Changes in intestinal flora after administration of panipenem/betamipron or sulbactam/cefoperazone for treatment of postoperative infections in gastrectomy patients

To determine the effect of antibiotics used for the treatment of postoperative infections on the normal intestinal flora in patients who have undergone gastroenterological surgery, we performed a prospective randomized study in patients who had undergone distal gastrectomy. Cefazoline was administered up to postoperative day 3 for prophylaxis. For the treatment of postoperative infections, either panipenem/betamipron (PAPM/BP; n = 5) or sulbactam/cefoperazone (SBT/CPZ; n = 5) was adminstered to ten patients with signs of postoperative infections. Feces were examined for bacteria before and 4 and 7 days after the commencement of administration of these therapeutic antibiotics. The anaerobic bacterial count decreased significantly in four of five patients treated with SBT/CPZ, from 10^10.2±0.36/g before treatment to 10^5.22±3.51/g. In the PAPM/BP-treated group, the anaerobic bacterial count did not change after antibiotic therapy. We also investigated the major genera of colonic anaerobes, and found that the numbers of bifidobacteria were maintained during PAPM/BP administration. However, in the SBT/CPZ group, the number of bifidobacteria decreased to below the detection limit in four of five patients. Little change was observed in the aerobic bacterial count in either group. However, Enterobacteriaceae were replaced by enterococcus or candida in all patients from the SBT/CPZ group and in one of five patients from the PAPM/BP group. Physicians should be alert for the possible clinical consequences of changes in intestinal microflora after antibiotic treatment of postoperative infections. Received: June 29, 1998 / Accepted: November 5, 1998     

比浊法测定硫酸卡那霉素注射液的效价

目的　建立测定硫酸卡那霉素效价的方法。方法　采用比浊法,并与管碟法相比较。结果　比浊法线性范围为2～1 0U·ml-1 ,线性方程:A =1 .1 0 4 0 - 1 .2 6 5 9logC(r=0 .992 5 ) ;平均回收率为97.1 1 %(n =4 )。结论　比浊法与管碟法的测定结果无显著性差异,可作为硫酸卡那霉素的效价测定方法之一,且更快捷、方便。     

高效液相色谱—蒸发光散射检测法测定氨基糖苷类抗生素中硫酸盐含量的研究

目的:建立高效液相色谱-蒸发光散射检测法测定氨基糖苷类抗生素中硫酸盐的含量。方法:采用ODS柱,以含0.015mol·L-1正已胺和0.025mol·L-1甲酸的水-乙腈（88:12）为流动相,流速为10mL·min-1,蒸发光散射检测,检测器温度:45℃,雾化气体（空气）压力:0.35 MPa。结果:SO42-在22～435μg·mL-1范围内呈良好的线性关系,r=0.9997;平均回收率为99.8％,RSD=0.31％（n=6）;日内精密度（RSD=1.1％,n=8）良好。结论:本方法简便,快速,结果准确,可靠,重现性好。     

十一种抗菌药对五种细菌的抗生素后效应

目的：测定不同类别抗菌药对5种细菌的抗生素后效应（PAE）。方法：以肉汤稀释法测定抗菌药的最低抑菌浓度,PAE实验采用洗涤法去除抗菌药,以活菌落计数法测定菌液浓度,作生长曲线、计算PAE。结果：大环内酯类红霉素、阿奇霉素、克拉霉素及罗红霉素对金黄色葡萄球菌的PAE为3．10－4．15h,对肺炎链球菌的PAE为1．85－3．3h,明显较其他抗菌药的PAE为长（P＜0．01）。大环内酯类抗菌药对流感嗜血杆菌的PAE为1－4h,其中阿奇霉素的PAE达4h。环丙沙星、阿米卡星对大肠杆菌及肺炎克雷伯菌的PAE为1．38－2．00h,明显较哌拉西林、头孢唑啉或头孢噻肟的PAE（0．1－0．5h)为长（P＜0．01）。结论：各类抗菌药对细菌的PAE长短不一,PAE作为一个药效学指标,对抗菌药给药方案的制订及其合理应用有一定的参考价值。     

Identification and antibiotic resistance of faecal enterococci isolated from water samples

We have isolated 47 strains of presumptive faecal streptococci from different water samples. Identification was made by the method of Facklam et al. (1989). Antibiotic resistance was studied on Mueller-Hinton Agar. Twelve antibiotics were tested. High-level aminoglycoside resistance (HLAR) and resistance to glycopeptides were studied. Biochemical identification of presumptive faecal streptococci isolates gave the following results: 19 Enterococcus faecalis, 12 E. faecium, 8 E. hirae, 4 E. durans and 4 E. mundtii. E. mundtii is not included among faecal enterococci. None of the strains were resistant to glycopeptides (vancomycin and teicoplanin). Three strains of Enterococci showed HLAR. Two of them were isolated from coastal bathing waters and the other from wastewater. This suggests that water could contribute to spread of HLAR enterococci and it should be a matter of concern for public health authorities.     

腰蛛网膜下腔持续引流注药治疗重症颅内感染40例分析

目的 研究一种治疗重症颅内感染的新方法。方法 选择重症颅内感染40例,随机分组进行间断腰穿注药及蛛网膜下腔置管持续引流注药治疗,对比疗效。结果 蛛网膜下腔置管持续引流注药治疗具有脑脊液药物浓度高,能有效控制颅内压,减轻脑膜刺激,缩短感染治疗住院日,具有良好效果。结论 一旦发生手术及创伤后颅内感染,可优先应用腰蛛网膜下腔持续引流注药治疗。     

Antibiotic resistance: a guide for effective prescribing in women's health

Current national and international trends in antibiotic resistance are becoming a public health crisis. Multi-drug resistant organisms are more prevalent in hospital settings and, alarmingly, are now being identified in the community. Over-reliance on broad-spectrum antibiotics, as well as inappropriate prescribing practices, play a significant role in encouraging the emergence of resistant organisms. This article reviews the mechanisms of bacterial resistance, current trends in national and international antibiotic resistance, and examines approaches to combat pathogens while sparing benign microbes.     

Characteristics of microorganisms cultured from infected wounds post-hysterectomy

Objective

To characterize organisms causing wound infection following abdominal hysterectomy.

Study design

All patients who underwent an abdominal hysterectomy (December 2002–January 2006) and developed abdominal wall wound infection proven by a positive culture were included in the study. Patient information was collected from the computerized files. The isolated microorganisms were characterized for antibiotics susceptibility.

Results

Sixty-eight (68/620, 10.96%) patients had positive wound cultures. Of 100 isolated microorganisms, 44 were resistant to cefonicid (prophylactic treatment) and 15 were resistant to combined ampicillin, gentamicin and metronidazole (empirical treatment). Major co-morbidities (including diabetes mellitus, hypertension, past malignancies, renal, cardiovascular and pulmonary diseases, hypothyroidism or anemia), were found to be significantly associated with pseudomonal infection (P < .008).

Conclusion

A significant portion of pathogens causing post-hysterectomy abdominal wall wound infection are resistant to the prophylactic treatment, and some are resistant to the empirical treatment. Further studies are necessary to evaluate the effectiveness of various prophylactic regimens with better coverage of Enterococcus fecalis, as well as the effectiveness of empirical treatment active against the resistant Enterobacteriaceae group.     

两药联合对铜绿假单胞菌生物膜作用研究进展

铜绿假单胞菌（PA）已成为院内感染的一个重要致病菌,其诱发疾病的特点呈慢性并反复急性发作,死亡率高。铜绿假单胞茵生物被膜（BF）的形成是其重要原因之一。细菌的生物膜能保护细菌抵御抗生素的作用形成耐药性,并能逃避机体免疫系统的攻击,从而造成慢性难治性感染。查阅近年有关文献表明,单种药物很难清除细菌生物被膜,药物联合在防治细菌生物膜感染方面具有独特的优势。该文就抗生素联合、中药联合抗生素抗铜绿假单胞菌生物膜的研究进行综述。