葡萄球菌检验的改进分析

目的 对现行食品安全国家标准检验方法进行改进,使之更适合检测速冻食品中金黄色葡萄球菌.方法 从仁化地区大商场超市销售的速冻食品中随机采样,按Baird-Parker平板计数法检测;用营养肉汤(NB)为介质修复Baird-Parker平板,计数典型菌落总数,典型菌落做确认鉴定,计算确认率;从速冻食品中分离的典型菌落,用营养琼脂(NA)纯化,进行血浆凝固酶试验,计算试验阳性率.结果 在NB修复的Baird-Parker平板上,生长的典型菌落总数较多(49.4 CFU/ml),典型菌落确认率较高(92.1％),与未修复平板比较,差异均有统计学意义(P＜0.05).NA纯化的典型菌落做血浆凝固酶试验,试验阳性率较高(77.5％),与未纯化的典型菌落比较,差异有统计学意义(P＜0.05).结论 用改进的实验定量检测速冻食品中金黄色葡萄球菌,操作简单,能提高检出率,计数结果更准确,适合在基层实验室推广应用.     

耐甲氧西林葡萄球菌耐药性分析

耐甲氧西林葡萄球菌是引起医院内感染的重要致病菌。为了解该菌的耐药情况，进而为临床预防与治疗提供依据，我们对８８株葡萄球菌进行了耐甲氧西林及耐其它１４种常用抗生素和产β－内酰胺酶的测定。结果：耐甲氧西林金黄色葡萄球菌检出率为５６％，耐甲氧西林凝固酶阴性葡萄球菌检出率为４７．６％；耐甲氧西林敏感葡萄球菌对１４种常用抗生素的耐药性及多重耐药性均高于甲氧西林敏感葡萄球菌；产β－内酰胺酶最高的是耐甲氧西林金黄色葡萄球菌，产酶率为９２．９％，最低的是甲氧西林敏感凝固酶阴性葡萄球菌，为３９．４％，说明产酶与耐药之间有一定关系。耐甲氧西林葡萄球菌对万古霉素、呋喃妥因敏感，提示这２种药可作为临床治疗该类菌的首选药物。     

In vitro control of Staphylococcus aureus (NCTC 6571) and Escherichia coli (ATCC 25922) by Ricinus communis L.

Objective

To evaluate antibacterial activity of hot and cold ethanol and methanol leaf extracts of Ricinus communis L (R. communis) against Staphylococcus aureus (S. aureus) (NCTC 6571) and Escherichia coli (E. coli) (ATCC 25922).

Methods

Leaf powder of R. communis L. was extracted with hot (in Soxhlet) and cold ethanol and methanol, separately. The antibacterial activity of the extracts was determined by agar well diffusion and macro broth dilution methods. The extracts were also subjected to phytochemical analysis.

Results

All the four test extracts showed inhibition on both S. aureus and E. coli. Hot and cold ethanol extracts revealed significantly (P<0.05) higher inhibition on S. aureus than methanol extracts, and the hot ethanol extract had the lowest minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) values (5 mg/mL and 10 mg/mL, respectively). E. coli was highly inhibited by hot extracts of both ethanol and methanol with the MIC and MBC of 40 mg/mL and 80 mg/mL, respectively. Phytochemical analysis revealed the presence of saponins, cardiac glycosides, tannins, flavonoids and terpenoids in all test extracts.

Conclusions

This study demonstrates that the hot and cold methanol and ethanol extracts are potential sources for control of S. aureus and E. coli. Especially, the hot and cold extracts of ethanol are more inhibitive against S. aureus even at lower concentration. Further study is needed to identify the specific bioactive compounds, their mode of action and their nontoxic nature in vivo condition.     

比较全自动微生物分析仪与基因分析在凝固酶阴性葡萄球菌鉴定中的作用

目的比较Vitek32鉴定系统和16S rRNA序列分析法鉴定凝固酶阴性葡萄球菌的灵敏度和特异性。方法选择2004年12月~2006年11月重症监护病房分离的凝固酶阴性葡萄球菌70株,常规细菌培养后,用Vitek32鉴定系统和16S rRNA基因测序进行分类,以AP IStaph系统为参照,比较2种鉴定方法的优势和不足。结果根据Vitek32鉴定系统判断标准,将鉴定结果分为3组:Ⅰ组(25株):“不可接受”,%id<80;Ⅱ组(35株):“可接受的”,%id80~90;Ⅲ组(10株):“好的”,%id90~98,标准菌株为金黄色葡萄球菌(ATCC29213),分别进行16S rRNA基因测序。16S rRNA基因分析法全部鉴定到种,2种方法鉴定符合率分别为Ⅰ组64%、Ⅱ组74.3%、Ⅲ组100%,总体鉴定符合率74.4%。结论Vitek32在进行凝固酶阴性葡萄球菌鉴定时有局限性,16SrRNA序列分析可以弥补鉴定上的不足,在发展难培养和不能培养微生物的鉴定中将发挥重要作用。     

基于刃天青微平板法检测金黄色葡萄球菌对天然产物的敏感性

[目的] 以刃天青为检测试剂,评价大黄酸、棉子酚、盐酸小檗碱、兰雪醌、槲皮素5种天然产物对金黄色葡萄球菌的抑制作用。[方法] 比较刃天青浓度、菌悬液浓度、培养基种类和反应时间对吸光值的影响,优化刃天青的工作条件。刃天青法进行药敏性实验得到五种天然产物的最低抑菌浓度（MIC）,求得毒力回归方程、相关系数（R²）和半抑菌浓度（IC₅₀）。通过Z值判断刃天青显色法适用于高通量筛选药物的可行性。[结果] 当刃天青孔内终浓度为20μg/mL,培养基为LB,菌悬液浓度为5×10⁵CFU/mL,反应时间9h时适用于金黄色葡萄球菌的药敏性实验。刃天青显色法与微量肉汤法检测得到的五种天然产物的抑菌结果具有一致性。[结论] 五种天然产物均具有一定的抑菌活性。刃天青显色法具有准确性好、灵敏度高及高通量的特点,适用于天然产物抗菌活性的筛选。