创面复合敷料抑菌作用的研究

目的 观察创面复合敷料体外抑菌作用。方法 采用琼脂稀释法观察不同浓度复合敷料对大肠杆菌、金黄色葡萄球菌、绿脓杆菌、产气英膜杆菌和破伤风杆菌的抗体外抑菌活性，并分别与云南白药(阳性)和生理盐水(阴性)进行对照，并研究其最低抑菌浓度(MIC)。结果 实验结果显示敷料液和云南白药液都具有抑菌作用，但敷料对各种样品菌抑菌效果明显优于云南白药，该敷料对细菌的MIC在6．25—25mg／mL之间，而用于敷料中的浓度是MICl0—20倍之间。结论 创面复合敷料具有高效的抑菌作用。     

氮酮的抑菌作用

目的:探讨氮酮在抑菌中的作用。方法:选择308株临床菌株采用液体抑菌活性检测,通过本次实验观察氮酮的抑菌效果。结果:氮酮对112株金黄色葡萄球菌、112株表皮葡萄球菌和28株肠球菌的MIC50分别为0.72、1.44、0.72 mg/mL;其MIC90分别为1.44、1.44、0.72 mg/mL。对肺炎克雷伯菌和大肠杆菌的MIC90分别为2.88、1.44 mg/mL。结论:氮酮对革兰阳性球菌和某些革兰阴性杆菌均有较好的抑菌作用     

宁泌泰胶囊对葡萄球菌和大肠杆菌及其生物膜体外形成抑制作用的研究

目的:评估宁泌泰胶囊对葡萄球菌和大肠杆菌增殖以及体外培养生物膜的抑制作用。方法:使用梯度稀释法检测表皮葡萄球菌(1457),金黄色葡萄球菌(NCTC8325-4、Newman、MU50),大肠埃希菌(ATCC25922、CFT073)对宁泌泰的最低抑菌浓度(MIC);使用扫描电镜,观察不同浓度的宁泌泰对表皮葡萄球菌1457、金黄色葡萄球菌NCTC8325-4,以及大肠埃希菌CFT073和ATCC25922生物膜形成的影响。结果:MIC检测结果显示,宁泌泰对表皮葡萄球菌1457、金黄色葡萄球菌NCTC8325-4、Newman、MU50以及大肠埃希菌ATCC25922和CFT073均具有抑制效果,MIC为20 mg/ml;扫描电镜结果显示,宁泌泰能够抑制表皮葡萄球菌1457、金黄色葡萄球菌NCTC8325-4,以及大肠埃希菌CFT073和ATCC25922体外生物膜的形成。结论:宁泌泰胶囊既能够抑制葡萄球菌和大肠杆菌的增殖,也能够抑制其生物膜的形成,具有较为全面的抗细菌效果。     

输液器对酚妥拉明吸附作用的实验研究

目的 探讨输液器对酚妥拉明的吸附作用及其影响因素。方法 采用紫外分光法测定不同浓度，不同输注速度的酚妥拉明在通过输液器前及输液器后各时段药物浓度。结果 不同输注速度及不同浓度酚妥拉明注射液通过输液器即刻其浓度显著下降（P〈0．05，P〈0．01）。同时段不同输注速度相同浓度间差异无显著性意义（均P〉0．05）；相同输注速度不同浓度间差异有显著性意义（均P〈0．05）．其中浓度为16mg／100ml的吸附量显著高于浓度为8mg／100ml和4mg／100ml（均P〈0．01）．后两者之间差异无显著性意义（P〉0．05）。结论 输液器对酚妥拉明有显著吸附作用．浓度越高吸附作用越大．其吸附作用随输注时间延长而降低．30min后基本恢复至原液水平。     

载银纳米抗菌复合骨填充材料体外抗菌性能及生物相容性研究

[目的]探讨载银纳米抗菌复合骨填充材料其体外抗菌性能及生物相容性。[方法]采用抑菌环试验、菌落数试验检测材料对金黄色葡萄球菌及大肠杆菌的体外抗菌效果,采用扫描电镜观察材料对金黄色葡萄球菌及大肠杆菌的抗粘附效果。并采用MTT法检测细胞毒性及急性溶血实验评价载银纳米抗菌复合骨填充材料的生物相容性。[结果]抑菌环试验显示第1 d时载银纳米抗菌复合骨填充材料对金黄色葡萄球菌和大肠杆菌的抑菌环直径均最大,分别为(23.6±1.14)mm和(18.8±0.84)mm,随后抑菌环直径随时间延长而缩小,抑菌环在金黄色葡萄球菌和大肠杆菌中的持续时间分别为33、24 d;菌落数试验显示细菌与载银纳米抗菌复合骨填充材料接触24 h后,对金黄色葡萄球菌和大肠杆菌的抗菌率分别为94.18%和85.96%;扫描电镜发现实验组材料表面黏附的细菌明显少于对照组。MTT法测定示载银纳米抗菌复合骨填充材料毒性分级为1级,急性溶血实验示载银纳米抗菌复合骨填充材料溶血率为0.28%。[结论]载银纳米抗菌复合骨填充材料有良好的生物相容性,对金黄色葡萄球菌及大肠杆菌有明显抗菌作用,无明显细胞毒性和红细胞破坏性。     

粪鬼伞菌丝体提取液的抗菌活性

以深层发酵得到的粪鬼伞菌丝体为原料,分别用水和80%的乙醇溶液进行超声波浸提,对浸提液进行体外抗菌实验,然后用与总糖浓度相同的多糖溶液和水提液对比进行抗菌试验.结果表明,水提液对大肠杆菌和枯草芽孢杆菌的最低抑菌浓度(MIC) 为3.2 mg/mL, 对金黄色葡萄球菌的MIC为1.6 mg/mL;对大肠杆菌的最低杀菌浓度(MBC)为12.5 mg/mL,对金黄色葡萄球菌和枯草芽孢杆菌的MBC为25 mg/mL;对青霉和黑曲霉没有作用;醇提液对大肠杆菌和枯草芽孢杆菌的MIC为50 mg/mL,对金黄色葡萄球菌、青霉和黑曲霉没有作用;总糖质量浓度相同的多糖溶液和水提液具有等效的抑菌和杀菌能力.因此,粪鬼伞多糖就是水提液中的主要抗菌活性物质.     

醋酸泼尼松炉甘石洗剂治疗敷贴胶布致皮肤过敏疗效观察

目的探讨自制醋酸泼尼松炉甘石洗剂外涂治疗敷贴、胶布致皮肤过敏患儿的疗效。方法将敷贴、胶布致皮肤过敏的64例患儿随机分为观察组和对照组各32例,观察组局部采用自制醋酸泼尼松炉甘石洗剂外涂,对照组采用炉甘石洗剂外涂,两组均治疗1次／6h,治疗3d后评估疗效。结果观察组治疗效果显著优于对照组（P〈0．05）。结论自制醋酸泼尼松炉甘石洗剂外涂治疗敷贴、胶布引起的皮肤过敏疗效显著。     

盐酸格拉司琼体外抑菌作用的实验研究

目的观察盐酸格拉司琼在体外对大肠埃希菌、金黄色葡萄球菌、铜绿假单胞菌抑菌作用的影响。方法将盐酸格拉司琼注射液用无菌生理盐水稀释至终浓度分别为0.5、0.25、0.125和0.0625 mg/mL,与大肠埃希杆菌、金黄色葡萄球菌、和铜绿假单胞菌培养,每个实验重复三遍,所有菌株的稀释的系列测定均进行两次。结果格拉司琼对大肠埃希菌、金黄色葡萄球菌、铜绿假单胞菌均有明显的抑菌作用,格拉司琼对大肠埃希菌的抑菌作用随着格拉司琼浓度的增加而增加,至0.0625 mg/mL时仍有明显的抑菌作用(P<0.05)。格拉司琼对金黄色葡萄球菌和铜绿假单胞菌的抑菌作用在格拉司琼浓度为0.125 mg/mL时消失。结论格拉司琼在体外可以抑制大肠埃希菌、金黄色葡萄球菌、铜绿假单胞菌的生长,对于预防麻醉相关的感染可能有一定的临床意义。     

健康志愿者自体富血小板凝胶体外抑菌作用研究

目的自体富血小板凝胶(autologous platelet-rich gel,APG)作为一种新技术和有希望广泛用于临床的抗感染治疗方法,其作用机制尚不清楚。许多研究表明血小板具有抗菌的多功能属性,可直接与病原微生物作用将病原体从血液中清除。通过体外实验评价APG是否具有抑菌作用。方法抽取17例健康志愿者外周静脉血,制备富血小板血浆(platelet-rich plasma,PRP)、贫血小板血浆(platelet-poor plasma,PPP)及APG。通过抑菌实验观察APG、PRP以及加入夹竹桃麻素(apocynin,APO)的APG(APG-APO)对金黄色葡萄球菌、大肠埃希杆菌及铜绿假单胞菌是否有抑菌作用。结果APG和APG-APO对金黄色葡萄球菌的生长具有明显抑制作用,最大抑制作用出现在前4h,抑菌作用分别可持续至24h和8h。APG与PRP、PPP相比,24h内均具有显著的抑菌作用(P0.05);在前8h APG与APG-APO的抑菌作用差异无统计学意义(P0.05),12h后差异有统计学意义(P0.05);APG-APO与PRP、PPP相比在前4h具有显著的抑菌作用(P0.05),6h后差异无统计学意义(P0.05)。各时间点APG和APG-APO对大肠埃希杆菌的抑菌率分别为27.36%～52.97%和18.82%～51.52%,对铜绿假单胞菌的抑菌率均在35%以下,与PRP比较差异均无统计学意义(P0.05);各时间点PRP对金黄色葡萄球菌、大肠埃希杆菌及铜绿假单胞菌的抑菌率均在15%以下。结论APG对金黄色葡萄球菌有抑菌作用,抑菌作用可能来自于血小板;对大肠埃希杆菌及铜绿假单胞菌无明显抑菌作用。PRP对金黄色葡萄球菌、大肠埃希杆菌及铜绿假单胞菌均无明显抑菌作用。     

复方黄柏液治疗肛门瘙痒症的疗效观察

为观察外用复方黄柏液治疗肛门瘙痒症的疗效,选取肛门瘙痒症患者181例,随机分为三组,一组用10％复方黄柏液坐浴患处（A组）,一组用复方黄柏液原液涂抹患处（B组）,另一组用冰磺洗剂涂抹患处（C组）,对比分析三组患者的疗效。结果显示,A、B、C三组患者总显效率分别为74．6％o、93．5％和71．7％。经统计学分析,B组总显效率明显高于A、C组,P〈0．05;而A组和C组间差异无统计学意义,P〉0．05。结果表明,复方黄柏液原液外涂患处治疗肛门瘙痒症疗效显著。     

盐酸昂丹司琼体外抑菌作用的实验研究

目的观察盐酸昂丹司琼在体外对大肠埃希菌、金黄色葡萄球菌、铜绿假单胞菌抑菌作用的影响。。方法将盐酸昂丹司琼注射液用无菌生理盐水稀释至终浓度分别为0.5、0.25、0.125和0.0625 mg/mL,与大肠埃希杆菌、金黄色葡萄球菌、和铜绿假单胞菌培养,每个实验重复三遍,所有菌株的稀释的系列测定均进行两次。结果昂丹司琼对大肠埃希菌、金黄色葡萄球菌、铜绿假单胞菌均有明显的抑菌作用,昂丹司琼对大肠埃希菌的抑菌作用随着昂丹司琼浓度的增加而增加,至0.0625 mg/mL时仍有明显的抑菌作用(P<0.05)。昂丹司琼对金黄色葡萄球菌和铜绿假单胞菌的抑菌作用在昂丹司琼浓度为0.125 mg/mL时消失。结论昂丹司琼在体外可以抑制大肠埃希菌、金黄色葡萄球菌、铜绿假单胞菌的生长,对于预防麻醉相关的感染可能有一定的临床意义。     

Superior antimicrobial activity of trisodium citrate over heparin for catheter locking.

BACKGROUND: Haemodialysis catheters used for vascular access are frequently complicated by infection and catheter-related thrombosis. Improvement of interdialytic locking solutions could reduce these problems. Trisodium citrate (TSC) has been advocated in recent years because it might have antimicrobial qualities. METHODS: Antimicrobial efficacy of four concentrations of TSC (2.2, 7.5, 15 and 30%) was compared with three equi-osmolal sodium chloride (NaCl) concentrations, unfractionated heparin 5000 IU/ml and a solution of gentamicin 1 mg/ml in TSC 7.5%. We analysed antimicrobial properties by two classical in vitro susceptibility tests. All tests were performed in triplicate by incubation of test fluids with Staphylococcus aureus, Staphylococcus epidermidis, Escherichia coli, Pseudomonas aeruginosa and Candida albicans. RESULTS: Increasing TSC concentrations effectively killed the staphylococcal strains in both assays. For E.coli and P.aeruginosa complete killing was achieved only with TSC 30%. TSC 30% was also the only solution that significantly inhibited growth of C.albicans. Heparin manifested no antimicrobial effect of any significance. Adding gentamicin to TSC provided superior bacterial growth inhibition but had no effect on yeast growth. TSC solutions manifested superior antimicrobial activity compared with iso-osmolal NaCl solutions in both assays. CONCLUSION: This in vitro study demonstrates superior antimicrobial activity of TSC, especially in higher concentrations, in contrast to heparin. The mechanism seems to differ from hyperosmolality. Ca(2+) and Mg(2+) chelating effects are probably more important. Adding gentamicin provided the most potent antimicrobial solution. However, for reasons concerning development of bacterial resistance and sensitization of the patient, continuous exposition to aminoglycosides seems not advisable.     

Antimicrobial effects of two anaesthetic agents: dexmedetomidine and midazolam

Some anaesthetic agents are known to inhibit microbial growth. The aim of this in vitro study was to investigate possible antimicrobial effects of two frequently used agents in intensive care units, dexmedetomidine and midazolam. Antimicrobial effect was tested on Staphylococcus aureus, Enterococcus faecalis, Escherichia coli and Pseudomonas aeruginosa by broth microdilution method. Midazolam showed inhibitor and bactericidal effect on S. aureus at concentrations 256 mmicrog x ml(-1) and 512/microg x ml(-1) respectively and on E. faecalis at concentrations 128 microg x ml(-1) and 256 microg x ml(-1). Dexmedetomidine demonstrated inhibitor effect on S. aureus, E. coli and P aeruginosa at concentrations 32 microg x ml(-1), 16 microg x ml(-1) and 16 microg x ml(-1) respectively. Midazolam had inhibitor and bactericidal effects on S. aureus and E. faecalis. Dexmedetomidine had only inhibitor effects on S. aureus, E. coli and P aeruginosa. Further studies are needed to determine the antimicrobial mechanisms and clinical applications.     

载去甲万古霉素缓释钢板在兔胫骨金葡菌污染模型中病理学与放射学评价

目的探讨载去甲万古霉素缓释钢板在兔胫骨金黄色葡萄球菌污染模型中的预防作用。方法新西兰白兔64只,制备胫骨中段单侧皮质横断骨折模型,分别置入载去甲万古霉素缓释钢板（32只）和普通不锈钢钢板（32只）,注射1×10^5CFU/ml金葡菌,于第1、3、7、14、28天留取病理标本,从病理学和放射学角度比较两种钢板对兔胫骨金葡菌污染模型的预防作用。结果50只兔存活,两组各25只。实验组发生骨髓炎8只,感染率为32%;普通不锈钢钢板对照组发生骨髓炎23只,感染率为92%,两组感染率比较差异有统计学意义（P〈0.05）。两组X线片比较显示：发生感染兔均有骨破坏、骨赘形成、软组织脓肿影等变化,但实验组较对照组发生率低（P〈0.05）。病理学显示,感染兔较未感染兔的软组织及骨HE染色显示：大量中性粒细胞弥漫分布,骨质呈小灶性坏死至片状坏死。结论从病理学和放射学角度观察,载去甲万古霉素缓释钢板在兔胫骨金黄色葡萄球菌污染模型中有较明确的预防作用。     

Protection with antibody to tumor necrosis factor differs with similarly lethal Escherichia coli versus Staphylococcus aureus pneumonia in rats

BACKGROUND: Differing factors may alter the effects of antibody to tumor necrosis factor (TNF) in infection and sepsis. The authors tested whether bacteria type or treatment route alters antibody to TNF in a rat model of bacterial pneumonia. METHODS: Rats (n = 231) received similarly lethal doses of either intratracheal Escherichia coli or Staphylococcus aureus followed by treatment with either intratracheal or intraperitoneal antibody to TNF or control serum. Animals received antibiotics (cefotiam daily dose, 100 mg/kg) starting 4 h after inoculation and were studied for up to 96 h. RESULTS: Compared with S. aureus, E. coli increased serum TNF and interleukin-6 concentrations, lung lavage TNF concentrations, neutrophil counts, and alveolar-to-arterial oxygen gradients and decreased circulating neutrophils and lymphocytes (P > or = 0.05 for all). Compared with controls, with both bacteria, except for lung lavage TNF concentrations (which decreased with intratracheal but not with intraperitoneal antibody to TNF), treatment route did not alter the effects of antibody to TNF on any parameter (P = not significant for all). Antibody to TNF reduced mortality rates (relative risk of death +/- SEM) with both E. coli (-1.6 +/- 0.6; P = 0.006) and S. aureus (-0.5 +/- 0.04; P = 0.185), but these reductions were greater with E. coli than with S. aureus in a trend approaching statistical significance (P = 0.09). Compared with controls, similarly (P = not significant) with both bacteria, antibody to TNF decreased lung lavage and tissue bacteria concentrations (both P < 0.05) and serum TNF concentration (P < 0.09) and increased circulating neutrophils and lymphocytes (both P < or = 0.01). Compared with S. aureus, with E. coli antibody to TNF decreased alveolar-to-arterial oxygen gradients (P = 0.04) and increased serum interleukin-6 concentrations (P = 0.003). CONCLUSION: Antibody to TNF improved host defense and survival rates with both lethal E. coli and S. aureus pneumonia, but protection was greater with E. coli, where TNF concentrations were higher than with S. aureus. The efficacy of antiinflammatory agents in sepsis may be altered by bacteria type.     

Sufentanil modifies the antibacterial activity of bupivacaine and ropivacaine

PURPOSE: The purpose of our study was to investigate the effect on the growth of Escherichia coli (E. coli), Staphylococcus aureus (S. aureus), and Enterococcus faecalis (E. faecalis) of bupivacaine at a final concentration of 0.77 mg.mL(-1), ropivacaine at 1.2 mg.mL(-1), and sufentanil at 0.38 and 0.5 microg.mL(-1) (alone or in combination with bupivacaine and ropivacaine). METHODS: The strains were diluted to approximately 3 x 10(4) cfu.mL(-1) in Mueller-Hinton broth. The anesthetics (0.5 mL) were incubated with the bacterial suspensions (0.5 mL) for 24 hr at 37 degrees C. RESULTS: Bupivacaine inhibited the growth of E. coli (59 +/- 0.8%; P < 0.05) and S. aureus (22 +/- 3.6%; P < 0.05). Ropivacaine also inhibited the growth of E. coli (41 +/- 1.2%; P < 0.05) and S. aureus (25.5 +/- 4.1%; P < 0.05). Both anesthetics were ineffective against E. faecalis. Sufentanil only inhibited S. aureus (13.8 +/- 3.1%; P < 0.05) at a concentration of 0.5 microg.mL(-1). Sufentanil modified the antibacterial activity of bupivacaine and ropivacaine. It increased the inhibitory effect of bupivacaine on E. faecalis and S. aureus by 10 +/- 2.1% (P < 0.05) and on E. coli by 7% (P < 0.05). Sufentanil did not increase the inhibitory effect of ropivacaine on the growth of S. aureus. On the other hand, sufentanil reduced the inhibitory effect of ropivacaine on E. coli by 11% (P < 0.05). CONCLUSION: Both bupivacaine and ropivacaine alone or combined with sufentanil inhibited the growth of E. coli and S. aureus. E. faecalis was partially sensitive to a bupivacaine + sufentanil mixture. Sufentanil had a partial synergistic effect on bupivacaine and a partial antagonistic effect on ropivacaine's antibacterial activity.     

腹腔感染细菌流行病学调查

目的监测2006年10月至2007年10月我国不同地区14家教学医院分离的腹腔感染病原菌的菌种分布及其体外药物敏感性。方法按设计方案收集来自腹腔感染的病原菌。菌株经中心实验室复核后,采用琼脂稀释法测定10类共29种抗菌药物的最低抑菌浓度（MIC）,数据输入WHONET5．4软件进行耐药性分析。结果此次监测收集的腹腔感染病例数为742例,分离出的病原菌为743株,其中革兰阴性菌占76．7％（570／743）,革兰阳性菌占23．3％（173／743）。病原菌中分离率位于前5位的分别为大肠埃希菌（38．8％）、肺炎克雷伯菌（10．2％）、铜绿假单胞菌（9．2％）、屎肠球菌（8-2％）和金黄色葡萄球菌（4．4％）。对于所有肠杆菌科菌,敏感率高于90％的抗菌药物包括美罗培南、亚胺培南、替加环素、阿米卡星和他唑西林-三唑巴坦。对产超广谱β-内酰胺酶（ESBLs）的大肠埃希菌和克雷伯菌,敏感性大于90％的药物包括亚胺培南（100％）、美罗培南（100％）、替加环素（100％）和他唑西林-三唑巴坦（91．5％～91．7％）。铜绿假单胞菌中多重耐药菌株的检出率为14．7％,鲍曼不动杆菌为61．3％。金黄色葡萄球菌中耐甲氧西林（MRSA）的发生率为69．7％,所有菌株对替加环素、万古霉素和替考拉宁均敏感。替加环素对所有粪肠球菌和屎肠球菌均保持了100％的敏感率。粪肠球菌中敏感性较高的抗菌药物还有万古霉素（100％）、替考拉宁（100％）和氨苄西林（81．5％）。屎肠球菌中敏感性较高的抗菌药物还有万古霉素和替考拉宁（96．7％）。结论引起腹腔感染的病原菌以革兰阴性菌特别是肠杆菌科菌为主。替加环素、碳青酶烯类、他唑西林-三唑巴坦和阿米卡星对腹腔感染肠杆菌科菌保持了较高的抗菌活性,非发酵的革兰阴性杆菌的耐药性令人担忧。替加环素、万     

Antimicrobial systems of the surgical wound. II. Detection of antimicrobial protein in cell-free wound fluid.

Human wound fluid contains heat-stable proteins with moderate antibacterial activity against Staphylococcus aureus and Escherichia coli, and different heat-labile proteins with antibacterial activity against E coli. Blood serum also contains heat-labile antibacterial substances, but little heat-stable activity against Staphylococcus aureus. Both blood serum and wound fluid have bacteriostatic activity against S epidermidis, and early growth of Streptococcus fecalis occurs in serum and wound fluids. The concentration or activity of antimicrobial proteins increases during the first week in the fresh wound and then decreases as the wound matures.     

Antibacterial activity of gentamicin-bonded gelatin-sealed polyethylene terephthalate vascular prostheses.

OBJECTIVES: To create an antibiotic-modified vascular prosthesis with a prolonged bactericidal activity, susceptible to endothelialisation. METHODS: We used a covalent method of gentamicin sulphate immobilisation to polyethylene terephthalate prosthesis sealed with gelatin. Antibacterial activity was assayed in Luria-Bertani medium against Staphylococcus aureus, Escherichia coli and Pseudomonas aeruginosa strains. Prosthesis endothelialisation was performed using bovine aorta endothelial cells (BAEC). RESULTS: Gentamicin was bound to vascular prostheses in the amount of 12g per kg of prosthesis. Ninety-seven percent of antibiotic bound in covalent way and remained on the biomaterial for at least 30 days during shaking in PBS solution. Gentamicin-modified prostheses exerted bactericidal or bacteriostatic effect on growth of clinical and reference bacterial strains, prevented biofilm formation and were highly susceptible to endothelialisation. BAEC viability exceeded 90%, which indicated that gentamicin-vascular prostheses were not toxic for these cells. CONCLUSIONS: Covalent gentamicin immobilisation resulted in effective antibacterial protection of vascular prostheses against clinical and reference strains of S. aureus, E. coli and P. aeruginosa and allowed for a strong adherence of endothelial cells to antibiotic-modified prostheses.