2014—2018年天津市宝坻区人民医院感染性疾病病原菌的分布及耐药性分析

目的 分析2014—2018年天津市宝坻区人民医院感染性疾病病原菌的分布及耐药性,为临床抗菌药物的合理应用提供依据。方法 回顾性分析2014—2018年天津市宝坻区人民医院感染性疾病病原菌的分布及耐药性。结果 共分离出病原菌13 614株,标本主要来源于痰液、分泌物、尿液、血液,分别占38.10%、19.00%、14.31%、13.41%。革兰阴性杆菌共8 808株,占64.70%,革兰阳性球菌3 796株,占27.88%,革兰阳性杆菌76株,占0.56%;革兰阴性球菌7株,占0.05%,真菌927株,占6.81%。不同部位标本分离的病原菌有所不同。大肠埃希菌、肺炎克雷伯菌对氨苄西林耐药率较高,对美罗培南、亚胺培南、哌拉西林/他唑巴坦、阿米卡星的耐药率低于5%以下;铜绿假单胞菌对头孢唑林、呋喃妥因、复方新诺明、氨苄西林、头孢呋辛钠、头孢曲松的耐药率均在90%以上,对阿米卡星的耐药率在10%以下;鲍曼不动杆菌对阿米卡星耐药率在5%以下,对大部分药物的耐药率较高。金黄色葡萄球菌、表皮葡萄球菌对万古霉素、利奈唑胺、替加环素无耐药,对青霉素、红霉素耐药率较高;肺炎链球菌对克林霉素、红霉素耐药率较高,对万古霉素、利福平无耐药;屎肠球菌对克林霉素、红霉素、青霉素耐药率较高,对替加环素无耐药,对万古霉素、利奈唑胺耐药率为1.98%。结论 天津市宝坻区人民医院分离的病原菌对抗菌药物有不同程度的耐药,加强病原学检查及耐药监测有助于临床合理选择抗菌药。     

2016—2021年清镇市第一人民医院神经外科患者下呼吸道标本病原菌分布特征及耐药性分析

目的 探讨清镇市第一人民医院神经外科患者下呼吸道标本病原菌构成特点及耐药情况,为临床合理使用抗菌药物治疗提供参考依据。方法 收集2016年1月—2021年12月清镇市第一人民医院神经外科患者送检的合格下呼吸道标本,采用梅里埃VITEK 2-compact分析仪进行细菌鉴定和药物敏感性试验。结果 共检出663株细菌,其中革兰阴性杆菌有556株,占比83.9%;革兰阳性球菌有107株,占比16.1%;常见病原菌为肺炎克雷伯菌（214株,32.3%）、鲍曼不动杆菌（93株,14.0%）、金黄色葡萄球菌（91株,13.7%）、铜绿假单胞菌（80株,12.1%）和大肠埃希菌（61株,9.2%）。耐药性监测结果显示,肺炎克雷伯菌和大肠埃希菌产超广谱β-内酰胺酶（ESBLs）菌株分别占33.1%、60.6%,对碳青霉烯类药物的耐药率为8.9%、1.6%;鲍曼不动杆菌对氨曲南、头孢他啶、氨苄西林/舒巴坦、环丙沙星和头孢吡肟的耐药率超过60.0%,对亚胺培南的耐药率为53.8%;铜绿假单胞菌对庆大霉素、阿米卡星和妥布霉素的耐药率低于15.0%,对亚胺培南的耐药率为45.0%。金黄色葡萄球菌中甲氧西林耐药金黄色葡萄球菌（MRSA）检出率为62.6%,MRSA的耐药率明显高于甲氧西林敏感金黄色葡萄球菌（MSSA）,未检出对替加环素、万古霉素和利奈唑胺耐药的菌株。结论 清镇市第一人民医院神经外科患者下呼吸道感染病原菌以革兰阴性杆菌为主,肺炎克雷伯菌、鲍曼不动杆菌、金黄色葡萄球菌、铜绿假单胞菌和大肠埃希菌是常见的病原菌。病原菌对临床常用抗菌药物耐药严重,多重耐药细菌检出率高,临床用药治疗前应及时采样进行细菌培养和药物敏感性试验,根据药敏试验结果制定合理的治疗方案。     

2017年福州市第二医院病原菌的分布及耐药性分析

目的 了解2017年福州市第二医院临床分离病原菌的分布及对抗菌药物的敏感性,为临床用药提供指导。方法 共收集2 720株非重复分离菌,采用纸片扩散法或自动化仪器法进行药敏试验,按CLSI标准判读药敏结果。结果 2 720株细菌中,标本主要来源于伤口分泌物（989株）,占36.3%。革兰阴性菌1 786株,占65.7%,主要为大肠埃希菌、肺炎克雷伯菌、铜绿假单胞菌、鲍曼不动杆菌、嗜麦芽窄食单胞菌和阴沟肠杆菌;革兰阳性菌934株,占34.3%,主要为金黄色葡萄球菌、粪肠球菌和凝固酶阴性葡萄球菌。耐甲氧西林耐药株金黄色葡萄球菌、凝固酶阴性葡萄球菌的检出率分别为42.7%、84.2%。未发现对万古霉素、替考拉宁和利奈唑胺耐药的葡萄球菌。粪肠球菌对大多数抗菌药物的耐药率明显低于屎肠球菌。肠球菌属中未发现万古霉素、利奈唑胺、替考拉宁耐药的肠球菌。除对黏菌素100%敏感外,铜绿假单胞菌对其他常见抗菌药物的耐药率均较低,鲍曼不动杆菌除对黏菌素敏感外,对其他药物的耐药性均较高,均达46.2%以上。结论 2017年福州市第二医院病原菌耐药形势依旧严峻,应加强合理用药,避免交叉感染。     

儿童血源性感染患者病原菌菌群分布及耐药性分析

目的了解2012年住院患儿血培养中分离的病原菌分布及耐药状况,为血源性感染患儿的临床诊治与流行病学特征提供用药依据。方法回顾性分析该院导致血源性感染的663株病原菌分布及其抗菌药物耐药情况。结果 6 333份血培养标本分离出病原菌663株,阳性率10.5%;其中革兰阳性球菌404株占60.9%,包括凝固酶阴性葡萄球菌、金黄色葡萄球菌、肠球菌属;革兰阴性杆菌253株占38.2%,主要包括阴沟肠杆菌、铜绿假单胞菌、木糖氧化产碱杆菌、嗜麦芽窄食假单胞菌等;真菌6株占0.9%。药敏试验检出革兰阳性球菌对万古霉素、利奈唑胺敏感,对青霉素、红霉素、氨苄西林〉90%以上耐药;革兰阴性杆菌未发现耐亚胺培南菌株。结论儿童血液感染患者菌种较复杂,革兰阳性球菌是引起菌血症的主要病原菌,药敏结果提示检出菌株耐药性较强,因此需要根据血液感染细菌的分布特性和耐药性,选择敏感的抗生素治疗血源性感染患儿。     

重症监护病房分离细菌病原学分布及其耐药性分析

目的 分析重症监护病房（ICU）细菌感染的病原菌分布,并分析其耐药性。方法 收集2015年1~12月安徽省立医院ICU内分离的病原菌并分析其耐药性。结果 855株病原菌中常见革兰阴性杆菌占73.5%,常见革兰阳性球菌占10.1%;阴性杆菌以鲍曼不动杆菌（38.5%）、铜绿假单胞菌（14.5%）、肺炎克雷伯杆菌（12.4%）、大肠埃希菌（7.8%）为主,肺炎克雷伯杆菌、大肠埃希菌产超广谱β-内酰胺酶菌株分别为20.6%、64.2%;阴性杆菌对碳青霉烯类、β内酰胺酶类、阿米卡星等较敏感。阳性球菌主要为金黄色葡萄球菌（3.9%）、肠球菌属（3.6%）、凝固酶阴性葡萄球菌（2.2%）等;耐甲氧西林金黄色葡萄球菌与耐甲氧西林的凝固酶阴性葡萄球菌检出率分别为87.5%和50.0%。结论 ICU分离的病原菌以阴性杆菌为主,且对抗菌药物敏感性差,应加强细菌耐药性的检测,指导抗菌药物运用。     

重症监护病房院内感染患者细菌种类及耐药性分析

目的 分析重症监护病房（ICU）院内感染患者的细菌种类及其耐药情况,指导抗菌药物的合理应用。方法 2013年1月至2015年12月宁国市人民医院ICU院内感染患者的各类标本中分离出225株病原菌,分析病原菌耐药情况。结果 225株病原菌中革兰氏阴性杆菌占82.67%（186株）,革兰氏阳性球菌占17.33%（39株）。前5位病原菌依次为鲍曼不动杆菌、肺炎克雷伯菌、铜绿假单胞菌、金黄色葡萄球菌、嗜麦芽寡养单胞菌。革兰氏阴性杆菌对阿米卡星、亚胺培南、美罗培南、头孢哌酮/舒巴坦和哌拉西林/他唑巴坦耐药率较低,对其他头孢类及喹诺酮类等抗菌药物耐药率较高;金黄色葡萄球菌对万古霉素、利奈唑胺和替考拉宁均敏感,对其他抗菌药物存在不同程度的耐药,且耐甲氧西林金黄色葡萄球菌菌株检出率为52.94%。结论 革兰氏阴性杆菌占ICU中感染病原菌的大多数,且其耐药情况相当严重,临床医师在经验性选用抗菌药物时应注意。     

下呼吸道感染患者支气管肺泡灌洗液病原菌分布及耐药性分析

目的 探讨下呼吸道感染患者支气管肺泡灌洗液病原菌分布及对常用抗菌药物药敏结果,为临床合理用药提供依据。方法 回顾性分析焦作市人民医院2019年1月—2020年12月下呼吸道感染患者支气管肺泡灌洗液定量分离培养结果。结果 365例患者主要来源于呼吸与危重症医学科269例,占73.7%;血液病科26例,占7.1%;重症监护病房20例,占5.5%;风湿免疫科13例,占3.6%。病原菌以革兰阴性杆菌为主,116例,占82.3%,排在前3位的是肺炎克雷伯氏菌(39株,27.7%)、鲍曼不动杆菌(35株,24.8%)和铜绿假单胞菌(25株,17.7%);真菌19株,占13.5%,其中念珠菌属13株,曲霉菌属5株,青霉菌属1株;革兰阳性球菌6株,占4.3%,主要为肺炎链球菌(3株,2.1%);肺炎克雷伯氏菌对亚胺培南、美罗培南耐药率分别为36.1%、35.6%;鲍曼不动杆菌对亚胺培南、美罗培南耐药率均为94.2%、94.2%;铜绿假单胞菌对亚胺培南、美罗培南耐药率分别为34.0%、22.0%。结论 支气管肺泡灌洗液主要病原菌为革兰阴性杆菌,以肺炎克雷伯氏菌、鲍曼不动杆菌和铜绿假单胞菌为主,各病原菌耐...     

2020—2022年临沧市人民医院佤族患者下呼吸道标本病原菌分布及耐药性分析

目的 分析2020—2022年临沧市人民医院佤族患者下呼吸道标本病原菌检出情况及其耐药率,为临床合理治疗佤族患者下呼吸道感染提供参考依据。方法 收集临沧市人民医院2020年1月—2022年12月送检的佤族患者合格下呼吸道标本进行回顾性分析。结果 共检出278株细菌,其中革兰阴性细菌231株（占83.1%）,革兰阳性细菌47株（占16.9%）。肺炎克雷伯菌、大肠埃希菌、铜绿假单胞菌、金黄色葡萄球菌和嗜麦芽窄食单胞菌是佤族患者下呼吸道标本最为常见的细菌。铜绿假单胞菌对常用抗假单胞菌药物耐药率均较低（＜10%）,对亚胺培南的耐药率为3.8%;嗜麦芽窄食单胞菌对米诺环素耐药率达57.1%,对左氧氟沙星、复方磺胺甲唑无耐药菌株。金黄色葡萄球菌对青霉素耐药率为87.5%,耐甲氧西林金黄色葡萄球菌（MRSA）检出率为12.5%,未检出对万古霉素和利奈唑胺耐药的菌株;肺炎链球菌对青霉素耐药率为0,对红霉素、克林霉素和四环素耐药率较高,均达81.8%。结论 临沧市人民医院佤族患者下呼吸道感染细菌以革兰阴性杆菌为主。检出的主要病原菌对临床常用抗菌药物的耐药率低于其他研究,临床治疗时应选择适宜抗菌谱的药物,同时及时进行微生物学培养,根据药敏试验结果制定合理的药物治疗方案。     

我院临床标本细菌分布及耐药性分析

目的对我院2001～2002各科室送检标本病原菌的分布及抗生素耐药性进行分析,为临床抗感染治疗提供参考依据。方法细菌鉴定及药敏试验采用VITEK-32全自动微生物鉴定仪,少数细菌药敏试验采用K-B法。结果两年来共分离病原菌1583株。其中革兰阴性肝菌1047株,革兰阳性球菌491株,真菌45株。在革兰阴性杆菌中铜绿假单胞菌最多,其次是大肠杆菌。革兰阳性球菌中,以凝固酶阴性葡萄球菌为主。大肠杆菌和肺炎克雷伯菌产超广谱酶(ESBLs)的细菌分别占39%和42%。革兰阴性杆菌对亚胺培南较敏感,铜绿假单胞菌耐药性最强,革兰阳性球菌对万古霉素最敏感,屎肠球菌耐药性较强。结论两年我院主要病原菌构成比与国内省级医院大致相同。医院感染的多重耐药相当严重,加强病原菌分布及耐药性检测,对指导临床合理用药具有重要意义。     

重症医学科病原菌分布及耐药性分析

目的：了解本院重症医学科病房病原菌的分布及耐药性,为临床用药提供依据。方法回顾性调查分析2013年1月至2013年12月重症医学科病房送检标本中分离的314株病原菌,用DL-96微生物鉴定系统进行鉴定及药敏试验。结果314株病原菌中,革兰阳性球菌45株（14．3％）,革兰阴性杆菌244株（77．7％）。主要的非念珠菌病原菌为铜绿假单胞菌、肺炎克雷伯菌、大肠埃希菌、屎肠球菌。革兰阴性杆菌对常用抗菌药物耐药严重,且呈多药耐药。革兰阴性杆菌产超广谱β-内酰胺酶（ESBLs）的检出率为55．0％。结论重症医学科病房病原菌以革兰阴性杆菌铜绿假单胞菌为主,肺炎克雷伯菌和大肠埃希菌对常用抗菌药物耐药严重,应动态监测病原菌流行株及其耐药情况,合理使用抗菌药物。     

Investigation of the prevalence of tetQ, tetX and tetX1 genes in Bacteroides strains with elevated tigecycline minimum inhibitory concentrations

In this study, the antibiotic susceptibilities to tigecycline and tetracycline of 35 selected Bacteroides fragilis group strains were determined by Etest, and the presence of tetQ, tetX, tetX1 and ermF genes was investigated by polymerase chain reaction (PCR). tetQ was detected in all 12 B. fragilis group isolates (100%) exhibiting elevated tigecycline minimum inhibitory concentrations (MICs) (≥8 μg/mL) as well as the 8 strains (100%) with a tigecycline MIC of 4 μg/mL, whilst tetX and tetX1 were present in 15% and 75% of these strains, respectively. All of these strains were fully resistant to tetracycline (MIC ≥ 16 μg/mL). On the other hand, amongst the group of strains with tigecycline MICs < 4 μg/mL (15 isolates), tetQ, tetX and tetX1 were found less frequently (73.3%, 13.3% and 46.7%, respectively). All but two strains harbouring the tetQ gene in this group were non-susceptible to tetracycline, with a MIC > 4 μg/mL. These data suggest that in most cases tigecycline overcomes the tetracycline resistance mechanisms frequently observed in Bacteroides strains. However, the presence of tetX and tetX1 genes in some of the strains exhibiting elevated MICs for tigecycline draws attention to the possible development and spread of resistance to this antibiotic agent amongst Bacteroides strains. The common occurrence of ermF, tetX, tetX1 and tetQ genes together predicted the presence of the CTnDOT-like Bacteroides conjugative transposon in this collection of Bacteroides strains.     

Synthesis and evaluation of 2,6-piperidinedione derivatives as potentially novel compounds with analgesic and other CNS activities

New 2,6-piperidinediones 2_a–g and 4_a–d were prepared by initial condensation of aromatic aldehydes or cycloalkanones with cyanoacetamide to give α-cyanocinnamides l_a–g or cycloalkylidenes 3_a,b which underwent Michae1 addition with ethyl cyanoacetate or diethylmalonate. Compounds 4_a–d were alkylated by various alkyl halides to produce the N-alkylated 2,6-piperidinedione derivatives 5_a–m. Some new selected compounds 2_a–c,f, 4_a–d & 5_e,h,j were pharmacologically evaluated for potential anticonvulsant, sedative and analgesic activities. These compounds exhibited significant anticonvulsant and analgesic effects after a single I.P. administration 100 mg/kg b.wt. . On the other hand all the investigated compounds induced hypnotic activity and prolonged the phenobarbital sodium- induced sleep as compared with the control group and the most potent compound was found to be 2_f.     

EFFECT OF POLICOSANOL SUCCESSIVE DOSE INCREASES ON PLATELET AGGREGATION IN HEALTHY VOLUNTEERS

Policosanol is a cholesterol-lowering drug with hypocholesterolemic effects demonstrated in experimental models, healthy volunteers and type II hypercholesterolemic patients. In addition, antiplatelet effects of policosanol have been shown in experimental models and healthy volunteers. The effect of successively increasing doses of policosanol on platelet aggregation was investigated in a randomized, placebo-controlled, double-blind study conducted in 37 healthy volunteers. The volunteers were on a placebo-baseline period (two tablets per day) for 7 days and thereafter they received randomly, under double-blind conditions, placebo or policosanol (10mgday⁻¹) for 7 days. After this period dosage was doubled to 20mgday⁻¹for the next 7 days and then again doubled to 40mgday⁻¹, while the control group received placebo tablets all the time. Platelet aggregation as well as coagulation time was measured at baseline and after each dosing step. Results showed that antiplatelet effects of policosanol were successfully enhanced throughout the study, thus suggesting a dose-dependent relationship. No significant effect was reached during the first dosing period, but significant reductions of epinephrine and ADP-induced platelet aggregation were observed after the second one. Finally, a significant inhibition of platelet aggregation induced by all the agonists was observed at the last dosing step. Coagulation time remained unchanged during the trial.     

栝楼不同药用部位质量控制的研究进展

瓜蒌子、瓜蒌皮、瓜蒌、天花粉来源于栝楼的不同药用部位,4味药材均为常用的大宗药材,现行版《中国药典》对其制定的质量标准过于简单,无法科学合理地控制其质量。本文对瓜蒌子、瓜蒌皮、瓜蒌、天花粉安全性和有效组分的研究进行综述,明确了相关研究存在的问题并针对问题提出建议,为科学全面的药材及饮片标准的制定提供参考依据。     

NEURAMIDE STIMULATES ADRENOCORTICOTROPIN BUT NOT PROLACTIN RELEASE FROM RAT PITUITARY

Neuramide (NMD), a substance found in crude preparations of porcine stomach extract, is a viral inhibitor that also has putative immunostimulatory effects. The effects of NMD on stress-hormone (ACTH and prolactin—PRL) release were assessed inin vivoandin vitrostudies. In the former, blood levels of corticosterone and PRL were measured in NMD-treated male rats.In vitroexperiments were performed to evaluate the effects of NMD and three of its fractions (obtained with high performance liquid chromatography) on ACTH and PRL release from perfused rat pituitary slices. NMD increased plasma corticosterone levelsin vivoand produced dose-dependent increases inin vitropituitary release of ACTH. No effects on PRL secretion were observedin vivoorin vitro. The stimulatory effects on ACTH release were caused by the NMD fraction with a molecular weight of >5000<10000Da.     

Genotyping and in vitro antifungal susceptibility of Neoscytalidium dimidiatum isolates from different origins

This study evaluated the genetic variability and in vitro susceptibility patterns of isolates of Neoscytalidium dimidiatum and Scytalidium hyalinum from different geographical origins. Partial sequences of four loci (the ITS region and D1/D2 domains of the 28S rRNA gene and the tubulin and chitin synthase genes) were analysed. Among a total of 1970 bp sequenced in 24 isolates, 7 polymorphic positions (0.36%) were detected, representing five different sequence types (ST1–ST5), from which two (ST2 and ST3) were detected exclusively in isolates from plants, two (ST1 and ST5) were found only in clinical isolates and one (ST4) was observed in isolates from humans and from a mango tree. We propose subordinating S. hyalinum as a variety of N. dimidiatum. Amphotericin B was the most active drug, but low minimum inhibitory concentrations were also detected for voriconazole, terbinafine and anidulafungin.     

鼻渊净胶囊的HPLC指纹图谱研究

目的 建立鼻渊净胶囊的高效液相色谱(HPLC)指纹图谱.方法 采用Agilent SB-C18(4.6 mm×250 mm,5μm)色谱柱,乙腈-水为流动相、以1.0 ml/min流速行梯度洗脱,检测波长210 nm,柱温30℃,洗脱时间为80 min.采用中药色谱指纹图谱相似度评价系统(2004A版)对检测出色谱进行...     

INDIRECT PARASYMPATHOMIMETIC ACTIVITY OF THE CLASS III ANTIARRHYTHMIC SUBSTANCE / -SOTALOLIN VITRO: REVERSIBLE INHIBITION OF CHOLINESTERASE ISOENZYMES FROM BLOOD AND THE HUMAN CENTRAL NERVOUS SYSTEM

Inhibitory effects of the class III antiarrhythmic compound / -sotalol on acetylcholinesterase (AChE; EC 3.1.1.7) isoenzymes of both erythrocytes and the human caudate nucleus and on serum cholinesterase (ChE; EC 3.1.1.8) were studiedin vitrousing a spectrophotometric kinetic assay with acetylthiocholine (ASCh) as substrate. Sotalol concentrations in the assays varied from 0.32 to 3.2m . All isoenzymes studied were inhibited by / -sotalol in a reversible and concentration-dependent manner. Double reciprocal plots of the reaction velocity against varying ASCh concentrations revealed that / -sotalol reduced substrate affinity (apparent Michaelis constant, KM, increased) of serum ChE, but did not change the enzyme's maximal rate of ASCh hydrolysis (V_max). Thus, / -sotalol inhibition of serum ChE was of the competitive type (rate constant for reversible competitive inhibition: K_i=0.51m ). In contrast, / sotalol reduced the maximal reaction velocity of the AChE isoenzyme from the central nervous system (caudate nucleus), but had no influence on substrate affinity of the enzyme (K_Mwith ASCh unchanged) indicating purely non-competitive inhibition kinetics (rate constant of reversible non-competitive inhibition: K_i′=0.44m ). / -sotalol inhibition of erythrocyte AChE was of mixed competitive/non-competitive type (K_i=0.31m , K_i′=0.49m ). Non-competitive / -sotalol inhibition of caudate nucleus AChE and the non-competitive component of erythrocyte AChE inhibition cannot be overcome by increased concentrations of the cholinergic transmitter acetylcholine (ACh). Peak / -sotalol plasma levels as described in the literature for both humans (15μ ) and experimental animals (dogs: 18μ ; rats: 260μ ) as well as maximal myocardial concentrations of the substance (dogs: 46μ ; rats: 478μ ) are in the range of about 2% to 100% of the sotalol inhibition rate constants determined in the present paper for cholinesterase isoenzymesin vitro. Thus, / -sotalol inhibition of ACh hydrolysisin vivomay contribute to both the well known antiarrhythmic potential and proarrhythmic side effects of the compound.     

2017—2020年克拉玛依市中心医院抗菌药物使用强度与分离菌耐药性变化情况

目的 分析克拉玛依市中心医院2017—2020年住院患者常见分离菌分布及耐药率的变迁情况,为指导抗菌药物临床合理应用提供依据。方法 收集2017—2020年克拉玛依市中心医院住院患者抗菌药物使用情况及分离菌,分析主要分离菌对常见抗菌药物的耐药率变化趋势。结果 2017—2019克拉玛依市中心医院抗菌药物使用率和使用强度呈下降趋势,4年共有分离菌12 135株,其中革兰阳性菌2 567株,占21.15%;革兰阴性菌6 310株,占52.00%;真菌3 258株,占26.85%。居前5位的分离菌分别是白色假丝酵母菌（19.59%）、大肠埃希菌（16.84%）、肺炎克雷伯菌（13.33%）、鲍曼不动杆菌（8.71%）和铜绿假单胞菌（7.94%）。主要分离菌对常用抗菌药物耐药率总体呈下降趋势,肠杆菌科细菌对临床常用抗菌药物耐药性下降最明显。结论 克拉玛依市中心医院分离菌逐年增加,耐药率有下降趋势,抗菌药物临床应用基本合理,但需完善真菌检测能力。