436例临床感染的厌氧细菌学分析

为探讨厌氧菌与临床感染的关系,了解临床厌氧菌感染率、厌氧菌感染的特点及优势厌氧感染菌,采用需氧和厌氧培养方法,对４３６例临床感染患者标本进行了厌氧细菌学分析,结果：４３６例临床感染患者的厌氧菌感染率为８８．３％（３８５／４３６）。优势菌是革兰氏阴性无芽胞的厌氧杆菌（拟杆菌、普氏菌、叶啉单胞菌）和消化链球菌。由人体的厌氧菌作为主要病原菌引起的内源性感染和混合菌感染是临床厌氧菌感染的特点     

436例临床感染的厌氧细菌学分析

为探讨厌氧菌与临床感染的关系，了解临床厌氧菌感染率，厌氧菌感染的特点及优势厌氧感染菌，采用需氧和厌氧培养方法，对４３６例临床感染患者标本进行了厌氧细菌学分析：结果４３６临床感染患者的厌氧菌感染率为８８．３％。     

临床厌氧菌感染病原学探讨

对400例疑有厌氧菌感染患者421份标本进行厌氧菌、需氧菌和真菌培养,结果厌氧菌阳性率为56.5％(238/421),厌氧菌阳性者中24.7％(104/421)与需氧菌组成的混合感染,厌氧菌单纯感染为30.9％(130/421),单纯需氧菌17.6％(74/421),真菌2.9％(12/421)含白色念株菌一株。其中的胆道感染,慢性上颌窦炎、阑尾炎、呼吸道感染、牙髓炎等厌氧菌感染阳性率颇高。同时做了厌氧菌感染者的血清抗体及内毒素测定。经统计学处理,(P<0.01),提示厌氧菌在临床感染中的地位越来越突出,本文就不同感染部位病原学特点不同,以其厌氧菌药敏进行讨论。     

烧伤痂下组织细菌学检测的临床意义

我们采用改良的较精确的细菌滴注培养法及高选择性培养基对49例深度烧伤患者的106份痂下组织进行了厌氧及需氧的细菌学检验。结果发现:痂下组织的细菌主要为G~+球菌,其中肠球菌占21.77％,金葡占19.73％。G~-杆菌次之,其中肠道杆菌占44％创面脓毒血症的临介水平为≥10~6/克。厌氧菌与需氧菌混合感染时创面脓毒症的发生率比需氧菌或厌氧菌单独感染时显著增高。     

38例慢性化脓性中耳炎厌氧菌分析

目的：探讨慢性化脓性中耳炎患者脓性标本厌氧菌的茵种分布及耐药性。方法：采用抽气换气厌氧环境下进行培养、分离、鉴定、归类及对药敏检测。结果：32例培养阳性、总检出率84．2％，其中单纯厌氧菌和需氧菌检出率，分别占阳性标本的21．9％和40．6％。两组混合阳性占37．5。药敏检测以氯霉素、庆大霉素、林可霉素最敏感。结论：检出的厌氧菌中以革兰氏阳性球菌多见48．0％(12／25)，需氧菌以铜绿假单胞菌多见42．8％(12／28)，厌氧菌对临床常用药物耐药性均高。     

急性阑尾炎细菌学分析

本文报告52份阑尾炎脓液标本的细菌学检测和药敏试验结果:检出需氧菌173株。其中大肠杆菌占56.16%,其他肠道菌为24.66%,球菌19.18%;厌氧菌47株,其中脆弱拟杆菌占38.17%,其他拟杆菌21.28%,革兰氏阳性无芽胞杆菌12.77%,厌氧球菌17.02%,革兰氏阳性梭状芽胞杆菌10.64%。以多重细菌混合感染为主,提示本病多属内源性感     

74例慢性化脓性中耳炎细菌检出及药敏结果分析

目的了解慢性化脓性中耳炎（CSOM）主要病原菌的种类及对抗生素的耐药情况。方法无菌采集74例中耳炎性分泌物，分别进行需氧菌和厌氧菌培养，对分离的病原菌进行药物敏感试验。结果74例CSOM患者中53例细菌培养阳性，总检出率为71．6％。其中纯需氧菌和纯厌氧菌检出阳性例数分别占阳性总例数的37．70％和20．s％，两者混合感染阳性占41．5％。厌氧菌中以革兰阳性球菌多见占51．2％，其次为拟杆菌。需氧菌以铜绿假单胞菌多见，占27．3％。厌氧菌对灭滴灵、氯林可霉素、氯霉素敏感率高，分别为75．6％、70．7％、68．3％，对氨苄青霉素、卡那霉素敏感率低，分别为34．1％，24．4％。结论CSOM为厌氧菌和需氧菌在内的多种细菌混合感染所致，厌氧菌感染主要为消化链球菌引起。厌氧菌对灭滴灵、氯林可霉素、氯霉素较敏感。     

肛周脓肿细菌感染菌群分布研究

①目的探讨肛周脓肿厌氧与需氧茵的菌群分布。②方法选择31例肛周脓肿患，对其脓液中的厌氧茵和需氧菌进行培养鉴定。③结果肛周脓肿感染患中男27例，女4例；感染中共分离出51株细菌，其中厌氧菌30株，需氧菌21株。厌氧菌总检出率为96．8％，需氧菌总检出率为67．4％。单纯厌氧菌感染检出率为32．3％，单纯需氧菌检出率为32％。、厌氧和需氧菌混合感染捡出率为64．5％。在所分离出的30株厌氧菌中，脆弱类杆菌占80％，消化链球菌占13％，普通类杆菌和产黑色素类杆菌各占33％21株需氧菌中，大肠杆菌占71％，肺炎克雷伯菌、产气肠杆菌、阴沟肠杆菌各占9．5％。④结论肛周脓肿男性患病率高于女性；细菌感染菌群分布以脆弱类杆菌和大肠杆菌为主；感染类型以厌氧和需氧菌混合感染居多。     

腹部化脓感染厌氧菌的分离鉴定

收集27份腹腔内和腹壁切口感染脓汁标本,进行以无芽胞厌氧菌为重点的细菌学分离鉴定。其中共检出需氧菌(含兼性厌氧菌)28株和专性厌氧菌22株。厌氧菌中类杆菌属占90.9％。细菌培养结果表明,单独需氧菌感染占55.6％,单独厌氧菌感染占18.5％,需氧菌和厌氧菌混合感染占25.9％。厌氧菌的总感染率为44.4％。几种不同标本中,以阑尾炎手术后化脓感染检出厌氧菌的比率最高,占58.3％。这一结果表明,厌氧菌在腹部化脓感染中,占有不可忽视的地位。     

胆囊癌组织及胆汁中厌氧菌谱的检测

为探讨厌氧菌感染与胆囊组织癌变的相关关系，采用微生物自动检测鉴定系统，对２９例胆囊癌患者的胆汁及９例胆囊癌中心组织进行厌氧菌培养及自动检测分析。结果２９例胆囊癌胆汁中厌氧菌检出率为６５．５％（１９／２９），胆囊癌组织检出率为５５．６％（５／５），且均为兼性厌氧。两者厌氧菌株均以产气英膜梭菌为主。认为胆囊粘膜癌变可能与厌氧菌尤其是产气英膜梭菌感染有关，厌氧菌与需氧菌协同作用，长期刺激胆囊粘膜是导致其     

Clindamycin plus gentamicin as expectant therapy for presumed mixed infections.

The prevalence of obligate anaerobes was studied prospectively in 60 patients with severe sepsis of intra-abdominal, soft tissue, female genital or oropulmonary origin. In addition, the efficacy of clindamycin (for anaerobes) plus gentamicin (for aerobic bacteria, especially coliforms) as initial empiric therapy in these patients was evaluated. Among 54 patients with cultural proof of infection, anaerobic pathogens were recovered from 52%. Nineteen patients had bacteremia; Bacteroides fragilis and Klebsiella pneumoniae were the most prevalent pathogens, being isolated in five patients each. Infection was eradicated in 56 of the 60 patients (93%). Mortality related to sepsis was 7% in the entire group, 16% in patients with bacteremia and 2% in patients without bacteremia. Eighty-five percent of aerobic isolates tested were susceptible in vitro to either gentamicin or clindamycin; 97% of anaerobic isolates were inhibited by 5 mug/ml of clindamycin.     

Quantitative direct gas-liquid chromatography for rapid diagnosis of anaerobic infections]

Quantitative direct gas-liquid chromatography (GLC) was performed on 74 specimens of surgical infections and relevant findings were compared with cultural results. In the present study, significant amounts of multiple volatile fatty acids (VFA) and/or succinate were found as markers of anaerobic infections. At least one of the VFA (propionic, isobutyric, butyric, isovaleric or valeric acid) greater than or equal to 0.1 mumol/ml and/or succinate greater than or equal to 0.3 mumol/ml was strong evidence for anaerobic infections. More than 3.5 mumol/ml of butyric acid was interpreted as indication of the presence of Fusobacterium spp. Succinate greater than or equal to 0.3 mumol/ml was associated with the presence of Bacteroides fragilis.     

Erythromycin for anaerobic pleuropulmonary and soft-tissue infections.

Erythromycin has been reported to be active in vitro against most anaerobic bacteria. We found it effective in treating 14 of 17 patients with mild to moderately severe anaerobic or mixed aerobic/anaerobic pleuropulmonary of soft-tissue infections when adjunctive measures (eg, drainage, débridement, and the use of additional antibiotics to treat important aerobic pathogens) were employed. Erythromycin offers a reasonable therapeutic alternative to penicillin in the treatment of a penicillin-allergic patient who has a mild or moderately severe anaerobic or mixed aerobic/anaerobic infection not involving Bacteroides fragilis or fusobacteria.     

西宁地区30例中老年人慢性根尖周炎根内厌氧菌的分离培养研究

应用严格的厌氧技术，稳定的环境条件，对西宁地区30例中老年漫性根尖周炎患者根管内厌氧菌的细菌学研究。结果表明，分离培养的主要厌氧菌属，以感染的频率依次为消化链球菌、拟杆菌、放线菌、梭杆菌、丙酸杆菌、韦荣氏球菌等八属。感染的类型是以厌氧菌为主的混合感染。厌氧菌的感染率为97％，需氧菌感染率为3％。由于中老年人机体的免疫功能降低，使厌氧菌长期存在造成慢性感染。     

Anaerobic bacterial flora of wound sepsis

Two hundred specimens from wound infection (surgical and non-surgical) were cultured for the isolation of anaerobic and aerobic bacteria. Positive cultures were obtained in 174 (87%) and 26(13%) were sterile. Anaerobes were isolated from 31(17.8%), as single culture in 6(3.4%) and as mixed culture with aerobes in 25(14.3%). Amongst anaerobes, anaerobic cocci were predominant (45.9%). Of aerobes Staph pyogenes (35%) was predominant. Metronidazole was the most effective drug against anaerobes and gentamicin against aerobes. No significant difference was noted in antimicrobial susceptibility of anaerobes of surgical and non-surgical wounds. Among aerobes high resistance was observed in surgical wounds.     

慢性化脓性中耳炎病人细菌感染分析

目的了解慢性化脓性中耳炎病人病原菌群分布,为治疗提供依据。方法采用厌氧培养箱,用抽气换气钯粒催化耗氧法造成厌氧环境,对65例中耳炎病人中耳分泌物进行厌氧菌及需氧菌分离培养。结果65例病人中,有62例检出病原菌,总检出率为95.4%。其中纯厌氧菌和纯需氧菌分别为20.0%和35.4%,两者混合为40.0%。厌氧菌和需氧菌检出率分别为75.4%和60.0%。共检出细菌109株,厌氧菌和需氧菌各占45.0%和55.0%,平均每份阳性标本含菌株1.76株。结论慢性化脓性中耳炎病人感染病原菌中以需氧菌多见,但同时厌氧菌也有较高的检出率,且混合感染多见。表明厌氧菌感染在慢性化脓性中耳炎中占有重要地位。