NIRS结合化学计量学技术无损鉴别头孢菌素类粉针剂

目的利用NIRS结合化学计量学技术建立一种简单有效的鉴别头孢菌素类粉针剂的方法.方法 收集8种常见头孢菌素类粉针,采集其近红外漫反射光谱,用化学计量学方法对光谱进行处理和判别分析.结果 采用一阶导数+矢量归一化预处理后所建立的模型可有效的对8种头孢类粉针进行识别.结论 NIRS可以实现头孢菌素类粉针剂的无损快速判别,为头孢类粉针的鉴别提供了一种简便可行的参考方法.     

2009~2011年杭州地区头孢类抗菌药物用药分析

目的：了解目前杭州地区头孢类抗菌药物使用现状,分析用药特点及趋势。方法：根据杭州地区11家三甲医院和9家二甲医院2009～2011年的用药数据,采用金额分析法和数据汇总法进行统计分析。结果：3年来杭州地区20家医院头孢类抗菌药物品种数基本维持在36～37种,购药金额维持在5.5～7.0亿元之间,其中2011年头孢类抗菌药物购药金额首次出现大幅下降（20.68%）。从购药金额和用药频度（DDDs）来看,杭州地区头孢类抗菌药物以第三代头孢菌素使用最为广泛,其次是头霉素类。结论：杭州地区头孢类抗菌药物使用情况受抗菌药物管理政策的影响明显,为控制抗菌药物的滥用,应进一步加强管理,使抗菌药物临床使用趋于安全、有效、经济的方向发展。     

Antibiotic prophylaxis for joint replacement surgery: the current practice in Britain

Although over a hundred thousand hip and knee joint replacement procedures are now undertaken in Britain every year, deep infection following surgery remains a concern. Measures to minimise this risk of infection include administration of prophylactic antibiotics but unfortunately with the lack of national guidelines, much variability exists between each hospital’s local prescribing policies. We undertook a national survey to highlight this by interviewing Orthopaedic trainees at 52 randomly selected hospitals. A structured telephone questionnaire was used. Although all the hospitals were found to prescribe antibiotic prophylaxis, only 33 of the hospitals surveyed had strict local guidelines in place. Most hospitals administer cephalosporins (46), with only a few still relying on penicillins (3). Only four of the surveyed hospitals administer any prohylaxis against methicillin resistant staphyloccus aureus, such as Teicoplanin. Our results highlight the need for national guidelines to be implemented to improve our practice of joint replacement surgery.     

紫外线与亚硝酸复合诱变在顶头孢霉菌选育中的应用

为了提高头孢菌素C的产量，通过对头孢菌素C产生菌顶头孢霉菌B42-V2进行紫外线和亚硝酸的复合诱变处理，得到变株B42-V2N，单位提高10．04％，且遗传性状非常稳定。实验表明：紫外线和亚硝酸复合诱变，操作简便、安全高效，所选育菌种遗传性状稳定。     

Risk factors and treatment outcomes of bloodstream infection caused by extended-spectrum cephalosporin-resistant Enterobacter species in adults with cancer

Treatment of Enterobacter infection is complicated due to its intrinsic resistance to cephalosporins. Medical records of 192 adults with cancer who had Enterobacter bacteremia were analyzed retrospectively to evaluate the risk factors for and the treatment outcomes in extended-spectrum cephalosporin (ESC)–resistant Enterobacter bacteremia in adults with cancer. The main outcome measure was 30-day mortality. Of the 192 patients, 53 (27.6%) had bloodstream infections caused by ESC-resistant Enterobacter species. Recent use of a third-generation cephalosporin, older age, tumor progression at last evaluation, recent surgery, and nosocomial acquisition were associated with ESC-resistant Enterobacter bacteremia. The 30-day mortality rate was significantly higher in the resistant group. Multivariate analysis showed that respiratory tract infection, tumor progression, septic shock at presentation, Enterobacter aerogenes as the culprit pathogen, and diabetes mellitus were independent risk factors for mortality. ESC resistance was significantly associated with mortality in patients with E. aerogenes bacteremia, although not in the overall patient population.     

头孢类抗菌素的溶解和配伍稳定性研究

头孢类抗菌素是目前临床上很重要的一类新抗菌素。本文采用恒温加速试验法研究了头孢他定、先锋必素和几种常用输液配伍后的稳定性。结果表明此类抗菌素的稳定性与溶剂、温度、ＰＨ及时间有关；预测头孢类抗菌素的溶剂选择和在输液中的贮存期、稳定性，为临床安全、有效用药提供了实验依据，可供临床配伍使用时参考。     

肾功能不全头孢菌素脑病16例临床分析

目的总结肾功能不全头孢菌素脑病的诊治经验,指导肾功不全患者的抗感染治疗。方法回顾性分析我科16例肾功能不全患者应用头孢类抗生素时引起的神经精神症状及相关临床资料。结果使用头孢菌素到出现神经精神症状时间间隔（4.26±1.85）天（2～6天）,临床表现为神志恍惚、谵妄、幻觉、嗜睡、口齿不清、记忆力障碍、肌肉震颤、抽搐等。所有患者停药并血液净化治疗后好转。结论 肾功能不全患者使用常规剂量的头孢菌素可造成神经毒性,因此应根据肌酐清除率调整剂量,一旦出现症状需立即停药。