2010年度部队疗养院病原菌的耐药性分析

目的调查分析部队疗养院2010年度主要病原菌的耐药情况.方法采用BBL Crystal型细菌鉴定仪对一家部队疗养院2010年度住院的1089例患者临床分离出的病原菌进行鉴定,同时采用Kirby-Bauer纸片扩散法进行药敏试验.结果共分离出病原菌418株,其中革兰阴性菌298株,占71.3%;革兰阳性菌113株,占27.0%;真菌7株,占1.7%.革兰阴性菌对哌拉西林、氨苄西林、头孢唑啉、头孢呋辛、头孢噻肟、复方磺胺甲硝唑、阿米卡星、亚胺培南具有多重耐药;大多数菌对头孢他啶、头孢吡肟、左氧氟沙星具有耐药性;仅头孢哌酮/舒巴坦对大多数菌有较好的抗菌效果.结论部分革兰阴性杆菌和革兰阳性球菌耐药情况较为严重,临床上应合理使用抗生素.     

57例葡萄球菌性烫伤样皮肤综合征临床及药敏分析

目的:探讨葡萄球菌烫伤样皮肤综合征(SSSS)的临床特征和对抗菌药物敏感性的分布情况。方法:对57例SSSS患者的临床资料及药敏实验结果进行回顾性分析。结果:本组57例SSSS患者均治愈出院,对金葡菌敏感率较高的药物有替考拉宁(88.89%)、亚胺培南(86.11%)、去甲万古霉素(80.56%)、夫西地酸(77.78%)、头孢唑啉(66.67%)。结论:SSSS好发于1～3岁儿童,及早使用敏感抗菌药物及进行细菌药敏检测可提高治愈率。     

57例葡萄球菌性烫伤样皮肤综合征临床及药敏分析

目的:探讨葡萄球菌烫伤样皮肤综合征(SSSS)的临床特征和对抗菌药物敏感性的分布情况.方法:对57例SSSS患者的临床资料及药敏实验结果进行回顾性分析.结果:本组57例SSSS患者均治愈出院,对金葡菌敏感率较高的药物有替考拉宁(88 89%)、亚胺培南(86 11%)、去甲万古霉素(80 56%)、夫西地酸(77 78%)、头孢唑啉(66 67%).结论:SSSS好发于1～3岁儿童,及早使用敏感抗菌药物及进行细菌药敏检测可提高治愈率.     

皮肤软组织感染致病菌的菌种构成和药敏变化趋势分析

目的:分析近5年皮肤软组织感染致病菌的菌种构成和体外药物敏感性变化的趋势,为临床诊治提供参考。方法:采用回顾性调查分析方法,对我院2009年1月至2013年8月送检的皮肤软组织感染标本的致病菌的菌种及体外药物敏感性试验结果进行统计、分析。结果:参检标本共366例,分离出404株致病菌,共18种。最常见的致病菌种为金黄色葡萄球菌(21.42%),其后依次为表皮葡萄球菌(14.81%)、溶血葡萄球菌(10.37%)、铜绿假单胞菌(5.98%)及粪肠球菌(3.33%),其他的菌种包括溶血性链球菌、肺炎克雷伯菌、粘质沙雷菌、微球菌、奇异变形杆菌等;5年来,皮肤软组织感染的菌种构成基本稳定。金黄色葡萄球菌对利奈唑烷、阿米卡星、万古霉素、左氧氟沙星、亚胺培南、头孢唑啉敏感性高;表皮葡萄球菌及溶血葡萄球菌对万古霉素、利奈唑烷、左氧氟沙星、环丙沙星、克林霉素、庆大霉素、氯霉素敏感性高;铜绿假单胞菌对亚胺培南、左氧氟沙星、环丙沙星、阿米卡星敏感性高。结论:近年来皮肤软组织感染致病菌种构成稳定,以G+球菌为主。在感染早期临床上可考虑选用的一线抗菌药物有左氧氟沙星、环丙沙星、头孢唑啉、克林霉素、庆大霉素,考虑选用的二线抗菌药物有利奈唑烷、万古霉素及阿米卡星。     

319株ICU病原菌分布特点及抗菌药物敏感率分析

目的：探讨ICU病区病原菌分布特点及药物敏感率情况,为临床合理选用抗菌药物提供参考。方法统计2012年7月~12月北京天坛医院ICU检出病原菌的种类、数量、标本来源及药敏结果等数据,并分析这一时段ICU病原菌的流行特点及药敏和耐药特点。结果ICU分离的病原菌来源主要是痰标本,占79.0%。病原菌种类革兰氏阴性菌占76.2%,革兰氏阳性菌占23.8%。常见革兰氏阴性菌前3位依次是铜绿假单胞菌、肺炎克雷伯菌、鲍曼不动杆菌。其中鲍曼不动杆菌耐药严重,对美罗培南的敏感率只有9.8%。革兰氏阳性菌中以金黄色葡萄球菌为主,占81.6%。金黄色葡萄球菌中耐甲氧西林的金黄色葡萄球菌（MRSA）占61.3%;凝固酶阴性葡萄球菌中耐甲氧西林凝固酶阴性葡萄球菌（MRCNS）占45.5%。结论由于ICU抗菌药物使用频率高、剂量大、时间长等原因,导致病原菌敏感率低,耐药严重。医院应加强ICU抗菌药物使用的监督和管理,避免耐药率上升。     

疑似下生殖道感染孕妇细菌和真菌分布及其抗生素敏感性分析

目的了解孕妇下生殖道感染病原菌及对抗生素敏感性,为临床合理用药提供依据。方法对本院2011年1月-2014年6月产科住院和产科门诊送检的480份宫颈分泌物培养中分离出的143株病原菌进行分析,并进行鉴定和体外药敏实验。结果假丝酵母菌46株,肠杆菌科细菌33株,葡萄球菌属细菌24株,肠球菌23株,β溶血性链球菌7株,淋球菌10株。肠杆菌科细菌对头孢西丁、头孢哌酮/舒巴坦、美罗培南的敏感率较高;葡萄球菌属对青霉素、苯唑西林、大环内酯类耐药率较高,对万古霉素、利奈唑胺、替考拉宁均敏感;肠球菌属细菌对氨苄西林的敏感率为78.26%,对高浓度庆大霉素敏感率为60.87%;假丝酵母菌对氟康唑的敏感率为58.69%。结论孕妇下生殖道感染菌种类多,耐药性严重,临床应重视病原学检查,根据细菌鉴定及药敏试验结果合理选择药物治疗。     

广州地区380例儿童脓疱疮病原菌培养及药敏分析

目的了解广州地区儿童脓疱疮的病原菌分布及药物敏感性。方法对380例脓疱疮患儿的脓疱疮液做细菌培养,并对分离出的368株金黄色葡萄球菌(简称金葡)进行12种抗生素的药敏试验。结果分离出病原菌分别为金葡368株(96.8%),凝固酶阴性葡萄球菌2株(0.5%),产气杆菌2株(0.5%),大肠埃希菌2株(0.5%),摩根摩根菌1株(0.3%)。对368株金葡菌进行的药敏试验结果显示:金葡菌对青霉素、红霉素、克林霉素的耐药率>63.6%。对万古霉素、阿米卡星、头孢呋辛钠、头孢唑林、头孢西丁、苯唑西林、阿莫西林/克拉维酸、头孢曲松、头孢他啶则高敏感率,敏感率>95.4%。结论广州地区儿童脓疱疮的主要致病菌为金葡菌,青霉素、红霉素、克林霉素的耐药性较高,已不适于治疗本地区由金葡菌感染引起的脓疱疮。     

肺结核并MDRO肺部感染耐药情况及其危险因素分析

目的 探讨肺结核并多重耐药菌(MDRO)肺部感染耐药情况及其危险因素。方法 选取2018年1月—2021年9月河北省胸科医院收治的220例耐药肺结核并肺部感染患者进行回顾性研究,根据是否为MDRO肺部感染分为MDRO组、非MDRO组,分析MDRO组病原菌与耐药情况,比较两组临床资料,采用多因素Logistic回归方程分析肺结核并MDRO肺部感染的相关影响因素,采用受试者工作特征曲线(ROC)及ROC下面积(AUC)分析Logistic回归模型预测肺结核并MDRO肺部感染价值。结果 121例肺结核并MDRO肺部感染患者共分离出132株MDRO,其中包括革兰阴性菌94株(71.21%),革兰阳性菌38株(28.79%);主要革兰阳性菌有溶血葡萄球菌、金黄色葡萄球菌、表皮葡萄球菌,三者均对替考拉宁、万古霉素敏感;主要革兰阴性菌有肺炎克雷伯氏菌、铜绿假单胞菌、大肠埃希菌,肺炎克雷伯氏菌、大肠埃希菌均对头孢哌酮舒巴坦敏感,铜绿假单胞菌对常用抗菌药物耐药率均较高;两组肺结核耐药类型、慢性阻塞性肺疾病、糖尿病、癌症、抗结核治疗遵医行为、抗肺部感染药物数量比较,差异有统计学意义(P<0.05);...     

葡萄球菌烫伤样皮肤综合征62例临床及药敏分析

目的:探讨葡萄球菌烫伤样皮肤综合征(SSSS)的临床特征和对抗菌药物敏感性的分布情况,以提高临床诊断及指导临床用药。方法:对2012年1月~2014年6月期间入住梅州市人民医院皮肤科的62例确诊为SSSS患儿进行临床特征、病原菌分布及药敏结果进行回顾性分析。结果:62例患儿中发热26例,心肌酶谱异常33例,白细胞升高46例;62例患儿中送检标本58例,共分离出病原菌36株,其中金葡菌27株,表皮葡萄球菌3株,中间葡萄球菌2株,溶血性链球菌2株,杂菌2株。对36株病原菌行药敏分析,敏感率较高的药物依次为万古霉素(100%)、左氧氟沙星(94.4%)、呋喃妥英(91.7%)、头孢唑啉(86.1%)。结论:62例SSSS患儿以金葡菌感染为主,早期足量使用敏感抗菌药是治疗成功的关键。     

皮肤溃疡感染创面376例细菌培养结果及耐药性分析

目的了解皮肤溃疡创面培养细菌的分布及其耐药情况。方法收集本科2013年1月-2015年12月分离培养的细菌共376株,并用EXCEL及SPSS软件分析金黄色葡萄球菌和铜绿假单胞菌的耐药情况。结果金黄色葡萄球菌在各年所占比例均在20%以上,铜绿假单菌检出率各年分别为16.80%、17.24%、13.21%。检出的金葡菌对万古霉素、利奈唑胺、替加环素耐药率为0,对青霉素、红霉素耐药率分别为88.12%和77.23%;铜绿假单胞菌对哌拉西林/他唑巴坦、亚胺培南、阿米卡星耐药率均为0,对氨苄西林、氨苄西林/舒巴坦、头孢唑林、头孢替坦、复方新诺明、呋喃妥因耐药率均高于95%。结论金黄色葡萄球菌和铜绿假单菌在皮肤溃疡创面分离的细菌中占前两位;细菌感染类型及细菌耐药性的变化值得大家关注。     

99例复杂皮肤软组织感染的病原学分析

目的 分析复杂皮肤软组织感染的病原菌及对抗生素的敏感性。方法 回顾性分析99例复杂皮肤软组织感染住院患者的临床资料和病原学检验结果。结果 复杂皮肤软组织感染共99例,共检出99株病原菌,其中革兰阳性菌51株,葡萄球菌是主要致病菌,该菌对红霉素、青霉素G、氯洁霉素、苯唑西林、左氧氟沙星有较高的耐药率,其中红霉素的耐药率达95.45%、青霉素G 72.73%;对替考拉宁、万古霉素、利拉唑胺、夫西地酸、莫西沙星敏感性较高;葡萄球菌中社区获得性感染对复方磺胺甲噁唑、四环素、环丙沙星的敏感性高于医院感染（P < 0.05）;发现耐甲氧西林金黄色葡萄球菌11株。革兰阴性菌48株,铜绿假单胞菌、肺炎克雷伯菌、大肠埃希菌、鲍曼不动杆菌等为主要的致病菌;革兰阴性菌对左氧氟沙星、复方磺胺甲噁唑、庆大霉素有较高的耐药性,医院感染尤为突出;对碳青霉烯类、妥布霉素、哌拉西林、他唑巴坦敏感性较好。结论 复杂皮肤软组织感染的病原菌种类繁多,耐药性较高,应在药物敏感试验指导下合理用药。     

可溶性Toll样受体2联合PCT检测对血流感染致脓毒症诊断价值分析

目的探讨可溶性Toll样受体2(sTLR-2)联合降钙素原(PCT)检测对血流感染致脓毒症诊断价值。方法选取2019年3月—2021年3月西安交通大学第二附属医院收治的112例血流感染致脓毒症患者为研究对象,统计血流感染致脓毒症患者病原菌分布情况;分析影响血流感染致脓毒症患者病原菌感染特征的因素;分析sTLR-2联合PCT检测对血流感染致脓毒症患者的诊断价值。结果112例血流感染致脓毒症患者中有81例(72.32%)感染革兰阴性菌,有31例(27.68%)感染革兰阳性菌。Logistic回归多因素分析显示PCT(OR:4.035,95%CI:1.660~9.806)、sTLR-2(OR:3.904,95%CI:1.606~9.488)是影响血流感染致脓毒症患者病原菌感染类型的独立因素(P<0.05)。ROC曲线显示PCT、sTLR-2及二者联合诊断革兰阴性菌血流感染所致脓毒症的AUC分别为0.755、0.753、0.885(95%CI分别为:0.655~0.856,0.642~0.864,0.800~0.949)。结论革兰阴性菌血流感染致脓毒症发生风险高,PCT、sTLR-2与血流感染致脓毒症患者病原菌感染类型有关,二者联合预测革兰阴性菌血流感染所致脓毒症具有较高效能。     

综合ICU晚发性呼吸机相关性肺炎细菌学耐药性的调查研究

目的调查综合性ICU晚发性呼吸机相关性肺炎(VAP)的病原菌及其耐药性,为防治晚发性VAP提供依据。方法对综合性ICU收治的67名机械通气患者痰液进行常规培养、分离致病菌及药敏试验,以机械通气超过5d为限分为非VAP组及晚发性VAP组两组,对临床资料和微生物资料进行回顾性分析,调查晚发性VAP患者的病原菌分布及耐药性。结果晚发性VAP组共分离出病原菌116株,病原菌以G-菌为主,占菌株总数的75.0%;G+菌占菌株总数的6.03%;真菌占菌株总数的18.97%。G-菌主要是铜绿假单胞菌、鲍曼不动杆菌、肺炎克雷伯菌。G+菌主要以金黄色葡萄球菌为主要致病菌。结论G-杆菌为晚发性VAP的优势菌群,大多数G-菌对常用的抗菌药物具有较高的耐药性。     

汶川地震致头皮伤口感染细菌谱及耐药性分析

目的探讨地震灾害引起的开放性头皮损伤伤121感染的病原菌分布,耐药性特点及抗生素治疗措施。方法回顾分析5·12汶川地震后,四川大学华西医院神经外科收治的38例开放性颅伤患者头皮伤口感染的病原学资料。结果全组38例开放性头皮伤口感染的病原菌菌株51株,革兰阳性菌35株（68．63％）,分别是金黄色葡萄球菌21株（41．18％）,表皮葡萄球菌14株（27．45％）;革兰阴性菌16株（31．37％）,分别是阴沟肠杆菌8株（15．69％）,肺炎克雷伯杆菌4株（7．84％）,绿脓杆菌2株（3．92％）,深红沙雷氏菌2株（3．92％）。这些菌株对临床常用抗生素都有不同程度的耐药。经彻底清创及应用敏感抗生素,能有效控制感染。结论地震引起的开放性头皮伤口感染的病原菌,多以革兰阳性的金黄色葡萄球菌感染为主。早期彻底清创,营养支持,应用敏感抗生素能提高治疗效果。     

烧伤患者铜绿假单胞杆菌感染分布与耐药性分析

目的调查烧伤患者中铜绿假单胞杆菌感染的分布及病原体耐药现状。方法对2004年1月～2006年12月期间收治烧伤患者中培养鉴定感染铜绿假单胞杆菌481株及其药敏试验结果进行统计学分析。结果铜绿假单胞杆菌在本院烧伤患者感染病原菌的比例逐年上升,该菌对各种广谱抗生素也具有不同程度敏感性变化,在2004年1月～2006年12月期间铜绿假单胞杆菌多重耐药率逐年上升。结论铜绿假单胞杆菌是烧伤患者感染的主要多重耐药致病菌之一,通过实际研究对患者感染铜绿假单胞杆菌合坪而谨慎使用抗生素仍是延缓其耐药株快速升高的最好办法。     

Infections of the skin caused by gram-negative pathogens. Foot infections--wound infections--folliculitis

Gram-negative bacilli are ubiquitous. They are found in 10-15% of the intertriginous bacterial flora and the most important one is Pseudomonas aeruginosa. Heat, moisture, mazeration, and reduction of the normal Gram-positive flora favor a rapid establishment of Gram-negative bacilli and the ensuing development of clinical infections. The diagnosis depends of the characteristic clinical features and localization, the patient's history, as well as the result of bacteriological investigation. The significance of the isolation of Gram-negative bacilli from non-specific lesions must be carefully evaluated. Cutaneous lesions respond well to therapy if they can be dried. Systemic antibiotics acting against Gram-negative bacilli have been found helpful. In patients with acne and Gram-negative folliculitis, isotretinoin has a good effect.     

Antibiotic susceptibility of Staphylococcus aureus strains responsible for community-acquired skin infections

BACKGROUND: The appearance and worldwide spread of community-acquired methicillin-resistant Staphylococcus aureus (MRSA) skin infections warrant new studies of antibiotic resistance among strains of S. aureus responsible for cutaneous infections seen in general practice. PATIENTS AND METHODS: A prospective, multicentre study was performed from December 2003 to August 2004 in outpatients of both sexes presenting with a common bacterial skin infection presumed due to S. aureus (primary or secondary impetigo, ecthyma, paronychia, folliculitis, furunculosis). The investigators (n=50) were GPs from seven French regions. Clinical data (history, previous hospitalisation, type of infection, site, previous treatment, etc.) were collected using a standard questionnaire. A bacteriological sample was taken in attempt to isolate S. aureus after which antibiograms were prepared and minimal inhibiting concentrations determined (11 antibiotics). RESULTS: Four hundred and eighty patients of mean age 42 years (range: 2-94 years) were included. S. aureus was isolated from cultures in 205 of 477 samples, i.e. in 197 patients (eight had two strains of S. aureus). Patients with S. aureus had a primary skin infection in 104/197 cases (53%) (24 impetigo, 20 paronychia, 45 folliculitis or furunculosis) and a secondary infection in 93/197 cases (47%), with 4.9% patients being hospitalized within the preceding six months (median: 10 days). Percentages of resistant S. aureus strains were as follows: penicillin: 86%, erythromycin: 32%, ciprofloxacin: 9.3%, tetracycline: 5.8%, oxacillin: 5.8% (representing MRSA strains), fusidic acid: 4.4%, clindamycin: 3.4%, mupirocin: 1% and gentamicin: 0.5%. All S. aureus strains were sensitive to vancomycin and rifampicin. Except for one strain also resistant to tetracycline and fusidic acid, all MRSA strains were also resistant to ciprofloxacin. DISCUSSION: Multiresistant bacterial strains could become a concern in the community in France in the near future. In our study, only 14/197 (6.8%) S. aureus strains were sensitive to all tested antibiotics, whereas 21/197 (10.7%) were resistant to at least three of them. Compared to a French study performed in private practice in 2000, the level of MRSA is growing only slowly (5.8% versus 3.9%), whereas the percentage of strains of Peni-R/Oxa-S S. aureus are stable (80.5%). CONCLUSION: Common bacterial infections of the skin due to MRSA or to multiresistant S. aureus are not rare in France and have tended to increase slowly in recent years.     

重症监护病房革兰氏阴性菌院内感染：217例分析

目的探讨重症监护病房（ICU）革兰氏阴性菌院内感染的临床特点：方法收集温州医学院附属第一医院ICU2005年1月～2007年12月ICU院内感染病例217的痰、尿、血、大便、创口分泌物及腹水标本719份进行细菌培养,并分析革兰氏阴性致病菌的种类和耐药性：结果719份送检标本共分离出各种致病菌658株：革兰氏阴性菌372株,占56．53％。其中占前5位的是鲍曼不动杆菌62株（16．67％）、洋葱假单胞菌61株（16．40％）、铜绿假单胞菌58株（15．59％）、嗜麦芽窄食单胞菌41株（11．02％）、肺炎克莱布斯氏杆菌34株（9．14％）．革兰氏阴性菌院内感染部位主要为下呼吸道（79．84％）、血液（6．99％）和泌尿道（4．84％）：结论ICU院内感染的病原菌多为革兰氏阴性菌,且对绝大多数抗菌药物都耐药。感染部位以下呼吸道占绝大多数。     

Ceftobiprole

Ceftobiprole, an investigational cephalosporin, is currently in phase III clinical development. Ceftobiprole is a broad-spectrum cephalosporin with demonstrated in vitro activity against Gram-positive cocci, including meticillin-resistant Staphylococcus aureus (MRSA) and meticillin-resistant S. epidermidis, penicillin-resistant S. pneumoniae, Enterococcus faecalis, Gram-negative bacilli including AmpC-producing Escherichia coli and Pseudomonas aeruginosa, but excluding extended-spectrum beta-lactamase-producing strains. Like cefotaxime, ceftriaxone, ceftazidime, and cefepime, ceftobiprole demonstrates limited activity against anaerobes such as Bacteroides fragilis and non-fragilis Bacteroides spp. In single-step and serial passage in vitro resistance development studies, ceftobiprole demonstrated a low propensity to select for resistant subpopulations. Ceftobiprole, like cefepime, is a weak inducer and a poor substrate for AmpC beta-lactamases.Ceftobiprole medocaril, the prodrug of ceftobiprole, is converted by plasma esterases to ceftobiprole in <30 minutes. Peak serum concentrations of ceftobiprole observed at the end of a single 30-minute infusion were 35.5 mug/mL for a 500-mg dose and 59.6 mug/mL for a 750-mg dose. The volume of distribution of ceftobiprole is 0.26 L/kg ( approximately 18 L), protein binding is 16%, and its serum half-life is approximately 3.5 hours. Ceftobiprole is renally excreted ( approximately 70% in the active form) and systemic clearance correlates with creatinine clearance, meaning that dosage adjustment is required in patients with renal dysfunction. Ceftobiprole has a modest post-antibiotic effect (PAE) of approximately 0.5 hours for MRSA and a longer PAE of approximately 2 hours for penicillin-resistant pneumococci. Ceftobiprole, when administered intravenously at 500 mg once every 8 hours (2-hour infusion), has a >90% probability of achieving f T(>MIC) (free drug concentration exceeds the minimum inhibitory concentration [MIC]) for 40% and 60%, respectively, of the dosing interval for isolates with ceftobiprole MIC < or =4 and < or =2 mg/L, respectively.Currently, only limited clinical trial data are published for ceftobiprole. In a phase III trial, 784 patients with Gram-positive skin infections were randomized to treatment with either ceftobiprole 500 mg or vancomycin 1 g, each administered twice daily for 7-14 days; 93.3% of patients were clinically cured with ceftobiprole compared with 93.5% receiving vancomycin, and the eradication rate for MRSA infections was 91.8% for ceftobiprole compared with 90% for vancomycin. A phase III, randomized, double-blind, multicenter trial compared ceftobiprole 500 mg every 8 hours with vancomycin 1 g every 12 hours plus ceftazidime 1 g every 8 hours in patients with complicated skin and skin structure infections. Of the 828 patients enrolled, 31% had diabetic foot infections, 30% had abscesses, and 22% had wounds. No difference in clinical cure was reported in the clinically evaluable, intent-to-treat and microbiologically evaluable populations with cure rates of 90.5%, 81.9%, and 90.8%, respectively, in the ceftobiprole-treated patients and 90.2%, 80.8%, and 90.5%, respectively, in the vancomycin plus ceftazidime-treated group. Microbiologic eradication of Gram-positive cocci meticillin-susceptible S. aureus (MSSA) [ceftobiprole 91% vs vancomycin plus ceftazidime 92%] and MRSA (ceftobiprole 87% vs vancomycin plus ceftazidime 80%), as well as Gram-negative bacilli, E. coli (ceftobiprole 89% vs vancomycin plus ceftazidime 92%), and P. aeruginosa (ceftobiprole 87% vs vancomycin plus ceftazidime 100%), was not significantly different between groups. Similar cures rates in the microbiologically evaluable population occurred in both groups for Panton-Valentine leukocidin (PVL)-positive MSSA and PVL-positive MRSA.Currently, ceftobiprole has completed phase III trials for complicated skin and skin structure infections due to MRSA and nosocomial pneumonia due to suspected or proven MRSA; phase III trials are also ongoing in community-acquired pneumonia. Ceftobiprole has so far demonstrated a good safety profile in preliminary studies with similar tolerability to comparators. The broad-spectrum activity of ceftobiprole may allow it to be used as monotherapy in situations where a combination of antibacterials might be required. Further clinical studies are needed to determine the efficacy and safety of ceftobiprole and to define its role in patient care.     

分娩前4小时抗生素治疗对妊娠晚期B族链球菌筛查阳性孕妇围产结局的影响

目的了解妊娠晚期B族链球菌(group B streptococcus,GBS)阳性孕妇在分娩前4小时应用抗生素对围产结局的影响。方法选取2018年6月至2019年6月北京市海淀区妇幼保健院诊治的妊娠晚期顺产孕妇739例作为研究对象。其中GBS筛查阳性439例作为观察组,并根据是否在分娩前4小时应用抗生素,将观察组分为甲、乙两组,观察甲组(应用)312例,观察乙组(未应用)127例。再选取同时期妊娠晚期GBS筛查阴性的孕妇300例,作为对照组。比较观察甲、乙组和对照组的母儿结局。结果观察甲组、乙组和对照组胎儿窘迫、产后出血、早产的发生率比较,差异无统计学意义(P>0.05)。观察甲组胎膜早破率(8.7%)低于观察乙组(16.5%)、差异具有统计学意义(P<0.017),与对照组(8.7%)比较,差异无统计学意义(P>0.017)。观察甲组宫腔感染+产褥感染发生率低于乙组、略高于对照组,但差异无统计学意义(P>0.017);而观察乙组宫腔感染+产褥感染发生率高于对照组,差异具有统计学意义(P<0.017)。观察乙组新生儿感染及新生儿高胆红素血症的发生率明显高于观察甲组及对照组,差异具有统计学意义(P<0.017)。结论对于GBS筛查阳性的妊娠晚期孕妇,不仅需要预防性应用抗生素,还应尽可能在分娩前4小时以上应用,以改善围产结局。