深圳市龙岗区患者痰培养细菌菌谱和耐药性研究

目的研究深圳市龙岗区患者痰培养细菌菌谱和耐药性,为临床合理应用抗菌药物提供依据。方法对来自深圳市龙岗区4间医院2007年1月至2008年6月患者合格痰标本中培养的细菌药敏试验进行回顾性分析。结果727株细菌中,革兰阴性杆菌595株,占81．8％,以鲍曼不动杆菌、铜绿假单胞菌为主;革兰阳性球菌132株,占18．2％,以凝固酶阴性葡萄球菌、金黄色葡萄球菌为主,而且凝固酶阴性葡萄球菌株数超过金黄色葡萄球菌。药敏结果提示革兰阴性杆菌及革兰阳性球菌对相当多数的抗生素耐药率较高。结论深圳市龙岗区患者痰培养细菌耐药情况较严重,条件致病菌菌株数比例较高。应加强药物尤其是抗菌药物的使用管理,规范应用抗生素。     

小儿烧伤患者感染细菌学调查与感染情况分析

目的分析小儿烧伤患者感染细菌学及其感染情况,为临床治疗提供参考。方法从225例小儿烧伤患者创面、血、痰及尿液等标本中分离出218株细菌,对感染病原菌进行药物敏感试验,分析小儿烧伤患者感染情况。结果（1）225例感染病例中,创面感染占所有感染病例的60.0%,其次是静脉导管感染（14.3%）、呼吸道感染（9.3%）、泌尿道感染（8.0%）和败血症（8.0%）。（2）检出的细菌中革兰阳性球菌113株（51.8%）,革兰阴性杆菌105株（48.2%）,其中金黄色葡萄球菌73株（33.5%）,铜绿假单胞菌50株（22.9%）。金黄色葡萄球菌是创面、静脉导管、败血症感染病原菌中最常见的细菌。（3）检出的73株金黄色葡萄球菌均为甲氧西林耐药金黄色葡萄球菌（MRSA）,对呋喃妥因、替考拉宁、万古霉素等抗生素的敏感率都达到了100%。铜绿假单胞菌对亚胺培南的敏感率为100%。鲍氏不动杆菌药物敏感试验结果显示多重耐药性。结论本组小儿烧伤患者最常见的感染是烧伤创面感染。感染细菌以革兰阳性球菌为主,革兰阴性杆菌次之,感染细菌对多种常用抗生素表现出高耐药性。     

烧伤病房内小儿烧伤创面感染病原菌调查及抗生素敏感性分析

目的分析烧伤病房内小儿烧伤创面感染细菌分布及抗生素敏感情况。 方法收集2010年1月至2017年12月期间安徽医科大学第一附属医院烧伤科病房内符合入选标准的小儿住院烧伤患者共170例。对患儿创面分泌物做细菌培养及药物敏感试验,对菌种分布特点及抗生素敏感性进行分析。 结果共检出138株病原菌。其中革兰阴性杆菌以铜绿假单胞菌、鲍氏不动杆菌及大肠埃希菌为主,分别为39株(28.3%)、22株(16.0%)、14株(10.1%);革兰阳性球菌以金黄色葡萄球菌25株(18.1%)、溶血葡萄球菌14株(10.1%)为主。另外检出的金黄色葡萄球菌中均为耐甲氧西林金黄色葡萄球菌,仅对替加环素及万古霉素的药物敏感率为100%,对利奈唑胺及喹努普汀-达福普汀的敏感率分别为96.0%、80.0%。检出的铜绿假单胞菌对多粘菌素B及米诺环素的药物敏感率为100%,鲍曼不动杆菌对替加环素及多粘菌素B的敏感率为100%。 结论在安徽医科大学第一附属医院烧伤小儿住院患者创面感染的菌株前三位分别是铜绿假单胞菌、金黄色葡萄球菌及鲍曼不动杆菌。以革兰阴性杆菌感染为主,并呈现出多重耐药性,只对少数抗生素敏感。建议在预防医源性感染、监测细菌药物敏感情况的条件下,合理应用抗生素。     

2016年北京市海淀医院细菌耐药性监测

目的 了解北京市海淀医院2016年临床分离细菌对抗菌药物的耐药性.方法 共收集2268株非重复分离菌株,自动化仪器法进行药敏试验,按CLSI 2016年版标准判读药敏结果,采用WHONET 5.6软件进行数据分析.结果 2268株细菌中,革兰阴性菌占75.6％,革兰阳性菌占24.4％.10种最常见的细菌分别为:大肠埃希菌(16.8％),肺炎克雷伯菌(13.4％),铜绿假单胞菌(11.6％),鲍曼不动杆菌(10.1％),凝固酶阴性葡萄球菌(8.0％),屎肠球菌(6.7％),阴沟肠杆菌(5.1％),嗜麦芽窄食单胞菌(3.8％),粪肠球菌(3.4％),金黄色葡萄球菌(金葡菌)(3.2％).耐甲氧西林金葡菌(MRSA)和凝固酶阴性葡萄球菌(MRCNS)的检出率分别为34.2％和70.7％.耐甲氧西林葡萄球菌对β内酰胺类和其他抗菌药物的耐药率明显高于甲氧西林敏感葡萄球菌.未发现对万古霉素、替加环素和利奈唑胺耐药的葡萄球菌.粪肠球菌(除四环素外)对大多数抗菌药物的耐药率明显低于屎肠球菌.发现少数万古霉素耐药肠球菌(VRE),未发现对利奈唑胺耐药的肠球菌.分离到的45株无乳链球菌对青霉素的敏感率为100％.肺炎链球菌对红霉素的耐药率为100％.克雷伯菌属对亚胺培南和美罗培南的耐药率为20.2％和19.6％,其它肠杆菌科细菌对碳青霉烯类仍高度敏感,总耐药率≤6.9％.多重耐药肺炎克雷伯菌的检出率为47.5％.铜绿假单胞菌对亚胺培南的耐药率为26.6％,对阿米卡星的耐药率1.5％.鲍曼不动杆菌亚胺培南的耐药率为42.3％,对阿米卡星的耐药率为2.4％.多重耐药鲍曼不动杆菌和铜绿假单胞菌的检出率分别是42.4％和28.9％.结论 细菌对抗菌药物的耐药率呈下降趋势,特别是多重耐药的鲍曼不动杆菌下降明显,应持续采取有效的医院感染控制措施和加强抗菌药物的合理使用,进一步降低多重耐药菌的比例.     

2017～2020年血液病患者血流感染病原菌分布及耐药性分析

目的 探讨2017～2020年血液病患者血流感染的病原菌分布及耐药情况,为临床合理使用抗菌药物提供参考.方法 回顾性分析2017年1月至2020年12月发生血流感染的血液病患者病原菌分布及药物敏感性情况.结果 发生血流感染的306例患者共分离出病原菌347株,其中革兰阴性杆菌214株(61.7％),革兰阳性球菌106株(30.5％),真菌27株(7.8％).革兰阴性杆菌以大肠埃希菌、肺炎克雷伯菌、铜绿假单胞菌为主,革兰阳性球菌以凝固酶阴性葡萄球菌为主,真菌以热带念珠菌为主.肠杆菌科细菌对碳青霉烯类、替加环素、阿米卡星的敏感性较好>90.7％.铜绿假单胞菌对阿米卡星、头孢吡肟、头孢他啶、喹诺酮类、哌拉西林他唑巴坦的敏感性较高>91.7％,高于碳青霉烯类.主要革兰阳性球菌对替考拉宁、万古霉素、利奈唑胺、替加环素的敏感性好,发现一株粪肠球菌对利奈唑胺耐药.热带念珠菌对唑类耐药率高>30％,对其他抗真菌药物敏感性均较好.结论 血液病患者血流感染病原菌的种类较多,以革兰阴性杆菌为主,不同的病原菌对抗菌药物的敏感性不同,应根据本地区本病种血流感染的病原菌分布及耐药情况合理使用抗菌药物.     

2012年深圳市光明新区人民医院细菌耐药监测

目的了解2012年深圳市光明新区人民医院临床分离菌对常用抗菌药物的耐药性。方法采用Microscanauto4鉴定及药敏系统对临床常规细菌进行监测．按CLSl2009年版标准判断药敏结果．并用WHONET5．4软件统计分析。结果全年共分离细菌1818株,其中革兰阳性菌占35．6％,革兰阴性菌占58．O％。葡萄球菌中耐甲氧西林金黄色葡萄球菌（MRSA）占18．3％,凝固酶阴性葡萄球菌（MRCNS）占71．9％。肺炎链球菌中青霉素非敏感的肺炎链球菌（PNSSP）占20．7％。大肠埃希菌和肺炎克雷伯杆菌产ESBLs菌株分别占43．2％和22．4％。检出5株亚胺培南耐药的肠杆科细菌。铜绿假单胞菌和鲍曼不动杆菌对头孢他啶、哌拉西林、妥布霉素、阿米卡星、环丙沙星、亚胺培南的耐药率均低于10％。结论本院常见致病菌耐药性不是十分严重,尤其是院内感染的铜绿假单胞菌和鲍曼不动杆菌对常用抗菌药物耐药率较低。     

烧伤创面细菌学检测及耐药性分析

目的本研究通过对烧伤创面细菌学调查及耐药性分析，为临床治疗提供参考。方法从2004年1月至2007年4月本院收治的69例烧伤患者创面细菌培养分离出细菌170株，用纸片琼脂扩散法进行药物敏感试验，就其中前5种细菌进行回顾性分析。结果在本组检出的细菌中，革兰阴性杆（G^-）菌122株（71．76％），革兰阳性（G^＋）菌48株（28．24％）。其中，数量较多的前5种细菌为鲍曼不动杆菌（17．00％），阴沟肠杆菌（11．18％），铜绿假单胞菌（10．00％），金黄色葡萄球菌（10．59％），肺炎克雷伯菌（8、82％）。鲍曼不动杆菌占G^-杆菌的23．77％，该菌对几乎所有抗菌药物耐药，对亚胺培南的耐药率高达75．86％。阴沟肠杆菌占G^-杆菌的15．57％，对抗菌药物的耐药率超过90％，对亚胺培南敏感。铜绿假单胞菌和肺炎克雷伯菌对抗菌药物的耐药率超过50％。金黄色葡萄球菌占G^＋菌的37．5％，对万古霉素的耐药率为17．65％。以上5种细菌对大多数常用抗菌药物表现出高耐药性。结论本组烧伤患者感染细菌以G^-杆菌为主，G^＋菌次之，这些细菌对常用抗菌药物有多重耐药性，亚胺培南对大多数G^-杆菌仍有较高的抗菌活性。G^＋菌对万古霉素敏感。     

脑脊液病原菌变迁和耐药性分析

目的了解临床脑脊液培养阳性患者病原菌分布及其耐药情况。方法对2002—2008年临床脑脊液培养病原菌阳性患者标本进行回顾性统计分析;按常规方法进行细菌分离和鉴定;细菌药物敏感试验采用Kirby—Bauer纸片扩散法。结果分离出细菌97株,其中革兰阳性球菌占54．63％,革兰阴性菌占28．87％：新型隐球菌占13．40％。最常见的6种感染菌分别为凝固酶阴性葡萄球菌（40．21％）、不动杆菌属（8．25％）、铜绿假单胞菌（6．19％）、金黄色葡萄球菌（5．15％）、肺炎克雷伯菌（5．15％）、肠球菌属（5．15％）;耐甲氧西林凝固酶阴性葡萄球菌（MRSCN）和耐甲氧西林金黄色葡萄球菌（MRSA）的检出率分别是89．7％和80．0％。细菌对常用抗生素耐药性较高,未见万古霉素耐药的葡萄球菌;美洛培南以及头孢哌N／舒巴坦对革兰氏阴性杆菌有良好的抗菌活性。结论近6年来细菌性脑膜炎患者病原菌以革兰阳性球菌为主,主要为医院获得性细菌性脑膜炎感染。检出病原菌对常用抗生素耐药性较高,临床需警惕新型隐球菌的高发病趋势。     

高原地区慢性难愈性创面感染常见致病菌监测及耐药性分析

目的了解慢性难愈性创面感染的常见致病菌分布及耐药性变化,为临床合理应用抗菌药物和感染的控制提供可靠依据。方法收集青海大学附属医院2015年1月至12月慢性难愈性创面患者的创面细菌培养分离的致病菌,用VITEK-AMS微生物自动鉴定仪做菌株鉴定,用K-B纸片扩散法进行药物敏感性试验,并按照美国临床实验室标准化委员会/临床和实验室标准协会标准判定结果,回顾性分析感染菌株分布特点及耐药性情况。结果共分离致病菌92株,其中革兰阳性球菌58株(63.04%),革兰阴性杆菌为34株(36.96%)。革兰阳性球菌分离率由高到底排序依次为金黄色葡萄球菌、表皮葡萄球菌、屎肠球菌、粪肠球菌、变异链球菌;革兰阴性杆菌分离率由高到底排序依次为大肠杆菌、肺炎克雷杆菌、大肠杆菌、铜绿假单胞菌、鲍曼不动杆菌。在革兰阳性球菌中,以金黄色葡萄球菌、屎肠球菌和粪肠球菌为主,对万古霉素、利奈唑胺敏感率较高;在革兰阴性杆菌中以大肠杆菌、肺炎克雷杆菌为主,对亚胺培南、氨曲南、阿米卡星敏感率较高。结论每个创面分离的细菌所占的优势不同,都有其特殊性,细菌对抗生素的敏感性有一定的差异,合理应用抗生素,应用负压封闭引流等技术治疗可促进慢性创面的愈合。     

烧伤患者医院感染病原菌分布及耐药变迁分析

目的了解烧伤病房感染病原菌分布及耐药变迁特点。方法回顾海南省人民医院2002-2009年住院烧伤感染患者病原菌的分布,并对比前、后4年病原菌构成比及耐药情况。结果检出634株病原菌,其中革兰阴性（G-）杆菌389株（61.4%）,主要为铜绿假单胞菌196株（30.9%）、鲍曼不动杆菌89株（14.0%）和大肠埃希菌56株（8.8%）;革兰阳性（G＋）球菌220株（34.7%）,主要为金黄色葡萄球菌109株（17.2%）和表皮葡萄球菌79株（12.5%）;真菌25株（3.9%）。前、后4年里,铜绿假单胞菌及金黄色葡萄球菌的构成比有下降趋势（P〈0.05）,而条件致病菌如鲍曼不动杆菌、表皮葡萄球菌的构成比呈明显上升趋势（P〈0.01）;铜绿假单胞菌、鲍曼不动杆菌对第三代头孢菌素、喹诺酮类抗生素的耐药率有上升趋势（P〈0.05）。109株金黄色葡萄球菌中耐甲氧西林金黄色葡萄球菌（MRSA）52株（47.8%）,对万古霉素100%敏感。结论近8年来烧伤病房患者感染病原菌以G-杆菌为主,条件致病菌的检出率呈上升趋势;常见病原菌对第三代头孢菌素的耐药率呈上升趋势,对此应予以重视。     

Renal dysplasia and asplenia in two sibs

A family is reported in which two sibs, one male and the other female, both died within 24 hours of birth with enlarged polycystic kidneys. Postmortem histology in the second child showed gross renal dysplasia. In both children the pancreas was enlarged, nodular and cystic but the liver appeared macroscopically normal. In the second child, histological examination confirmed pancreatic fibrosis with cystic dilation of ducts, but showed portal fibrosis with bile duct proliferation in the liver.
This combination of findings is very reminiscent of those in a girl and her brother reported by Ivemark et al. (1959). The children reported here also showed absence or hypoplasia of the spleen, cardiac anomalies and other features of the Ivemark syndrome (Ivemark 1955), a quite different, usually sporadic, congenital disorder. It is suggested that the children described here have a distinct lethal congenital disorder, probably inherited in an autosomal recessive manner.     

Schizophrenia in a North Swedish geographical isolate, 1900–1977. Epidemiology, genetics and biochemistry

Over 200 schizophrenic patients belonging to three major and interrelated pedigree complexes have been investigated over the past 30 years in a North Swedish geographically isolated population, presently numbering about 6,000. An intensive investigation of a number of biochemical correlates and genetic markers in a few selected families belonging to one of the major pedigrees has indicated new strategies for the current research program.
Schizophrenia, as defined operationally, is significantly associated with decreased activities of two enzymes (1) blood platelet monoamine oxidase, (2) plasma dopamine-β-hydroxylase, and (3) with the genetic marker Gc² (group specific antigen). Both enzymes are subject to genetic variation. A positive score for linkage between schizophrenia and low plasma DBH activity has been calculated, but, so far, available data are insufficient for discrimination between linkage and partial contribution of genetically controlled low plasma DBH to the pathogenesis of the disease. Alternatively, both mechanisms could be involved.
As a model for continued research, schizophrenia is explained as based on a double dominant-recessive genotype (Aabb), representing a vulnerability which in about 50 % of cases develops into clinical schizophrenia. It is suggested that the dominant mutation (A) operates on or affects MAO activity, and that the recessive genotype (bb) is instrumental in low variates of DBH activity and very likely such variates within the normal range of physiological variation. Moreover, it is suggested that the combined effects of MAO- and DBH-reduced efficiency on the metabolism of e.g. dopamine could be an essential pathogenic mechanism for the schizophrenic illness which is segregating in this population.     

The dominant diseases of modernized societies as omega-3 essential fatty acid deficiency syndrome: Substrate beriberi

About 1900, modern food selection and processing caused widespread $\text{epidemics}$ of the B vitamin deficiency diseases of beriberi and pellagra which, for genetic reasons, often expressed as different diseases ranging from bowel and heart disease to dermatoses and psychoses. But the B vitamins merely help convert essential fatty acids (EFA) into the prostaglandin (PG) tissue regulators and it now turns out that, through hydrogenation, milling and selection of w3-poor southern foods, we have also been systematically depleting, by as much as 90%, a newly discovered trace Nordic EFA (w3) of special importance to primates and sole precursor of the PG3(4) series, even as a concurrent fiber deficiency increases body demand for EFA. Since substrate EFA is processed by many B vitamin catalysts, an EFA deficiency will mimic a $\text{panh}$ypovitaminosis B, i.e., a mixture of $\text{substrate}$ beriberi and $\text{substrate}$ pellagra resembling vitamin beriberi and pellagra but exhibiting as even more diverse $\text{endemic}$ disease. This would consitute a second stage of the Modern Malnutrition and explain why some workers now hold the dominant diseases of modermized societies to be new, nutritionally based, pellagraform yet lipid-related and to range, once again, from heart disease to psychosis. It is an assumption that our dominant diseases are unrelated to each other or are merely revealed by our diagnostic acumen and therapeutic success; and that hydrogenating millions of tons of food oils annually, to destroy the rancidity producing w3-EFA, is safe for $\text{primates}$. Extensive beriberiform disease is reported here in 32 typical cases taken from medical practice which responds strikingly to linseed oil supplements (60% w3-EFA) in confirmation of identical results in Capuchins.     

What will studies of Fulani individuals naturally exposed to malaria teach us about protective immunity to malaria?

There are an estimated over 200 million yearly cases of malaria worldwide. Despite concerted international effort to combat the disease, it still causes approximately half a million deaths every year, the majority of which are young children with Plasmodium falciparum infection in sub-Saharan Africa. Successes are largely attributed to malaria prevention strategies, such as insecticide-treated mosquito nets and indoor spraying, as well as improved access to existing treatments. One important hurdle to new approaches for the treatment and prevention of malaria is our limited understanding of the biology of Plasmodium infection and its complex interaction with the immune system of its human host. Therefore, the elimination of malaria in Africa not only relies on existing tools to reduce malaria burden, but also requires fundamental research to develop innovative approaches. Here, we summarize our discoveries from investigations of ethnic groups of West Africa who have different susceptibility to malaria.     

'Very sore nights and days': the child's experience of illness in early modern England, c.1580-1720

Sick children were ubiquitous in early modern England, and yet they have received very little attention from historians. Taking the elusive perspective of the child, this article explores the physical, emotional, and spiritual experience of illness in England between approximately 1580 and 1720. What was it like being ill and suffering pain? How did the young respond emotionally to the anticipation of death? It is argued that children’s experiences were characterised by profound ambivalence: illness could be terrifying and distressing, but also a source of emotional and spiritual fulfilment and joy. This interpretation challenges the common assumption amongst medical historians that the experiences of early modern patients were utterly miserable. It also sheds light on children’s emotional feelings for their parents, a subject often overlooked in the historiography of childhood. The primary sources used in this article include diaries, autobiographies, letters, the biographies of pious children, printed possession cases, doctors’ casebooks, and theological treatises concerning the afterlife.     

Guidelines for the Validation and Use of Immunoassays for Determination of Introduced Proteins in Biotechnology Enhanced Crops and Derived Food Ingredients

Recent advancements in agricultural biotechnology have created a need for analytical techniques to determine introduced proteins in crops enhanced through modern biotechnology techniques. These proteins are expressed in plant tissues and may be present in food ingredients. Immunoassays are ideally suited for protein detection and may be used as both quantitative and threshold methods. Microplate ELISA and lateral flow devices are two of the most commonly used immunoassay formats for agricultural biotechnology applications. This paper provides general background information and a discussion of criteria for the validation and application of immunochemical methods to the analysis of proteins introduced into plants and food ingredients using biotechnology methods. It is the result of a collaborative effort of members of the Analytical Environmental Immunochemical Consortium. This collaborative effort represents the combined expertise of several organizations to reach consensus on establishing guidelines for the validation and use of immunoassays. Further, the paper offers developers and users a consistent approach to adopting the technology as well as aid in producing accurate and meaningful results.     

HLA in North Colombia Chimila Amerindians

HLA-A,-B,-C,-DRB1 and -DQB1 alleles have been studied in Chimila Amerindians from Sabana de San Angel (North Colombian Coast) by using high resolution molecular typing. A frequent extended haplotype was found:HLA-A*24:02-B*51:10-C*15:02-BRB1*04:07-DQB1*03:02 (28.7%) which has also been described in Amerinndian Mayos Mexican population (Mexico, California Gulf, Pacific Ocean). Other haplotypes had already been found in Amerindians from Mexico (Pacific and Atlantic Coast), Peru (highlands and Amazon Basin), Bolivia and North USA. A geographic pattern according to HLA allele or haplotype frequencies is lacking in Amerindians, as already known. Also, five new extended haplotypes were found in Chimila Amerindians. Their HLA-A*24:02 high frequencies characteristic is shared with aboriginal populations of Taiwan; also, HLA-C*01:02 high frequencies are found in New Zealand Maoris, New Caledonians and Kimberly Aborigines from Australia. Finally, this study may show a model of evolutionary factors acting and rising one HLA allele frequency (-A*24:02), but not in others that belong to the same or different HLA loci.     

Ultracryotomy: development and application (with examples from the yeast cytology) (author's transl)

The preparation steps usually necessary for obtaining ultrathin frozen sections of biological material (chemical prefixation, enclosing, cryoprotective treatment, freezing, sectioning, and post-staining the sections for transmission electron microscopy) are submitted to a critical analysis. The application of cryo-ultramicrotomy, in particularly for cytochemical purposes, is reviewed. Fundamental considerations of chemical prefixation and poststaining are supported by examples from yeast cytology. Furthermore, the efficiency of the cryo-ultramicrotomy (electron optical resolution of ultrastructural details) is demonstrated on yeast cells and protoplasts.     

The universal muscular chamber. A basic unit of the genitourinary, cardiovascular, gastro-intestinal, skeletal, cutaneous, respiratory and other systems, endocameral hypertension; and spasm, the key to their idiopathic diseases and arthropathies

Starting with the integument, we see many organs are contractile sacs or multiples thereof, which tubes or bags constitute the major part of the entire body. Recognition of this basic unit and its characteristics sheds new light, individually and collectively, on many disorders previously considered unrelated. Muscular tears and perforations develop in the walls of these chambers, being no way peculiar to those organs, wherein, hydrochloric acid occurs. So, it is not necessary to explain the absence of excessive acid from patients who exhibit holes in the gastric, uterine, aortic, duodenal, rectal, pulmonary, retina, and other walls. Muscle, not acid is the great common factor relating idiopathic disorders in the gastrointestinal tract to each other and to similar diseases in other systems. When the units are linked together, the lesions tend to appear as arthropathies, i.e. at the joints. Rephrasing common-place observations, frees us from conventional, conceptual cul-de-sacs. An observation is only as good as its interpretation, so all possibilities must be considered, otherwise, we will remain blinded by our misconceptions.