In vivo efficacy of cefotaxime and amoxicillin against penicillin-susceptible, penicillin-resistant and penicillin-cephalosporin-resistant strains of Streptococcus pneumoniae in a mouse pneumonia model

Objective: To compare cefotaxime (CTX) to amoxicillin (AMO) (usually considered the definitive therapy for penicillinsusceptible Streptococcus pneumoniae infections) in an immunocompromised mouse pneumonia model.
Methods: Three S. pneumoniae clinical isolates were used: two serotype 19 strains, a penicillin-susceptible (P^s) strain (penicillin MIC = 0.03 μ/mL) and a highly penicillin-resistant (P^r) strain (penicillin MIC = 4 μ/mL), and one serotype 23F strain, a penicillin-cephalosporin-resistant (CFTR) strain (CTX MIC = 4 μ/mL).
Results: CTX activity in this mouse model of pneumonia induced by the highly penicillin-resistant strain of S. pneumoniae was lower than expected from its low MIC against this organism. Furthermore, AMO had greater efficacy than CTX against a CFTR S. pneumoniae strain.
Conclusion: Our data suggest that there is no major difference in the in vivo efficacy of the two agents, cefotaxime and amoxicillin, against penicillin-resistant and penicillin-cephalosporin-resistant S. pneumoniae.     

Proteína C reactiva y escala SOFA: una simple escala como factor predictivo temprano de la necesidad de cuidados críticos en los pacientes con neumonía causada por COVID-19 en España

ObjectiveTo identify potential markers at admission predicting the need for critical care in patients with COVID-19 pneumonia.Material and methodsAn approved, observational, retrospective study was conducted between March 15 to April 15, 2020. 150 adult patients aged less than 75 with Charlson comorbidity index ≤ 6 diagnosed with COVID-19 pneumonia were included. Seventy-five patients were randomly selected from those admitted to the critical care units (critical care group [CG]) and seventy-five hospitalized patients who did not require critical care (non-critical care group [nCG]) represent the control group. One additional cohort of hospitalized patients with COVID-19 were used to validate the score.Measurements and main resultsMultivariable regression showed increasing odds of in-hospital critical care associated with increased C-reactive protein (CRP) (odds ratio 1.052 [1.009-1.101]; P = .0043) and higher Sequential Organ Failure Assessment (SOFA) score (1.968 [1.389-2.590]; P < .0001), both at the time of hospital admission. The AUC-ROC for the combined model was 0.83 (0.76-0.90) (vs AUC-ROC SOFA P < .05). The AUC-ROC for the validation cohort was 0.89 (0.82-0.95) (P > 0.05 vs AUC-ROC development).ConclusionPatients COVID-19 presenting at admission SOFA score ≥ 2 combined with CRP ≥ 9,1 mg/mL could be at high risk to require critical care.     

妇科门诊患者生殖道支原体感染及耐药性分析

目的:了解妇科门诊患者生殖道支原体感染状况及支原体的耐药性。方法:采用法国BioMerieux 公司的Mycoplasma IST试剂盒,对妇科门诊患者的生殖道分泌物标本进行支原体培养和耐药性检测。结果:受检者中解脲脲原体( Uu)阳性率为60% ,人型支原体( Mh) 阳性率为26 % ;6 种抗生素的药敏试验显示,Uu 和Mh 对红霉素完全耐药,对氧氟沙星耐药在60% 以上,对交沙霉素和普那霉素最为敏感。结论:妇科门诊患者中存在较大比例的支原体感染和携带,且对常用抗生素已产生一定的耐药性,这种状况应引起临床医生的注意     

肺炎性假瘤24例的临床X线误诊分析

目的探讨肺炎性假瘤的临床与X线误诊原因;方法依据临床与X线资料分析;结果均有不同程度的呼吸道症状,有14例痰中带血丝。肿块直径小于4cm11例,密度高而均匀,边缘光整,误诊为肺良性肿瘤。肿块直径大于4cm13例,密度不太均,边缘有分叶或有毛刺,误诊为肺癌;结论临床上多无急慢性感染症状,本病与其他占位性病变极相似,缺少特征,对本病缺乏认识是导致误诊的主要原因。肿块邻近胸膜,边缘出现尖角征,动态变化缓慢这3点对提高正确诊断率有独特的价值。     

小儿肺炎电超导治疗的研究

目的 评价电超导辅助治疗小儿肺炎的临床疗效。方法 所有144例，治疗组84例，对照组64例，对照组应用抗生素，同时止咳，化痰，平喘对症处理，治疗组在以照组的基础上超导辅助治疗，疗程一周。结果 治疗组总有效率100％，总痊愈率92．86％。而对照组总有效率仅为71．67％。结论 在原有治疗基础上加用电超导，可明显提高治愈率及总有效率。     

436例小儿肺炎的中西医结合治疗

对436例肺炎患儿在抗生素治疗的同时，给予清热宣肺，化痰平喘，健脾益气，养阴清肺中药口服，结果总有效率达97．25％。中西医结合治疗小儿肺炎可以缩短病程，减少抗生素的使用。     

三种细菌生物被膜中超广谱β-内酰胺酶的检测

目的检测肺炎克雷伯氏菌、大肠埃希氏菌、铜绿假单胞菌三种细菌的生物被膜(biofilm,BF)中超广谱β-内酰胺酶(Extended-spectrumβ-lactamases,ESBLs)的产生。方法用改良平板培养法在硅胶膜上建立肺炎克雷伯氏菌、大肠埃希氏菌、铜绿假单胞菌BF的体外模型。用银染法及扫描电镜对BF进行鉴定。用双纸片试验检测ESBLs,等电聚焦电泳测定β-内酰胺酶的等电点。结果三种细菌的各30株中,BF肺炎克雷伯氏菌组(A2组)中ESBLs的产生率最高(14株,46.7%),其浮游菌组(A1组)检出8株(26.7%);BF大肠埃希氏菌组(B2组)有10株(33.3%)产生ESBLs,其浮游菌组(B1组)检出6株(20.0%);BF铜绿假单胞菌组(C2组)有3株(10%)产ESBLs,其浮游组(C1组)为2株(6.7%)。浮游菌组中ESBLs的产生率低于BF菌组,其中肺炎克雷伯氏菌及大肠埃希氏菌的BF组和浮游菌组的检出率之间有显著差异(P<0.05)。A2组共检出14株产生ESBLs,有4种ESBLs,等电点分别为8.2(4株)、7.6(8株)、6.3(1株)和5.6(1株),A1组检出8株产生ESBLs,为3种ESBLs,等电点分别为8.2(2株)、7.6(5株)和5.6(1株);B2、B1组检出2种相同等电点分别为7.6(B1组4株,B2组6株)、8.2(B1组2株,B2组4株)的ESBLs;C1、C2组检出一种等电点为6.4的ESBLs(C1组2株,C2组3株)。以pI为7.6的β-内酰胺酶的检出率最高,其     

DNA analysis for phospholipase A2 coding sequences of Mycoplasma hominis isolated from women with a normal pregnancy and women with a pregnancy complicated by preterm labour

A possible cause of preterm labour is an increased synthesis of prostaglandins by a phospholipase A2 (PLA2) activity. PLA2 activity has been detected in Mycoplasma hominis. The aim of this study was to test whether chromosomal DNA of M. hominis contains sequences coding for PLA2. M. hominis was cultured in specimens from 5 women with normal pregnancy and 4 in preterm labour. Using sequence alignment, primer pairs for the active part of PLA2 of different species were designed for PCR analysis. No sequences coding for PLA2 could be amplified. Whatever its role in preterm labour, M. hominis is not involved in causing an increase of prostaglandin synthesis. Received: 21 September 1997 / Accepted: 17 January 1998     

支原体耐药性与抗菌药消耗量相关性研究

目的：了解支原体耐药性与抗生素消耗量之间的相关性。方法：对112份解脲支原体阳性标本进行9种抗菌药敏感性试验，统计2002～2003年有关药物的消耗量，分析解脲支原体耐药率与相应药品消耗量之间的关系。结果：多因素逐步回归分析表明上年度相关药物成人剂型的消耗量是有显著性意义的相关因素（r=0．858，F=16.778，P〈0．01）。结论：支原体的耐药率主要与上一年度的相关药物消耗量相关。