肠外瘘并发腹腔感染的致病菌谱与耐药性分析

目的 研究肠外瘘并发腹腔感染的主要致病菌谱及致病菌对常用抗生素的耐药特点.方法 取226例肠外瘘并发腹腔感染患者的腹腔脓液进行细菌培养和抗生素药物敏感试验.结果 获取菌株520株,其中革兰阴性菌333株,革兰阳性菌180株,真菌7株.前10位的为大肠埃希菌131株,金黄色葡萄球菌62株,肠球菌59株,铜绿假单胞菌50株,肺炎克雷伯杆菌23株,鲍曼不动杆菌18株,阴沟肠杆菌17株,奇异变形杆菌15株,摩氏摩根菌15株,粪肠球菌12株.大肠埃希菌和肺炎克雷伯杆菌中表达超广谱13内酰胺酶阳性菌株分别为102株和17株.甲氧两林耐药金黄色葡萄球菌60株.结论 肠外瘘并发腹腔感染的致病菌谱以革兰阴性菌为主,超广谱β内酰胺酶阳性率较高;金黄色葡萄球菌则基本对甲氧西林耐药.     

84例产褥感染的临床特点及常见致病微生物耐药性分析

目的 研究产褥感染的危险因素及常见致病微生物耐药情况,为临床治疗提供参考。方法 回顾性分析我院2017 年1 月～2019 年12 月发生的84 例产褥感染病例的临床资料,与同时期未发生产褥感染的200 例产妇进行对照研究,分析产褥感染的影响因素,并对分离获得的致病微生物进行耐药性分析。结果 感染组妊娠糖尿病、产钳助产、宫口开全后中转剖宫产患者的分布率高于对照组,差异有统计学意义（P＜0.05）;经多因素Logistic 回归分析,妊娠糖尿病是产褥感染的独立影响因素（P＜0.05）。本研究中共检出致病微生物40 株,其中革兰阴性菌13 株（占32.50%）,革兰阳性菌10 株（占25.00%）,支原体16 株（占40.00%）,衣原体1 株（占2.50%）,革兰阴性菌中以大肠埃希菌最常见,对二代头孢菌素类抗生素耐药率20%。革兰阳性菌以金黄色葡萄球菌最常见,对青霉素及头孢菌素耐药率高,未发现对亚胺培南及万古霉素耐药。结论 产钳助产、妊娠糖尿病、宫口开全后中转剖宫产是产褥感染可能的危险因素,其中,妊娠糖尿病是产褥感染的独立危险因素。目前临床常见致病微生物谱及耐药率未发生明显变化。     

晚期非小细胞肺癌患者恶性肿瘤组织中定植菌群研究

目的 探讨晚期非小细胞肺癌(Non-small cell lung cancer,NSCLC)患者恶性肿瘤组织中定植菌群情况,分析气道定植菌群与NSCLC发生发展的关系。方法 回顾性研究2017年1月～2018年10月我院行肺叶切除手术的NSCLC患者212例,肺癌标本采集于癌性病变部位及毗邻癌性病变的正常组织,分析细菌定植情况。根据是否存在定植菌群分为定植组32例和非定植组180例。对两组患者细菌取样培养和SP-D水平检测。结果NSCLC患者中有15.09%(32/212)患者存在定植菌群,而正常组织有3.77%(8/212)存在定植菌群,肺癌组织中定植菌发生率明显高于正常组织(P0.05)。两组菌群分布以肺炎链球菌、肺炎克雷伯菌多见。定植组SP-D水平明显高于非定植组(P0.05)。相关性分析显示,血清SP-D水平与致病性定植菌发生呈正相关,相关系数为0.215(P=0.023)。术后定植组并发症发生率明显高于非定植组(P0.05),而定植组以肺部感染为主要并发症,肺部感染发生率明显高于非定植组(P0.05)。结论 细菌定植与肺癌的发生具有一定的相关性,肺癌患者合并致病性定植菌与术后并发症发生密切相关,血清SP-D水平与患者术前致病菌定植状态相关。     

糖尿病下呼吸道感染病原菌特点及其耐药性分析

目的探讨糖尿病下呼吸道感染的细菌学特点及耐药情况。方法分析59例糖尿病住院患者合并医院内下呼吸道感染的临床资料。结果糖尿病患者下呼吸道感染的病原菌以革兰阴性杆菌为主（71．2％），其中大肠埃希菌占26．9％，G^-菌对亚胺培南耐药率为0％；G^＋球菌占21．9％，G^＋球菌对万古霉素耐药率为0％；共分离出耐药菌株21株占28．7％；比较耐药细菌组和非耐药细菌组间患者的脏器衰竭情况及白蛋白均有差异。结论糖尿病下呼吸道感染病原菌以G杆菌常见，对泰能敏感；应重视糖尿病下呼吸道感染患者细菌学特点及耐药性，合理使用抗生素，积极改善脏器功能，以提高治愈率。     

幽门螺杆菌Omp22-HpaA融合基因工程菌蛋白的表达

目的:优化幽门螺杆菌Omp22-HpaA基因工程菌pMAL-c2X-Omp22-HpaA-TB1的表达条件,并对其表达产物进行纯化和鉴定.方法:在不同诱导时机、不同诱导剂(IPTG)浓度和不同诱导时间条件下诱导pMAL-c2X-Omp22-HpaA-TB1的表达,测定目的蛋白的表达量.在优化条件下诱导工程菌表达,并应用SDS-PAGE方法对表达产物进行分析,采用Amyloss树脂预装柱对可溶性Omp22-HpaA蛋白进行分离、纯化,对纯化后的蛋白行Western blot分析.结果:工程菌培养2 h时加入IPTG(终浓度为0.4 mmol/L)诱导7 h,目的蛋白Omp22-HpaA表达量达到菌体总蛋白的20%以上.经纯化得到了较高纯度(＞90%)的目的蛋白,并具有良好的免疫原性.结论:建立了从pMAL-c2X-Omp22-HpaA-TB1可溶性表达产物中纯化较高纯度Omp22-HpaA融合蛋白的方法.     

急性胆道感染患者胆汁标本病原菌分布及其耐药性

目的:分析急性胆道感染患者胆汁标本病原菌分布及其耐药性。方法:选取294例急性胆道感染患者为研究对象,均采集胆汁标本,进行病原菌培养、分离鉴定和药敏试验,统计病原菌分布情况,并分析主要革兰阴性菌和革兰阳性菌对抗菌药物的耐药性。结果:294份胆汁标本共分离出468株病原菌,其中革兰阴性菌占比最高(71.37%),革兰阳性菌次之(26.07%),真菌最低(2.56%)。大肠埃希菌、肺炎克雷伯菌和铜绿假单胞菌对氨苄西林的耐药性均最高,其中,大肠埃希菌对氨苄西林的耐药率为85.71%,其次是莫西沙星(71.43%);肺炎克雷伯菌对氨苄西林的耐药率为84.78%,其次是莫西沙星(71.74%);铜绿假单胞菌对呋喃妥因、氨苄西林的耐药性最高(100.00%),其次是头孢曲松(90.70%);鲍曼不动杆菌对氨曲南的耐药性最高(100.00%),其次是头孢噻肟(76.19%);屎肠球菌对利福平的耐药性最高(100.00%),其次为红霉素(95.00%);粪肠球菌对利福平、奎奴普丁/达福普汀的耐药性最高(100.00%),其次为四环素(80.00%)。屎肠球菌对替考拉宁、替加环素、万古霉素和利奈唑胺的耐药性较低,均<2%;粪肠球菌对替加环素、利奈唑胺、呋喃妥因和氨苄西林的耐药性较低,均为0。结论:急性胆道感染患者胆汁标本病原菌分布以革兰阴性菌为主,对氨苄西林、莫西沙星、呋喃妥因等药物耐药性较高,且存在多重耐药现象;临床应根据患者具体药敏试验结果,选用敏感性抗菌药物,减少抗菌药物滥用、泛用等不良现象。     

老年泌尿道感染患者病原菌分布特点及耐药状况

目的 探究老年泌尿道感染患者的病原菌分布特点以及耐药状况.方法 选取2018年1月至2020年5月于盘锦辽油宝石花医院泌尿外科诊治的老年泌尿道感染患者1340例为研究对象,均采集尿标本进行细菌培养,分析病原菌的分布特点,并进行药敏试验.结果 本组1340例患者共分离出378株病原菌,检出率28.21％;其中革兰阴性菌占...     

Effect of different modeling time on intestinal bacteria in letrozole induced PCOS rats

Objective: The differences of ovarian morphology, reproductive hormones, glucose and lipid metabolism and intestinal bacteria in rats with polycystic ovary syndrome (PCOS) induced by triazole were compared. Method: Eighteen 21 SPF female SD rats were randomly divided into group A (3-week group), group B (5-week group) and group D (control group) by random number table.Group A received letrozole + CMC-Na mixture by gavage in the first 3 weeks and CMC-Na solution by gavage in the last 2 weeks, group B received letrozole + CMC-Na mixture by gavage for 5 weeks, and group D received CMC-Na solution by gavage for 5 weeks, and all three groups of rats were fed with normal diet.At the end of gavage, the body weight of rats in each group was observed, the histological changes of ovaries were observed by hematoxylin-eosin (HE) staining, the serum levels of estradiol (E2), follicle stimulating hormone (FSH), luteinizing hormone (LH), testosterone (T), total cholesterol (TC), triglyceride (TG), fasting blood glucose (Glu), fasting insulin (FINS) and lipopolysaccharide (LPS) were measured by enzyme-linked immunosorbent assay (ELISA), and the LH/FSH ratio and insulin resistance index (HOMA IR) were calculated; the intestinal bacteria of rats were detected by 16S rRNA technique. Result: 1. Comparison of ovary histomorphology: Under light microscope, multiple luteum and oocytes were observed in mature follicles in group D, and granulosa cells were orderly arranged and multilayered, without cystic dilated follicles. There were no mature follicles in the ovarian tissues of group A and GROUP B. The follicles were irregular in structure and more cystic dilated follicles were visible. The number of granular cells in some follicles decreased or even disappeared. 2. Comparison of sex hormone levels: compared with group D, T level in group B was significantly increased (P < 0.001), and T level in group A had an upward trend (P > 0.05); The LH/FSH levels in group A and B were significantly increased (P < 0.001; P < 0.001). Compared with group A, E2 in group B was significantly decreased (P < 0.05) and T was significantly increased (P < 0.01). 3. Comparison of glucose and lipid metabolism levels: Compared with group D, TC levels in groups A and B were significantly increased (P < 0.01; P < 0.01). Compared with group A, TG in group B was significantly increased (P < 0.05). There were no significant differences in Glu, FINS and HOMA-IR levels among all groups. 4. Comparison of LPS levels: Compared with group D, the serum LPS levels of rats in groups A and B were significantly increased (P < 0.001; P < 0.01). 5. Intestinal flora analysis and comparison: At the phylum level, compared with group D, the abundance of Firmicutes in group B increased (P < 0.01), Firmicutes in group A showed an upward trend (P > 0.05), and the abundance of Bacteroidetes in groups A and B decreased (P < 0.05). At the genus level, compared with group D, Lactobacillus in group B increased (P < 0.01). The results of LEfSe analysis showed that there were differences in the composition of various intestinal bacteria among the three groups (LDA > 3).Conclusion: The phenotype of PCOS rats was related to the length of modeling, and the phenotypic characteristics of PCOS in rats at 5 weeks of modeling were more typical than those in rats at 3 weeks of modeling; PCOS can cause changes in intestinal flora, and the changes in the structure of intestinal flora between groups are related to different modeling duration.     

新型有益菌纤维素敷料抑菌作用的实验研究

目的通过对三种创面敷料在体抑菌作用的比较,为临床针对外科创面选择并应用合适创面敷料提供理论依据。方法选用新型有益菌纤维素敷料、凡士林纱布和浸有新霉素黄连素溶液的敷料三种敷料,分别对金黄色葡萄球菌和大肠杆菌进行在体创面抑菌实验的比较。结果新型有益菌纤维素敷料具有较好的广谱抑菌作用。结论新型有益菌纤维素敷料是目前临床上较为理想的创面敷料。     

牙周致病菌和致龋菌对羟基磷灰石的附着能力

目的研究牙周致病菌和致龋菌对羟基磷灰石(HA)的附着能力。方法将与牙周病和龋病发生密切相关的6种国际参考标准菌株(牙龈卟啉单胞菌、伴放线放线杆菌、具核梭杆菌、变形链球菌、血链球菌、黏性放线菌),分别接种于模拟口腔环境的改良MD-300恒化器中培养,1 h后分离培养HA表面附着的细菌,检测各菌种对HA的附着能力及其相互作用。结果检测菌种中,血链球菌对HA的附着能力最强,其他依次为黏性放线菌、变形链球菌、伴放线放线杆菌、具核梭杆菌和牙龈卟啉单胞菌。血链球菌和黏性放线菌均能增强牙周致病菌对HA的附着能力,变形链球菌降低牙龈卟啉单胞菌的附着能力;所有牙周致病菌均降低血链球菌对HA的附着能力,而对变形链球菌和黏性放线菌无明显影响。结论牙周致病菌对HA的附着能力明显弱于致龋菌,其借助早期定植菌成为牙周生态系的优势菌和牙周病的主要病原菌。