嗜水气单胞菌及其对人的致病性

嗜水气单胞菌在自然界广泛分布,是一种典型的人-畜-鱼共患病病原菌,人类可因致病性嗜水气单胞菌感染而发生腹泻、食物中毒、继发感染。由于嗜水气单胞菌菌落易与肠杆菌科细菌特别是大肠杆菌混淆,氧化酶试验阳性是其特征,常规检测非常必要。蛋白酶阳性可确定该菌为致病性嗜水气单胞菌,另外还可用PCR检测Aer基因来区别致病性嗜水气单胞菌和非致病性嗜水气单胞菌。目前,国外已将嗜水气单胞菌纳入腹泻病原菌的检测范围,是食品卫生检测的对象。因此,建议在食品、饮用水检测指标中增加嗜水气单胞菌作为细菌学指标,并将其纳入食物中毒诊断标准中。     

内镜与手术中肝总管胆汁细菌培养对比研究--附59例分析

目的 :通过对内镜与术中肝管胆汁细菌培养和药敏试验的结果进行对比研究 ,以明确前者在指导临床应用抗菌药物的价值。方法 :以感染严重评分 (SSS) <3 0和感染评分 (SS) <10作为入选条件 (Psss=0 .42 6,Pss=0 .52 9) ,分为内镜组 (n =3 1)和手术组 (n =2 8) ,内镜组经肝管插管获取胆汁 ,手术组经穿刺肝管获取胆汁 ,立即进行细菌培养和药敏测试 ,对结果进行对比分析。结果 :对比内镜组与手术组的阳性率 (P =0 .510 6) ,革兰阴性菌菌株分布 (P =0 .43 4 ) ,革兰阳性菌分布 (P =0 .860 )。革兰阴性菌药物敏感 (P =0 .644) ,中度敏感(P =0 .3 72 )。革兰阳性菌药物敏感 (P =0 .668) ,中度敏感 (P =0 .3 90 )。P值均大于 0 .0 5,两组没有统计学差异。结论 :通过内镜取材进行细菌培养可以正确反映胆管内细菌学状况 ,不应轻易放弃并值得推广     

Ano-genital gonorrhoea and pharyngeal colonisation with meningococci: a serogroup analysis

Among patients attending a clinic for sexually transmitted diseases, women without gonorrhoea were significantly less likely to be colonised with meningococci than were women with gonorrhoea, men with gonorrhoea and men without gonorrhoea: the respective carriage rates (per cent) for groupable plus non-groupable meningococci were 16, 26, 23 and 31. Considering groupable and non-groupable meningococci separately it was found that women without gonorrhoea were also significantly less likely to be colonised with groupable meningococci but there were no significant differences in the carriage rates of non-groupable meningococci. The association between ano-genital gonorrhoea and meningococcal colonisation of the pharynx observed previously with certain groups of patients most likely results from increased mouth-to-mouth contact in 'high-risk' patients rather than individual susceptibility to neisserial infection. The possibility that there is a difference in the predominant means of spread of groupable and non-groupable meningococci is discussed.     

Chlamydia trachomatis infection in patients with laparoscopically verified acute salpingitis: Results of isolation and antibody determinations

Culture and serology studies have shown Chlamydia trachomatis (CT) to be one of the causes of acute salpingitis (AS). In the present investigation, results of cervical cultures were correlated with serum antibody titers to CT in patients with laparoscopically verified AS. Serum samples from 206 patients, including paired sera from 80, were assayed. Of 206 patients, 118 had chlamydial lgG antibody titers of 1:64 or more. Patients with negative cultures for CT and an lgG titer of 1:64 or more had a significantly higher geometric mean titer than corresponding patients with positive cultures. In paired sera, a seroconversion or a fourfold or greater rise in lgG titer to CT was demonstrated in 35%, while a further 11% had detectable lgM antibody in a titer of 1:8 or more. The overall isolation frequency of CT was 33%, compared with 19% for Neisseria gonorrhoeae.     

胆汁细菌学检验及其对抗生素的耐药性分析

目的　了解胆道感染常见病原菌的种类及其对常用抗生素的耐药性 ,以指导临床合理用药。　方法　将 1998年 1月至 2 0 0 2年 6月间 6 9例住院病人胆汁培养阳性的 73株需氧菌及其对抗生素敏感性试验结果进行统计分析。　结果　标本的阳性检出率为 70 .4 % ,在分离株中 ,大多数病原菌为大肠埃希菌、肺炎克雷伯菌和肠球菌。革兰氏阴性杆菌对亚胺培南、阿米卡星和头孢他啶较为敏感 ,阳性球菌对万古霉素全部敏感。　结论　引起胆道感染的常见的需氧菌为大肠埃希菌、肺炎克雷伯菌和肠球菌 ,治疗时应根据药敏选择抗生素 ,必要时联合用药     

高温高湿环境猪肢体火器伤初期外科处理的初步观察及细菌学分析

目的初步观察高温高湿环境下肢体火器伤不同初期外科处理方法的效果。方法建立猪双后肢火器伤动物模型并立即置于高温高湿环境,分别于伤后3h和4h进行外科处理。每一处理时限均分为一期闭合组(组1:8只,16肢)和开放引流组(组2:6只,12肢)两组。分别观察每一时限下,两种不同外科处理前及处理后8h、24h、48h、72h、1周时血中白细胞数、伤道壁组织细菌数及伤口愈合情况。结果在伤后3h处理时限下,两种外科处理前后的各时间点白细胞数均无显著差异;外科处理后组1的细菌数低于组2且渗出较少,除两组中有个别肢体有少量干性脓苔外其余均无明显感染征象;组1的伤口愈合时间明显低于组2(P<0.05)且瘢痕形成小。在伤后4h处理时限下,外科处理后1周前的白细胞数和细菌数两组均无差别,致1周时组1要明显高于组2(P<0.05);组1有4肢伤口发生感染,而组2只1肢有少量脓苔样分泌物外其余均无明显感染发生;伤口愈合时间两组已无差别。结论结果显示高温高湿环境下的猪肢体火器伤在伤后3h内采用一期闭合处理效果较好,但应考虑到实验与实战环境有着较大的距离;而且在延长较短的处理时限后就会使感染有增加的趋势。因此,高温高湿环境肢体火器伤,即使受伤时间极短,若要采用较为积极的清创缝合时,应充分考虑伤口的污染及组织损伤程度、受伤     

In-line milk filter analysis: Escherichia coli O157 surveillance of milk production holdings

Escherichia coli O157 is a major etiological agent of food-borne illness. Bovine animals are recognized reservoirs for this organism and represent a significant source from where these pathogens can enter the food chain. Food products derived from these animals are convenient vehicles, and are often the focal point(s) of infection. As a useful strategy to provide herd-level surveillance and to investigate for the presence of this pathogen in a population of Irish dairy cattle, milk filters from 97 farms were analysed by conventional culture and other methods. Five hundred and thirty-six milk filters were evaluated over a 2-year period. Filters from 12 of the 97 farms (12%) were found to contain E. coli O157, based on culture methods. Sixteen verocytotoxigenic E. coli O157 organisms were recovered and characterized in detail. The farm families in each case were consuming raw milk from their respective herds. The potential risk to public health associated with the detection of E. coli O157 and the local consumption of raw milk are discussed.     

Mechanical Bowel Preparation or Not? Outcome of a Multicenter, Randomized Trial in Elective Open Colon Surgery

PURPOSE Mechanical bowel preparation is common practice in elective colon surgery. In recent literature the value of this procedure is under discussion. To verify the value of mechanical bowel preparation in elective open colon surgery, a randomized clinical trial was conducted.METHODS During a prospective, multicenter, randomized study, 250 patients undergoing elective open colon surgery were randomized between receiving mechanical bowel preparation with polyethylene glycol (PEG group, 125 patients) and having a normal meal preoperatively (normal meal preoperatively group, 125 patients). Outcome parameters were wound infection with bacterial results of intraoperative swabs and anastomotic leak.RESULTS In the polyethylene glycol group there were a total of nine wound infections (7.2 percent) and seven anastomotic leaks (5.6 percent) compared with seven wound infections (5.6 percent) (P = 0.61) and six anastomotic leaks (4.8 percent) (P = 0.78) in the normal meal preoperatively group. Bacterial results showed 52 percent sterile subcutis swabs in the PEG group and 63 percent sterile subcutis swabs in the normal meal preoperatively group (P = 0.11).CONCLUSION In the pres-ent study we could not detect a difference in outcome parameters between patients receiving mechanical bowel preparation in elective open colon surgery and patients without preoperative treatment of the bowel. The present study, although underpowered, did not show a difference in the primary outcome of bacterial wound cultures between patients receiving preoperative mechanical bowel preparation and patients receiving no preoperative bowel treatment. We conclude that there may be no need to continue the use of mechanical bowel preparation in elective open colon surgery.Presented at the Fourth Belgian Surgical Week, May 2 to 4, 2003, Oostende, Belgium, and at the Dutch Surgical Week, May 15 to 16, 2003, Veldhoven, The Netherlands.Reprints are not available     

Relationships between high-resolution computed tomography, lung function and bacteriology in stable bronchiectasis

To determine the relationship between high-resolution computed tomography (HRCT) findings, lung function, and bacteriology in bronchiectasis, we conducted a retrospective study of 49 Korean patients with stable bronchiectasis. To quantify the extent and severity of bronchiectasis, we used a CT scoring system consisting of bronchial dilatation, bronchial wall thickening, the number of bronchiectatic segments, the number of bulla, and the number of emphysema segments. The presence of air-fluid levels and lung consolidation were also evaluated. The results of CT scoring, spirometry and sputum culture were analyzed. Patients with cystic bronchiectasis had higher CT score, more dilated lumen and lower forced vital capacity (FVC), forced expiratory volume in 1 sec (FEV1), and FEV1/FVC than patients with cylindrical bronchiectasis. Patients with mixed ventilatory impairment had larger number of bronchiectatic segments than patients with obstructive ventilatory impairment. CT score and the number of bronchiectatic segments were significantly associated with FVC and FEV1, while CT score and the number of emphysema segments were significantly associated with FEV1/FVC. Twenty-one patients of 49 patients showed a positive sputum culture including 15 cases of Pseudomonas aeruginosa. The CT score was the most important predictor of lung function. The presence of air-fluid levels predicted bacterial colonization.     

2008至2012年苏州地区住院患儿下呼吸道感染细菌病原学分布及耐药性分析

目的 探讨苏州地区下呼吸道感染住院患儿细菌病原的构成和耐药性.方法 回顾性分析2008年1月至2012年12月于苏州大学附属儿童医院呼吸科住院的8 863例进行痰细菌学培养的下呼吸道感染患儿的资料.采用传统手工方法鉴定、分离细菌,纸片扩散法（K-B法）进行药敏试验.采用x2检验或Fisher确切概率法进行统计学检验.结果 8 863例患儿中2 980例痰培养阳性,阳性率为33.6％.共分离出菌株3 283株,其中肺炎链球菌1 182株（13.3％）,其次为流感嗜血杆菌530株（6.0％）,金黄色葡萄球菌413株（4.7％）和卡他莫拉菌324株（3.7％）等.6个月及以下患儿细菌检出率最高（37.6％）,＞6个月～1岁为32.3％,＞1 ～3岁为32.7％,＞3～7岁为33.7％,7岁以上儿童细菌检出率最低,为20.0％.6月以上患儿中检出的细菌以肺炎链球菌为主,而6个月以内患儿大肠埃希菌、肺炎克雷伯菌和金黄色葡萄球菌的检出率升高.入院前使用抗菌药物的患儿痰细菌培养检出率明显低于未使用抗菌药物的患儿（29.4％：38.8％,x2=26.335,P＜0.01）,且抗菌药物使用的时间对细菌的检出率也存在一定影响.药敏试验结果显示,肺炎链球菌及金黄色葡萄球菌分别对阿莫西林及苯唑西林敏感,而大肠埃希菌和肺炎克雷伯菌对第三代头孢菌素类药物的耐药性有升高趋势,对哌拉西林/他唑巴坦及头孢哌酮/舒巴坦仍较敏感.结论 肺炎链球菌是苏州地区儿童下呼吸道感染的首要病原菌,不同年龄组患儿检出细菌的构成不同,且入院前使用抗菌药物会影响细菌的检出率.