一起集体上呼吸道爆发感染的调查

目的调查与分析深圳市1起集体上呼吸道爆发感染的原因,及时采取措施控制疫情。方法按照《公共交通等候室卫生标准》（GB9672—1996）,《公共场所卫生监测技术规范》（GB／T17220—1998）和《公共场所集中空调通风系统卫生规范》进行调查。结果在病人咽拭子中未检出引起上呼吸道感染的病毒,病人血清中有1份A型流感IgM抗体阳性;病人咽拭子中溶血性链球菌和金黄色葡萄球菌的阳性率分别为12．5％和20．8％,经PFGE分析,病人咽拭子和车间空气中分离出的金黄色葡萄球菌无同源性;车间4楼空调系统积尘中细菌总数和霉菌数分别为20060和10810cfu／g;车间4楼空气细菌总数达3650cfu／m^3,超出标准要求,这与该次感染在4楼罹患率最高保持一致。结论结合流行病学特征、临床症状和实验室检查结果,可判断该次感染为1起细菌性近距离传播所致的群体上呼吸道爆发感染。     

Diversity of Salmonella spp. and fungi in northern Greek rivers and their correlation to fecal pollution indicators

The prevalence and diversity of Salmonella spp., filamentous fungi, and yeasts and their correlation with fecal pollution indicators (total coliforms, fecal coliforms, enterococci) and total heterotrophic bacteria counts were investigated in 95 water samples from the northern Greek rivers Aliakmon and Axios. Salmonella spp. were isolated in 27.4% of the samples and a total of 19 serotypes were identified. The frequency of Salmonella isolation was higher in the Axios (36.8%) than in the Aliakmon (21.0%) river. Significantly (P<0.001) more Salmonella spp. were recovered during warm (41.4%) than cold (5.4%) months. Salmonella-positive samples showed significantly higher counts of total heterotrophic bacteria and coliforms. Filamentous fungi were isolated from 98.9% and yeasts from 17.9% of the samples with respective mean counts of 2.36 x 10(3) and 1.28 x 10(2)cfu/100mL. Totals of 23 genera of filamentous fungi and 3 genera of yeasts were identified. The most frequent filamentous fungi were Penicillium and Aspergillus, while Candida was the most prevalent yeast. A significant (P<0.001) positive correlation of the fecal pollution indicators was demonstrated only for filamentous fungi. The results of this study indicate that these rivers may be potential pathways for human and other animal contamination with Salmonella spp., filamentous fungi, and yeasts, which contribute to the pollution of marine waters and the surrounding environment.     

支气管哮喘患者医院肺部真菌感染的临床分析

目的探讨支气管哮喘(简称哮喘)继发医院肺部真菌感染的临床特征及危险因素. 方法采用回顾性调查方法,分析48例哮喘医院肺部真菌感染患者的临床资料. 结果 328例哮喘患者继发医院肺部真菌感染48例,感染率占14.6%;临床表现无特异性;病原菌主要以白色念珠菌为主,占67.9%;主要危险因素有患者年龄、病情分度、侵入性操作、不合理使用抗生素以及应用糖皮质激素. 结论避免盲目使用高效广谱抗生素及糖皮质激素、及时诊断和治疗是减少哮喘并发医院肺部真菌感染的关键.     

12例确诊肺曲霉菌病临床分析

目的 通过对12例确诊肺曲霉菌病患者的临床特征、宿主因素、CT特点、诊断及治疗的回顾性分析,以提高早期诊断和治疗水平.方法 采用回顾性研究,查阅2004年1月-2011年9月新疆医科大学第一附属医院病历资料,收集肺曲霉菌病确诊病历相关资料,制作调查表格.结果 12例患者中侵袭性肺曲霉病2例,均有宿主因素,临床特征以发热、呼吸急促为主,胸部CT主要表现为结节、实变、斑片及空洞影,1例出现新月征,1例支气管镜下取痰曲霉菌属培养阳性,1例肺组织病理检查阳性,1例抗真菌治疗有效,1例死亡;寄生性肺曲霉菌病10例,8例有肺部基础疾病,临床症状以咯血多见,胸部CT表现结节8例,团块、空洞、斑片各2例,晕轮征、新月征各1例;9例行手术治疗,其中6例在术前未被考虑肺曲霉菌病;术后电话随访7例,治愈6例.结论 肺曲霉菌病临床特征不典型,痰检阳性率低,早期不易诊断,另外部分患者因病情危重不能耐受手术或气管镜检查;其早期诊断方法有待进一步探讨.     

红茶菌对家兔实验性动脉粥样硬化的预防作用

红茶菌能降低血清总胆固醇、甘油三脂和低密度脂蛋白,服用时间越长,效果越显著,但对高密度脂蛋白无明显作用。本文采用肉眼、光镜和透射电镜观察,结果红茶菌有抑制实验性动脉粥样硬化斑块的形成,且能明显减轻其病变程度。认为红茶菌对实验性动脉粥样硬化确有防治作用。     

姜黄油抗真菌作用的超微结构研究

本文应用透射电镜对姜黄油的抗石膏样毛癣菌的超微结构进行了研究。其初步结果:正常对照组在电镜下可见孢子呈圈形或椭圆形,中央可见胞核,细胞质中隐约可见板层状膜状结构和颗粒核醣体。细胞壁较厚,分为二层,内层电子密度低,外层电子密度较高。菌丝呈长条形可见中隔。纯姜黄油组和0.1%姜黄油乙醇组可见到细胞壁肿胀,膜的完整性被破坏,细胞质内出现多数空泡或均质化。上述所见与试管内药物敏感试验相符合,初步阐明姜黄油在体外试验中有较强的抗石膏样毛癣菌的作用。     

Effects of γ-radiation on the fungus Alternaria alternata in artificially inoculated cereal samples

The objective of this study was to evaluate the effects of different γ-radiation doses on the growth of Alternaria alternata in artificially inoculated cereal samples. Seeds and grains were divided into four groups: Control Group (not irradiated), and Groups 1, 2 and 3, inoculated with an A. alternata spore suspension (1×10⁶ spores/mL) and exposed to 2, 5 and 10 kGy, respectively. Serial dilutions of the samples were prepared and seeded on DRBC (dichloran rose bengal chloramphenicol agar) and DCMA (dichloran chloramphenicol malt extract agar) media, after which the number of colony-forming units per gram was determined in each group. In addition, fungal morphology after irradiation was analyzed by scanning electron microscopy (SEM). The results showed that ionizing radiation at a dose of 5 kGy was effective in reducing the growth of A. alternata. However, a dose of 10 kGy was necessary to inhibit fungal growth completely. SEM made it possible to visualize structural alterations induced by the different γ-radiation doses used.     

我院呼吸内科真菌性医院感染的调查与耐药性分析

目的探讨呼吸内科真菌性医院感染的分布、基础疾病、危险因素和耐药性。方法对142例病例进行回顾性调查分析并统计资料。结果呼吸内科真菌性医院感染以白色念珠菌为主，慢性阻塞性肺病、支气管扩张、肺癌占基础疾病的前3位，患者抵抗力下降和侵入性诊疗措施是其主要的危险因素，真菌的耐药性也逐渐增多。结论临床上应重视呼吸内科患者的真菌性医院感染，改善患者的基础状况，合理诊疗，减少真菌耐药性的发生，有效地预防和治疗呼吸内科真菌性医院感染.     

慢性阻塞性肺疾病继发真菌感染临床研究

目的研究慢性阻塞性肺疾病（COPD）继发真菌感染患者的病原菌分布及耐药特点,指导临床用药。方法选取本院住院的COPD合并真菌感染的患者58例,对其痰液进行真菌培养鉴定,并进行药物敏感性试验。结果58例COPD继发真菌感染患者检测出白色念珠菌36例（62.07%）,热带念珠菌9例（15.52%）,克柔念珠菌8例（13.79%）,光滑念珠菌3例（5.17%）,曲霉菌2例（3.45%）。药敏结果显示白色念珠菌对制霉菌素、两性霉素B、伊曲康唑和5-氟尿嘧啶敏感性较高,对益康唑和酮康唑敏感性较低。结论COPD患者继发肺部真菌感染多为白色念珠菌感染。临床治疗时应选择针对性强、抗菌谱窄的抗生素。