儿童下呼吸道感染细菌病原及耐药分析

目的调查分析马鞍山市近期儿童下呼吸道感染的病原菌及其耐药性,指导临床合理使用抗生素。方法对入住我院儿科的630例下呼吸道感染患儿的痰液标本进行分离培养,做菌株鉴定和药敏实验。结果分离培养出病原菌216株,阳性率34．3％,其中革兰阴性菌155株（71．8％）,革兰阳性菌61株（28．2％）。革兰阴性菌以大肠埃希菌、阴沟肠杆菌、肺炎克雷伯菌肺炎亚种、鲍氏不动杆菌、铜绿假单胞菌为主。敏感的抗生素为亚胺培南、美洛培南、哌拉西林／他唑巴坦、阿米卡星。革兰阳性菌以金黄色葡萄球菌,肺炎链球菌为主,金黄色葡萄球菌、肺炎链球菌对青霉素的耐药率达89％、56％,对红霉素的耐药率为53％、100％,对左氧氟沙星、万古霉素敏感。结论我院儿童下呼吸道感染的病原菌以革兰阴性菌为主,大肠埃希氏菌、阴沟肠杆菌、肺炎克雷伯菌肺炎亚种、鲍氏不动杆菌、铜绿假单胞菌、金黄色葡萄球菌、肺炎链球菌为主要病原菌,对抗生素的耐药性较强,应定期监测病原菌及其耐药谱变化,为抗生素的合理使用提供依据。     

某院食管癌患者根治术后并发肺部感染的病原菌分布与耐药性分析

目的：分析医院食管癌患者根治术后并发肺部感染的病原菌分布与耐药特点,为临床此类患者的抗感染治疗提供参考。方法：选取2019年1月—2022年5月医院收治的67例食管癌根治术后并发肺部感染的患者作为研究对象,统计其患者术后痰液标本的病原菌培养及其药敏试验结果,分析其感染病原菌的分布与其耐药情况。结果：67例术后肺部感染患者痰液标本中检出病原菌78株,其中革兰阴性菌50株（占64.10%）、革兰阳性菌24株（占30.77%）和真菌4株（占5.13%）;革兰阴性菌中以铜绿假单胞菌、肺炎克雷伯菌、大肠埃希菌为主,革兰阳性菌中以金黄色葡萄球菌、表皮葡萄球菌、肺炎链球菌为主;药敏结果显示,铜绿假单胞菌、肺炎克雷伯菌、大肠埃希菌对头孢曲松、氨苄西林、头孢他啶、哌拉西林的耐药率较高（≥57.00%）,对亚胺培南、美罗培南尚未产生耐药（仍保持高度敏感）;金黄色葡萄球菌、表皮葡萄球菌、肺炎链球菌对红霉素、四环素、青霉素、苯唑西林的耐药率较高（≥60.00%）,对利奈唑胺、万古霉素仍保持高度敏感。结论：食管癌根治术后肺部感染病原菌以革兰阴性菌为主,且病原菌对常用抗菌药物均有不同程度的多重耐药,临床应结合药敏...     

我院儿科2015-2017年痰培养病原菌分布及耐药性分析

目的：了解我院儿科患儿痰培养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：筛选出我院儿科2015-2017年做痰培养检查的出院病例,对分离的病原菌及其耐药性进行分析与总结。结果：3 900份标本共检出病原菌1 003株（阳性率25.72%）,其中革兰阳性菌351株（35.00%）,革兰阴性菌617株（61.52%）,真菌35株（3.49%）;检出菌排名前5位的分别是大肠埃希菌260株（25.92%）、肺炎链球菌239株（23.83%）、肺炎克雷伯菌141株（14.06%）、金黄色葡萄球菌107株（10.67%）和流感嗜血杆菌64株（6.38%）。革兰阳性菌对红霉素、克林霉素和青霉素的耐药率高,其中肺炎链球菌对红霉素的耐药率为97.91%,金黄色葡萄球菌对青霉素的耐药率为96.33%。革兰阴性菌对第三代、第四代头孢菌素、含酶抑制剂的β-内酰胺类、单环β-内酰胺类、碳青霉烯类药物的耐药率较低,其中大肠埃希菌和肺炎克雷伯菌对头孢他啶的耐药率分别为13.85%和36.62%。耐甲氧西林金黄色葡萄球菌（MRSA）的检出率为15.89%,产超广谱β-内酰胺酶（ESBLs）的大肠埃希菌和肺炎克雷伯菌检出率分别为48.46%和51.06%。结论：我院儿科住院患者痰培养检出的病原菌以革兰阴性菌为主,不同病原菌对常用抗菌药物的耐药性不同,临床可参考细菌药敏试验结果选用抗菌药物,以提高疗效,减少耐药菌株的产生。     

146例肺炎患儿痰标本中病原菌的分布与耐药情况分析

目的：分析肺炎患儿痰标本中病原菌的分布与耐药情况,为临床用药提供参考。方法：选取2020年4月—2021年4月赣县区妇幼保健院收治的146例肺炎患儿作为研究对象,采集其痰液行病原菌培养与药敏试验,分析标本中病原菌的分布特征与耐药情况。结果：146例肺炎患者痰液标本中分离出157株病原菌,其中革兰阴性菌89株（占56.69%,以肺炎克雷伯菌、铜绿假单胞菌、大肠埃希菌为主）、革兰阳性菌68株（占43.31%,以肺炎链球菌、金黄色葡萄球菌为主）;肺炎克雷伯菌、铜绿假单胞菌、大肠埃希菌对亚胺培南、美罗培南、庆大霉素、头孢噻肟耐药率低（<15.00）,对氨苄西林、头孢唑林、头孢替坦、哌拉西林、左氧氟沙星、头孢西丁、复方磺胺甲噁唑的耐药率较高（≥75.00%）;肺炎链球菌、金黄色葡萄球菌对利奈唑胺、利福平、万古霉素和呋喃妥因耐药率较低（<15.00%）,对青霉素G、四环素、红霉素、阿奇霉素耐药率较高（>80.00%）。结论：肺炎患儿感染的病原菌以革兰阴性菌为主,且不同病原菌对临床常用抗菌药物均具有较高的耐药率,临床应结合病原菌分布与药敏试验结果合理选用药物,以减少耐药菌株的产生。     

血流感染的病原菌分布及耐药性分析

目的：分析2015年1月~2015年12月我院血流感染患者主要病原菌的构成及耐药性,为临床血流感染的诊断与治疗提供依据。方法血液培养采用美国 BD 公司 Bactec FX 型和法国梅里埃公司 Bact/ Alert 3D 240型血培养仪;细菌鉴定采用德国 Walkway 96 Plus 和法国梅里埃 API 鉴定系统;抗菌药物敏感试验分别采用 Micro Scan药敏板联合 K-B 纸片扩散法;药物敏感性结果统计分析采用 Whonet 5.6软件。结果血流感染患者中革兰阳性菌检出率为34.55%,革兰阴性菌检出率为63.11%,其中革兰阴性杆菌主要为大肠埃希菌（31.69%）和肺炎克雷伯菌（8.83%）,革兰阳性菌主要为表皮葡萄球菌（8.05%）和金黄色葡萄球菌（7.53%）;葡萄球菌、肠球菌和肺炎链球菌对万古霉素、利奈唑胺100%敏感,对红霉素和克林霉素耐药率均高于70%;大肠埃希菌、肺炎克雷伯菌、弗氏枸橼酸杆菌和阴沟肠杆菌对亚胺培南和美罗培南100%敏感,铜绿假单胞菌对亚胺培南和美罗培南耐药率均为15.4%,大肠埃希菌和肺炎克雷伯菌对头孢曲松的耐药率分别47.5%和32.4%,对左氧氟沙星的耐药率分别51.6%和20.6%。结论我院血流感染病原菌以革兰阴性菌为主,大肠埃希菌和凝固酶阴性葡萄球菌耐药严重,临床应重视血培养标本送检和细菌耐药监测,合理使用抗菌药物。     

872例重症肺炎患者病原菌的分布与耐药性分析

目的：分析重症肺炎患者病原菌的分布与耐药特点。方法：选取医院2019年12月—2021年2月收治的重症肺炎患者872例病历资料,统计与分析常见病原菌的分布与耐药特点。结果：872例患者中分离、检出病原菌816株,其中革兰阳性菌228株（占27.94%）、革兰阴性菌588株（占72.06%）;革兰阳性菌中以肺炎链球菌和金黄色葡萄球菌为主,革兰阴性菌中以大肠埃希菌、鲍曼不动杆菌为主;药敏试验结果显示,肺炎链球菌、金黄色葡萄球菌对左氧氟沙星、利奈唑胺、万古霉素耐药率均达100.00%,而对氯林可霉素、红霉素耐药率均低于10.00%;革兰阴性菌中大肠埃希菌、鲍曼不动杆菌、肺炎克雷伯菌对亚胺培南、头孢哌酮-舒巴坦钠、阿米卡星、哌拉西林-他唑巴坦钠、环丙沙星耐药率均高于80%,其对头孢吡肟、头孢唑林耐药率较低。结论：重症肺炎患者感染病原菌以革兰阴性菌为主,且普遍存在耐药现象,临床应高度重视病原菌的检测与药敏试验,选择敏感率高的抗菌药物治疗,以确保其治疗效果。     

基层医院儿科病区病原菌分布及耐药性分析

目的：了解我院儿科病区的病原菌分布及耐药情况,为抗菌药物的合理使用提供依据。方法：对2013年10月至2015年5月我院儿科病区分离的病原菌及其耐药性进行回顾性分析与总结。结果：1 564份标本共检出病原菌327株,阳性率为20.9%;其中革兰阳性菌占52.6%,革兰阴性菌占44.3%,真菌占3.1%。排名前5位的病原菌依次为肺炎链球菌（25.4%）、金黄色葡萄球菌（16.5%）、大肠埃希菌（14.7%）、肺炎克雷伯菌（8.6%）和流感嗜血杆菌（6.1%）。革兰阳性菌对红霉素和青霉素的耐药率较高,其中肺炎链球菌对红霉素和青霉素的耐药率分别为95.5%和62.1%;革兰阴性菌对第三、四代头孢菌素、单环β-内酰胺类、碳青霉烯类等的耐药率较低,其中大肠埃希菌和肺炎克雷伯菌对头孢他啶的耐药率分别为8.8%和25.0%。多重耐药肺炎链球菌、表皮葡萄球菌、阴沟肠杆菌的检出率分别为45.6%、87.5%和35.7%,耐甲氧西林金黄色葡萄球菌（MRSA）的检出率为18.4%,产超广谱β内酰胺酶（ESBLs）大肠埃希菌和肺炎克雷伯菌的检出率为53.5%和38.5%。结论：我院儿科病区以革兰阳性球菌感染为主,多重耐药肺炎链球菌的检出率较高,应加强抗菌药物合理使用的监管,减少耐药菌株的产生。     

小叶性肺炎患儿痰标本中病原菌的分布与耐药性分析

目的：分析小叶性肺炎患儿痰标本中病原菌的分布及主要致病菌对抗菌药物的耐药情况。方法：选取2018年1月—2020年12月台前县人民医院收治的164例小叶性肺炎患儿作为研究对象,分析其痰液标本的病原菌培养与药敏试验结果。结果：164例小叶性肺炎患儿痰标本中分离出病原菌92株,其中革兰阴性菌60株（占65.22%,以大肠埃希菌、肺炎克雷伯菌为主）、革兰阳性菌32株（占34.78%,以金黄色葡萄球菌、肺炎链球菌为主）;药敏检测结果显示大肠埃希菌对氨苄西林-舒巴坦钠的耐药率达100.00%,而对阿米卡星的敏感率达100.00%;肺炎克雷伯菌对氨苄西林-舒巴坦钠、氨苄西林、复方磺胺甲噁唑、氨曲南的耐药率均高于70.00%,而对阿米卡星的敏感率高于95.00%;金黄色葡萄球菌对氨苄西林-舒巴坦钠、四环素的耐药率均为100.00%,而对亚胺培南的敏感率达100.00%;肺炎链球菌对氨苄西林、氨苄西林-舒巴坦钠的耐药率均高于50.00%,对亚胺培南、美罗培南的敏感率均达100.00%。结论：小叶性肺炎患儿感染的病原菌以大肠埃希菌、肺炎克雷伯菌、金黄色葡萄球菌和肺炎链球菌为主,且各病原菌对抗菌药物的耐药...     

骨伤科分泌物病原菌耐药性分析及抗感染药物选择

目的 分析骨伤科伤口分泌物病原菌分布及耐药性,为临床合理使用抗菌药物提供依据。方法 收集2017年1月至2020年12月内蒙古自治区人民医院骨伤科分离的586株阳性菌株,采用VITEK 2 Comapct 60全自动细菌鉴定药敏分析系统对细菌鉴定和药敏进行分析。结果 分离出阳性菌株586株,革兰阳性菌408株,占69.62%;革兰阴性菌171株,占29.18%。革兰阳性球菌检出前三位分别是：金黄色葡萄球菌,表皮葡萄球菌,粪肠球菌。革兰阴性杆菌检出前三位分别是：大肠埃希菌,阴沟肠杆菌,肺炎克雷伯菌。药敏试验结果表明革兰阳性球菌中金黄色葡萄球菌和表皮葡萄球菌对青霉素耐药率高,对万古霉素和利奈唑胺敏感性高。革兰阴性杆菌中大肠埃希菌和肺炎克雷伯菌对青霉素类药物耐药率高,对亚胺培南、美罗培南耐药率低,大肠埃希菌的耐药性总体显著高于肺炎克雷伯菌和阴沟肠杆菌。结论 骨伤科分泌物检出以革兰阳性菌为主,其中金黄色葡萄球菌大约占三分之一。临床上应结合药敏试验和病人病情,选择合适的药物进行抗感染治疗。     

Mohnarin2009年度报告:门急诊患者来源细菌耐药监测

目的 了解我国门急诊患者分离细菌的耐药状况与发展趋势.方法 监测2009年度卫生部全国细菌耐药监测网(Mohnarin)所属114所医院临床分离细菌耐药状况,采用标准纸片扩散法或自动化临床微生物方法,测定细菌敏感性,依据CISI 2009年标准,以WHONET 5.5软件进行数据分析.结果 114所医院按照监测方案共获得临床分离菌9929株,其中革兰阴性菌6109株(61.5%);革兰阳性菌3820株(38.5%).最常见的细菌依次为大肠埃希菌、肺炎克雷伯菌、金黄色葡萄球菌、铜绿假单胞菌与表皮葡萄球菌.耐甲氧西林金黄色葡萄球菌、表皮葡萄球菌及溶血葡萄球菌的检出率分别为45.6%,69.8%和68.1%;未发现万古霉素耐药葡萄球菌.粪肠球菌和屎肠球菌对万古霉素耐药率分别为1.2%和3.1%;未发现利奈唑胺耐药肠球菌.肺炎链球菌对青霉素的敏感率>60.0%.大肠埃希菌及肺炎克雷伯菌产ESBL比率分别为51.7%和45.9%.有0.3%的大肠埃希菌和0.7%的肺炎克雷伯菌对亚胺培南耐药.铜绿假单胞菌对碳青酶烯类的耐药率约20%;鲍曼不动杆菌对其耐药率大多>50%.结论 我国门急诊来源病原菌以大肠埃希菌、肺炎克雷伯菌、金黄色葡萄球菌、铜绿假单胞菌多见;门急诊来源MRSA的发生率较2008年低;但大肠埃希菌和肺炎克雷伯菌ESBLs的阳性率高于2008年.     

Alkaloids from Aspidosperma species from Bolivia

Two Bolivian Aspidosperma species were investigated. The seed and stem bark of Aspidosperma macrocarpon Mart. contain six known alkaloids: (-)-vincadifformine, ervinceine, kopsanone, kopsinine, kopsanol in the seed, and kopsanone, kopsinine, kopsanol, 18-epikopsanol in the stem bark. The stem bark of Aspidosperma pyrifolium Mart. contains eleven known alkaloids: (-)-vincadifformine, O-demethylpalosine, haplocine, N-formylaspidospermidine, vallesine, demethoxyaspidospermine, palosine, (-)-aspidospermine, aspidospermidine, akuammicine, tubotaiwine, beside the two new bases dehydroxyhaplocidine and 10-methoxyaspidospermidine.     

Emerging biopharmaceuticals from bioactive peptides derived from marine organisms

Biologically active natural products are spontaneous medicinal entrants, which encourage synthetic access for enhancing and supporting drug discovery and development. Marine bioactive peptides are considered as a rich source of natural products that may provide long‐term health, in addition to many prophylactic and curative medicinal drug treatments. The large literature concerning marine peptides has been collected, which shows high potential of nutraceutical and therapeutic efficacy encompassing wide spectra of bioactivities against a number of infection‐causing agents. Their antimicrobial, antimalarial, antitumor, antiviral, and cardioprotective actions have achieved the attention of the pharmaceutical industry toward new design of drug formulations, for treatment and prevention of several infections. However, the mechanism of action of many peptide molecules has been still untapped. So in this regard, this paper reviews several peptide compounds by which they interfere with human pathogenesis. This knowledge is one of the key tools to be understood especially for the biotransformation of biomolecules into targeted medicines. The fact that different diseases have the capability to fight at different sites inside the body can lead to a new wave of increasing the chances to produce targeted medicines.     

Decreased sensitivity of isolated hepatocytes from baby rats,from regenerating and from poisoned livers to phalloidin

Summary Isolated hepatocytes, prepared from 5 day old rats, from regenerating livers or from livers after poisoning with carbon tetrachloride, are less sensitive to phalloidin in vitro than hepatocytes from untreated adult controls. The time course of the reduced susceptibility to phalloidin was compared with the ability of hepatocytes to take up bile acids under various conditions. SDS-electrophoresis of cell lysates gave no evidence for decreased levels of actin in cells with reduced sensitivity to phalloidin. In contrast, there was a good relationship between the active uptake of bile acids and the sensitivity of hepatocytes to phalloidin. The decreased response of hepatocytes from baby rats, from regenerating livers or from poisoned livers to phalloidin is more probably related to differences in phalloidin uptake than to a reduced endowment with microfilamentous structures.This work is supported by the Deutsche Forschungsgemeinschaft     

Drug release from laminated polymeric films prepared from aqueous latexes

Laminated films comprised of a drug-containing reservoir layer and a drug-free, rate-controlling membrane were prepared from aqueous latexes and investigated as an alternative drug delivery system to polymeric films cast from organic solvents. The reservoir layer was prepared by casting and drying the latex [copolymer of poly(ethylacrylate-methylmethacrylate) esters - Eudragit NE 30D (NE 30D)] containing the dissolved drugs (chlorpheniramine maleate, propranolol HCl, or salicylic acid). Monolithic solutions (salicylic acid-NE 30D) or dispersions (chlorpheniramine maleate or propranolol HCl-NE 30D) were formed, depending on the solubility of the drug in the polymer matrix. Zero-order drug release was achieved by laminating a second, drug-free latex film onto the reservoir layer. The rate-controlling membrane was either attached to, or cast directly onto the reservoir. The release rate was independent of loading for the monolithic dispersions, but dependent on loading for the monolithic solution. Release rates were enhanced by the addition of a hydrophilic polymer, hydroxypropyl methylcellulose, to the rate-controlling membrane. An inverse relationship was observed between the release rate and membrane thickness. The rate-controlling membrane, cast from organic polymer solutions, had a denser structure, resulting in slower drug release when compared with latex-cast laminates.     

Composition of the essential oil from Thymus moesiacus from Macedonia

Composition of the essential oil of Thymus moesiacus Velen. from Macedonia was examined by GC and GC-MS methods. The main constituents of the oil were geraniol, linalool, geranyl acetate, and terpenyl acetate.