女性生殖道厌氧菌感染及体外抗生素抗菌活性的分析

目的:了解该地区妇产科厌氧菌感染的优势菌群及其对抗生素的敏感谱,为临床合理使用抗生素提供依据.方法:采用厌氧培养法分离培养女性生殖道感染病例的厌氧菌,采用微量生化反应法及抗生素纸片法鉴定厌氧菌的种类,采用K-B法及微量肉汤稀释法分析抗生素对厌氧菌的抗菌活性.结果:103例临床标本中,分离出专性厌氧菌72株,阳性率69.90％.优势厌氧菌菌群为革兰氏阴性无芽孢类杆菌(28株,38.89％),其次为消化链球菌(18株,25.00％).厌氧球菌、类杆菌及韦荣球菌对甲硝唑的敏感率分别为90.91％、85.71％和80.00％.3种厌氧菌对丁胺卡那霉素、红霉素和克林霉素的耐药率均高于60％.比较3种厌氧菌对甲硝唑、青霉素G和林可霉素的MIC50值及MIC90值,发现甲硝唑的MIC50值和MIC90值最低.结论:厌氧菌已成为女性生殖道感染的重要致病菌.虽然甲硝唑在体外对临床分离的厌氧菌菌株显示出良好的抗菌活性,但已经出现了耐药菌株,其对厌氧菌的MIC值有不同程度的上升趋势.     

利福平对幽门螺杆菌体外抗菌活性的检测

目的 体外试验检测利福平对幽门螺杆菌(HP)的抗菌活性,为临床用药提供试验依据.方法 来自115例有上消化道症状的患者,取胃黏膜组织培养获得的HP菌株,采用E-test法测定HP对阿莫西林、克拉霉素、甲硝唑、左氧氟沙星和利福平的最低抑菌浓度(MIC).结果 HP对阿莫西林、克拉霉素、甲硝唑、左氧氟沙星的耐药率分别为5.17%、15.50%、63.80%、8.62%,分离的58株菌中未发现对利福平耐药的菌株;HP对利福平的耐药率与阿莫西林差异统计学意义(P＞0.05),明显低于克拉霉素(P＜0.01)、甲硝唑(P＜0.01)、左氧氟沙星(P＜0.05);利福平对HP的抗菌活性与阿莫西林相近,MIC50和MIC90分别为(0.125,0.5 mg/L)和(0.064,0.25 mg/L).结论 HP对甲硝唑和克拉霉素耐药菌株多见,利福平对HP有良好的抗菌活性,在其他抗HP感染一线药物耐药时,利福平是一种可供选择的治疗药物.     

广州地区52株流感嗜血杆菌对6种抗生素体外抗菌活性分析-Etest法

目的调查广州地区流感嗜血杆菌对6种抗生素的体外活性,以了解广州地区流感嗜血杆菌的耐药性并指导临床合理使用抗生素. 方法采用Etest法测定从呼吸道感染标本中分离到的52株流感嗜血杆菌对6种抗生素药敏试验. 结果流感嗜血杆菌对6种抗生素的体外药敏结果依次为:头孢噻肟MIC900.023 mg/L、MIC500.016 mg/L;左氧氟沙星MIC900.064 mg/L、MIC500.032 mg/L;亚胺培南MIC901.5 mg/L、MIC500.5 mg/L;阿奇霉素MIC904 mg/L、MIC503 mg/L;氯霉素MIC900.75 mg/L、MIC500.38 mg/L;氨苄西林MIC90256 mg/L、MIC500.5 mg/L. 结论广州地区流感嗜血杆菌对头孢噻肟、左氧氟沙星、氯霉素、亚胺培南、阿奇霉素的耐药率低,其可作为临床治疗流感嗜血杆菌感染的首选药物,而对氨苄西林的耐药率较高,其作为临床治疗流感嗜血杆菌首选药物的传统地位受到了严重挑战.     

β-内酰胺类抗菌药物诱导异质性万古霉素中介金黄色葡萄球菌及其药敏试验研究

目的体外观察β-内酰胺类抗菌药物能否诱导产生异质性万古霉素中介金黄色葡萄球菌(hVISA),并对其进行药敏试验。方法挑选医院2015年8月-10月临床MRSA 5株,选择头孢他啶、哌拉西林/他唑巴坦、美罗培南3种常用β-内酰胺药物,逐步诱导菌株,应用菌群分析曲线法检测hVISA,E-test法测定hVISA对万古霉素、利奈唑胺、替加环素、达托霉素的MIC,棋盘格法测定联合药敏试验。结果 3种β-内酰胺类抗菌药物诱导产生的hVISA菌株分别为3株、3株、1株。7株hVISA对万古霉素的MIC范围在2~4mg/L,联合利福平、左氧氟沙星、夫西地酸药物后,hVISA对万古霉素的MIC范围分别为1~4mg/L,1~4mg/L,1~2mg/L,对利奈唑胺、替加环素、达托霉素的MIC范围分别为0.25~1mg/L,0.125~0.5mg/L,0.064~0.25mg/L。结论体外β-内酰胺类抗菌药物可以诱导产生hVISA,头孢类与半合成青霉素类较碳青霉烯类抗菌药物更容易诱导产生hVISA,联合用药不能显著降低hVSA对万古霉素的MIC值,新型治疗MRSA药物利奈唑胺、替加环素、达托霉素对hVISA均较为敏感,可有效治疗hVISA感染。     

替加环素体外抗菌活性的研究

目的 评价替加环素的体外抗菌作用.方法 采用微量肉汤稀释法测定替加环素对从北京协和医院临床分离200株菌的最低抑菌浓度(MIC),并与有关抗菌药物进行比较;数据分析采用WHONET-5.4软件.结果 对临床分离的200株菌的MIC测定结果显示,替加环素、万古霉素、利奈唑烷对MRSA有高度的抗菌活性;1株耐万古霉素屎肠球菌对替加环素和利奈唑烷均敏感;所测抗菌药物中,替加环素对耐青霉素肺炎链球菌的MIC90值为0.064 mg/L,对鲍氏不动杆菌的MIC90值为2 mg/L,对产ESBL的12株大肠埃希菌和5株肺炎克雷伯菌敏感,对铜绿假单胞菌的MIC90值为32 mg/L.结论 替加环素对与感染有关的常见需氧革兰阳性球菌和革兰阴性杆菌有很好的广谱抗菌活性,对铜绿假单胞菌的抗菌活性较低.     

甲硝唑与不同抗菌药物联合对艰难梭菌体外抗菌活性对比研究

目的不同种类抗菌药物会以不同的作用机制对艰难梭菌(难辨梭状芽孢杆菌,clostridium difficile,CD)起效,因此联合用药在临床上比较常见。探讨甲硝唑与卡达唑胺、非达霉素、万古霉素分别联用对临床分离的CD的体外抗菌活性,为临床联合用药提供实验依据。方法将甲硝唑与卡达唑胺、非达霉素、万古霉素在体外单独以及分别联用作用于32株CD菌株,采用琼脂二倍稀释法,测定最低抑菌浓度(minimum inhibitory concentration,MIC)、计算部分抑菌浓度指数(fractional inhibitory concentration,FIC),绘制杀菌曲线。评价甲硝唑与其他3种抗菌药物分别联合应用的体外抗菌活性。结果万古霉素与甲硝唑联合后18.8%为相加作用,无拮抗作用,MIC值无明显改变;卡达唑胺联合甲硝唑后89.1%为协同作用,卡达唑胺的MIC50、MIC90值分别下降为单用时的60.0%和50.0%;非达霉素联合甲硝唑后90.6%为协同作用,非达霉素的MIC50、MIC90值分别下降为单用时的50.0%和12.8%。结论卡达唑胺、非达霉素分别与甲硝唑在体外联合均具有协同抗菌作用,能降低对CD的MIC,而万古霉素联合甲硝唑MIC无明显改变。     

国产利福霉素对耐甲氧西林葡萄球菌及其他致病菌抗菌活性研究

目的 了解国产利福霉素（立复欣）对近两年来临床分离耐甲氧西林葡萄球菌及其他致病菌的耐药性,方法 用琼脂稀释法测定利福霉素和万古霉素对临床分离385株致病菌的最低抑菌浓度,并以MIC50、MIC90众数MIC比较利福霉素和万古霉素的抗菌活性。结果 利福霉素对MRSA和MSSA抗菌活性与万古霉素相同,MIC50MIC90分别均为1．0mg/L和2．0mg/L。对MRSE,MIC50低于万古霉素4倍为0．5mg／L;对肺炎链球菌、卡他莫拉菌和李斯特菌的MIC50分别比万古霉素低8、128和4倍。结论 国产利福霉素对MRS和大部分临床的离致病菌具有良好抗菌活性,可作为MRSA和MRSE感染症的选择药物。     

儿童感染肺炎链球菌对抗菌药物的耐药性调查

目的了解儿童感染肺炎链球菌临床分离株对各类抗菌药物的耐药状况及特点。方法对从温州医学院附属育英儿童医院2005年1月-2006年12月住院患者送检标本中分离到的203株肺炎链球菌,进行10种抗菌药物敏感性试验,其中对青霉素进行8个药物浓度检测。结果203株肺炎链球菌中,万古霉素未检出耐药菌株,敏感率为100.0%;左氧氟沙星对肺炎链球菌也显示了很好的抗菌活性,敏感率为98.0%;青霉素、红霉素、克林霉素、四环素和复方新诺明对肺炎链球菌的敏感性很低,均<15.0%。对青霉素的不敏感率达86.2%,MIC值≥4μg/ml的菌株占了总数的11.8%。结论肺炎链球菌临床检出株对大多数常用抗菌药物的耐药性强,多重耐药菌比例很高;肺炎链球菌对万古霉素和左氧氟沙星最为敏感,其次是氯霉素;克林霉素、四环素、红霉素和复方新诺明已不是治疗肺炎链球菌的有效药物。     

上海市6所医院供水系统36株军团菌体外药敏结果分析

目的评估4种抗菌药物对医院环境中分离军团菌的体外抗菌活性,为临床治疗军团菌感染选择抗菌药物提供参考。方法收集2009年5-9月上海市6所医院供水系统中军团菌分离株36株,其中嗜肺军团菌血清1型(Lp-1)19株,嗜肺军团菌血清2-15型(Lp2-15)6株,其他军团菌属细菌(L.spp)11株,使用酵母琼脂培养基(BYE),采用琼脂稀释法药敏试验,孵育48h分别测定左氧氟沙星(LEV)、莫西沙星(MXF)、阿奇霉素(AZM)和红霉素(ERY)4种抗菌药物的最低抑菌浓度(MIC)。结果 4种药物的MIC范围分别为:LEV 0.015～0.06 mg/L,MXF 0.06～0.5 mg/L,ERY 0.125～1 mg/L,AZM 0.03～1 mg/L,MIC50、MIC90分别为LEV0.0150、.06 mg/L,MXF 0.06、0.06 mg/L,AZM 0.25、0.5 mg/L,ERY 0.5、1 mg/L;4种药物的抑菌商数(IQ)分别为LEV=185.13±49.98,MXF=53.61±28.03,AZM=30.40±28.94,ERY=9.83±6.52。结论氟喹诺酮类药物的体外抗军团菌的活性优于大环内酯类,同类抗菌药物比较,左氧氟沙星的体外抗军团菌活性优于莫西沙星,阿奇霉素的体外活性优于红霉素。     

抗菌药物对肠球菌属细菌体外抗菌活性

目的了解抗菌药物对某院临床分离肠球菌属细菌的体外抗菌活性。方法对2013年6月—2014年7月该院临床各科室送检标本分离的188株肠球菌属细菌进行细菌鉴定及药物敏感试验。结果 188株肠球菌属细菌其中屎肠球菌119株、粪肠球菌60株、鸟肠球菌9株,主要分布在尿和血标本,分别占34.57%和19.15%。未检出对达托霉素及利奈唑胺耐药的肠球菌属细菌;屎肠球菌对万古霉素的耐药率为1.68%,对青霉素、氨苄西林、高浓度庆大霉素、红霉素、左氧氟沙星的耐药率均70%;除四环素外,粪肠球对其他抗菌药物的耐药率均低于屎肠球菌,粪肠球对青霉素、氨苄西林耐药率较低,分别为16.67%,13.33%。结论达托霉素对该院肠球菌属细菌具有良好的抗菌效果。     

Antimicrobial susceptibility of Listeria monocytogenes from food products

This study was conducted to determine the susceptibility of Listeria monocytogenes isolated from food products to antimicrobial agents commonly used for treatment of infections with gram-positive bacteria, and to disinfectants. A total of 114 L. monocytogenes retail isolates were tested for susceptibility to ceftiofur, chloramphenicol, ciprofloxacin, erythromycin, florfenicol, penicillin, spectinomycin, streptomycin, tetracycline, tiamulin, trimethoprim, and co-trimoxazole, and the disinfectants benzalkonium chloride and triclosan, by determination of minimum inhibitory concentrations (MICs). All isolates were resistant to ceftiofur, but susceptible to the other antibiotics. A single isolate had a MIC of 4 mg/L for ciprofloxacin. For tiamulin. the MIC values were around the breakpoint used. Most isolates had MICs for triclosan at 16 mg/L. The MICs for benzalkonium chloride formed a bimodal distribution, with 105 isolates having a MIC of 4 mg/L and 9 isolates MICs of 16 and 32 mg/L. This study showed that Danish isolates of L. monocytogenes have not developed or acquired resistance to antimicrobial agents used for treatment or disinfection, except for benzalkonium chloride. The MICs for triclosan was high compared to other gram-positive bacteria, suggesting that triclosan might not be useful against L. monocytogenes if incorporated in materials in the food industry.     

130株临床肠球菌属感染特点及耐药性分析

目的分析肠球菌属感染的临床特点、预后及对抗菌药物的耐药性。方法收集临床标本常规培养及鉴定,并测定了对6种抗菌药物的敏感性。结果130株肠球菌属感染主要来自重症监护室呼吸衰竭、心力衰竭、肝衰竭患者的血液、尿液、痰液和腹水,复合菌感染占45.8%,多数患者伴有并发症,肠球菌属对青霉素、氨苄西林、万古霉素、链霉素、庆大霉素及左氧氟沙星耐药率分别是91.5%、23.4%、0、27.0%、32.0%及24.0%,治愈率63.6%,死亡率11.9%,且肠球菌属与其他菌混合感染者预后较差。结论应高度重视肠球菌属感染,依据药敏结果抗感染治疗,彻底清除病原菌,改善预后,提高生命质量。     

Prevalence of antimicrobial resistance genes in Listeria monocytogenes isolated from dairy farms

Antimicrobial resistance of Listeria monocytogenes (n = 38) isolated from the four dairy farms to 15 antimicrobial agents was evaluated. All 38 L. monocytogenes isolates from the four farms evaluated were resistant to more than one antimicrobial in different combinations. All L. monocytogenes isolates evaluated were resistant to cephalosporin C (minimum inhibitory concentration [MIC] > or = 512 microg/mL), streptomycin (MIC > or = 32) and trimethoprim (MIC > or = 512). Most L. monocytogenes isolates were resistant to ampicillin (92%, MIC > or = 2), rifampicin (84%, MIC > or = 4), rifamycin (84%, MIC > or = 4), and florfenicol (66%, MIC > or = 32) and some were resistant to tetracycline (45%, MIC > or = 16), penicillin G (40%, MIC > or = 2) and chloramphenicol (32%, MIC > or = 32). All L. monocytogenes isolates were susceptible to amoxicillin, erythromycin, gentamicin, kanamycin and vancomycin. Susceptibility of L. monocytogenes to the antimicrobials evaluated was quite consistent among the dairy farms evaluated. However, some variability in antimicrobial susceptibility among dairy farms was noted. Nineteen of 38 L. monocytogenes isolates contained more than one antimicrobial resistance gene sequence. A high frequency of floR (66%) was found in L. monocytogenes followed by penA (37%), strA (34%), tetA (32%), and sulI (16%). Other tetracycline resistance genes (tetB, tetC, tetD, tetE, and tetG) and other antimicrobial resistance genes (cmlA, strB, aadA, sulI, vanA, vanB, ampC, ermB, ereA, and ereB) were not found in any of the L. monocytogenes isolates from the four dairy farms. Results of the present study demonstrated that L. monocytogenes isolated from the dairy farm environment were resistant to many antimicrobials and contained one or more antimicrobial resistance genes.     

2018—2022年某地市级儿童医院小儿肺炎患者分离苛养菌分布及耐药性

目的 调查某儿童专科医院苛养菌分布及对抗菌药物的耐药性特点, 为儿科医生合理使用抗菌药物提供参考依据。 方法 通过连续性监测分析某院2018—2022年呼吸道标本分离的主要苛养菌种及其耐药性。 结果 分离株数居前三位的苛养菌是: 肺炎链球菌(Spn)、流感嗜血杆菌(Hi)、卡他莫拉菌(Mc)。Spn对红霉素、克林霉素、四环素、头孢呋辛的平均耐药率高(均＞75%), 对青霉素、头孢曲松、阿莫西林/克拉维酸的平均耐药率低(均＜15%); Hi对氨苄西林的平均耐药率较高(接近75%), 对头孢噻肟、头孢呋辛、头孢克洛、阿莫西林/克拉维酸的耐药率较低(＜45%); Mc对氨苄西林平均耐药率高(＞90%), 对其余常用抗菌药物平均耐药率均低(＜30%)。三种细菌5年间对上述药物的耐药率比较, 差异均有统计学意义(均P＜0.05)。 结论 考虑小儿使用抗菌药物的特殊性并结合本研究结果, Spn可先经验性使用青霉素类、第三代头孢类、β-内酰胺酶类药物, Hi可先经验性使用第二、三代头孢类、β-内酰胺类药物, Mc可经验性使用除氨苄西林外的抗菌药物, 再根据病原学结果及药敏结果回报调整用药方案。     

Antimicrobial activities of Psophocarpus tetragonolobus (L.) DC extracts

Consecutive chloroform, ethanol, and ethyl acetate partitions of extracts from winged bean [Psophocarpus tetragonolobus (L.) DC] root, stem, leaf, and pod extracts were tested for their antimicrobial activity against 19 microbial species, including 11 bacterial pathogens, four yeasts, and four molds using the disk diffusion assay technique. The pod extract was found to be most effective against all of the tested organisms, followed by the stem, root, and leaf extracts, and the ethanol fraction showed the most significant (p < 0.05) antimicrobial activity against all of the tests among three soluble fractions of extract, followed by the ethyl acetate and chloroform fractions. The minimum inhibitory concentrations (MICs) of extracts determined by the broth dilution method ranged from 1.25 to 10.0 mg/mL. The MIC of ethanol fraction of pod extracts was the lowest by comparison with the other two extracts. The MIC for fungi was at or below 2.5 mg/mL and for bacteria was at or above 2.5 mg/mL.     

社区获得性与医院获得性泌尿道感染病原菌及耐药性

目的分析社区获得性和医院获得性泌尿道感染病原菌构成和耐药性差异。方法回顾性调查2013年1月—2014年6月某院960例泌尿道感染住院患者的临床资料和尿标本微生物送检信息,分析其感染病原菌构成和耐药性差异。结果社区感染403例,医院感染557例;社区获得性和医院获得性泌尿道感染病原菌均以革兰阴性菌(G-)为主,分别占78.16%和66.97%。社区获得性和医院获得性泌尿道感染病原菌构成比较,差异有统计学意义(χ2=21.68,P0.001)。社区感染与医院感染大肠埃希菌耐药率比较:哌拉西林/他唑巴坦、头孢唑林、头孢哌酮/舒巴坦、氨曲南、美罗培南、厄他培南、庆大霉素、复方磺胺甲口恶唑耐药率差异均有统计学意义(均P0.05);除氨曲南外,大肠埃希菌对上述抗菌药物的耐药率医院感染均高于社区感染。医院感染屎肠球菌对青霉素、氨苄西林、庆大霉素、左氧氟沙星、环丙沙星、莫西沙星的耐药率均高于社区感染的屎肠球菌,差异均有统计学意义(均P0.05)。结论社区获得性和医院获得性泌尿道感染病原菌构成和耐药率方面存在一定差异,应结合病原菌构成特点和耐药菌的变化规律,选择适宜的治疗药物,防止和减少耐药菌产生,提高临床治疗效果。     

High level resistance to trimethoprim, cotrimoxazole and other antimicrobial agents among clinical isolates of Shigella species in Ontario, Canada--an update.

A total of 598 isolates of Shigella species (24 S. dysenteriae, 254 S. flexneri, 30 S. boydii, 290 S. sonnei) submitted to the Ontario Public Health Laboratories in 1990 were tested for their susceptibility to 14 antimicrobial agents by the agar dilution method. Overall 79.6% of isolates were resistant to one or more antimicrobial agents and 52.0% were resistant to four or more. Trimethoprim resistance ranged from 26.7% among isolates of S. boydii to 39.4% among S. flexneri strains. The majority of the 224 TMP resistant isolates (88.8%) demonstrated high level resistance (MIC > 1000 mg/l) to trimethoprim. Resistance to cotrimoxazole increased from 3% in 1978 to between 26.7 and 37.6% in 1990. MICs for 90% of isolates (MIC90s) for ampicillin, ticarcillin and piperacillin were 128 to > 256 mg/l, > 256 for tetracycline and chloramphenicol, and > 2.0/38.0 for cotrimoxazole. These results from the Canadian Province of Ontario emphasize the need for prudent use of antimicrobial agents in the treatment of shigellosis.     

哺乳期乳腺脓肿病原菌分布及耐药情况

目的了解哺乳期乳腺脓肿患者病原菌分布及其耐药情况,以指导临床医生进行合理治疗。方法回顾性分析2015年1月—2016年12月某专科医院哺乳期乳腺脓肿患者脓液分离病原菌及其药敏结果。结果共收集142例哺乳期乳腺脓肿患者脓液标本,其中98份脓液标本分离病原菌99株,金黄色葡萄球菌94株(94/99,94.95%),耐甲氧西林金黄色葡萄球菌(MRSA)43株(43/94,45.74%),肺炎克雷伯菌2株,表皮葡萄球菌、粪肠球菌和彭氏变形杆菌各1株。金黄色葡萄球菌对青霉素耐药率高达90.43%,对红霉素、克林霉素、四环素耐药率分别为55.32%、39.36%和27.66%,对环丙沙星、莫匹罗星、复方磺胺甲口恶唑、阿米卡星耐药率相对较低,尚未发现耐万古霉素、夫西地酸、替考拉宁、奎奴普丁/达福普汀、利奈唑胺菌株;43株MRSA对红霉素、克林霉素、四环素耐药率分别为83.72%、72.09%和44.19%。结论引起哺乳期乳腺脓肿的病原菌主要为金黄色葡萄球菌,其对青霉素、红霉素、克林霉素和四环素耐药率相对较高,不应经验性选择上述药物治疗乳腺脓肿;同时,应警惕MRSA感染存在的可能,根据药敏结果合理选择抗菌药物,对暂停哺乳者进行母乳移除的指导。     

关节置换术后假体周围感染病原菌分布特点及治疗

 目的 分析关节置换术后假体周围感染(PJI)病原菌分布特点、耐药情况及治疗, 为临床合理选择抗菌药物提供依据。方法 回顾性收集2019年1月—2021年11月某院收治的关节PJI患者临床资料, 统计分析PJI病原菌分布、药敏试验结果以及患者抗菌药物使用情况。结果 研究共纳入96例PJI患者, 分离获得112株病原菌, 革兰阳性菌株占80.36%, 以葡萄球菌属细菌为主。药敏试验结果显示, 表皮葡萄球菌对青霉素、苯唑西林耐药率分别为96.30%、81.48%, 大肠埃希菌对庆大霉素、复方磺胺甲口恶唑、氨苄西林耐药率均为100%。PJI患者住院期间抗菌药物使用主要以联合用药为主, 其中万古霉素联合美罗培南占26.04%;骨水泥中人工添加抗生素也以万古霉素和美罗培南为主。结论 关节置换术后PJI主要病原菌为表皮葡萄球菌, 其对青霉素、苯唑西林等普遍耐药, 抗感染治疗以万古霉素联合美罗培南为主。