22种抗生素对肺炎克雷伯菌肺炎亚种抑菌浓度的研究

用ＡＭＳ法测定２２种抗生素对１０５株ＫＰＰ的抑菌浓度，结果显示ＣＩＰ的抑菌浓度为０．６４ｍｇ／Ｌ，ＧＥＮ、ＴＯＢ、ＡＭＩ、ＣＦＸ、ＩＭＩ、ＣＦＴ、ＣＦＳ、ＣＦＵ、ＣＥＴ、ＴＥＰ、ＣＦＺ、ＣＦＰ为１．０８～９．９５ｍｇ／Ｌ，ＡＺＴ、ＣＦＡ、ＰＩＰ、ＴＩＡ、ＡＭＰ、ＭＥＺ为１０．１７～３７．０５ｍｇ／Ｌ，ＮＩＴ为９０．９６ｍｇ／Ｌ，ＴＩＣ为１５８．１９ｍｇ／Ｌ，ＣＡＲ为３５５．８６ｍｇ／Ｌ。在痰液与粪便分离的ＫＰＰ中，ＭＥＺ、ＮＩＴ、ＴＩＣ对痰液分离菌的抑菌浓度明显高于粪便分离菌（Ｐ＜０．０５），其他１９种抗生素无显著性差异（Ｐ＞０．０５）。     

医院感染革兰阴性杆菌流行质粒监测及其传播方式的初步研究

目的对Ｇ－杆菌医院感染进行监测和控制。方法运用质粒图谱，限制性内切酶谱，质粒消除，接合传递等系列实验对耐药革兰阴性杆菌的Ｒ－质粒进行分析。结果发现有同源性的４种质粒，即３５．２ｋｂ、５．５６ｋｂ、３．６４ｋｂ、２．５１ｋｂ质粒在１２１株带质粒的医院感染菌中分别占３３．０％、１４．０％、２４．８％、２０．７％。提示它们是医院感染菌的流行质粒。结论质粒消除结果显示质粒介导的耐药菌在革兰阴性菌耐药菌中占大多数。其中３５．２ｋｂ质粒与耐ＧＭ有关，３．６４ｋｂ与耐ＡＭＰ、ＣＢＰＣ有关，２．５１ｋｂ与耐ＡＭＰ有关，５．５６ｋｂ与耐ＡＭＰ、ＣＸＭ、ＣＲＯ、ＣＴＸ有关。５．５６ｋｂ质粒可通过接合传递方式在不同的菌属间传播，其传递频率介于３×１０－４间。     

缺锌对大鼠胸腺发育影响及机理探讨

目的：研究缺锌对胸腺发育及Ｔ淋巴细胞活化与增殖功能的影响。方法：建立大鼠缺锌（ＺＤ）模型，测定胸腺肽、胸腺激素活性、胸腺Ｔ淋巴细胞转化、活化Ｔ淋巴细胞钙离子和活性钙调蛋白等。结果：１．ＺＤ组的血清、毛、胸腺细胞锌含量低于对照（ＡＬ）组（Ｐ＜０．０１）。２．ＺＤ组的胸腺重量、指数和细胞大小低于ＡＬ组（Ｐ＜０．０１或Ｐ＜０．０５）。３．ＺＤ组胸腺的胸腺肽含量、胸腺素活性低于ＡＬ组（Ｐ＜０．０１）。４．ＺＤ组胸腺细胞的ＤＮＡ、ＲＮＡ和蛋白质含量低于ＡＬ组（Ｐ＜０．０１）。５．ＺＤ组胸腺细胞中增殖期细胞（Ｓ＋Ｇ２／Ｍ）、增殖指数（ＰＩ）低于ＡＬ组（Ｐ＜０．０１）。６．ＺＤ组胸腺细胞内ｃＡＭＰ含量与ｃＡＭＰ／ｃＧＭＰ比值高于ＡＬ组（Ｐ＜０．０１）。７．ＺＤ组胸腺细胞内的Ｃａ２＋、ＣａＭ、ＩＬ－２、ＩＬ－２Ｒα及Ｔ细胞增殖率低于ＡＬ组（Ｐ＜０．０１）。８．ＺＤ组胸腺Ｔ淋巴细胞内的锌离子与Ｃａ２＋、ＣａＭ、ＩＬ－２、ＩＬ－２Ｒα、Ｔ淋巴细胞增殖率呈正相关（Ｐ＜０．０１）；Ｃａ２＋与ＩＬ－２、ＩＬ－２Ｒα呈正相关（Ｐ＜０．０１）；ＣａＭ与ＩＬ－２、ＩＬ－２Ｒα呈正相关（Ｐ＜０．０１）。结论：适量锌有促进胸腺发育、胸腺激素活?     

头孢哌酮／舒巴坦对医院感染细菌的抗菌活性

评价ＣＰＺ／ＳＢＴ对３４８株医院感染细菌的抗菌活性，并与ＣＰＺ等其他抗生素进行对比。３４８菌株的产β－内酰胺酶率为６０．３％。纸片法药敏试验结果表明，细菌对ＣＰＺ／ＳＢＴ的敏感率（８８．８％）明显高于ＣＰＺ（７１．６％）、ＣＴＸ（６１．８％）和ＣＡＺ（７１．０％）（Ｐ＜０．０５或０．０１），而略低于ＩＭＰ（９２．５％）（Ｐ＞０．０５）。又在革兰阴性肠杆菌科细菌、革兰阴性不发酵杆菌和革兰阳性球菌中分别比较各抗生素的抗菌活性，亦都以对ＣＰＺ／ＳＢＴ和ＩＭＰ的敏感率高于其他各药而ＣＰＺ／ＳＢＴ和ＩＭＰ之间无明显差异。从而提示ＣＰＺ／ＳＢＴ作为一种新型广谱抗生素，对治疗产β－内酰胺酶耐药菌株引起的严重感染将具有良好的前景。     

不稳定心绞痛与急性心肌梗死血脂变化比较

目的：探讨不稳定心绞痛（ＵＡＰ）和急性心肌梗死（ＡＭＩ）之间血脂变化。方法：对１０９例ＵＡＰ和１４３例ＡＭＩ病人血脂值进行统计学处理分析。结果：ＵＡＰ组ＴＧ（１７１．２±１４６．９）ｍｇ／ｄｌ高于ＡＭＩ组（１３６．９±８４）ｍｇ／ｄｌ（Ｐ＜０．０１）及ＴＧ／ＨＤＬ－Ｃ（５．５±６．２）比（４．１±３．３）和ＬＤＬ－Ｃ／ＨＤＬ－Ｃ（４．０±１．９）比（３．６±１．６）高于ＡＭＩ组（两者均Ｐ＜０．０５）。结论：ＵＡＰ病人ＬＤＬ－Ｃ／ＨＤＬ－Ｃ比值增高可能与其血管病变严重性相关     

慢性乙型肝炎患者外周血T淋巴细胞亚群的变化与分析

采用免疫花环法对４９例慢性肝炎患者外周血Ｔ淋巴细胞亚群进行观察，发现与正常人相比，慢性肝炎患者Ｔ３＋、Ｔ４＋，Ｔ４＋／Ｔ８＋比值明显低于正常人（Ｐ＜００１），Ｔ８＋明显高于正常人（Ｐ＜００１）；ＣＡＨ－Ｂ、ＣＰＨ－Ｂ的Ｔ３＋、Ｔ４＋、Ｔ４＋／Ｔ８＋比值亦明显低于正常人（Ｐ＜００５），Ｔ８＋明显高于正常人（Ｐ＜００５），而二组间无明显区别（Ｐ＞００５），慢性乙肝（ＣＡＨ－Ｈ、ＣＰＨ－Ｂ）患者的Ｔ淋巴细胞亚群间存在平衡失调，功能紊乱     

金属硫蛋白与细胞耐寒力的关系

目的　观察不同金属硫蛋白（ ＭＴ） 表达的水平与细胞耐寒力的关系。方法　将质粒ｐＢＡｃＮｅｏＭＴⅡＡ 转染ＮＩＨ３Ｔ３ 细胞，检测其在不同温度下的存活力。结果　各细胞克隆的存活力随着温度的下降而下降，如细胞克隆Ｓｎｅｏ（ 相对荧光强度１ ．３ ％ ）０ ℃时的吸光度（ Ａ 值） 较３７ ℃时下降了０ ．５２９ ，但ＭＴ 表达上调可提高细胞对低温的耐受性，ＭＴ 含量越高对低温的耐受性越大，细胞克隆ＳＭＴ１（２９ ．４ ％ ）０ ℃时的Ａ 值较细胞克隆Ｓｎｅｏ 高约０ ．１６０ ，二者在统计学上差异有显著意义。细胞形态学上也得到了充分证实。结论　ＭＴ 表达上调对细胞耐寒力的提高有一定的积极作用     

异基因外周血造血干细胞移植治疗白血病

探讨用 Ｈ Ｌ Ａ 相合的同胞异基因外周血干细胞移植治疗急性髓细胞白血病及 Ａ Ｂ Ｏ 血型不合的 Ｐ Ｂ Ｓ Ｃ Ｔ 的情况,采用 Ｃ Ｔ Ｘ６０ｍｇ／ｋｇ ×２ ＋ Ｔ Ｂ Ｉ７０ ～７５ Ｇｙ 直线加速器照射＋ Ｃ Ｃ Ｎ Ｕ５０ｍｇ／ｋｇ ×１ ± Ｖ Ｐ１６３０ｍｇ／ｋｇ ×１ 对受者作预处理,供者经 Ｇ－ Ｃ Ｓ Ｆ６μｇ／ｋｇ ×５ｄ 动员后,用血细胞分离机（ Ｂａｘｔｅｒ Ｃ Ｓ３０００ｐｌｕｓ） 分离采集干细胞去除红细胞。对 Ａ Ｂ Ｏ 血型不合的 Ｐ Ｂ Ｓ Ｃ,强化移植物抗宿主病（ Ｇ Ｖ Ｈ Ｄ） 预防方案中 Ｍ Ｔ Ｘ 用量及次数;选输合适血制品。结果３ 例病人输注单个核细胞数分别为４０ 、１００ 、５０ ×１０８／ｋｇ , Ｃ Ｄ３４ ＋ 细胞分别为３６ 、１９０ 、２０ ×１０６／ｋｇ ;干细胞悬液中红细胞残存量分别为２３ｍｌ、１４ｍｌ、２６ ｍｌ,红细胞残存率分别为４ ％ 、３ ％ 、５３ ％ 。移植后造血重建迅速。例１ 于＋ ３４ｄ 染色体完全转变为供者型;例２ 于＋ ４０ｄ 血型完全转变为供者型,＋ ４５ｄ 染色体完全转变为供者型,例３ ＋ ５５ｄ 血型完全转变为供者型。没有输血溶血和免疫溶血发生。例２ 为主,次要 Ａ Ｂ Ｏ 均不合,则早期     

CPB-ST融合基因的构建及表达研究

用限制性核酸内切酶ＥｃｏＲＩ和ＳａｌⅠ双酶切含有大肠杆菌耐热性肠毒素ＳＴ１前体蛋白基因的质粒ｐＸＳＴ１，回收３２５ｂｐ的ＳＴ基因片段，然后，通过Ｔ４ＤＮＡ连接酶将其定向连接于事先经同样的双酶切处理的带有产气荚膜梭菌β－毒素基因（ＣＰＢ）的重组质粒ｐＥＣＢ２中ＣＰＢ基因的下降，转化受体菌ＢＬ２１（ＤＥ３）中，经ＢａｍＨＩ和ＥｃｏＲＩ酶切反应鉴定重组质粒，得到了理想重组质粒ｐＥＣＢ－ＳＴ１。重组菌株Ｂｌ２１（ＤＥ３）（ｐＥＣＢ－ＳＴ１）经ＩＰＴＧ诱导后，其表达产物经ＳＤＳ－ＰＡＧＥ、Ｗｅｓｔｅｒｎ－ｂｌｏｔｉｎｇ及ＥＬＩＳＡ检测，结果表明重组菌株可以表达ＣＰＢ－ＳＴ融合蛋白，而且该融合蛋白无天然β－毒素和ＳＴ１的生物毒性。     

NIDDM患者血浆纤溶酶原激活物抑制剂-1(PAI-1)与并发冠心病关系的探讨

为明确血浆纤溶酶原激活物抑制剂－１（ＰＡＩ－１）在ＮＩＤＤＭ发生冠心病中所起的作用，并分析其影响因素。将６０例ＮＩＤＤＭ患者分为冠心病（ＣＡＤ）组和非ＣＡＤ组，用底物发光法检测血浆ＰＡＩ－１及组织型纤溶酶原（ｔ－ＰＡ），同时检测血糖、血胰岛素、血脂等指标。结果表明：ＣＡＤ组血浆ＰＡＩ－１活性水平明显高于非ＣＡＤ组，分别为１０．０６±２．５与８．０８±２．６２，单位Ａｕ／ｍｌ，Ｐ＜０．０１。两组ｔ－ＰＡ相似。在ＣＡＤ组，血浆ＰＡＩ－１活性与空腹胰岛素、胰岛素敏感指数均相关，相关系数分别为０．２４（Ｐ＜０．０５）与－０．３（Ｐ＜０．０１），且与甘油三酯呈正相关（ｒ＝０．２４，Ｐ＜０．０５），和ＡｐｏＢ正相关（ｒ＝０．５１，Ｐ＜０．０５）。血浆ＰＡＩ－１活性水平的升高与ＮＩＤ－ＤＭ发生ＣＡＤ危险性存在相关。胰岛素抵抗状态、高胰岛素血症、高ＴＧ水平都可刺激血浆ＰＡＩ－１活性的升高，而高血糖对其无直接的作用。ＡｐｏＢ参与ＰＡＩ－１活性改变这一过程，并在ＣＡＤ发生中可能介导其它脂质异常刺激ＰＡＩ－１升高的作用。     

Genetics of drug resistance in methicillin-resistant Staphylococcus aureus from Australian hospitals

The drug-resistance determinants in methicillin-resistant Staphylococcus aureus (MRSA) from three different hospitals in Eastern Australia have been examined. With one exception, all the isolates had chromosomal determinants for penicillinase and resistance to cadmium (Cd), mercury (Hg), phenyl mercuric acetate, methicillin, tetracycline, erythromycin, lincomycin and low level streptomycin. The strain which was the exception differed in that it did not have chromosomal resistance to Cd and lincomycin. In addition, the strains often contained plasmids which belonged to one of three categories: a small cryptic plasmid of either c. 1.4 Mdal, c. 1.7 Mdal or c. 1.9 Mdal; a chloramphenicol resistance plasmid of c. 2.8 Mdal; and a gentamicin resistance plasmid within the range of c. 15.3 to c. 28.5 Mdal. The predominant gentamicin-resistant plasmid in isolates from two hospitals had a molecular weight of c. 18 Mdal, whereas the isolates from the third hospital had a plasmid of molecular weight c. 15.3 Mdal. The only other gentamicin resistance plasmids detected were associated with penicillinase determinants. In one isolate, this corresponded to a plasmid of c. 19.6 Mdal and in the other to a plasmid of c. 28.5 Mdal. These results indicate that MRSAs which are prevalent in Eastern Australian hospitals are substantially different in the location of their drug resistance determinants to earlier strains reported in the literature.     

Characterization of R-plasmids coding for ampicillin resistance from Salmonella species.

A sudden increase in the incidence of ampicillin resistance was observed among Salmonella species isolated within New Zealand in 1973--4. This increase was due mainly to the apperance and proliferation of Salmonella newington and Salmonella anatum serotypes resistant to ampicillin. The plasmid complements of 14 ampicillin-resistant S. newington and S. anatum isolates obtained from widely separated geographical areas within New Zealand between 1973 and 1974 were characterized by agarose gel electrophoresis. Each contained one or more plasmids ranging in molecular weight from 1.4 to 42 Mdal. Eleven isolates contained a self-transmissible plasmid of 33 Mdal which encoded resistance to ampicillin. After transfer to Escherichia coli, the 33 Mdal R-plasmids from each of these isolates were shown to be identical by restriction endonuclease analysis. The remaining three strains contained ampicillin R-plasmids having molecular weights of 35, 37.5 and 42 Mdal. These plasmids were shown by restriction endonuclease analysis to be related to the 33 Mdal R-plasmid. We conclude that the 33 Mdal plasmid and its derivatives were responsible for the increase in the incidence of ampicillin-resistant S. newington and S. anatum serotypes among the total Salmonella population.     

铜绿假单胞菌医院感染与外环境关系的研究

目的 分析比较铜绿假单胞菌(PA)医院感染与外环境中PA的相关性，以了解医院感染病原菌来源。方法 比较PA医院感染株、社区感染株、环境株的耐药谱以及随机引物扩增多态性基因分型(RAPD)型别之间的差异，判断三者之间的相关性。结果 收集PA医院感染株18株，社区感染株17株；1190份环境样中共分离到PA21株，环境分离率为1．76％。耐药谱与RAPD分型表明医院感染株与社区感染株、环境株之间无明显相关性。结论 铜绿假单胞菌医院感染可能以内源性途径为主。     

Investigation of an outbreak of Salmonella typhi in a public school in Madrid

A typhoid fever outbreak affecting 54 school students occurred in a Public School of Móstoles, Madrid. The date of onset was 11 June 1991 and the last detected case was 8 July 1991. Salmonella typhi was cultured from blood and/or stool samples corresponding to 54 patients and one food-handler. There were no secondary cases detected. Epidemiological investigation suggested a salad or a custard as the common source. Patients and the food-handler were treated with ampicillin/amoxicillin for up to three weeks. There were seven relapses that were also treated with the same antibiotics with success. None were found to be excreting the organisms when tested after four months. All the Salmonella ryphi isolated strains were phagetype 34, biotype Xylose +, Tetrationate Reductase + and harboured a similar 22 Mdal plasmid, they were also susceptible to the antibiotics tested.     

Plasmid profile of penicillinase-producing Neisseria gonorrhoeae in Greece

Four plasmid patterns were detected in thirteen strains of -lactamase-producing Neisseria gonorrhoeae isolated in Greece. Nine strains harbored the 4.5 Mdal penicillin-resistance plasmid with or without a 24.5 Mdal conjugative plasmid, two strains carried the 3.2 Mdal penicillin-resistance plasmid and two strains the new combination of the 3.2 Mdal penicillin-resistance plasmid and the conjugative plasmid (24.5 Mdal). Conjugal transfer experiments between Neisseria gonorrhoeae and E. coli revealed that -lactamase activity was acquired by recipient E. coli. The 4.5 and 3.2 Mdal penicillin-resistance plasmids were detected in the transconjugants by agarose gel electrophoresis, but co-transfer of the conjugative plasmid did not occur. The auxotypes and plasmid profiles were also compared.Corresponding author.     

老年感染患者的肠球菌分布及耐药性分析

目的　了解肠球菌引起老年患者感染的临床分布及其对常用抗菌药物的耐药性。方法　对 2 0 0 0年 4月至 2 0 0 3年 5月从老年病区临床标本分离出的 2 81株肠球菌进行对常用抗菌药物的耐药性及临床感染分布作回顾性分析。结果　 2 81株肠球菌中粪肠球菌占 42 .0 %,屎肠球菌占 5 1.6 %,其它肠球菌占 6 .4%。肠球菌在各类标本中的分离率以尿液、痰液、伤口分泌物最高 ,分别占 71.5 %、17.4%、2 .5 %。药敏结果显示屎肠球菌的耐药性高于粪肠球菌。粪肠球菌对氨苄西林、青霉素、呋喃妥因、万古霉素较敏感 ,对其他抗菌药物高度耐药。结论　粪肠球菌和屎肠球菌是引起医院内感染的常见病原菌 ,引起感染部位以泌尿系统多见。肠球菌属存在严重的耐药性 ,目前万古霉素对肠球菌仍具较高的抗菌活性。     

Characterization of Pseudomonas aeruginosa strains isolated from burned patients hospitalized in a major burn center in Tehran, Iran

Pseudomonas aeruginosa is an important life-threatening nosocomial pathogen and plays a prominent role in serious infections in burned patients. The current study was undertaken to characterize P. aeruginosa strains isolated from burned patients in Tehran, Iran. The study was conducted in a major burn center in Tehran, Iran in 2007. A total of seventy specimens obtained from different clinical origin with positive culture results for P. aeruginosa were included in the study. Antimicrobial susceptibility test was performed according to the standard CLSI guideline. The relationship between the strains was also determined using antimicrobial drug resistance pattern analysis and plasmid profiling. All strains were multi drug resistant. The percentage of resistance to tested antibiotics was: imipenem 97.5%, amikacin 90%, piperacillin 87.5%, ceftizoxime 72.7%, gentamicin 67.5%, ciprofloxacin 65%, ceftriaxone 60%, and ceftazidime 57.5%. Thirteen resistant phenotypes were recognized, R3 (TET, IPM, AMK, CIP, PIP, GM, CAZ, CRO, CT) was the predominant resistance pattern seen in 27.5% of isolates. Results obtained from E-test showed that 100% of P. aeruginosa strains were resistant to cefoxitin, 97% to cefotetan, 93% to ticarcillin, 89% to ticarcillin/clav, 76% to gentamicin and imipenem, 63% to piperacillin, 49% to tetracycline, and 20% to meropenem. Nine different plasmid profiles were observed among the strains. The current study showed an increase rate of resistance for some antibiotics tested among P. aeruginosa strains isolated from burned patients in Tehran. A combination of antibiotic susceptibility testing and profile plasmid analysis, which are relatively cheap and available methods, showed to be useful to characterize the clinical strains of P. aeruginosa isolated from burned patients in Iran.     

Isolation and Characterization of Heavy Metal Resistant Bacteria from Barak River Contaminated with Pulp Paper Mill Effluent,South Assam

A group of 15 heavy metal resistant bacteria were isolated from Barak River contaminated with paper and pulp effluents. These isolates displayed different degrees of chromium tolerance. Four isolates showed 34 %-49 % of growth at a concentration of 4.0 mM of Cr(6+) and subjected to chromium reduction assay under aerobic condition. The isolate E (4) showed highest reduction (34.38 %) followed by E (3) and K(6)PA6, both showed 28.75 % reduction and then D (2) (27.5 %) after 72 h of incubation. These 4 isolates also showed different degrees of resistance to other heavy metals like Ni, Cu, Co and Cd. Antibiotic sensitivity profile of these selected bacterial strains was determined against 10 different antibiotics. Isolate E (4) appeared to be most susceptible being inhibited by eight antibiotics and resistant to penicillin G and ampicillin. The isolate E (3) was resistant to as many as five antibiotics and showed susceptible responses to the rest of the antibiotics. Both the isolates K(6)PA6 and D (2) were resistant to four antibiotics and showed intermediate to susceptible responses to the rest of the antibiotics.     

不同尿液引流方法的尿液检查分析

目的探讨不同引流方法引起菌尿症的机率。方法通过对留置尿管持续引流、留管后膀胱冲洗及肾盂输尿管支架导管引流三组患者的尿液，在即刻、第２、４、７、１０、１４天后进行细菌培养、药敏和检查分析。结果持续引流组较膀胱冲洗组尿培养出现菌尿的机率稍低，７天菌尿出现率分别为３３．３％和４６．７％，两组比较无显著性差异，但支架管引流组出现菌尿例数明显要少，７天菌尿出现率仅７．１％，与前两组比较有显著性差异，培养出的细菌对大多数抗生素不敏感。结论留置尿管期间膀胱冲洗并不降低菌尿的发生率，细菌通过尿管周围间隙侵入是尿管相关性感染的重要途径，尿液中的细菌对多种抗生素耐药，应引起重视。     

Simultaneous outbreaks of infection due to Serratia marcescens in a general hospital

Seventy isolates of Serratia marcescens were obtained from 30 patients in different units of one hospital between April 1982 and February 1983. No common source was found. Not all isolates were multi-resistant and nearly all that were, fell into two main groups, A and B. These groups were defined by phage typing and cephalosporin sensitivity, all apart from one Group B isolate were multi-resistant, whereas Group A isolates contained multi-resistant and sensitive strains. Plasmid screening, resistance transfer studies and plasmid elimination experiments demonstrated that the multi-resistant phenotype was due to a 120 Mdal transmissible plasmid. Resistance to cephalosporins was chromosomally encoded.