Two genes for chloramphenicol resistance common to Staphylococci and streptococci

Southern blot hybridization and pneumococcal transformation were used to study the epidemiology at a molecular level of the genes for chloramphenicol resistance (cat) in streptococci and staphylococci. The cat gene of staphylococcal plasmid pC194 showed homology to the cat genes of the chromosomal elements of 5 different strains of Streptococcus pneumoniae and of Streptococcus agalactiae B109. DNA sequence homology was also detected between the cat gene of staphylococcal plasmid pC221 and the cat gene of broad host range conjugative plasmid pIP501, originally isolated from S. agalactiae. Two different cat genes appear to be present in clinical isolates of both streptococci and staphylococci.     

Viridans group streptococci: a reservoir of resistant bacteria in oral cavities

The worldwide spread of erythromycin A-resistant streptococci, including Streptococcus pneumoniae , is of concern. Many studies have demonstrated that the viridans group streptococci can be a reservoir of erythromycin A resistance. Within oral streptoccoci, an important difference in the susceptibility pattern has been noted. The purpose of this short editorial is to highlight the importance of this group of bacteria as a reservoir of resistance to erythromycin A and the possible transfer of resistance to S. pneumoniae and S. pyogenes.     

Serum IgA and IgG functional antibodies and their subclasses to Streptococcus pneumoniae capsular antigen found in two aged‐matched cohorts of children with and without otitis media with effusion

Serum IgA and IgG functional antibodies and their subclasses to Streptococcus pneumoniae capsular antigen found in two aged‐matched cohorts of children with and without otitis media with effusion The relationship between acute otitis media and otitis media with effusion (OME) is uncertain and the aetiology of OME is multifactorial. Otitis media with effusion may be an inflammatory condition; both bacteria and viral infections could play a part in this inflammation. The four bacteria Streptococcus pneumoniae, Haemophilus influenza, Staphylococcus aureus and Branhamella catarrhalis cause 60% of the infections whereas S. pneumoniae accounts for up to 35%. IgA provides the dominant surface response to polysaccharide and lipopolysaccharide antigens, of which IgA₂ is the main subclass. Once the mucosa has been breached, most protection is provided by IgG. IgG₂ acts mainly against bacterial capsular antigens. This study looked at two groups of 50 children with and without OME who were aged between 3 and 10 years. The aims were to determine if, firstly, the levels of the serum immunoglobulins were different in the two groups, secondly whether these children made the appropriate antibody response to the capsular antigen to S. pneumoniae (PCP), and finally if there was a delay in the maturity of the IgA response. The total IgG, IgA and all subclass levels were measured using radial immunodiffusion. Levels of functional IgA and IgG were measured using ELISAs (25 patients in each group). The results were analysed with non‐parametric tests. The immunoglobulin levels were within the normal levels for both groups. There were very good correlations between the IgG total anti‐PCP and the IgG₂ anti‐PCP (R > 0.9, p = 0.001). There was a good correlation between the levels of both IgG total and IgG₂ anti‐PCP against IgA total anti‐PCP in both groups (R > 0.85, p > 0.01). This confirms a normal antibody response between both groups of patients. The ages of the controls and patients (50 samples) were correlated with increasing titres of circulating functional antibodies (P = 0.001). This is highly suggestive of a normal age‐related response. In conclusion, the findings were contradictory to our original hypothesis that there is a subtle difference in surface protection between children with and without OME. We believe that a previous history of recurrent acute otitis media is unrelated to the development of OME after 3 years of age.     

肺炎衣原体抗体效价与多发性硬化的相关性探讨

目的 探讨肺炎衣原体（Chlamydia pneumoniae）感染在多发性硬化（MS）发病和进展中的作用和致病机制。方法 选取急性期MS患者31例，缓解期MS患者28例及其他神经系统疾病患者30例，健康对照者30名，应用酶联免疫吸附试验测定患者和对照者血清及脑脊液中肺炎衣原体IgG和IgM抗体水平。结果 急性期MS组、缓解期MS组、其他神经系统疾病组和健康对照组的肺炎衣原体血清IgG分别为48．4％、35．7％、30．0％、23．3％；4组IgM抗体效价分别为12．9％、14．3％、20．0％、10．0％，总体比较差异无统计学意义（P〉0．05）；急性期MS组与其他神经系统疾病组的脑脊液IgG和IgM抗体效价分别为0、6．7％和0、0，差异无统计学意义（P〉0．05）。结论 肺炎衣原体的感染或重复感染与MS发病相关不紧密，可能仅为MS的伴随感染。     

肺炎克雷伯菌致婴幼儿腹泻发病动态观察

目的观察肺炎克雷伯菌所致婴幼儿腹泻的发病动态与流行趋势，探索有效治疗措施。方法取腹泻患儿新鲜大便，送作细菌培养，从中筛查出肺炎克雷伯菌所致病例，进行整理分析。结果从大便培养阳性的1005例病例中，筛查出肺炎克雷伯菌322例，占32％，居同期病原菌之首。年龄均在3岁以下，其中1岁以内婴儿占71．7％，夏秋季为发病高峰。结论肺炎克雷伯菌是人体肠道正常寄居菌之一，当机体抵抗力低下时，可致婴幼儿腹泻，成为重要的条件致病菌，其发病的流行因素与年龄、免疫力、季节、喂养方式及抗生素的应用等多种因素有关。近几年来，发病人数呈逐年上升趋势，提请临床儿科医生引起关注。     

Gram-negative bacterial pneumonia with secondary aspergillosis in an AIDS patient

Summary A 40-year-old, HIV-infected female patient received antibiotic treatment for a urinary tract infection. After the initial success of therapy and a symptom-free period, she developed pneumonia with septic shock and adult respiratory distress syndrome (ARDS). In spite of intensive care and respirator therapy with positive end-expiratory pressure (PEEP), she died of infectious toxic shock. Autopsy findings showed relapsing, gramnegative, bacterial pneumonia (morphologically compatible with Klebsiella pneumonia) and secondary, invasive aspergillosis. The pathogenesis and epidemiology of these unusual complications of AIDS are discussed.Abbreviations AIDS acquired immunodeficiency syndrome - ARDS adult respiratory distress syndrome - CDC Centers for Disease Control - HIV human immunodeficiency virus - PEEP positive end-expiratory pressure     

婴幼儿感染性腹泻25例临床分析

婴幼儿感染性腹泻是婴幼儿常见病之一，近年来在病原学方面有明显变迁，以致病性大肠杆菌感染多见，据我院儿科１９８９年的统计结果表明，大肠艾希氏菌和克雷伯氏菌感染明显上升，病程长，病情重，应引起重视，本文就１９８９年１年的婴幼儿感染性腹泻的发病机制与病原学进行了分析。     

肺炎克雷伯杆菌肺炎50例临床分析

目的：了解肺炎克雷伯菌肺炎的发病现状和对抗生素的耐药性及其治疗。方法：采用回顾性分析我院于2001年1月－2002年6月住院肺炎克雷伯杆菌肺炎50例的发病，对抗生素耐药性及其治疗。结果：患多见于中老年男性，临床表现以发热、咳嗽、咳痰多见。结果：肺炎克雷伯杆菌对抗生素具有多重耐药性，耐药率为氨苄西林100％，替卡西林96％，阿莫西林／棒酸54％，头孢西丁46％，庆大霉素44％，培福沙星42％，头孢他定38％，未发现对亚胺培南的耐药菌株。结论：肺炎克雷伯杆菌肺炎临床表现无特殊性，亚胺培南对肺炎克雷伯杆菌的耐药率最低，应作为治疗重症肺炎克雷伯杆菌肺炎首选用药。