1995-2004年上海地区部分医院脑脊液分离菌的分布及耐药性

目的了解上海地区部分医院脑脊液分离菌的分布及耐药性。方法对上海地区部分医院1995年1月-2004年12月,所有脑脊液标本按常规方法进行分离、培养、鉴定,按统一方案用K-B纸片扩散法进行抗菌药物敏感试验。结果10年脑脊液标本获分离菌428株,其中G 菌占49.8%,G-菌占50.2%;G 菌所占比例由1995-1996年的44.6%增加至2003-2004年的51.2%,G-菌所占比例由1995-1996年的55.4%降低至2003-2004年的48.8%;最常见的G 菌为凝固酶阴性葡萄球菌、金黄色葡萄球菌、肠球菌属和肺炎链球菌,最常见的G-菌为不动杆菌属、克雷伯菌属、大肠埃希菌,葡萄球菌属及肠球菌属中均未发现万古霉素耐药株;G-菌对碳青酶烯类高度敏感。结论1995-2004年革兰阳性菌,尤其是凝固酶阴性葡萄球菌在中枢神经系统感染中占重要地位,脑脊液分离菌中革兰阳性菌所占比例呈增多趋势,脑脊液分离株对常用抗菌药耐药明显。     

Nosocomial infections: cockroaches as possible vectors of drug-resistant Klebsiella.

The possibility that hospital cockroaches may act as vectors of drug-resistant Klebsiella spp. was investigated during Nov 1985 to April 1989, at the All India Institute of Medical Sciences (AIIMS) hospital. Klebsiella spp. (majority Klebsiella pneumoniae) were isolated from 28.3% of hospital cockroaches and 28.1% of infected wounds of patients. Most of Klebsiella isolates from patients (96.3%), and hospital cockroaches (85.9%) showed multiple drug resistance to four or more antimicrobials. Similar strains of Klebsiella spp. were encountered among patients and hospital cockroaches. These findings suggest that hospital cockroaches may act as vectors of drug-resistant Klebsiella spp. and may contribute to the epidemiology of nosocomial infections.     

Vector potential of hospital houseflies with special reference to Klebsiella species.

The vector potential of houseflies (Musca domestica) for Klebsiella spp. was investigated. Klebsiella spp. (mostly Klebsiella pneumoniae) were isolated from 36.7% of hospital flies and 28.1% of infected wounds of patients. Antibiograms of Klebsiella spp. showed that 82.0% of isolates from hospital flies and 96.3% from infected wounds were resistant to four or more commonly used antimicrobials. In contrast, from the control group, only 8.7% klebsiella isolates showed similar antimicrobial resistance pattern (P less than 0.001). Similar strains of Klebsiella spp. were encountered among patients and hospital houseflies. The results indicate that flies in the hospital environs are potential vectors of hospital resistant strains of Klebsiella spp.     

铜陵地区细菌耐药性监测与分析

目的　研究铜陵地区临床分离菌对抗菌药物的耐药特征。方法　收集 2 0 0 0年 1月 1日至 2 0 0 1年12月 31日在铜陵地区 3所综合性医院临床分离的致病菌。采用Kirby -Bauer法进行药敏试验 ,按照美国临床实验标准委员会 2 0 0 0年判断标准分析结果。结果　 2年共收集致病菌 2 4 5 9株 ,包括革兰阳性球菌 911株(37.0 % ) ,革兰阴性杆菌 14 75株 (6 0 .0 % ) ;致病菌以表皮葡萄球菌、大肠埃希氏菌、铜绿假单胞菌、金黄色葡萄球菌、克雷伯氏菌属多见。有 79.9%的凝固酶阴性葡萄球菌和 5 0 .3%的金黄色葡萄球菌耐苯唑西林 ,对其它药物耐药率亦高。铜绿假单胞菌、克雷伯氏菌属、肠杆菌属、不动杆菌对第三代头孢菌素和氟喹诺酮类的耐药性均有显著增高。结论　合理用药和控制滥用是当务之急     

Characteristics of bacteria isolated from body surface of German cockroaches caught in hospitals

The objective of the study was to identify bacterial flora from external parts of German cockroaches caught in hospitals. The susceptibility of the bacteria to the most important groups of antimicrobial agents was also examined. 80 strains of bacteria were isolated, among them 34 strains of Gram-positive cocci and 31 strains of Gram-negative rods. One of isolated strains of Citrobacter freundii and two strains of Serratia liquefaciens showed ESBL mechanism of resistance and extended level of AmpC--type beta-lactamases. Two Staphylococcus strains (S. epidermidis and S. equorum) were resistant to erythromycin and clindamycin (MLSB mechanism of resistance). Such strains, resistant to antibiotics and chemiotherapeutics may be reservoirs of resistance genes which can be transmitted into other bacteria. Presence of such pathogens on the body surface of German cockroaches, very mobile insects, might create conditions for easy dissemination of them in hospital environment.     

Enterobacteria isolated from cockroaches (Periplaneta americana) captured in a Brazilian hospital]

OBJECTIVE: To isolate and identify microorganisms from cockroaches that were captured in a public hospital and to test the antimicrobial susceptibility of these microorganisms. METHODS: Cockroaches were captured in the morning and at night. They were placed in flasks rinsed with 70% alcohol, transferred to sterilized flasks, and then taken to the laboratory. Only cockroaches captured whole and live were utilized for the study. After being immobilized at 0 degree C, each cockroach was placed in a test tube with sterile saline solution (0.8%) and then homogenized. The resulting solution was then placed in the following five culture media: MacConkey agar, nutrient broth, brain-heart infusion agar, Sabouraud agar, and mannitol. The cultures were examined using a stereomicroscope, and colony-forming units were counted. The disk diffusion test was used to determine antimicrobial susceptibility. RESULTS: We found a 56% prevalence of enterobacteria and an 18% prevalence of coagulase-negative staphylococci. Fifteen species of enterobacteria were identified. The most frequent were Klebsiella pneumoniae (17%), Enterobacter aerogenes (14%), Serratia marcescens (13%), Hafnia alvei (12%), Enterobacter gergoviae and Enterobacter cloacae (each 9%), and Serratia spp. (6%). Both the enterobacteria and the coagulase-negative staphylococci showed significant resistance to antimicrobials, including oxacillin. CONCLUSIONS: The prevalence of enteropathogenic bacteria and coagulase-negative staphylococci isolated from Periplaneta americana cockroaches in the studied hospital reflects the weakness of the measures adopted both for vector control and for antimicrobial use. The results show the need to implement effective health-institution programs focusing on hygiene and the rational use of antimicrobials.     

肠杆菌科细菌对头孢哌酮/舒巴坦的耐药性分析

目的 了解头孢哌酮/舒巴坦作用肠杆菌科细菌的耐药情况.方法 对2010年1月-2011年2月医院临床分离的1280株肠杆菌科细菌进行头孢哌酮/舒巴坦药物敏感试验,并对结果进行分析.结果 在临床分离的1280株肠杆菌科细菌中,主要为埃希菌属、克雷伯菌属、变形菌属、沙雷菌属,分别占60.2％、13.2％、12.0％、6.5％;埃希菌属对头孢哌酮/舒巴坦的耐药率为6.5％,克雷伯菌为14.8％,变形菌属为1.9％,肠杆菌属为13.0％,沙雷菌属为4.8％,柠檬酸杆菌属为17.4％,摩氏摩根菌及沙门菌属的耐药率均为0.结论 头孢哌酮/舒巴坦可作为医院中重度感染的首选药物之一.     

Molecular identification of coliform bacteria isolated from drinking water reservoirs with traditional methods and the Colilert-18 system

The accuracy of a traditional method (lactose utilization with acid and gas production) for the detection of coliform bacteria and E. coli was tested in comparison with method ISO 9308-1 (based on acid formation from lactose) and the Colilert-18 system (detection of beta-galactosidase). A total of 345 isolates were identified after isolation from water samples using API 20E strips. The Colilert-18 led to the highest number of positive findings (95% of the isolates were assigned to coliforms), whereas the ISO-9308-1 method resulted only in 29% coliform findings. With the traditional method only 15% were rated positive. Most of the isolates were identified by the API 20E system as Enterobacter spp. (species of the Enterobacter cloacae complex), Serratia spp., Citrobacter spp.and Klebsiella spp.; but species identification remained vague in several cases. A more detailed identification of 126 pure cultures by using 16S rRNA gene sequence analysis and analysis of the hsp60 gene resulted in the identification of Enterobacter nimipressuralis, E. amnigenus, E. asburiae, E. hormaechei, and Serratia fonticola as predominat coliforms. These species are beta-galactosidase positive, but show acid formation from lactose often after a prolonged incubation time. They are often not of fecal origin and may interfere with the ability to accurately detect coliforms of fecal origin.     

Susceptibility of gram-negative bacterial isolates to six beta-lactam and two aminoglycoside antibiotics at our university hospital

Susceptibilities of Gram-negative bacterial strains isolated at the University Hospital in 1987 to six beta-Lactam antibiotics (azthreonam cefmetazole, ceftizoxime, latamoxef, aminobenzyl-penicillin and piperacillin) and two aminoglycoside antibiotics (gentamicin and amikacin) were examined by agar dilution and the agar diffusion method. Results obtained from both methods correlated well in most of the strains. Most of the strains belonging to Escherichia coli, Klebsiella oxytoca, Klebsiella pneumoniae and Proteus mirabilis were sensitive to the beta-lactam antibiotics except aminobenzyl-penicillin and piperacillin. They were also sensitive to aminoglycoside antibiotics. Most strains of Citrobacter freundii, Enterobacter cloacae and Serratia marcescens were sensitive to azthreonam, latamoxef and aminoglycosides, but were less sensitive to other beta-lactams. Acinetobacter calcoaceticus was generally resistant to beta-lactams except ceftizoxime, but was sensitive to aminoglycosides. More than half of the strains of Pseudomonas aeruginosa were sensitive to azthreonam, piperacillin and aminoglycoside antibiotics and only latamoxef was active in Pseudomonas maltophilia.     

山东省101所医院重症监护病房患者分离细菌及耐药性特征

目的了解山东省重症监护病房(ICU)细菌分布及耐药情况。方法收集2014年山东省101所医院ICU及106所医院普通病房(非ICU)分离细菌的药敏数据,进行统计分析。结果共收集细菌24 458株,革兰阴性菌占80.37%,革兰阳性菌占19.63%。ICU分离居前5位的细菌依次为:肺炎克雷伯菌、鲍曼不动杆菌、铜绿假单胞菌、大肠埃希菌、金黄色葡萄球菌。来源于ICU的大肠埃希菌、肺炎克雷伯菌、阴沟肠杆菌、黏质沙雷菌对碳青霉烯类药物、哌拉西林/他唑巴坦、头孢哌酮/舒巴坦、阿米卡星耐药率高于非ICU来源菌株(均P0.01)。ICU分离鲍曼不动杆菌、铜绿假单胞菌、葡萄球菌属细菌对常用抗菌药物耐药率高于非ICU菌株(P0.05)。ICU分离鲍曼不动杆菌对亚胺培南和美罗培南耐药率分别为78.0%、79.0%;铜绿假单胞菌对前述药物耐药率分别为25.5%、21.6%,对其他常用抗菌药物的耐药率30.0%。ICU耐甲氧西林金黄色葡萄球菌(MRSA)检出率为39.7%,高于非ICU的26.0%(P0.05)。结论 ICU分离细菌耐药情况比较严重,应依据药敏结果指导抗菌药物合理应用,防止耐药菌感染扩散。     

Digestive tract microbiota in female Lutzomyia longipalpis (Lutz & Neiva, 1912) (Diptera: Psychodidae) from colonies feeding on blood meal and sucrose plus blood meal

There are very few reports on the microbiota of the digestive tract of sand flies, an important omission considering that blood is not the only meal ingested. Male and female sand flies obtain sugar meals from several sources, thereby increasing their chance of infection with microorganisms. Chances of contamination are higher when insects are bred in the laboratory, and this may affect the development of Leishmania spp. From the digestive tract of 300 sand fly females separated in two groups we isolated 10 species of bacteria in group 1 and 8 species in group 2. In group 1, Enterobacteriaceae of the following genera were identified: Serratia, Enterobacter, and Yokenella and the non-fermenters: Pseudomonas, Acinetobacter, and Stenotrophomonas. In group 2, the Enterobacteriaceae Enterobacter and Serratia were identified as well as the non-fermenters Acinetobacter, Stenotrophomonas, Burkolderia, and Pseudomonas.     

对2503例临床分离细菌的药敏分析

目的了解常见临床分离菌株的药敏状况并为临床合理用药提供依据,以减少耐药菌的产生。方法使用VITEK AMS微生物自动鉴定系统,对住院和门急诊患者分离阳性标本进行细菌鉴定和药敏试验,并使用WHONET5.0进行统计分析。结果检出G-杆菌1703株,35属62种;G 球菌800株,5属28种,共计40属90种;G-杆菌对亚胺培南仍较为敏感;产ESBLs的大肠埃希菌占41%、肺炎克雷伯菌占35%。结论分离的G-杆菌对β-内酰胺类抗菌药物耐药主要是产ESBLs,而非发酵菌则为多重耐药,由此产生的细菌感染首选碳青酶烯类亚胺培南,对于非发酵菌则结合具体临床药敏试验结果联合用药,万古霉素仍是治疗葡萄球菌属感染的首选药物。     

黄山市蟑螂携带肠道菌种多样性初探

目的了解黄山市蟑螂携带肠道菌种多样性,为开展蟑螂综合防治提供科学依据。方法在黄山市的屯溪区、汤口镇、风景区3个样区采用粘捕法开展调查采样,选取优势种德国小蠊和黑胸大蠊作为检测对象,每种随机挑选10只蟑螂作为1组,每盒捕获数量少于10只的粘蟑盒,全部采集作为1组,共78组541只。结果对蟑螂样品筛检、纯化出的203株菌落,通过微生物自动检测仪(VITEK2-compact)进行菌种鉴定,分析检测出了198株菌株,鉴定出宋内志贺菌和鸡沙门氏菌2种肠道致病菌和37种条件致病菌,包括粘质沙雷氏菌(带菌率34.62%/检出率21.21%)、弗氏柠檬酸杆菌(带菌率19.23%/检出率10.61%)、阴沟肠杆菌(带菌率11.54%/检出率6.57%)、肺炎克雷伯菌肺炎亚种(带菌率11.54%/检出率4.55%)、肺炎克雷伯氏菌(带菌率10.3%/检出率6.06%)、蜂房哈弗尼亚菌(带菌率8.97%/检出率6.06%)、泛菌属(带菌率8.97%/检出率5.05%)等优势菌种。室内优势蟑螂德国小蠊、黑胸大蠊携带的肠道菌种多样性不同,且肠道菌群带菌率差异具有统计学意义(t=2.435,df=39,sig.=0.020)。超市(20组)和宾馆(9组)采集样本带菌率最高,均为100%;农贸市场(35组)的样本带菌率次之,为97.14%;餐饮店(9组),带菌率为88.89%;居民区(3组)和医院(2组)带菌率最低,分别为66.67%和50%。不同生境蟑螂携带肠道菌种及多样性有差异,但生境间蟑螂携带肠道菌群的带菌率差异性不具有统计学意义[(t农贸-超市=0.284,df=31,sig.=0.778)、(t宾馆-餐饮=-1.046,df=17,sig.=0.310)]。结论蟑螂携带有宋内志贺菌和鸡沙门氏菌等肠道致病菌和条件致病菌。适时开展环境卫生学监测和蟑螂防治工作,对促进黄山市旅游产业可持续健康发展和推动卫生城市创建工作十分必要。     

医院病房蟑螂侵害及其带菌状况

目的了解某医院病房楼（1-11层）蟑螂侵害及其带菌状况,为开展蟑螂综合防治,消除蟑螂对医疗环境的污染提供科学依据。方法采用目测法和粘捕法进行蟑螂侵害的调查。从每层楼粘捕到的蟑螂中随机挑选5只为一组,共11组,按常规检验方法进行细菌培养分离、血清学鉴定和生化试验。结果调查一栋病房楼228间房屋,目测蟑迹阳性房间171间,蟑迹阳性间率为75.00%。布粘蟑纸191张,阳性80张,共粘捕蟑螂243只,纸测蟑螂侵害率为41.88%,蟑螂密度为1.27只/张。11组蟑螂体表 、体内均检出条件致病菌,所检出的病原菌主要为变形杆菌属（14株）、肺炎克雷伯菌（11株）、大肠埃希菌（7株）、聚团肠杆菌（8株）、铜绿假单胞菌（5株）、鲍曼不动杆菌（3株）。结论蟑螂是医院物表环境污染不可忽略的因素之一;定期杀灭蟑螂,适时地进行环境卫生学监测,是防止医院感染的重要措施。     

2015—2018年住院患者治疗性抗菌药物使用前分离菌株及药敏情况

目的 了解住院患者首次治疗性使用抗菌药物前分离菌株及药敏结果,为医院抗菌药物合理使用提供可靠的微生物依据。方法 基于某院抗菌药物临床决策支持系统后台相关节点数据及医院检验信息系统收集的住院患者分离菌株及药敏结果,收集2015—2018年患者入院后首次治疗性使用抗菌药物前临床分离菌株和住院期间送检标本所有临床分离菌株,比较抗菌药物使用前后菌株分布及其耐药情况。结果 2015—2018年住院患者所有送检标本共检出非重复菌株69 037株（包括细菌及真菌）,其中革兰阳性菌17 900株（占25.93%）,革兰阴性菌44 055株（占63.81%）,真菌7 082株（占10.26%）。住院患者入院后首次治疗性使用抗菌药物前采集标本中检出非重复菌株15 017株,其中革兰阳性菌4 661株（占31.04%）,革兰阴性菌9 451株（占62.93%）,真菌905株（占6.03%）。治疗用药前标本分离菌居前5位的依次是大肠埃希菌、肺炎克雷伯菌、金黄色葡萄球菌、铜绿假单胞菌和凝固酶阴性葡萄球菌,所有送检标本分离菌居前5位的分别为肺炎克雷伯菌、鲍曼不动杆菌、铜绿假单胞菌、假丝酵母菌属、大肠埃希菌,苛养菌如链球菌属、流感嗜血杆菌、卡他莫拉菌在所有送检标本中占比,较用药前低。临床常见分离菌包括金黄色葡萄球菌、大肠埃希菌、肺炎克雷伯菌、铜绿假单胞菌、鲍曼不动杆菌,抗菌治疗后送检标本分离菌株中耐药率更高。结论 研究首次报道大样本治疗性抗菌药物使用前临床送检标本分离的菌株及药敏情况,临床常见分离菌包括金黄色葡萄球菌、大肠埃希菌、肺炎克雷伯菌、铜绿假单胞菌、鲍曼不动杆菌,在抗菌治疗后标本中显示更高的耐药性。     

2001～2004年细菌耐药性监测及分析

目的了解我院乃至包头地区常见病原菌耐药情况,探讨2001～2004年细菌耐药及4年间耐药菌的变迁,为临床合理使用抗菌药物提供依据. 方法收集4年间我院临床标本分离病原菌及其药敏资料,用WHONET5.1软件进行统计分析. 结果共收集病原菌2 127株,分离率居前9位者分别为大肠埃希菌、铜绿假单胞菌、肺炎克雷伯菌、鲍氏不动杆菌、表皮葡萄球菌、阴沟肠杆菌、肠球菌属、金黄色葡萄球菌、弗氏柠檬酸杆菌,其中革兰阳性球菌 497株,占23.4%,革兰阴性杆菌1 630株,占76.6%;耐甲氧西林金黄色葡萄球菌(MRSA)和耐甲氧西林表皮葡萄球菌(MRSE)分别占68.2%和85.6%,未发现万古霉素耐药株;大肠埃希菌和克雷伯菌属产超广谱β-内酰胺酶(ESBLs)的发生率分别为24.4%和22.7%;鲍氏不动杆菌对第三代头孢菌素和亚胺培南的耐药率分别接近50%和16%,而喹诺酮类敏感率则＞70%;铜绿假单胞菌对头孢他啶和亚胺培南的耐药率达21.3%和13.4%. 结论本院常见病原菌耐药严重,临床应重视细菌学检查和耐药性资料的获得,合理使用抗菌药物,遏制抗菌药物的滥用.     

ICU感染患者病原菌分布和耐药性分析

目的 了解重症监护病房（ICU）感染患者病原菌分行和耐药情况，为合理使用抗生素提供理论依据：方法 对本院2003年ICU病房510份标本进行培养、分离、鉴定和药敏试验。结果 从510份标本共分离出460株病原菌，其中G^＋杆菌280株，占60．9％，以大肠埃希菌、肺炎克雷伯茼、铜绿假单胞菌为主；G^＋球菌128株。占27．8％。全部为金黄色葡萄球菌、血清凝固酶阴性葡萄球菌、肠球菌；真菌52株．占11．3％。产ESBLs大肠埃希菌、肺炎克雷伯菌和MR-SA、MRCNS的检出率分别为22．2％、367%和57．7％、40%。各类细菌对常用抗菌药物表现为严重耐药和多重耐药：在G^＋杆菌中，铜绿假单胞菌、嗜麦芽窄食单胞菌、不动杆菌对亚胺培南的耐药率达到20％以上；而大肠埃希菌、肺炎克雷伯菌、阴沟杆菌对亚胺培南的耐药率为0．00％：三种G^＋球菌对万古霉素的耐药率为000％：结论 通过了解ICU病房病原菌分布和耐药情况，为临床合理使用抗菌药提供依据，从而达到控制感染、减少新的耐药菌株出现的目的。     

Health significance of Gram‐negative bacteria associated with waste‐fed tropical aquaculture system

Commercially important freshwater fish species, Cyprinus carpio, Oreochromia niloticus, Sarother‐odon galilaeus and Clarias anguillaris grown in aquaculture ponds receiving untreated sewage and animal faecal waste and in an untreated concrete tank were sampled to determine the presence of potentially pathogenic Gram negative bacteria to man. The resistance of some representative bacterial isolates to some commonly used antibacterial drugs were also determined. Fourteen bacterial species from nine genera, namely, Escherichia, Citrobacter, Enterobacter, Proteus, Salmonella, Serratia, Klebsiella, Pseudomonas and Aeromonas from both fish intestinal tracts and culture water samples were identified. Escherichia coli predominated in the sewage and animal manure‐treated ponds, while fluorescent Pseudomonas were common in the untreated pond. Pathogenic Salmonella spp. were isolated at a low frequency (1.32%) in fish from the sewage pond. Of the 577 bacterial isolates identified, 199 (34.49%) were resistant to at least one antibacterial drug.     

深圳南山医院2010年细菌耐药性监测

目的了解某院2010年临床住院患者送检标本分离菌株对常用抗菌药物的耐药性。方法采用全自动细菌鉴定仪及配套鉴定与药物敏感试验试剂,检测临床分离菌对常用抗菌药物的耐药性,并用WHONET5.4软件进行统计分析。结果2010年1-12月共分离病原菌2 192株,其中革兰阳性菌占32.03%,革兰阴性菌占67.97%。金黄色葡萄球菌和凝固酶阴性葡萄球菌中,甲氧西林耐药株(MRSA 和 MRCNS)分别占 19.69%和54.59%。葡萄球菌属中耐甲氧西林株对β 内酰胺类抗生素和其他测试抗菌药物的耐药率显著高于甲氧西林敏感株。 MRSA对复方磺胺甲口恶唑、利福平、四环素、庆大霉素的耐药率分别为1.67%、41.54%、44.62%、58.46%;MRCNS对利福平、四环素的耐药率分别为17.27%和36.70%;未发现万古霉素、替考拉宁和利奈唑胺耐药株。肠球菌属中,粪肠球菌对大多数测试抗菌药物的耐药率低于屎肠球菌;此次监测首次在该院发现1株耐利奈唑胺的粪肠球菌,未发现耐万古霉素菌株。大肠埃希菌、肺炎克雷伯菌中产超广谱β 内酰胺酶(ESBLs)株分别为 44.29%和 15.79%。肠杆菌科细菌中产ESBLs株对抗菌药物的耐药率均比非产ESBLs株高。铜绿假单胞菌对亚胺培南和美罗培南的耐药率分别为 26.73%和13.79%,不动杆菌属(鲍曼不动杆菌占92.91%) 对二者的耐药率分别为31.35%和 27.17%。结论细菌耐药性仍呈增长趋势, 尤其革兰阴性杆菌;鲍曼不动杆菌及铜绿假单胞菌对碳青霉烯类抗生素耐药性的增加,对临床构成严重威胁。合理选用抗菌药物,及早检测泛耐药菌, 加强感染控制措施是当务之急。