某院320例尿标本培养中分离菌的临床分布及其耐药性分析

目的:分析某院尿标本培养中分离菌的临床分布及其耐药性。方法:抽取2018年4月-2019年3月间收治的被确诊为尿路感染患者320例资料,统计其尿液标本送检的致病菌培养和分离结果,分析其尿路感染患者尿液标本中病原菌谱的分布及主要革兰阳性菌及革兰阴性菌对抗菌药物的耐药率和敏感率。结果:320例尿路感染患者送检的尿液标本中,培养分离出152株病原菌,其中革兰阴性杆菌112株(检出率达73.68%,主要以大肠埃希菌、肺炎克雷伯菌和铜绿假单胞菌为主)、革兰阳性菌32株(占21.05%,主要以金黄色葡萄球菌、粪肠球菌和屎肠球菌为主)和真菌8株(占5.26%,主要以白色假丝酵母菌和光滑假丝酵母菌为主);主要革兰阳性菌(肺炎克雷伯菌、大肠埃希菌以及铜绿假单胞菌)对阿莫西林均完全耐药,大肠埃希菌和奇异变形菌对哌拉西林完全耐药,奇异变形菌对头孢他啶完全耐药,但其对阿米卡星不耐药;主要革兰阴性菌中粪肠球菌对环丙沙星、克林霉素和红霉素完全耐药,其对左氧氟沙星和利奈唑胺完全敏感。结论:医院收治的尿路感染患者均以革兰阴性菌感染为主,部分病原菌对某些抗菌药物的耐药率较高甚至完全耐药,临床应根据药敏试验结果合理选用抗菌药物治疗,以保障此类患者用药的有效性。     

某院2017年-2019年2836株临床常见血流感染病原菌的分布及常见病原菌的耐药性分析

目的:分析医院常见血流感染病原菌的分布及常见病原菌的耐药特点,为防控感染提供指导意见.方法:选取医院2017年1月-2019年12月收治的血流感染血培养阳性标本患者2400例病历资料,分析其常见病原菌的分布及其耐药特点.结果:2400例血培养阳性标本患者中,分离出病原菌2836株,其中革兰阴性菌1507株(占53.14％)、革兰阳性菌1108株(占39.07％)、真菌134株(占4.72％)和厌氧茸87株(占3.07％);革兰阳性菌中人葡萄球菌人亚种占10.23％,革兰阴性菌中大肠埃希菌占21.93％;2836株病原菌中各年度的分布分别为2017年占29.80％、2018年占40.40％和2019年占29.80％;药敏结果发现,人葡萄球菌人亚种对苯唑西林的耐药率为最高(达91.03％),大肠埃希菌对氨苄西林的耐药率为最高(达75.08％).结论:血流感染病患者感染病原菌以革兰阴性菌感染为主,其中革兰阳性菌中人葡萄球菌亚种和革兰阴性菌中大肠埃希菌对多种药物的耐药率均较高,临床应加强病原菌的监控,针对主要病原菌应根据药敏结果合理使用抗菌药物治疗,以确保其临床疗效.     

临床标本分离细菌耐药性监测分析

目的分析1998年1月～2002年12月铜陵市人民医院细菌耐药性流行状况.方法对5年来所有临床分离细菌2 152株,排除同一患者的重复菌株,用Kirby-Bauer法进行药敏试验,按美国临床试验标准委员会判断标准分析结果.结果 2152株细菌中,革兰阳性菌占33.92%,革兰阴性菌占66.08%.最常见的临床分离是凝固酶阴性葡萄球菌(1 5.33%),金黄色葡萄球菌(13.34%),铜绿假单胞菌(1 3.20%),大肠埃希菌(11.90%),不动杆菌属(9.57%)等.耐甲氧西林金黄色葡萄球菌(MRSA)和耐甲氧西林凝固酶阴性葡萄球菌(MRCNS)在相应的葡萄球菌中比例分别为31.36%和69.39%,未发现万古霉素耐药菌株.大肠埃希菌对氨苄西林、哌拉西林耐药株占70%以上,对第二、三代头孢菌素敏感性好.克雷伯菌属、肠杆菌属、枸橼酸菌属和不动杆菌属对第三代头孢菌素的耐药率多在30%以上,对亚胺培南敏感性好.铜绿假单胞菌对头孢他定和亚胺培南的耐药率达镲16%和8%;洋葱克伯霍尔德菌和嗜麦芽寡养单胞菌显示高度耐药,对亚胺培南耐药率为76%和97%.结论病原菌以革兰阴性菌为主,但革兰阳性菌呈上升趋势,尤以甲氧西林耐药菌株明显.细菌的耐药性呈上升趋势,应合理使用抗菌药物减缓耐药性的产生.     

76例狼疮性肾炎患者医院感染的病原菌分布与耐药性分析

目的:分析76例狼疮性肾炎(Lupus nephritis,LN)患者医院感染的病原菌分布与耐药情况.方法:选取医院2018年7月—2020年10月收治LN患者76例资料,采集其感染相关分泌物样本,进行病原菌培养和药敏试验,分析其病原菌分布、主要革兰阳性菌和主要革兰阴性菌的耐药特点.结果:76例样本分离出85株菌株,其中革兰阳性菌52株(占61.18％,以金黄色葡萄球菌、表皮葡萄球菌为主)、革兰阴性菌25株(占29.41％,以大肠埃希菌、肺炎克雷伯菌为主);主要革兰阳性菌金黄色葡萄球菌对氨苄西林、磺胺甲噁唑-甲氧苄啶的耐药率较高,表皮葡萄球菌对磺胺甲噁唑-甲氧苄啶、庆大霉素和呋喃妥因的耐药率较高,二者对万古霉素无耐药;主要革兰阴性菌大肠埃希菌、肺炎克雷伯菌对氨苄西林、哌拉西林的耐药率较高,其中肺炎克雷伯菌对氨苄西林的耐药率为100.00％,对亚胺培南无耐药.结论:LN患者医院感染的病原菌大多为革兰阳性菌,其次为革兰阴性菌;临床应根据患者的病原菌培养结果和抗菌药物耐药情况,合理选用抗菌药物,以提高其临床疗效和改善预后.     

某院2017年—2019年6346例血流感染患者阳性标本中感染病原菌的分布及其耐药性分析

目的:分析医院2017年-2019年血流感染患者阳性标本中感染病原菌的分布及其对抗菌药物的耐药情况,为临床合理使用抗菌药物提供参考.方法:选取医院2017年1月-2019年1月住院治疗的血流感染血标本培养阳性患者6346例病历资料,分析其血标本阳性患者的科室分布,以及检出病原菌谱的分布及其主要革兰阳性菌、革兰阴性菌对不同抗菌药物的耐药情况.结果:6346例患者血标本中,检出病原菌612株,病原菌中革兰阳性菌(占50.98％)明显多于革兰阴性菌(占34.15％)和真菌(占14.87％);革兰阳性菌以凝固酶阴性葡萄球菌、金黄色葡萄球菌、无乳链球菌为主,而革兰阴性菌以大肠埃希菌、肺炎克雷伯菌为主,真菌以白假丝酵母为主;阳性标本的科室分布以呼吸内科、消化内科、肾内科为主;药敏结果发现凝固酶阴性葡萄球菌、金黄色葡萄球菌对替考拉宁、万古霉素的敏感率均较高,而大肠埃希菌、肺炎克雷伯菌对美罗培南、亚胺培南的敏感率均达100.00％.结论:血流感染患者感染病原菌种类繁多,不同病原菌的耐药率各不相同,临床应根据其病原菌的分布特征及其药敏结果,合理选用抗菌药物治疗,以有效减少耐药菌株的产生,提高其临床疗效.     

某院2017年—2019年6346例血流感染患者阳性标本中感染病原菌的分布及其耐药性分析

目的:分析医院2017年-2019年血流感染患者阳性标本中感染病原菌的分布及其对抗菌药物的耐药情况,为临床合理使用抗菌药物提供参考.方法:选取医院2017年1月-2019年1月住院治疗的血流感染血标本培养阳性患者6346例病历资料,分析其血标本阳性患者的科室分布,以及检出病原菌谱的分布及其主要革兰阳性菌、革兰阴性菌对不同抗菌药物的耐药情况.结果:6346例患者血标本中,检出病原菌612株,病原菌中革兰阳性菌(占50.98％)明显多于革兰阴性菌(占34.15％)和真菌(占14.87％);革兰阳性菌以凝固酶阴性葡萄球菌、金黄色葡萄球菌、无乳链球菌为主,而革兰阴性菌以大肠埃希菌、肺炎克雷伯菌为主,真菌以白假丝酵母为主;阳性标本的科室分布以呼吸内科、消化内科、肾内科为主;药敏结果发现凝固酶阴性葡萄球菌、金黄色葡萄球菌对替考拉宁、万古霉素的敏感率均较高,而大肠埃希菌、肺炎克雷伯菌对美罗培南、亚胺培南的敏感率均达100.00％.结论:血流感染患者感染病原菌种类繁多,不同病原菌的耐药率各不相同,临床应根据其病原菌的分布特征及其药敏结果,合理选用抗菌药物治疗,以有效减少耐药菌株的产生,提高其临床疗效.     

某院2017年—2019年6346例血流感染患者阳性标本中感染病原菌的分布及其耐药性分析

目的:分析医院2017年-2019年血流感染患者阳性标本中感染病原菌的分布及其对抗菌药物的耐药情况,为临床合理使用抗菌药物提供参考.方法:选取医院2017年1月-2019年1月住院治疗的血流感染血标本培养阳性患者6346例病历资料,分析其血标本阳性患者的科室分布,以及检出病原菌谱的分布及其主要革兰阳性菌、革兰阴性菌对不同抗菌药物的耐药情况.结果:6346例患者血标本中,检出病原菌612株,病原菌中革兰阳性菌(占50.98％)明显多于革兰阴性菌(占34.15％)和真菌(占14.87％);革兰阳性菌以凝固酶阴性葡萄球菌、金黄色葡萄球菌、无乳链球菌为主,而革兰阴性菌以大肠埃希菌、肺炎克雷伯菌为主,真菌以白假丝酵母为主;阳性标本的科室分布以呼吸内科、消化内科、肾内科为主;药敏结果发现凝固酶阴性葡萄球菌、金黄色葡萄球菌对替考拉宁、万古霉素的敏感率均较高,而大肠埃希菌、肺炎克雷伯菌对美罗培南、亚胺培南的敏感率均达100.00％.结论:血流感染患者感染病原菌种类繁多,不同病原菌的耐药率各不相同,临床应根据其病原菌的分布特征及其药敏结果,合理选用抗菌药物治疗,以有效减少耐药菌株的产生,提高其临床疗效.     

126例化脓性脑膜炎患者脑脊液标本中主要病原菌的构成及其对抗菌药物的耐药性分析

目的:分析化脓性脑膜炎(PM)患者脑脊液标本中主要病原菌的构成及其对抗菌药物的耐药性.方法:选取医院2018年3月-2020年7月收治的PM患者126例病历资料,统计其脑脊液标本中细菌培养与药敏试验结果,分析其病原菌的分布及主要致病菌对抗菌药物的耐药性.结果:126例PM患者脑脊液标本中,分离出129株病原菌,其中革兰阳性菌87株(67.44％)、革兰阴性菌42株(32.56％);革兰阳性菌中溶血葡萄球菌、人葡萄球菌、表皮葡萄球菌、屎肠球菌对替考拉宁、万古霉素、利奈唑胺均无耐药,而对氨苄西林、红霉素的耐药率高于70％;革兰阴性菌中大肠埃希菌、肺炎克雷伯菌对哌拉西林、头孢唑林、氨苄西林的耐药率均高于80％,而大肠埃希菌对阿米卡星则无耐药.结论:PM患者脑脊液中感染病原菌分布较广,且各病原菌耐药性不同,经药敏试验、细菌培养可明确病原菌构成及其对抗菌药物的耐药性,有利于临床合理用药.     

新手儿临床抗本抗生素敏感性分析

目的：探索新生儿感染病原菌分布及常见抗菌药物敏感性,为经验性治疗提供依据。方法：按《全国临床检验操作规程》鉴定细菌,纸片扩散法做药敏试验。结果：1987－1998年内分离出病原菌2244株。院外感染前三位是表皮葡萄球菌、腐生葡萄球菌及大肠埃希菌,院内感染前三位是大肠埃希菌、克雷白菌及绿脓杆菌。院内外感染菌株对青霉素、氨苄西林等15种抗生纱的耐药率差异显著。阿米卡星的总敏感率86．2％,与青霉素联用敏感率增至89．9％。结论：院外感染致病菌以革兰阳性菌为主,而院内感染致病菌以革兰阴性菌为主,后者对许多抗菌药物更易产生耐药性,阿米卡星联合青霉素作为第一线抗菌药物值得推广。     

380例胎膜早破孕妇宫颈分泌物标本中病原菌的分布及其对抗菌药物的耐药性分析

目的:分析胎膜早破孕妇宫颈分泌物标本中病原菌的分布及其对抗菌药物的耐药情况,以期为临床治疗提供参考.方法:选取医院2018年6月—2020年3月收治的胎膜早破孕妇380例病历资料,统计其宫颈分泌物标本的细菌培养及药敏试验结果,分析其病原菌的分布情况及主要病原菌对抗菌药物的耐药特点.结果:380例胎膜早破孕妇宫颈分泌物标本中,分离出234株病原菌,其中革兰阴性菌占45.73％略高于革兰阳性菌(以大肠埃希菌、肺炎克雷伯菌、鲍曼不动杆菌为主)、革兰阳性菌占44.02％(以金黄色葡萄球菌、表皮葡萄球菌为主)和真菌占10.26％(以白假丝酵母、光滑假丝酵母为主);革兰阴性菌中大肠埃希菌、肺炎克雷伯菌对氨苄西林的耐药率均较高,而对亚胺培南的敏感率达100.00％,对哌拉西林、左氧氟沙星的耐药率较低,鲍曼不动杆菌对头孢唑林的耐药率较高,对亚胺培南、哌拉西林、庆大霉素的耐药率为0.00％,对左氧氟沙星的耐药率较低;主要革兰阳性菌中金黄色葡萄球菌对青霉素的耐药率较高,而对万古霉素的敏感率达100.00％,其对氨苄西林、左氧氟沙星的耐药率较低;表皮葡萄球菌对红霉素的耐药率较高,其对万古霉素的敏感率达100.00％,对氨苄西林、环丙沙星的耐药率较低.结论:胎膜早破孕妇宫颈分泌物标本中致病菌种类较多,其对抗菌药物的耐药率均不相同,临床应根据药敏试验结果合理选用敏感率高的抗菌药物治疗,以确保其临床疗效.     

Synthesis,Cytotoxicity and Antileishmanial Activity of Some N-(2-(indol-3-yl)ethyl)-7-chloroquinolin-4-amines

We report herein the condensation of 4,7-dichloroquinoline (1) with tryptamine (2) and D-tryptophan methyl ester (3) . Hydrolysis of the methyl ester adduct (5) yielded the free acid (6) . The compounds were evaluated in vitro for activity against four different species of Leishmania promastigote forms and for cytotoxic activity against Kb and Vero cells. Compound (5) showed good activity against the Leishmania species tested, while all three compounds displayed moderate activity in both Kb and Vero cells.     

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.

     

Lung disease and PKCs

The lung offers a rich opportunity for development of therapeutic strategies focused on isozymes of protein kinase C (PKCs). PKCs are important in many cellular responses in the lung, and existing therapies for pulmonary disorders are inadequate. The lung poses unique challenges as it interfaces with air and blood, contains a pulmonary and systemic circulation, and consists of many cell types. Key structures are bronchial and pulmonary vessels, branching airways, and distal air sacs defined by alveolar walls containing capillaries and interstitial space. The cellular composition of each vessel, airway, and alveolar wall is heterogeneous. Injurious environmental stimuli signal through PKCs and cause a variety of disorders. Edema formation and pulmonary hypertension (PHTN) result from derangements in endothelial, smooth muscle (SM), and/or adventitial fibroblast cell phenotype. Asthma, chronic obstructive pulmonary disease (COPD), and lung cancer are characterized by distinctive pathological changes in airway epithelial, SM, and mucous-generating cells. Acute and chronic pneumonitis and fibrosis occur in the alveolar space and interstitium with type 2 pneumocytes and interstitial fibroblasts/myofibroblasts playing a prominent role. At each site, inflammatory, immune, and vascular progenitor cells contribute to the injury and repair process. Many strategies have been used to investigate PKCs in lung injury. Isolated organ preparations and whole animal studies are powerful approaches especially when genetically engineered mice are used. More analysis of PKC isozymes in normal and diseased human lung tissue and cells is needed to complement this work. Since opposing or counter-regulatory effects of selected PKCs in the same cell or tissue have been found, it may be desirable to target more than one PKC isozyme and potentially in different directions. Because multiple signaling pathways contribute to the key cellular responses important in lung biology, therapeutic strategies targeting PKCs may be more effective if combined with inhibitors of other pathways for additive or synergistic effect. Mechanisms that regulate PKC activity, including phosphorylation and interaction with isozyme-specific binding proteins, are also potential therapeutic targets. Key isotypes of PKC involved in lung pathophysiology are summarized and current and evolving therapeutic approaches to target them are identified.     

In vitro studies on sterically stabilized liposomes (SL) as enzyme carriers in organophosphorus (OP) antagonism

This study describes a new approach for organophosphorous (OP) antidotal treatment by encapsulating an OP hydrolyzing enzyme, OPA anhydrolase (OPAA), within sterically stabilized liposomes. The recombinant OPAA enzyme was derived from Alteromonas strain JD6. It has broad substrate specificity to a wide range of OP compounds: DFP and the nerve agents, soman and sarin. Liposomes encapsulating OPAA (SL)* were made by mechanical dispersion method. Hydrolysis of DFP by (SL)* was measured by following an increase of fluoride ion concentration using a fluoride ion selective electrode. OPAA entrapped in the carrier liposomes rapidly hydrolyze DFP, with the rate of DFP hydrolysis directly proportional to the amount of (SL)* added to the solution. Liposomal carriers containing no enzyme did not hydrolyze DFP. The reaction was linear and the rate of hydrolysis was first order in the substrate. This enzyme carrier system serves as a biodegradable protective environment for the recombinant OP-metabolizing enzyme, OPAA, resulting in prolongation of enzymatic concentration in the body. These studies suggest that the protection of OP intoxication can be strikingly enhanced by adding OPAA encapsulated within (SL)* to pralidoxime and atropine.     

Gender-related symptoms and correlates of alcohol dependence among men and women with a lifetime diagnosis of alcohol use disorders

This study explored gender-related symptoms and correlates of alcohol dependence in a crosssectional study of 150 men and 150 women with a lifetime diagnosis of alcohol use disorders (AUD). Participants were recruited in equal numbers from treatment settings, correctional centres and the general community. Standardized measures were used to determine participants' use of substances, history of psychiatric disorders and psychosocial stress, their sensation seeking and family history of substance use and mental health disorders. Multivariate analyses were used to detect patterns of variables associated with gender and the lifetime severity of AUD. Men had a longer history of severe AUD than women. Women had similar levels of alcohol dependence and medical and psychological sequelae as men, despite 6 fewer years of AUD. More women than men had a history of severe psychosocial stress, severe dependence on other substances and antecedent mental health problems, especially mood and anxiety disorders. There were differences in family history of alcohol-related problems approximating same-gender aggregation. The severity of a lifetime AUD was predicted by its earlier age at onset and the occurrence of other disorders, especially anxiety, among both men and women. The limitations in the generalizability of these findings due to sample idiosyncrasies are discussed.     

Steroidal sapogenin contents in some domestic plants

In order to find out the values of the steroid resources for the future use. the compositions and contents of steroidal sapogenins from 13 domestic plants have been investigated. As a result,Dioscorea nipponica, D. quinqueloba andSmilax china were found to have large amount of diosgenin. And pennogenin inTrillium kamtschaticum andParis verticillata, yuccagenin inAllium fistulosum, hecogenin inAgave americana and neochlorogenin inSolanum nigum were appeared to be major steroidal sapogenins.