A case of Bacillus cereus bacteraemia.

A case is presented of Bacillus cereus bacteraemia in a patient receiving hepatic perfusion with 5-fluorouracil (5FU) for metastasis from a carcinoma of the breast. The literature concerning systemic B. cereus infections is briefly reviewed.     

蜡样芽胞杆菌1型引起的食物中毒分析

2006年9月14日，中方县某乡镇中学发生一起食物中毒，经流行病学调查和实验室检验，证实本次中毒是蜡样芽胞杆菌1型污染米饭引起的。现报告如下。[第一段]     

Pneumonia due to antibiotic resistant Streptococcus pneumoniae and Pseudomonas aeruginosa in the HAART era

Antibiotic resistance profiles are useful in directing therapeutic strategies during bacterial infections. Patterns of antimicrobial resistance in Streptococcus pneumoniae and Pseudomonas aeruginosa associated pneumonia were investigated in an HIV-1 infected cohort during the era of highly active antiretroviral therapy. The median CD4 count at presentation was significantly lower for cases of P aeruginosa than for S pneumoniae. However, the number of antibiotic resistant cases of P aeruginosa decreased throughout the study period, while the incidence of S pneumoniae remained unchanged. In contrast to pneumococcal pneumonia, we show that antiretrovirals have protected from pneumonia due to antibiotic resistant P aeruginosa. These findings have implications for the treatment of individuals presenting with serious infections in which antibiotic therapy needs to be instituted before identification and sensitivities are known.     

一起蜡样芽孢杆菌10型引起食物中毒的快速诊断与分子分型研究

目的对引起一起食物中毒的蜡样芽孢杆菌进行快速诊断和分子分型。方法对中毒人员的呕吐物、肛拭子、可疑食品等样品用国标方法进行实验室检测,同时采用自主建立的荧光PCR方法进行快速检测。所分离的菌株PCR扩增vrrA基因多态性位点,产物进行基因双向测序和比较分析。结果在10份呕吐物、肛拭子、可疑食品中用传统方法和荧光PCR方法同时检出8份蜡样芽孢杆菌阳性,生物分型为10型。PCR测序结果显示它们有99%的同源性。结论这是一起食用了由蜡样芽孢杆菌10型污染的食品引起的呕吐型食物中毒,用蜡样芽孢杆菌呕吐毒素基因cesB为检测靶标的荧光PCR方法可以快速灵敏地对此类食物中毒进行初步诊断。以vrrA基因为多态性位点的PCR基因测序方法可用于蜡样芽孢杆菌的分子分型和食品污染源的准确追踪。     

Distribution and inheritance of low serum thyroxine-binding globulin levels in Australian Aborigines: a new genetic variation

Evidence is presented that low serum thyroxine-binding globulin (TBG) levels in Aborigines are widely distributed throughout Australia, and that these are inherited rather than acquired. Levels of TBG in children, and lack of any correlation of low TBG levels with alcohol consumption or liver dysfunction, suggest that the low levels are not acquired in adult life. Genetic studies in eight families indicate (with one exception) an autosomal dominant pattern of inheritance with direct male-to-male transmission. These findings are in marked contrast to the much rarer X-linked pattern of inheritance of low TBG levels in Caucasians. This type of prevalent and inherited low level of TBG in serum appears so far to be unique to the Aboriginal race. The synthesis (or degradation) of TBG may be controlled by an autosomal gene in Aborigines.     

COMT 基因多态性和抗精神分裂症药物疗效关系的Meta 分析

目的：探讨儿茶酚胺氧位甲基转移酶(catechol O-methyltransferase,COMT)Val108/158 Met基因多态性与抗 精神分裂症药物疗效之间的关系,为抗精神分裂症药物的个体化用药提供一定的依据。方法：计算机检索PubMed, Embase,Cochrane Library,中国知网,万方,维普,中国生物医学文献数据库获取相关文献。在评价原始研究质 量,提取有效数据后,采用Stata12.0进行统计分析。结果：共筛选出9篇符合标准的文献,包含868例患者。Meta分 析结果显示各基因型合并后的RR值、95% CI及P值,以患者的总体症状改善情况来评价药物疗效时,Met与Val比较, RR=1.18,95% CI：1.04~1.35,P=0.013;Met/Met与Val/Val比较,RR=1.40,95% CI：1.08~1.82,P=0.010。以患者的阴 性症状改善情况来评价药物疗效时,Met与Val比较,RR=1.24,95% CI：1.05~1.46,P=0.013;Met/Met与Val/Val比较, RR=1.60,95% CI：1.04~2.46,P=0.031。结论：COMT Val108/158Met基因多态性与抗精神分裂症药物疗效显著相关, 其中Met基因为优势基因,对抗精神分裂症药物反应较好。     

应用角质层真菌计量生物学分析法建立药敏试验新模型

目的 应用角质层真菌计量生物学分析法建立药敏试验新模型,以更好地评价抗真菌药物的体内外一致性。方法21名健康志愿者被随机分为两组,分别口服不同剂量（200mg,2次／d;200mg,1次／d）的伊曲康唑1周;取志愿者服药前、服药后不同时间（多次）皮肤角质层作为培养基（皮肤角质层剥离条）,将红色毛癣菌、须毛癣菌、犬小孢子菌、白念珠菌、光滑念珠菌和热带念珠菌的菌悬液,和别接种其上。培养后,行碘酸-雪夫（PAS）染色;采用角质层真菌计量生物学分析法并辅以计算机辅助图像分析,测定被孢子和菌丝覆盖的面积大小。结果 在两组受试者的角质层培养基上6种真菌均可生长,但随着药物在角质层中的含量（浓度）不同,菌落的大小、菌丝稠密度、孢子数量也不同。真菌的生长受到药物的抑制,尤其是服药7d后真菌覆盖的面积明显低于服药前（P〈0．01）。两种不同服药方法对3种皮肤癣菌及白念珠菌和热带念珠菌的抑制作用差异无统计学意义,均P〉0．05。而对于光滑念珠菌差异则有统计学意义,P〈0．01。伊曲康唑在人体角质层的生物利用度较高,对6株菌表现了很高的抗真菌活性。伊曲康唑在人体角质层的生物利用度较高,对6株菌表现了很高的抗真菌活性。结论 应用改良的角质层真菌计量生物学分析辅以计算机图形分析法进行药物敏感性分析在概念上有别于传统的体外药敏试验,建立了一种与体内环境相似的新模型,对评价抗皮肤真菌药物的体内外一致性有一定的参考价值。     

rpoB作为蜡样芽胞杆菌群快速检测的标志基因的实验研究

目的探讨常规PCR和实时荧光定量PCR(Q-PCR)方法检测蜡样芽胞杆菌群rpoB基因的特异性和敏感性。方法提取蜡样芽胞杆菌群和其他各种对照细菌的基因组DNA,合成蜡样芽胞杆菌群rpoB基因扩增引物,采用常规PCR和SYBRgreen实时定量PCR两种方法扩增rpoB基因片段,并将PCR产物克隆到pMD18-T载体后进行DNA测序。结果常规PCR和Q-PCR均能扩增出蜡样芽胞杆菌群rpoB基因的174bpDNA片段,而各种对照菌株均未见扩增。序列比对发现蜡样芽胞杆菌群细菌在该片段中存在5处核苷酸的不同,差异率为2.88%。以炭疽芽胞杆菌基因组DNA系列稀释作为扩增模板显示常规PCR最小检出量为3.42pg,Q-PCR的敏感性达到171fg,3次重复实验显示Q-PCR检测rpoB基因的灵敏度为(3.32×101±7.45×100)拷贝。结论以rpoB基因为检测靶基因的Q-PCR方法具有高度的特异性和良好的敏感性,能实现对蜡样芽胞杆菌群快速而准确的检测。     

耐甲氧西林金黄色葡萄球菌基因多态性分型研究

目的研究耐甲氧西林金黄色葡萄球菌（MRSA）的基因多态性分型特征，为控制感染提供分子流行病学依据。方法利用一条10bp随机引物，建立随机引物多态性（RAPD）分析方法，并利用这一方法对44株MRSA进行基因分型的研究。结果44株MRSA中有30株产生RAPD指纹图谱，经电泳得到2．8条片段，可分为5个型，其中Ⅲ型菌株占50％。结论通过RAPD分型研究，可了解MRSA的基因型流行特征，为控制感染提供分子流行病学依据。     

Brittle Addison's disease: a new variation on a familiar theme

Unstable and unpredictable disease control in diabetes or asthma, with frequent hospitalisations, is frequently referred to as 'brittle'. We describe two cases of Addison's disease with recurrent hospitalisations in hypo-adrenal crises. Both patients had significant psychosocial disruption, and failure to take hydrocortisone replacement therapy was admitted in one and biochemically proven in the other. We propose that 'brittle' Addison's disease in these cases was due to poor treatment compliance related to psychosocial factors. These features have particular similarities with the syndrome of brittle diabetes.     

体外联合用药对多重耐药铜绿假单胞菌抗菌活性的研究

目的探讨头孢他啶、美罗培南、加替沙星、环丙沙星、左氧氟沙星、丁胺卡那体外联合应用对多重耐药铜绿假单胞菌的抗菌效应，为临床用药提供实验依据。方法采用棋盘法设计，微量肉汤稀释法测定，计算FIC指数，判定联合效应。结果头孢他啶、美罗培南和左氧氟沙星联合应用对铜绿假单胞菌的体外抗菌协同作用分别为25％和18．8％，相加作用分别为59．4％和59．4％，无关作用分别为15．6％和21．8％，无拮抗效应，其他组合均不理想。结论所有组合中，头孢他啶、美罗培南与左氧氟沙星联合应用，有显著效果，且它们联合应用，对多重耐药铜绿假单胞菌的体外抗菌作用以协同和相加作用为主，无关作用较少，无拮抗效应。     

阪崎肠杆菌新疆分离株生长特征及耐药性研究

目的 研究阪崎肠杆菌新疆分离株的生长特征及其耐药性.方法 分别用结晶紫中性红胆盐葡萄糖琼脂(VRGBA)、酪胨大豆胨琼脂(TSA)、脑心浸液培养液(BHI)、酪蛋白氨基酸酵母浸膏培养液(CAYE)培养各菌株,观察不同菌株的生长特征;采用纸片扩散法进行抗生素的药敏试验,分析其药物敏感性和耐药性.结果 在不同培养基中不同菌株的生长特征不完全相同;药敏试验表明所有阪崎肠杆菌对碳青霉烯类抗生素亚胺培南和美洛培南100%耐药,对20种抗生素敏感.结论 阪崎肠杆菌在肠杆菌科属耐药性不显著的细菌.     

Biogenesis of antibacterial silver nanoparticles using the endophytic bacterium Bacillus cereus isolated from Garcinia xanthochymus

ObjectiveTo synthesize the ecofriendly nanoparticles, which is viewed as an alternative to the chemical method which initiated the use of microbes like bacteria and fungi in their synthesis.MethodsThe current study uses the endophytic bacterium Bacillus cereus isolated from the Garcinia xanthochymus to synthesize the silver nanoparticles (AgNPs). The AgNPs were synthesized by reduction of silver nitrate solution by the endophytic bacterium after incubation for 3-5 d at room temperature. The synthesis was initially observed by colour change from pale white to brown which was confirmed by UV-Vis spectroscopy. The AgNPs were further characterized using FTIR, SEM-EDX and TEM analyses.ResultsThe synthesized nanoparticles were found to be spherical with the size in the range of 20-40 nm which showed a slight aggregation. The energy-dispersive spectra of the nanoparticle dispersion confirmed the presence of elemental silver. The AgNPs were found to have antibacterial activity against a few pathogenic bacteria like Escherichia coli, Pseudomonas aeruginosa, Staphylococcus aureus, Salmonella typhi and Klebsiella pneumoniae.ConclusionsThe endophytic bacteria identified as Bacillus cereus was able to synthesize silver nanoparticles with potential antibacterial activity.     

新方案救治急性重度有机磷农药中毒疗效观察

农村最常见的农药中毒是急性有机磷农药中毒(AOPP)，轻、中度的抢救成功率高，但每年仍有5～7万人中毒，病死率达10％以上，主要为重度AOPP。我院近4年来，采用新方案救治重度有机磷农药中毒，并对其疗效进行了观察。     

下呼吸道感染痰标本细菌学检查和耐药菌株的观察

目的：为合理使用抗生素治疗下呼吸道感染提供细菌学指标。方法：采集痰标本１１２４份,其中经涂片染色镜检确定为下呼吸道感染痰标本３４６份,占总标本数的３１,采用细菌培养法对３４６份痰标本进行病原学鉴定并做药敏试验。结果：经鉴定的标本中,涂片镜检２１３份找到细菌,２０６份培养出细菌,鉴定出菌株２８８株,其中２２份标本分离出两种以上细菌,鉴定出的Ｇ＾＋菌对头孢菌素类、喹诺酮类敏感,对青霉素耐药;Ｇ＾－菌对