获自发热患者血液一株猪霍乱沙门菌L型的研究

目的分析获自发热患者血液的一株猪霍乱沙门菌L型的性质,探讨猪霍乱沙门菌L型感染的病原学诊断与治疗。方法采用细菌L型分离培养方法从常规细菌学分离培养阴性的发热患者血清中获得一株猪霍乱沙门菌L型,对其形态与培养、抗原、返祖及药物敏感性进行分析与研究。结果猪霍乱沙门菌L型在常规细菌学液体或固体培养基内均不能形成明显的生长现象,在L型琼脂培养基上形成细小菌落。猪霍乱沙门菌L型为革兰阴性的长丝、圆球或不规则形态,生化反应及诊断血清凝集反应不典型,抗生素敏感性与其亲代细菌型有差别。L型经多次传代培养后可发生返祖,返祖菌的生化反应、诊断血清凝集反应以及抗生素敏感性与原来细菌型一致。结论抗生素的不规范使用可导致猪霍乱沙门菌在患者体内形成L型,从而造成患者的临床症状不典型以及病原学诊断漏诊和影响治疗效果。对于反复发生的以及常规细菌学分离培养多次阴性的血液感染患者,应当高度注意细菌L型的分离培养。     

人猪霍乱沙门菌败血症1例

我院于2004年10月诊断和治愈1例人猪霍乱沙门菌败血症，现予报道。     

猪霍乱沙门菌左膝局部脓肿1例

我科从1例左膝局部肿块患者的脓液中分离培养出猪霍乱沙门菌,现报道如下。 患者男．75岁,农民。5d前出现左膝部肿胀疼痛,在当地医院给予抗感染治疗,无明显效果,3d前上述症状明显加重,并出现发热,体温波动在38．5～39℃,于2009年2月26日来我院住院。患者主诉青少年时期即常有关节疼痛。到当地医院诊断为类风湿性关节炎、痛风。     

猪霍乱沙门菌致感染性腹主动脉瘤1例

感染性动脉瘤是一种少见病,但病情凶险,常导致患者突然死亡。本文报道猪霍乱沙门菌致感染性腹主动脉瘤1例,希望能引起临床医师对此类患者的重视。病历摘要患者男,81岁。因间歇发热3个月,加重1周于2010年1月29日入院。患者于3个月前第1次出现寒战、     

从腿部脓汁中分离1株猪霍乱沙门菌

猪霍乱沙门菌 (S .cholerae suis)属于沙门菌属 ,2 0 0 4年 1月 18日从一女性患者中分离到该菌 ,现报告如下。1　病历摘要患者 ,女 5 6岁 ,糖尿病史。小腿部内侧外伤合并感染数日。于 2 0 0 4年 1月 18日来我院门诊就诊。查体见右腿内侧有一 4 .5cm× 5 .1cm大小的溃疡面 ,用无     

伤寒沙门菌L型感染10例分析

2003年7～8月,萍乡市安源区某村发生一起伤寒疫情,发现发热病人55例,其中经临床诊断伤寒43人,血培养检出伤寒杆菌13例,其中检出伤寒沙门菌L型细菌10例,现将结果报告如下。1材料与方法1.1菌株来源10株伤寒菌株来自本院分离株,外单位分离3侏。在本院10株中都分离出L型细菌感染。1.2药敏纸片氨苄、头孢哌酮等20种药敏试纸片,由北京无坛药物生物技术开发公司提供。1.3培养基SS平板,伊红美兰平板、血液增菌培养基、血平板,由浙江杭州天和微生物试剂有限公司提供。1.4血高渗培养液由浙江杭州天和微生物试剂有限公司提供。2结果血培养生长菌13例,…     

猪霍乱沙门菌致腰部囊性肿块1例

2010年7月19日,我科从1例腰部囊性肿块患者的肿块穿刺液中分离到1株猪霍乱沙门菌,报道如下。1病历摘要患者,男,49岁,农民,从事养殖工作。1月前无明显诱因出现右腰部痛,无畏寒发热,无腹痛,无腹泻,无尿频、尿急、尿痛,无下肢感觉活动障碍,未曾就医及用药。于2010年7月16日,来我院就诊。B超:腰部囊性肿块。     

1例患儿血液中检出猪霍乱沙门菌

2008年10月,本院从1例诊断为败血症患儿的血液中检出猪霍乱沙门菌。1临床资料患儿,男,10个月,连续10d出现发热,体温38.5～39℃,     

婴幼儿感染猪霍乱沙门菌耐药基因特点及同源性分析

目的研究致婴幼儿败血症猪霍乱沙门菌的耐药基因特点及同源性。方法16株猪霍乱沙门菌．采用K—B纸片扩散法检测抗菌药物的耐药性,同时用PCR法及DNA测序法对其进行β-内酰胺酶类耐药基因检测;PFGE法测定同源性。结果对氨苄西林耐药的13株猪霍乱沙门菌经PCR扩增后并测序为bl岫。16株猪霍乱沙门菌经PFGE分型,可分为5个PFGE型,其中A型是最主要的克隆（12／16）。13株blTEM-1．基因阳性菌株分别为A型11株,B型1株,D型1株。结论产TEM-1割β-内酰胺酶是本地区猪霍乱沙门菌对氨苄西林耐药的主要机制,PFGE分型方法对猪霍乱沙门菌分型能力较好。克隆性传播为猪霍乱沙门菌的主要传播途径．同一PFGE型菌株的耐药谱非常接近。     

16例婴幼儿败血症猪霍乱沙门菌感染的耐药性分析

目的为临床针对婴幼儿败血症猪霍乱沙门菌感染的抗菌药物合理选用提供依据及预防和减少耐药菌株的产生和流行。方法分析我院2008-2011年经血液分离16株猪霍乱沙门菌的耐药性,并对其对不同抗菌药物药敏试验结果及耐药性进行分析。结果分离出的猪霍乱沙门菌80%耐3种以上抗生素,对氯霉素、氨苄西林、复方新诺明耐药率高,分别为75%、81.25%、87.25%;对头孢菌素、喹诺酮类耐药率低,分别有1株对头孢他啶中介,1株对头孢噻肟中介,5株对环丙沙星中介,1株对左旋氧氟沙星中介。结论猪霍乱沙门菌对临床常用的抗生素有较高的耐药性,头孢类可作为猪霍乱沙门菌感染的首选药,临床治疗婴幼儿败血症猪霍乱沙门菌感染应根据药敏结果合理使用抗菌药物。     

A new Microbacterium species isolated from the blood of a patient with fever: Microbacterium pyrexiae sp. nov

A Gram-positive bacterium, SMC-A8265(T), which was isolated from the blood of a patient with fever but could not be identified by a conventional microbiologic method, was finally characterized by performing phenotypic and genotypic analyses. 16S rRNA gene sequence analysis revealed that the strain SMC-A8265(T) belonged to the genus Microbacterium, but it did not correspond to any of the previously described Microbacterium spp. Biochemical tests and cellular fatty acid composition analysis also confirmed that this bacterium is distinct from other Microbacterium spp. Based on the phenotypic and genotypic characteristics, we propose that the strain SMC-A8265(T) should be classified as a new species, namely, Microbacterium pyrexiae sp. nov.     

Prototheca zopfii isolated from a patient with olecranon bursitis

Prototheca zopfii was isolated from a patient with olecranon bursitis. Olecranon bursitis caused by Prototheca is a distinct clinical entity. Recognition of this infection was made by observing characteristic organisms in tissue and subsequent isolation of the organism.     

First report on multidrug-resistant non-encapsulated Streptococcus pneumoniae isolated from a patient with pneumonia

The non-encapsulated Streptococcus pneumoniae (NESp) has emerged and increased in the clinical setting. The majority of NESp strains have been isolated from the nasopharynxes of healthy carriers and from respiratory specimens of patients with otitis media. NESp strains were shown to be more effective than encapsulated counterparts at forming biofilms. Therefore, NESp should become one of the leading causes of emerging refractory respiratory disease after the introduction of pneumococcal conjugate vaccines. We report the first case of multidrug-resistant - including fluoroquinolone-resistant - NESp isolated from the intrabronchial aspirate of a patient with pneumonia. Drug-resistant NESp infections can possibly emerge as a clinical problem and thus the continuous monitoring of NESp infections is of utmost importance.     

血培养细菌L型的观察

血培养分离细菌Ｌ型的阳性率各家报道不一，相差甚为悬殊。我们将２３１份血标本同时接种普通血液增菌培养基和高渗培养基，并以１００份血液标本比较了自制高渗培基和进口高渗培养基血培养结果。结果表明，普通血培养细菌检出阳性率为１１．６％，同时细菌Ｌ型培养阳性率为５．６％。应用自制高渗培养基和进口高渗培养基作血培养得到了一致的结果。模拟污染试验证实，血液标本存在的细菌、污染菌均可导致血培养细菌Ｌ型阳性率的升高，应引起注意。     

甲型副伤寒病例血培养研究

目的 比较疑似甲型副伤寒病例肠沙门菌肠亚种甲型副伤寒血清型血培养结果和检测速度.方法 采用BacT/ALERT 3D系统及其每瓶加入5ml血液的配对需氧和厌氧血培养瓶(AEB,ANB)对13 500份疑似甲型副伤寒病例标本进行血培养.结果 共分离到4 060株甲型副伤寒病原菌,当中,3 149株在AEB和ANB中生长,461株仅在AEB生长,450株仅在ANB生长,采用AEB和ANB的分离率均为26.7%(x2=0.023,P=0.880),在AEB和ANB配对培养中因额外血量的分离菌株数分别占总分离数的11.3%和11.1%;AEB和ANB阳性检测速度的差异有统计学意义,共生长3 149株菌的平均检测时间分别为(23.66±15.89)h和(25.48±16.92)h(t=7.007,P<0.01),单生长461和450株菌的平均检测时间分别为(31.80±20.97)h和(33.45±20.72)h(P<0.01).结论 取血量是决定血培养检出率的一个重要因素,虽然在AEB和ANB之间没有发现检出率差异,但是有更多分离株在AEB中生长较快.     

1例乳糖发酵鼠伤寒沙门菌腹泻病例株的表型和分子特征研究

目的 研究首次发现的乳糖发酵鼠伤寒沙门菌腹泻病例株的耐药型和分子型特征, 优化网络实验室检测方法。方法 网络参比实验室分别使用系统生化鉴定、血清分型鉴定、纸片扩散法和脉冲场凝胶电泳(PFGE)分型对菌株进行生化特征和血清型、耐药表型和分子型的复核鉴定。结果 菌株符合乳糖发酵的鼠伤寒沙门菌表型特征, 耐药型为多重耐药株, PFGE图谱经本地数据库比对属于新的分子型, 其遗传特征归属于本地的流行大克隆。结论 乳糖发酵的非伤寒沙门菌病例菌株的发现过程和鉴定对诊断和治疗感染性疾病、优化实验室检测流程、提升网络实验室的能力、阐述肠道菌遗传进化的生物多样性等方面具有多重意义。     

Genetic relatedness of a rarely isolated Salmonella: Salmonella enterica serotype Niakhar from NARMS animal isolates

BACKGROUND: In the United States, Salmonella enterica serotype Niakhar is infrequently isolated. Between 1997 and 2000, the animal arm of the National Antimicrobial Resistance Monitoring System-Enteric Bacteria (NARMS) assayed a total of 22,383 Salmonella isolates from various animal sources (swine, cattle, chickens, turkeys, cats, horses, exotics and dogs) for antimicrobial susceptibility. Isolates originated from diagnostic and non-diagnostic submissions. OBJECTIVES: To study the phenotypic and genotypic characteristics of Salmonella Niakhar. METHODS AND RESULTS: Only five (0.02%) of the 22,383 isolates were identified as Salmonella Niakhar. Antimicrobial resistance testing indicated that three isolates were pan-susceptible, one isolate was resistant to ampicillin and one isolate was resistant to ampicillin, chloramphenicol, ciprofloxacin, kanamycin, nalidixic acid, streptomycin, sulfamethoxazole, tetracycline and trimethoprim/sulfamethoxazole. RAPD-PCR analysis, PFGE and ribotyping indicated that two pan-susceptible isolates were genetically similar, whereas the three remaining isolates were genetically different. The one Salmonella Niakhar isolate that was multiresistant harboured a class I integron, intI1 and two large plasmids. CONCLUSIONS: This study represents the first report of a ciprofloxacin-resistant Salmonella isolate from the animal arm of NARMS.     

Mercaptopurine-induced fever in a patient with Crohn's disease.

OBJECTIVE: To report a case of mercaptopurine-induced fever. CASE SUMMARY: A patient with Crohn's disease was treated with mercaptopurine (6-MP) for an exacerbation of his illness. The patient developed fever and chills. After thorough diagnostic examinations and failure to respond to antimicrobial therapy, symptoms were attributed to an allergic-type reaction to 6-MP. The patient defervesced after 6-MP withdrawal. Fever and chills, along with arthralgias, recurred upon rechallenge with a single dose of 6-MP. DISCUSSION: Adverse effects attributable to 6-MP therapy in inflammatory bowel disease were reviewed in the literature. Drug-induced fever has been previously reported; however, it is an uncommon adverse effect and is difficult to diagnose. It is also difficult to predict which patients will have the reaction. It is a diagnosis of exclusion requiring a thorough investigation. CONCLUSIONS: Drug-induced fever should be considered when confronted with fever and chills in patients with inflammatory bowel disease being treated with 6-MP. This case report shows the difficulty in differentiating between an infectious process and an adverse reaction to a medication.