氯霉素对耐甲氧西林金黄色葡萄球菌体外抗菌活性观察

目的观察氯霉素对耐甲氧西林金黄色葡萄球菌（MRSA）体外抗菌活性。方法将86株MRSA（社区分离34株,医院分离52株）对14种常用抗菌药物进行耐药性比较。结果 14种抗菌药物中,万古霉素对MRSA完全敏感,除此外,氯霉素的敏感性最强。结论氯霉素治疗MRSA感染,效果良好,可减轻患者经济负担。     

氯霉素对耐甲氧西林金黄色葡萄球菌体外抗菌活性观察

目的 观察氯霉素对耐甲氧西林金黄色葡萄球菌(MRSA)体外抗菌活性.方法 将86株MRSA(社区分离34株,医院分离52株)对14种常用抗菌药物进行耐药性比较.结果 14种抗菌药物中,万古霉素对MRSA完全敏感,除此外,氯霉素的敏感性最强.结论 氯霉素治疗MRSA感染,效果良好,可减轻患者经济负担.     

培氟沙星治疗伤寒的实验研究

伤寒杆菌耐药菌株日益增多,不仅耐氯(?)素。数年来诺氟沙星的应用,现已有耐诺(?)沙星菌株出现。本文就近年来收集的39株伤寒菌株,测定其药敏试验,最小抑菌浓度(?)试管法联合药敏试验。探讨合理应用抗菌药秀治疗伤寒和培氟沙星的临床应用问题,(?)过试验显示39株伤寒杆菌对诺氟沙星及培氟沙星的敏感率均为97.44％,耐药率2.56,明显好于氯霉素及氨苄青霉素的51.28％、48.72％和48.72％、51.28％。诺氟沙星及培氟沙星对39株伤寒菌的MIC均在敏感范围,作者认为诺氟沙星及培氟沙星在伤寒的治疗中均是可取的抗菌药物。     

一起耐氯霉素伤寒菌株所致局部流行的临床分析

笔者于1986年9月中旬至11月下旬,收治了非伤寒流行区,未经伤寒菌苗接种的玉溪市冯井乡39例伤寒病人,其中31例早期血培养和药物敏感试验,检出耐氯霉素伤寒杆菌。呈多元性耐药菌,它们对氯霉素,红霉素,磺胺嘧啶,四环素等均具有不同程度的耐药性,而对丁胺卡那霉素高度敏感90.3％(28/31)故使用丁胺卡那霉素治疗,剂量儿童按     

伤寒杆菌对12种抗菌药物的体外敏感试验

目的：了解衡阳地区近年来伤寒杆菌耐药情况及治疗伤寒的最有效药物。方法：对本院近２ａ临床分离的１０８株伤寒杆菌用１２种抗菌药物作体外药敏（纸片法）试验。结果：对复方磺胺甲唑、氨苄西林高度耐药；对氟罗沙星、氧氟沙星、环丙沙星、洛美沙星、头孢噻肟耐药率低，对氯霉素和庆大霉素耐药率比既往资料有下降；对阿米卡星、诺氟沙星、头孢哌酮均不同程度耐药。结论：除诺氟沙星外的氟喹诺酮类目前是治疗伤寒最有效药物。近年伤寒杆菌对多年不用的氯霉素、庆大霉素敏感性有所恢复。儿童伤寒宜用头孢噻肟治疗。     

湖北地区2003-2004年葡萄球菌临床分离株的耐药性监测

目的：了解湖北地区葡萄球菌临床分离株的分布及其对常用抗菌药物的耐药率。方法：采用纸片扩散法检测1600株金黄色葡萄球菌和2596株凝固酶阴性葡萄球菌对11种抗菌药物的耐药性。结果：共检出甲氧西林耐药金黄色葡萄球菌824株，分离率为51．5％；检出甲氧西林耐药凝固酶阴性葡萄球菌1896株，分离率为73．03％。耐甲氧西林对庆大霉素、环丙沙星、克林霉素的耐药率分别为77％、91％、88％，比耐甲氧西株凝目酶阴性葡萄球菌对上述3种抗菌药物的耐药率28％、66％、56％均高，而耐甲氧西林凝固酶阴性葡萄球菌对复方磺胺甲嗯唑及氯霉素的耐药率较金黄色葡萄球菌为高。甲氧西林敏感的凝固酶阴性葡萄球菌对环丙沙星、复方磺胺甲嗯唑、四环素、氯霉素的耐药率较甲氧西林敏感的金黄色葡萄球菌为高。但仍对庆大霉素、环丙沙星、氯霉素、克林霉素表现出较好的抗菌活性。结论：湖北地区葡萄球菌耐药现状不容忽视，加强对葡萄球菌耐药性的监测，并根据药敏试验结果合理使用抗菌药物对控制感染及防治耐药菌的传播非常必要。     

小儿科痰培养肺炎链球菌耐药性分析

目的：研究小儿科痰培养肺炎链球菌对临床常用抗生素的耐药情况。方法：对本院117株肺炎链球菌进行药物敏感试验。结果：青霉素耐药株占21.36%,头孢霉素、四环素以及氯霉素随着青霉素的最低抑菌浓度（MIC）升高而对肺炎链球菌的敏感性下降。青霉素敏感株的7%、中度耐药株的85%和高度耐药株的100%对1种以上的其他抗生素耐药。结论：肺炎链球菌耐药性上升迅速,且耐药程度高,临床上应该注意避免盲目用药,应该及时行药物培养并根据药敏结果酌情用药。     

抗菌药物对侵入性肺炎链球菌的敏感性试验

采用K-B法对分离自侵入性感染患者的95株肺炎链球菌进行抗菌药物敏感性试验，敏感率为：青霉素67．4％，氯霉素95．8％，红霉素56．8％，SMZ／TMP35．8％，四环素65．3％，万古霉素100％。31株耐青霉素菌株中，29株抗2种以上抗菌药物。     

几种抗菌药物对耐药性伤寒杆菌的联合作用

如何控制耐药菌株感染是目前伤寒治疗中的重要课题。我们收集1989年以来流行于浙江舟山的耐氯霉素伤寒杆菌64株,进行联合用药的实验研究,现摘要报告如下。     

伤寒耐氯霉素菌株感染6例报告

伤寒耐氯霉素菌株感染６例报告漳浦县医院陈建成１９８８～１９８９年间，我院收治的血培养伤寒杆菌阳性肥达氏反应＂Ｈ＂和＂Ｏ＂均为１：３２０（阳性）的伤寒患者，经首选氯霉素治疗疗效差，改用氟哌酸（Ｎｆｘ）加氨苄青霉素（ＡＭＰ）治疗后疗效显著，提出应警惕耐氯...     

伤寒的临床特点与耐药性研究

目的　探讨近年伤寒的临床特点和常用抗菌药物的耐药性及疗效。方法　收集经血培养和(或 )骨髓培养确诊的伤寒住院病人 97例 ,分析其临床特征、药敏试验和治疗效果。结果　本组伤寒的临床特征是热程长 (平均为 2 5 6d) ,病情重 ,并发症多。稽留热仍较多见 (5 5 7% ) ,脾肿大是主要体征。肥达反应阳性率为 6 7 1%。药敏试验呈多重耐药性 ,抗菌药物以喹诺酮类和三代头孢菌素疗效显著 ,其他药物单用效果普遍不佳。结论　多重耐药性的伤寒临床症状重 ,对常用治疗药物耐药性大 ,抗菌治疗应以氟啶酸或氟嗪酸等喹诺酮类为首选 ,联合用药效果更佳。     

Comparative in vitro activity of enoxacin and other fluoroquinolones against multi-resistant strains of Salmonella typhi.

The in vitro activities of enoxacin, lomefloxacin, norfloxacin, ofloxacin, and pefloxacin against 274 strains of Salmonella typhi isolated from suspected typhoid fever patients (137 multi-resistant strains and 137 strains sensitive to chloramphenicol, ampicillin and/or co-trimoxazole) were determined using disk diffusion and agar dilution techniques. In vitro, enoxacin was active against all tested strains with a MIC90 and inhibition zone size against multi-resistant strains of 0.12 mg/l and 34 mm diameter, respectively. Similar results were found with the other fluoroquinolones. Enoxacin and other fluoroquinolones may be the therapy of choice in cases of typhoid fever caused by organisms resistant to the standard therapy, chloramphenicol.     

Recent advances in salmonellosis treatment based on in vitro susceptibilities

Chloramphenicol-resistant strains of Salmonella typhi (MIC 60 micrograms/ml), chloramphenicol and ampicillin-resistant strains of Salmonella typhimurium as well as multiresistant strains of various salmonella serotypes were found to be very sensitive to cephradine (MIC 0.078-0.625 micrograms/ml). Ten patients with Salmonella typhi bacteremia were successfully treated with cephradine; all the patients' strains were chloramphenicol-resistant. Cephradine appears to warrant further clinical trial for the treatment of salmonellosis.     

Clinical Importance of Salmonella Paratyphi A Infection to Enteric Fever in Nepal

Background : Enteric fever in Nepal is caused by infection with Salmonella typhi or Salmonella paratyphi A. The clinical presentation of these two illnesses has never been compared in a population of travelers and expatriates. If the illnesses are clinically comparable, and if S. paratyphi A infection is sufficiently common, the choice of typhoid vaccine for Nepal may have to take into account the vaccine's efficacy in preventing infection with S. paratyphi A.
Methods : NonNepalese patients presenting to the CIWEC Clinic with a history of 3 days of fever or greater were considered eligible for the study. Patients with positive blood or stool cultures for S. typhi or S. paratyphi A were entered into the study (along with three patients who had positive Widal titers only). A questionnaire was administered by a physician to determine signs and symptoms. Treatment with oral chloramphenicol was openly compared to treatment with oral ciprofloxacin.
Results : Forty-five cases of enteric fever were diagnosed during the 2 years of the study. Infection with S. typhi accounted for 20 cases, and S. paratyphi A was isolated in 22 cases. The illnesses were clinically indistinguishable. Treatment with chloramphenicol and ciprofloxacin was clinically comparable.
Conclusions : Infection with S. paratyphi A accounts for a significant percentage of enteric fever presentations among tourists in Nepal, and the illness is comparable to infection with S. typhi. Therefore, the choice of typhoid vaccine for long-term travelers or expatriates in Nepal should take into account the vaccine's potential ability to also prevent S. paratyphi A infection. The only typhoid vaccine that can currently offer this type of cross protection is the whole-cell killed preparation.     

Comparative in vitro activity of enoxacin and other fluoro-quinolones against multi-resistant strains of Salmonella typhi

Summary

The in vitro activities of enoxacin, lomefloxacin, norfloxacin, ofloxacin, and pefloxacin against 274 strains of Salmonella typhi isolated from suspected typhoid fever patients (137 multi-resistant strains and 137 strains sensitive to chlor-amphenicol, ampicillin and/or co-trimoxazole) were determined using disk diffusion and agar dilution techniques. In vitro, enoxacin was active against all tested strains with a MIC₉₀ and inhibition zone size against multi-resistant strains of 0.12?mg/l and 34?mm diameter, respectively. Similar results were found with the other fluoroquinolones. Enoxacin and other fluoroquinolones may be the therapy of choice in cases of typhoid fever caused by organisms resistant to the standard therapy, chloramphenicol.     

沙门菌的药敏结果及临床治疗研究

目的了解沙门菌的药敏试验结果以及临床治疗。方法对我院2010年²012年收治的122例伤寒患者进行治疗,对患者进行血液抽取,检测沙门菌的药敏性。此外,将患者随机分成观察组和对照组,每组各61例。观察组采用氯霉素药物治疗,对照组采用阿莫西林药物治疗,对比两组的治疗结果。结果沙门菌是主要的致病菌,该沙门菌对阿莫西林、头孢噻吩等药物的耐药性较强。对氯霉素、头孢噻肟、环丙沙星等药物的耐药性较弱。此外,观察组治疗的有效率达到98.36%,对照组治疗的有效率达到39.34%,组间对比,差异有统计学意义(P<0.05)。结论沙门菌对氯霉素和氟喹诺酮等药物的耐药性较低,并具有较高的敏感性,因此氯霉素和氟喹诺酮成为治疗沙门菌的有效用药。     

Typhoid and Paratyphoid Fever: A 10-Year Retrospective Study of 41 Cases in a Parisian Hospital

BACKGROUND: Enteric fever remains a major cause of fever in travelers. We evaluated new trends in enteric fever. METHODS: We reviewed the epidemiological, clinical, biological, bacteriological data, and outcome of all cases of typhoid and paratyphoid fever seen in our department over the last decade. The inclusion criteria were the presence of signs compatible with enteric fever and isolation of Salmonella typhi or Salmonella paratyphi A, B, or C from blood or stool cultures or any other site. RESULTS: Among the 41 patients, 38 (93%) had travel-associated enteric fever. The main geographic source of contamination was the Indian subcontinent. One patient had been vaccinated with parenteral Vi vaccine 1 year previously. Fever and headaches were the only signs which were present in more than 80% of patients. The Widal test at inclusion was positive in 27%, and a second serological test was found to be positive in 50% of evaluated cases. Blood cultures and stool cultures were positive in 34 cases and 10 cases, respectively. Salmonellae spp were isolated in both hemocultures and stool cultures in 4 cases and in urine in 1 case. Two strains of S. typhi were resistant to ampicillin, chloramphenicol, and trimethoprim-sulfamethoxazole. One strain of S. typhi and one of S. paratyphi B were nalidixic acid resistant. All evaluable patients were cured with the exception of 2 patients (1 failure, 1 relapse). We observed 3 toxic reactions. No patients died. CONCLUSION: The diagnosis and outcome of enteric fever are hampered by the lack of specificity of clinical and biological signs, the increasing rates of antimicrobial resistance, and the occurrence of toxic reactions during treatment.     

Salmonella typhi infection in adults is not limited to travellers returning from the tropics

We reviewed the case notes of 23 adult patients infected with Salmonella typhi and admitted to the infectious disease unit, Auckland Hospital between January 1977 and December 1984. Fifteen had typhoid fever and eight were chronic carriers of S typhi. All isolates were sensitive to amoxycillin, chloramphenicol and cotrimoxazole. Ten of those with typhoid fever had recently been in tropical countries, predominantly Pacific Islands. The remaining five all lived in South Auckland and had not travelled out of New Zealand: we suspect that contaminated shellfish collected from the Manukau Harbour in South Auckland were the source. Typhoid fever should be suspected in young travellers returning to New Zealand with fever, diarrhoea, abdominal pain and headache. Similarly this diagnosis should be suspected in Polynesians and Maoris from South Auckland who have not travelled. All but one patient with typhoid fever responded clinically to the initial regimen which was usually oral amoxycillin given for a median 18 days. One other patient relapsed. Cholescystectomy and subsequent oral antibacterials eradicated S typhi from five biliary carriers with abnormal gallbladders. Prolonged high dose oral amoxycillin alone was effective in one of two carrier patients with normal gallbladders. The role of the Department of Health in identifying carriers of S typhi remains important.     

Ciprofloxacin versus chloramphenicol in the treatment of salmonella infection

Strains of Salmonella typhi resistant to chloramphenicol and ampicillin have been isolated in several countries. This study compares treatment of Salmonella infection using ciprofloxacin (500 mg twice daily) for 10 days with chloramphenicol (50 mg/kg per day divided into four doses) for 14 days. The pathogen eradication rates for patients receiving ciprofloxacin was 18/20 (90%), compared with 25/28 (89%) for those who received chloramphenicol. Signs and symptoms in patients receiving chloramphenicol lasted longer and sometimes twice as long as patients treated with ciprofloxacin. In this study, ciprofloxacin was superior to cloramphenicol in the treatment of S. typhi infection and also had fewer side-effects and the convenience of a twice-a-day dosing     

恩施州部分伤寒沙门氏菌分离鉴定和基因分型结果分析

目的对两起由伤寒沙门氏菌引起的聚集性爆发流行中所分离到的伤寒沙门氏菌进行鉴定和基因分型,探讨恩施州伤寒沙门菌的分子流行病学,为科学防治提供依据。方法用传统方法对11株伤寒沙门氏菌菌株进行生化、血清学复核鉴定。对确认的伤寒沙门氏菌菌株,采用脉冲场凝胶电泳技术分析电泳酶切指纹图谱。结果 11株伤寒沙门菌经PFGE,根据其条带的差异可分为3个PFGE型别。结论两起伤寒沙门氏菌感染为不同亚型所致。