179株β-内酰胺酶阳性细菌的体外药敏试验

目的：探讨β－ 内酰胺酶阳性菌的抗药性。方法：从２１７ 株临床革兰阴性杆菌和革兰阳性葡萄球菌中测得β－ 内酰胺酶阳性者１７９ 株。采用 Ｋ－ Ｂ 法测定舒普深、优力新和安美汀对这１７９ 株细菌的体外药敏试验,并与头孢哌酮、氨苄青霉素、羟氨苄青霉素及其他一些抗生素进行比较。结果说明：３ 种复方制剂对产酶细菌的抗菌作用较相应单药均有不同程度的增效。此外,对产酶革兰阴性杆菌舒普深效果较好,对产酶葡萄球菌优力新效果较好。     

Protective effects induced by alcoholic Phlomis fruticosa and Phlomis herba‐venti extracts in isolated rat colon: Focus on antioxidant,anti‐inflammatory,and antimicrobial activities in vitro

Phlomis fruticosa L. and P. herba‐venti are species belonging to the Lamiaceae family, which have been traditionally used to prepare tonic and digestive drinks. Multiple studies also demonstrated the inhibitory effects of P. fruticosa extracts and essential oil against oxidative/proinflammatory pathways and bacterial strains deeply involved in ulcerative colitis. Considering these findings, the present study evaluated the effects of alcoholic P. fruticosa and P. herba‐venti leaf extracts in isolated rat colon challenged with Escherichia coli lipopolysaccharide (LPS), an ex vivo experimental paradigm of ulcerative colitis. In this context, we assayed colon levels of pro‐oxidant and proinflammatory biomarkers, including nitrites, malondialdehyde (MDA), lactate dehydrogenase (LDH), and serotonin (5‐HT). Additionally, the extracts have been tested in order to evaluate possible inhibitory effects on specific bacterial and fungal strains involved in ulcerative colitis. Alcoholic P. fruticosa and P. herba‐venti extracts were able to blunt LPS‐induced nitrite, MDA, 5‐HT, and LDH levels in isolated rat colon. The same extracts also inhibited the growth of Pseudomonas aeruginosa, E. coli, Staphylococcus aureus, Candida albicans and Candida tropicalis. In conclusion, our findings show a potential role exerted by alcoholic P. fruticosa and P. herba‐venti in managing the clinical symptoms related to ulcerative colitis.     

Prevention of infectious complications after prostate biopsy procedure

Although febrile complications are rarely encountered after a prostate biopsy procedure, in recent years the number of cases of fatal infection after that have increased along with increases in resistant bacteria. The available biopsy approaches are transrectal and transperineal, with the transrectal approach primarily used. As the invasion path of the puncture needle differs between these approaches, pretreatment and the method of administration of preventive antimicrobial drugs should be separately considered for infection prevention. Recently, the Japanese guidelines for perioperative infection prevention in the field of urology were revised after receiving approval from the Japanese Urological Association. With use of the transrectal approach, attempts have been made to selectively administer prophylactic antibiotics by confirming the presence or absence of resistant bacteria in rectal swab culture results before carrying out a prostate biopsy procedure because of potential problems associated with resistant bacteria in rectal flora. For preventive antibiotics, a single dose of oral quinolone is recommended for patients with low risk, whereas daily administrations of piperacillin/tazobactam are recommended for those considered to be high risk. In contrast, for the transperineal procedure, a single dose of oral quinolone is recommended as a preventive antibiotic. With both approaches, it is important to empirically administer broad‐spectrum antimicrobials when occurrence of a febrile infection after a prostate biopsy procedure is confirmed.     

我院2013～2015年住院患者抗菌药物应用分析

目的分析并评价我院住院患者抗菌药物的应用情况,为合理使用抗菌药物提供参考依据。方法利用信息系统收集2013~2015年我院抗菌药物的使用数据,对抗菌药物的费用比例、用药频度(DDDs)及日均费用(DDC)等进行回顾性分析。结果我院住院患者使用抗菌药物DDDs排名前10位的药品基本来自头孢菌素类、其他β-内酰胺类、喹诺酮类、硝基咪唑类及青霉素类复方制剂,住院患者抗菌药物占总销售金额的比例逐年上升,头孢菌素类使用频度较高,部分药物DDC较高。结论我院还存在部分药物DDDs偏高的情况,应严格限制头孢菌素类(尤其是三代头孢菌素)、其他β-内酰胺类、喹诺酮类(尤其是左氧氟沙星)及青霉素类复方制剂的临床应用,避免DDDs的过快增长,加强监督和管理。     

Trowels and Tribulations: Review of Antimicrobial‐Impregnated Bone Cements in Prosthetic Joint Surgery

Antimicrobial‐impregnated bone cement (AIBC) is a staple of contemporary orthopedic surgery and has been used to either treat or prevent prosthetic joint infection. Applied intraoperatively during primary arthroplasty or prosthetic joint exchange, this drug‐delivery vehicle has become a popular means of maximizing drug concentrations within a joint space while minimizing systemic exposure. Antimicrobial characteristics conducive to cement loading include availability of a crystalline powder formulation, molecular characteristics, minimal impact on cement integrity, and other variables promoting drug elution. Antimicrobials most commonly incorporated into cements are vancomycin and aminoglycosides, usually in combination due to synergistic antibacterial activity and enhanced cement elution. Other classes include the β‐lactams, lipopeptides, oxazolidinones, and antifungals. With the exception of several commercially available AIBCs, most products are compounded extemporaneously without a formal safety or efficacy assessment. Few randomized controlled trials have been conducted to assess the benefit or optimal use of these cement preparations, and variable methodology renders cross‐study comparison challenging. Given the lack of standardization and multidisciplinary oversight often seen with practical AIBC use, additional data are needed. This review presents information intended to guide AIBC preparation, selection, dosing, and safe use. In addition, opportunities for best practice development, antimicrobial stewardship, and future research are discussed.     

Hypothesis-driven weight-of-evidence analysis of endocrine disruption potential: a case study with triclosan

Triclosan is an antimicrobial agent used in a range of consumer products, such as deodorants, oral care, clothing, and household items. As with many consumer products, triclosan can be rinsed down the drain and transported to wastewater treatment plants. While most is eliminated during activated sludge sewage treatment by biodegradation and adsorption, some triclosan enters the aquatic environment and may expose wildlife. Given the potential for exposure to both humans and wildlife, resolving whether triclosan is endocrine active is important due to growing concerns about potential adverse public health and environmental effects of endocrine-disrupting substances. A weight of evidence (WoE) analysis focusing on specific hypotheses related to interaction with estrogen, androgen, and thyroid hormone pathways, and steroidogenesis was applied to triclosan. This WoE procedure involved systematic consideration of each endpoint, focused on screening level studies in the US Endocrine Disruptor Screening Program, as well as those in levels 1 through 5 of the OECD Conceptual Framework. This was followed by a semiquantitative relevance weighting of each endpoint to a given hypothesis to reach scientifically justified conclusions. Use of all relevant and reliable information and consistent observations in multiple studies strengthen support for or against each mode of action hypothesis. Using data from multiple animal species and in vitro systems, this systematic and transparent WoE assessment indicated that triclosan is not acting as an agonist or antagonist within the estrogen, androgen, thyroid, or steroidogenic pathways and is not impacting endocrine pathways as a lead or primary mode of toxicity.     

A patent review of the therapeutic potential of isoflavones (2012-2016)

Introduction: Isoflavones are well-studied natural products isolated from natural sources with interesting chemodiversity and possess a wide variety of biological effects. Moreover, chemical modifications based on the isoflavone scaffold, has generated synthetic chemodiversity to enhance the bioactivities of isoflavones.

Areas covered: The current review summarizes the discovery of new chemotherapeutic agents possessing the isoflavone skeleton. This review incorporates patents filed between 2012 and 2016 mostly related to anticancer, antidiabetic, antimicrobial, anti-HIV, anti-gastric ulcer, anti-gastritis, antiparasitic and some other biological effects demonstrated by isoflavone analogs.

Expert opinion: The number of interesting patents published during the five year period (2012–2016) on the therapeutic potential of isoflavones indicated the importance of this molecule. Natural isoflavones possess potent anticancer, anti-HIV and antidiabetic activities and chemical analogs of natural isoflavones increase the abovementioned biological effects. Additionally isoflavones have only been tested for a limited number of biological activities and thus future research should focus on additional biological activities viz., anti-inflammatory, antimalarial, and anti-leishmanial effects. However, the absence of SAR studies and in vivo data restricted the rational design of more potent isoflavone analogs and we believe that in order to get lead compounds, there needs to be a greater focus on SAR and in vivo studies.     

Medical management of chronic rhinosinusitis – a review of traditional and novel medical therapies

Introduction: Chronic rhinosinusitis (CRS) is a commonly seen persistent inflammatory disease process affecting the paranasal sinuses with extensively reported economic implications. Despite an elusive pathophysiologic mechanism underlying this disease process, treatment outcomes are encouraging with the employment of an array of medical and surgical therapies.

Areas covered: The goal of this paper is to provide a comprehensive, up to date analysis of the literature concerning the medical management of CRS by summarizing the evidence in support of traditional medical therapies for the management of CRS in addition to highlighting novel medical therapies currently under investigation.

Expert opinion: The current staples of medical therapy for CRS based on the strength of available evidence include topical and oral corticosteroids, oral antibiotics and topical saline. The introduction of immunomodulatory therapies (‘Biologics’) for the treatment of CRS shows promise but have yet to be employed in a widespread fashion due to the need for additional research to better elucidate their role.     

91株恶臭假单胞菌流行病学特征及耐药性

目的分析临床分离恶臭假单胞菌的流行病学与耐药特点,为临床合理防治其感染提供依据。方法收集2010年1月—2015年12月临床分离的恶臭假单胞菌及其感染者临床资料,以美国临床实验室标准化协会中的K-B纸片扩散法、药敏判断标准进行药物敏感性试验及其结果判断,以WHONET5.5软件对分离菌株药敏结果进行统计分析。结果临床标本共分离出91株恶臭假单胞菌,以60岁以上老年患者为主(占70.33%);基础疾病以社区获得性肺炎检出最多(占23.08%),其次慢性肺原性心脏病(占15.38%);标本主要来源于深部痰(占57.14%),其次为中段尿(占27.47%);主要分布于呼吸内科(占28.57%),其次为心血管内科(占13.19%)。除对氨曲南耐药率(52.75%)较高外,对庆大霉素、亚胺培南、左氧氟沙星、头孢他啶、美罗培南、环丙沙星等耐药率较低,分别为7.78%、9.89%、2.20%、9.89%、7.69%、2.22%,对阿米卡星和多粘菌素的耐药率均为0。结论恶臭假单胞菌感染主要发生于伴有基础疾病的老年患者,以呼吸道感染为主,对多数抗菌药物的耐药率10%。     

中国东海及东太平洋海山区来源抗菌活性海洋微生物的筛选研究

摘要：目的 研究中国东海及东太平洋区域来源微生物的抗菌活性,意在筛选具有良好抗菌活性的海洋微生物,并初步研究活性菌株代谢产物的结构,为探求新型抗生素提供基础。方法 以金黄色葡萄球菌、大肠杆菌和白色念珠菌为指示菌株,采用牛津杯法进行抗菌活性微生物初筛和复筛。通过HPLC-DAD结合TLC对活性突出的4株真菌及1株细菌进行活性提取物指纹图谱分析。对广谱抗菌活性菌株WBX-38进行菌种鉴定及活性代谢产物分离纯化,利用核磁共振和质谱等手段对活性化合物进行结构鉴定。采用微量稀释法测定活性化合物的最小抑菌浓度（MIC）。结果与结论 从中国东海及东太平洋来源样品中共筛选90株海洋来源菌株,获得抗菌活性菌株16株,4株为海洋细菌,12株为海洋真菌。通过HPLC-DAD结合TLC分析,发现5株活性菌株均具有独特的色谱行为。海洋真菌WBX-38通过菌种鉴定,确认为海洋来源曲霉（Aspergillus sp.）。从其发酵液提取物中分离获得1个活性化合物5-hydroxymethylfuran-3-carboxylic acid,该化合物对3种指示菌均具有一定生长抑制活性。