湘潭市中心医院社区获得性肺炎住院患儿肺炎链球菌的耐药性研究

目的了解湘潭市中心医院因社区获得性肺炎住院的患儿肺炎链球菌(SP)的耐药情况。方法对本院2010-2011年住院患儿分离的115株SP进行分析,采用K-B纸片琼脂扩散法及浓度梯度法(E测试)检测SP对青霉素、头孢曲松、红霉素、克林霉素、左氧氟沙星、万古霉素、利奈唑胺、复方磺胺甲噁唑的耐药性。结果 115株SP中青霉素敏感肺炎链球菌(PSSP)占86.1%,青霉素中介肺炎链球菌(PISP)占7.8%,青霉素耐药肺炎链球菌(PRSP)占6.1%。SP对红霉素、克林霉素及复方磺胺甲噁唑的耐药率分别为95.6%、94.8%和73.9%,左氧氟沙星的耐药率为1.7%,头孢曲松的耐药率为6.9%,未发现对万古霉素及利奈唑胺耐药的SP菌株。结论本院分离的SP对儿科常用抗生素青霉素及头孢曲松钠仍高度敏感,但对大环内酯类抗生素红霉素、林可酰胺类抗生素克林霉素耐药情况严重。     

乌鲁木齐市SLE患者尿路感染病原菌分布特点及无乳链球菌药敏结果分析

目的 探究系统性红斑狼疮(SLE)患者无乳链球菌(GBS)尿路感染及药敏状况，为临床用药提供依据。方法 回顾性分析新疆维吾尔自治区人民医院2011年4月至2018年11月SLE患者继发尿路感染及药敏情况。结果 153例SLE患者尿培养阳性有78例，病原菌分布革兰阴性菌45例为大肠埃希菌18例、肺炎克雷伯9例、奇异变形菌6例、阴道加德纳菌4例、阴沟肠杆菌4例和铜绿假单胞菌4例；革兰阳性菌33例为GBS16例、粪肠球菌6例、葡萄球菌4例、屎肠球菌3例、酵母菌3例和唾液链球菌1例；药敏结果显示16株GBS对左氧氟沙星31.25%、红霉素68.75%、四环素37.5%和克林霉素81.25%出现耐药株；对左氧氟沙星6.25%出现中介株；对利奈唑胺、青霉素、万古霉素、美罗培南、氨苄西林和头孢曲松敏感率均为100%。结论 SLE患者GBS引起尿路感染应引起注意，临床医生需根据药敏结果合理选用抗生素。     

220例围生期孕妇B族链球菌感染及耐药情况分析

目的探究围生期孕妇B族链球菌(GBS)的感染及耐药情况。方法220例围生期孕妇,采用细菌培养法进行B族链球菌检测,药敏试验(K-B法)检测其耐药性。观察220例围生期孕妇的B族链球菌感染情况及B族链球菌对各种抗菌药物的耐药性。结果(1)220例孕妇中,检出B族链球菌感染21例,占9.55%。(2)药敏试验显示,分离的21株B族链球菌菌株对四环素、克拉霉素、克林霉素、红霉素的耐药性强,其次为左氧氟沙星,对万古霉素、利奈唑胺、头孢曲松、氨苄青霉素以及青霉素G的敏感性强。结论本院围生期孕妇的B族链球菌感染情况比较严重,其对多种抗菌药物具有不同程度的耐药性,应在日常工作中对B族链球菌的耐药性变化进行检测,从而为合理用药提供依据,尽可能减少抗生素滥用现象的发生,当进行治疗时应采取其他敏感性较强的抗菌药物进行治疗。     

围生期孕妇生殖道B群链球菌检测及耐药性的分析

目的调查围生期孕妇生殖道B群链球菌(GBS)定植状态及耐药特征,对临床使用抗菌药物起到一定的指导作用,对新生儿GBS病起到预防作用。方法收集1096例孕35~37周孕妇的阴道分泌物标本,进行GBS培养鉴定,阳性者做药敏试验,对结果进行统计分析。结果检出30株B群链球菌,检出率为2.7%。氨苄西林、头孢曲松、万古霉素、利奈唑胺、美罗培南耐药率为0%,青霉素的不敏感率为3.3%,左氧氟沙星耐药率为43.3%,四环素耐药率为60.0%,克林霉素耐药率为70.0%,红霉素耐药率为83.3%。结论对围生期孕妇应进行常规GBS筛查,合理选择抗菌药物,减少耐药菌株产生,预防新生儿GBS病,降低GBS感染对围生期孕妇的影响。     

2012-2014年痰培养肺炎链球菌耐药性分析

目的调查2012年8月—2014年6月聊城市传染病医院临床送检的痰标本中分离的60株肺炎链球菌对常用抗菌药物的耐药情况,为临床用药提供依据。方法对60株肺炎链球菌进行药敏试验,分析其对常见抗菌药物的耐药性。结果 60株肺炎链球菌对红霉素和四环素的耐药率最高,分别为98.25%和92.68%,其次为复方新诺明和青霉素,为66%和61.11%,而对喹诺酮类、氯霉素、碳青霉烯类和头孢类药物均保持较高的敏感率,60株肺炎链球菌对万古霉素、泰利霉素和利奈唑胺的敏感率均为100%。结论我院临床分离的肺炎链球菌耐药严重,对红霉素、四环素、复方新诺明和青霉素高度耐药,临床应尽量减少此类药物的经验性用药,依据药敏结果选择敏感率较高的喹诺酮类、氯霉素、碳青霉烯类、头孢类、万古霉素、泰利霉素和利奈唑胺进行治疗。     

13种抗菌药物对肺炎链球菌的体外抗菌活性分析

目的 探讨常用抗菌药物对临床分离的肺炎链球菌的体外抗菌活性.方法 用全自动微生物分析系统VITEK-2Compact对临床分离的154株肺炎链球菌进行鉴定和药敏试验.结果 药敏试验测得154株肺炎链球菌有85株（54.5%）对青霉素不敏感,其中72株（46.8%）对青霉素高度耐药,13株（8.4%）对青霉素中度耐药;测得氯霉素、美诺培南、头孢噻肟、头孢曲松、阿莫西林、复方新诺明、四环素、红霉素的耐药率分别为3.4%、16.2%、19.5%、20.8%、25.3%、68.8%、84.4%、90.9%;所有菌株对左旋氧氟沙星、莫西沙星、利奈唑胺、万古霉素敏感;135株对3种或3种以上抗生素耐药,多重耐药率为87.7%.结论 肺炎链球菌对左旋氧氟沙星、莫西沙星、利奈唑胺、万古霉素100%敏感,抗菌活性高;对氯霉素、美诺培南、头孢噻肟、头孢曲松、阿莫西林耐药率也较低,对青霉素、复方新诺明、四环素、红霉素的耐药率高,尤其是青霉素不敏感株和多重耐药菌株多见,应引起临床重视.     

45株金黄色葡萄球菌的药敏结果分析

目的 了解金黄色葡萄球菌对抗生素的敏感性,为临床合理治疗提供科学依据.方法 使用梅里埃公司的VITEK 2 Compact全自动细菌鉴定、药敏仪进行细菌分离鉴定和对12种抗生素作药敏试验.结果 金黄色葡萄球菌对万古霉素和利奈唑胺的敏感性最高,达到100％;对莫西沙星、复方新诺明的敏感率＞50％,对左氧氟沙星、环丙沙星的敏感率＞40％,对苯唑西林、四环素、庆大霉素、克林霉素、红霉素及青霉素的敏感率＜40％,耐药性较强.结论 万古霉素成为治疗金黄色葡萄球菌的首选药物,但其价格较高,连续用药有较高风险,利奈唑胺副作用小,临床疗效显著,可用来替代万古霉素.     

围生期孕妇生殖道B族链球菌感染情况与耐药性研究

目的 探讨孕妇在围生期的生殖道感染B族链球菌(GBS)情况及其耐药性.方法 将符合标准的366例孕妇纳入本研究,统计孕妇感染GBS的情况,分析GBS对青霉素、左氧氟沙星、环丙沙星、苯唑西林、头孢噻肟、万古霉素、克林霉素、氨苄西林、头孢曲松、四环素和红霉素11种药物的敏感性.结果 366名孕妇中,有57名孕妇感染了GBS,带菌率为15.6%;GBS对青霉素和头孢噻肟的敏感率为100%,对环丙沙星、苯唑西林、万古霉素、氨苄西林和头孢曲松的敏感率较高,分别为93.0%、93.0%、96.5%、96.5%和93.0%,对左氧氟沙星、克林霉素、四环素和红霉素的耐药性较高,分别为10.5%、10.5%、38.6%和26.3%.结论 提高鉴定GBS技术的敏感性和特异性,在孕晚期根据GBS耐药性及时调整临床用药对降低不良妊娠结局具有重要作用.     

太仓地区糖尿病足部感染患者病原菌分布及药敏和耐药性分析

目的 探究太仓地区糖尿病足部感染患者病原菌分布及药敏和耐药情况。方法 将70例糖尿病足部感染分泌物阳性患者纳入本次研究中,收取时间段在2013年8月至2022年3月,对患者病原菌分布、药敏、耐药性进行分析。结果 70例患者中,一共检出26种类细菌,均为革兰阳性菌感染33例（共计41株）,占比47.14%;均为革兰阴性菌感染26例（共29株）,占比37.14%;阳性菌与阴性菌混合感染11例（共计22株）,占比15.71%。在均是革兰阳性菌感染中以金黄色葡萄球菌、无乳链球菌最常见,药敏提示它们对万古霉素、利奈唑胺、利福平、莫西沙星敏感性高,对青霉素、红霉素、克林霉素、苯唑西林耐药;均为革兰阴性菌感染的菌株较多,大肠埃希菌、肺炎克雷伯杆菌、奇异变形杆菌较多见,药敏提示对亚胺培南、氨曲南、环丙沙星、哌拉西林他唑巴坦、头孢哌酮钠舒巴坦敏感性高,少部分对头孢曲松、头孢呋辛耐药。阳性菌与阴性菌混合感染中,药敏提示它们对万古霉素、利奈唑胺、美罗培南、利福平、莫西沙星、哌拉西林舒巴坦敏感,对青霉素、红霉素、克林霉素、头孢呋辛、头孢曲松、头孢他啶、氨苄西林、环丙沙星、磺胺甲噁唑耐药,耐药率明显上升。结论 ...     

肺炎链球菌致儿童下呼吸道感染的药敏分析

目的分析儿童下呼吸道感染的肺炎链球菌的耐药特征,为临床用药提供参考依据。方法 2012年1月至2012年12月住院首日患儿痰液培养检出肺炎链球菌256株,利用微生物全自动鉴定系统VITEK2compact及配套肺炎链球菌药敏卡对所有菌株进行药敏分析,青霉素最低抑菌浓度检测采用E-test法,药敏结果参照2010年CLSI M100-S20版指南判读。结果 256株肺炎链球菌对青霉素、红霉素、四环素和复方新诺明的耐药率分别为43.9%、98.8%、93.3%和66.5%;对头孢曲松、头孢噻肟的耐药率为53.9%、51.6%、;对万古霉素、利奈唑胺、泰利霉素和喹诺酮类较敏感。结论儿童下呼吸道分离的肺炎链球菌红霉素、四环素和复方新诺明耐药严重,耐青霉素肺炎链球菌检出率较高,临床治疗应依据药敏试验合理选用抗菌药物。     

Efficacy of gut lavage,hemodialysis, and hemoperfusion in the therapy of paraquat or diquat intoxication

Clinical and in vitro investigations were carried out to test the efficacy of gut lavage, hemodialysis, and hemoperfusion in the treatment of poisoning with paraquat or diquat. In a patient suffering from diquat intoxication 130 times more diquat was removed by gut lavage 30 h after ingestion than was removed by complete aspiration of the gastric contents.Determination of in vitro clearances for paraquat and diquat by hemodialysis showed that, at serum concentrations of 1–2 ppm, such as are frequently encountered in poisoning in man, toxicologically relevant quantities of herbicide cannot be removed from the body. At a concentration of 20 ppm, on the other hand, hemodialysis proved to be effective, the clearance being 70 ml/min at a blood flow rate of 100 ml/min. The efficacy of hemoperfusion with coated activated charcoal was on the whole better. Especially at concentrations around 1–2 ppm, the clearance values for hemoperfusion were some 5–7 times higher than those for hemodialysis.In a patient suffering from paraquat poisoning, both hemodialysis as well as hemoperfusion were carried out. The in vitro results could be confirmed: At serum concentrations of paraquat less than 1 ppm no clearance could be obtained by hemodialysis while by hemoperfusion with activated charcoal quite high clearance values were measured and the serum level dropped down to zero.

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Zusammenfassung Klinische Untersuchungen und Laboratoriumsversuche wurden durchgeführt, um die Wirksamkeit von Darmspülung, Hämodialyse und Hämoperfusion bei Paraquat- und Deiquat-Vergiftungen zu prüfen.Bei einem Patienten wurde 30 Std nach Deiquat-Aufnahme durch Darmspülung 130mal mehr Deiquat entfernt als durch vollständige Aspiration des Mageninhaltes. In vitro-Versuche ergaben, daß bei Blutserumkonzentrationen von 1–2 ppm, die bei Vergiftungen oft gemessen werden, durch Hämodialyse keine toxikologisch relevanten Paraquat- oder Deiquat-Mengen entfernt werden können. Dagegen erwies sich die Hämodialyse bei 20 ppm und einer Blutumlaufgeschwindigkeit von 100 ml/min mit einer Clearance von 70 ml/min als wirksam. Die Hämoperfusion mit beschicheter Aktivkohle war in diesen Versuchen aber eindeutig überlegen, denn insbesondere bei Konzentrationen um 1–2 ppm waren die Clearance-Werte 5–7mal höher als bei der Hämodialyse.Die in vitro-Ergebnisse wurden bei einem Patienten mit einer Paraquat-Vergiftung bestätigt: Bei Konzentrationen unter 1 ppm war die Hämodialyse wirkungslos, während durch Hämoperfusion relativ hohe Clearance-Werte erreicht wurden, so daß der Serumspiegel rasch unter die Nachweisgrenze abfiel.

     

Aquatic Insects and Trace Metals: Bioavailability,Bioaccumulation, and Toxicity

Abstract

The uptake of metals from food and water sources by insects is thought to be additive. For a given metal, the proportions taken up from water and food will depend both on the bioavailable concentration of the metal associated with each source and the mechanism and rate by which the metal enters the insect. Attempts to correlate insect trace metal concentrations with the trophic level of insects should be made with a knowledge of the feeding relationships of the individual taxa concerned. Pathways for the uptake of essential metals, such as copper and zinc, exist at the cellular level, and other nonessential metals, such as cadmium, also appear to enter via these routes. Within cells, trace metals can be bound to proteins or stored in granules. The internal distribution of metals among body tissues is very heterogeneous, and distribution patterns tend to be both metal and taxon specific. Trace metals associated with insects can be both bound on the surface of their chitinous exoskeleton and incorporated into body tissues. The quantities of trace meals accumulated by an individual reflect the net balance between the rate of metal influx from both dissolved and particulate sources and the rate of metal efflux from the organism. The toxicity of metals has been demonstrated at all levels of biological organization: cell, tissue, individual, population, and community. Much of the literature pertaining to the toxic effects of metals on aquatic insects is based on laboratory observations and, as such, it is difficult to extrapolate the data to insects in nature. The few experimental studies in nature suggest that trace metal contaminants can affect both the distribution and the abundance of aquatic insects. Insects have a largely unexploited potential as biomonitors of metal contamination in nature. A better understanding of the physico-chemical and biological mechanisms mediating trace metal bioavailability and exchange will facilitate the development of general predictive models relating trace metal concentrations in insects to those in their environment. Such models will facilitate the use of insects as contaminant biomonitors.     

Alzheimer’s disease – current trends in basic and clinical research. Highlights from the 16th ECNP

Advances in the molecular biological knowledge of neuronal nicotinic acetylcholine receptors (nAChRs) have led to a growing interest by the pharmaceutical industry in the development of novel compounds that selectively modulate nAChR function. The ability of (-)-nicotine, an activator of nAChRs, to enhance attentional aspects of cognition in animals and humans, to exert neuroprotective and anxiolytic-like effects, and presumably to mediate the negative correlation between smoking and Alzheimer's (and Parkinson's) Disease, has focused interest on the potential therapeutic utility of modulators of nAChR function for treatment of some of the deficits associated with these progressive, neurodegenerative conditions. Numerous compounds are known which activate nAChRs and which might serve as lead compounds toward the development of such agents. The pharmacologic diversity of neuronal nAChR subtypes suggests the possibility of developing selective compounds which would have more favourable side-effect profiles than existing agents. This broader class of agents, collectively called cholinergic channel modulators (ChCMs), is anticipated to encompass compounds which would have more favourable side-effect profiles than existing agents, which generally exhibit low selectivity. This selectivity may be achieved by preferentially activating some subtypes of nAChRs (i.e., Cholinergic Channel Activators, ChCAs) or inhibiting the function of other subtypes (Cholinergic Channel Inhibitors, ChCIs). An overview of the biology of nAChRs and the rationale for the use of ChCMs for the treatment of dementia related to neurodegenerative diseases are presented, followed by a discussion of lead compounds and compounds under consideration for clinical evaluation.     

2-(Acetoxyphenyl)-(Z)-styryl sulfides as cyclooxygenase inhibitors

2-(Acetoxyphenyl)-(Z)-styryl sulfides are described as selective cyclooxygenase-2 (COX-2) inhibitors, useful for treating inflammation and COX-2-mediated disorders including neoplasia. 2-(Acetoxyphenyl)-(Z)-styryl sulfide is claimed to be the most potent COX inhibitor in the series with a COX-2 selectivity ratio of 33. This compound is also claimed to be superior to celecoxib (Celebrex^®, Pfizer) in inhibiting cell growth of colorectal carcinoma cells. In this evaluation, the COX inhibitory activity of this compound is compared to that previously disclosed for diarylheterocycles and 2-(acetoxyphenyl)alkyl sulfides. The validity of the DLD-1 cell line in the growth inhibition studies is questioned based on recent literature reports indicating the lack of COX-2 expression in this cell line.     

Sleep-disordered breathing with chronic opioid use

Chronic opioid use for pain relief or as substitution therapy for illicit drug abuse is prevalent in our societies. In the US, retail distribution of methadone and oxycodone has increased by 824 and 660%, respectively, between 1997 and 2003. μ-Opioids depress respiration and deaths related to illicit and non illicit chronic opioid use are not uncommon. Since 2001 there has been an emerging literature that suggests that chronic opioid use is related to central sleep apnoea of both periodic and non-periodic breathing types, and occurs in ～ 30% of these subjects. The clinical significance of these sleep-related abnormalities are unknown. This review addresses the present knowledge of control of ventilation mechanisms during wakefulness and sleep, the effects of opioids on ventilatory control mechanisms, the sleep-disordered breathing found with chronic opioid use and a discussion regarding the future research directions in this area.     

Drug targets for cognitive enhancement in neuropsychiatric disorders

The investigation of novel drug targets for treating cognitive impairments associated with neurological and psychiatric disorders remains a primary focus of study in central nervous system (CNS) research. Many promising new therapies are progressing through preclinical and clinical development, and offer the potential of improved treatment options for neurodegenerative diseases such as Alzheimer's disease (AD) as well as other disorders that have not been particularly well treated to date like the cognitive impairments associated with schizophrenia (CIAS). Among targets under investigation, cholinergic receptors have received much attention with several nicotinic agonists (α7 and α4β2) actively in clinical trials for the treatment of AD, CIAS and attention deficit hyperactivity disorder (ADHD). Both glutamatergic and serotonergic (5-HT) agonists and antagonists have profound effects on neurotransmission and improve cognitive function in preclinical experiments with animals; some of these compounds are now in proof-of-concept studies in humans. Several histamine H3 receptor antagonists are in clinical development not only for cognitive enhancement, but also for the treatment of narcolepsy and cognitive deficits due to sleep deprivation because of their expression in brain sleep centers. Compounds that dampen inhibitory tone (e.g., GABA_A α5 inverse agonists) or elevate excitatory tone (e.g., glycine transporter inhibitors) offer novel approaches for treating diseases such as schizophrenia, AD and Down syndrome. In addition to cell surface receptors, intracellular drug targets such as the phosphodiesterases (PDEs) are known to impact signaling pathways that affect long-term memory formation and working memory. Overall, there is a genuine need to treat cognitive deficits associated with many neuropsychiatric conditions as well as an increasingly aging population.