呼吸道感染常见致病菌耐药趋势分析

目的：调查我院临床常见的G-致病菌在院内呼吸道感染病人的分布,并检测常用抗生素的种类对致病菌的效价情况,为呼吸道感染病人合理选用抗生素提供依据。方法：对来源于院内呼吸道感染病人的样本300个进行分离培养,用microscan au-toscan4（美国德灵半自动细菌分析仪）菌种鉴定及抗生素的药敏实验,回顾性分析肺部感染患者的痰细菌培养及药物敏感性测定结果。结果：从样本中分离获得825株主要致病菌,其中G＋致病菌389株,占47.2%,G-致病菌380株,占46.1%,真菌46株,占6.7%。G＋致病菌对检测10种抗生素的药敏性主要表现为传统的抗生素的疗效普遍偏低;而G-致病菌对检测的抗生素10种的药敏性情况表现出多元化态势。结论：院内呼吸道感染常见致病菌以革兰阴性菌为主,耐药性高,临床实践应重视病原学的监测,了解细菌的种类分布和耐药趋势,合理使用抗生素。     

呼吸道感染常见致病菌及耐药性分析

目的:调查导致呼吸道感染的主要致病菌的种类,及这些致病菌对我科常用抗生素的药敏性情况,为呼吸道感染的合理用药提供依据.方法:对680个样本进行分离培养,用全自动微生物分析仪-VITEK32进行菌种鉴定及抗生素的药敏实验.结果:共分离获得1484株主要致病菌,其中G 致病菌706株,占总量的47.6%,G-致病菌686株,占总量的46.2%,真菌92株,占总量的6.2%.G 致病菌对检测10种抗生素的药敏性主要表现为传统的抗生素的疗效普偏低;而G-致病菌对检测的抗生素10种的药敏性情况表现出多元化态势.结论:呼吸道感染常见致病菌的种类多样,且表现出较高能力的耐药性,这值得我们注意.     

小儿呼吸道感染常见病原菌及药敏结果分析

目的:了解小儿下呼吸道感染的常见病原菌及其对抗菌药物的敏感性.方法:对北京市和平里医院儿科两年来确诊治疗的156例小儿呼吸道感染患儿的痰标本进行培养及药敏试验.结果:156例标本检出致病菌98株,其中G-杆菌71株(72.4％),G+球菌23株(23.5％),真菌4株(4.1％),主要致病菌依次为肺炎克雷伯菌26株,大肠埃希菌20株.流感嗜血杆菌13株,金黄色葡萄球菌7株,肺炎链球菌5株.药敏结果显示,G-杆菌对亚胺培南均敏感,其次为头孢西丁、庆大霉素,G+球菌对万古霉素均敏感,对头孢西丁、庆大霉素、环丙沙星、阿米卡星有较高的敏感性.结论:革兰阴性杆菌为本地区小儿呼吸道感染的主要致病菌,真菌的感染率也呈上升趋势,临床上应及时检测,合理用药.     

临床常见G+致病菌的种类及耐药性的研究

目的:调查我院常见G 致病菌的种类及其对目前常用抗生素的耐药现状,为临床医生合理选用抗生素提供数据资料.方法:从3286个样本中分离到206株G 致病菌,用全自动微生物分析仪-VITEK 32进行菌种鉴定及药敏实验.结果:206株G 致病菌经鉴定属于6大类,其中金黄色葡萄球菌,74株,占35.9%;溶血葡萄球茵,47株,占22.8%;表皮葡萄球茵,47株,占22.8%;肠球菌属,33株,占16.0%;肺炎链球茵,3株,占1.5%;β-溶血链球菌,2株,占1.0%.肺炎链球茵和β-溶血链球菌仅对检测的14种抗生素中的少数敏感.在对14种抗生素的耐药性实验中,药效普遍较差的抗生素为:青霉素、庆大霉素、苯唑西林.它们三者的平均药敏感率依次为:16.52%、18.42%和21.07%.结论:临床G 致病菌的耐药性问题已非常严峻,合理的选择和使用抗生素已十分重要.     

临床标本优势菌种分布及耐药分析

目的了解临床标本中微生物分离率及其耐药性,为微生物检验教学改革提供临床依据。方法对近一年来临床标本的细菌分离情况及耐药性进行回顾性统计和分析,使用SPSS 13.0软件,采用计数资料进行统计描述分析。结果从2 989份标本中分离出644株病原菌,其中G-杆菌占67.7%,G+球菌占23.29%,真菌58株占9.01%。药敏结果显示大多细菌呈现泛耐药性。结论临床感染以G-杆菌为主,G-杆菌又以NFGNB常见,而G+球菌中肠球菌占主要地位。且这些细菌对常用抗菌药物耐药严重。     

肺癌患者呼吸道病原菌感染的回顾性分析

目的：了解肺癌患者呼吸道感染的病原菌及其耐药特点,方法：对我院2000年1月-2002年1月肺癌患者痰标本所分离细菌进行回顾性分析。结果：肺癌病人呼吸道感染以G-菌为主占54.5%,其次是真菌21.9%及G 菌14.1%,G-菌中以沙雷菌属(32.2%),大肠埃希菌和铜绿假单胞菌(9.7%)为主,在大肠埃希菌中,产超广谱β-内酰胺酶株(ESBLS)占40.6%,真菌以白色假丝酵母菌(87.8%)为主,G 球菌中以凝固酶阴性葡萄球菌为主(76.9%),耐苯唑西林凝固酶阴性葡萄球菌(MRSCN)占63.6%,所分离细菌除对舒普生,特治星,亚胺培南及万古霉素耐药率较低外,常用抗生素显示较高的耐药率,结论:肺癌患者呼吸道感染的病原菌以G-菌为主,而真菌为G 菌亦不容忽视,且大多数病原菌耐药率较高,临床合理,规范使用抗生素是当务之急.     

医院病原菌感染的临床分布及耐药性分析

目的:了解南京地区病原菌感染的临床分布及其耐药性变化情况。方法:对2009年全年住院病人病原菌感染病例进行统计,并且对相应抗生素的耐药情况进行分析。结果:2009年度共分离临床菌株3346株,其中G-杆菌占56.3%,G+球菌占25%,真菌感染占18.7%。以铜绿假单胞菌、鲍曼不动杆菌、大肠埃希菌为代表的革兰阴性菌为最常见的临床分离细菌,耐药现象较为严重。大多数医院感染革兰阴性菌对加酶抑制剂抗菌药耐药率菌有不同程度的下降。结论:为减少病原菌感染的发生率及控制细菌耐药性必须加强抗生素的合理应用。     

临床常见G-致病菌的种类及耐药性的研究

目的:调查我院常见G—致病菌的种类及其对目前常用抗生素的耐药现状,为临床医生合理选用抗生素提供数据资料。方法:从3286个样本中分离到742株G—致病菌,用全自动微生物分析仪--VITEK 32进行菌种鉴定及药敏实验。结果:742株G—致病菌经鉴定属于14大类,其中铜绿假单胞菌,170株,占22．91％;大肠埃希氏菌,145株,占19．54％;鲍曼不动杆菌,100株,占13,48％;产酸克雷伯菌,84株,占11．32％;其它10种G—致病菌所占的比例均小于8％。鲍曼不动杆菌、嗜麦芽假单胞菌、产气肠杆菌三种菌对检测的17种抗生素中的极少数敏感。在对17种抗生素的耐药性实验中,药效普遍较差的抗生素为:替卡西林、头孢呋辛、头孢噻吩三者的平均药敏感率依次为:20．72％、17.21％和11．71％。结论:临床G—致病菌的耐药性问题已非常严峻,降低G—致病菌的耐药性和控制其传播以迫在眉睫。     

临床常用抗生素对G-致病菌的效价分析

目的:调查我院常用抗生素的种类及其对,临床常见的G~-致病菌的效价情况,为合理选用抗生素提供临床资料。方法:从2246个样本中分离到646株G~-致病茵,用全自动微生物分析仪-VITEK 32进行菌种鉴定及20种抗生素的药敏实验。结果:646株G~-致病菌经鉴定属于14大类,其中铜绿假单胞菌160株,占24.77%;大肠埃希氏菌135株,占20.90%;鲍曼不动杆菌90株,占13.93%;克雷伯菌属116株,占17.96%;其它9种G~-致病菌所占的比例均小于7%。头孢类抗生素是目前最为常用的。在检测的20种抗生素对检测的14种G~-致病菌的效价最高的前三位分别是:亚胺培南(IMP)82.66%、美洛西林(MEZ)81.15%、环丙沙星(CIP)61.06%;效价最差的三位分别是:头孢呋辛(CFO)23.76%、头孢噻吩(CEP)26.74%、替卡西林(TIC)31.58%。结论:经典的抗生素对G~-致病菌的效价不容乐观,且非科学的联合用药可能会降低药效。     

综合性ICU败血症致病菌的变迁和对策

目的探讨败血症与医院感染发展的趋势、致病菌的变迁的关系。方法回顾性分析2005年1月至2005年12月,经血培养和临床资料证实的综合性ICU的27例31次败血症。结果27例31次败血症中院内感染占74.19%,院外感染占25.81%;有严重基础病与易感因素占92.59%;致病菌分布特点有G 菌呈上升趋势,G-菌则有下降趋势,但仍以G-菌为主;条件致病菌、复数菌和真菌感染发生明显增加;本组院内感染病死率高(37.04%)(不包含4例自动出院者),这往往与宿主防御机能低下或诱发因素有关。结论G 菌败血症呈上升趋势,G-菌则有下降趋势,条件致病菌和真菌败血症发生率明显增多;应注意合理用药、细菌培养和药敏试验。     

On the origin of the Hirudinea and the demise of the Oligochaeta

The phylogenetic relationships of the Clitellata were investigated with a data set of published and new complete 18S rRNA gene sequences of 51 species representing 41 families. Sequences were aligned on the basis of a secondary structure model and analysed with maximum parsimony and maximum likelihood. In contrast to the latter method, parsimony did not recover the monophyly of Clitellata. However, a close scrutiny of the data suggested a spurious attraction between some polychaetes and clitellates. As a rule, molecular trees are closely aligned with morphology-based phylogenies. Acanthobdellida and Euhirudinea were reconciled in their traditional Hirudinea clade and were included in the Oligochaeta with the Branchiobdellida via the Lumbriculidae as a possible link between the two assemblages. While the 18S gene yielded a meaningful historical signal for determining relationships within clitellates, the exact position of Hirudinea and Branchiobdellida within oligochaetes remained unresolved. The lack of phylogenetic signal is interpreted as evidence for a rapid radiation of these taxa. The placement of Clitellata within the Polychaeta remained unresolved. The biological reality of polytomies within annelids is suggested and supports the hypothesis of an extremely ancient radiation of polychaetes and emergence of clitellates.     

On the ontogeny of the haptor and the evolution of the Monogenea

Data on the ontogeny of the posterior haptor of monogeneans were obtained from more than 150 publications and summarised. These data were plotted into diagrams showing evolutionary capacity levels based on the theory of a progressive evolution of marginal hooks, anchors and other attachment components of the posterior haptor in the Monogenea (Malmberg, 1986). 5 + 5 unhinged marginal hooks are assumed to be the most primitive monogenean haptoral condition. Thus the diagrams were founded on a 5 + 5 unhinged marginal hook evolutionary capacity level, and the evolutionary capacity levels of anchors and other haptoral attachement components were arranged according to haptoral ontogenetical sequences. In the final plotting diagram data on hosts, type of spermatozoa, oncomiracidial ciliation, sensilla pattern and protonephridial systems were also included. In this way a number of correlations were revealed. Thus, for example, the number of 5 + 5 marginal hooks correlates with the most primitive monogenean type of spermatozoon and with few sensillae, many ciliated cells and a simple protonephridial system in the oncomiracidium. On the basis of the reviewed data it is concluded that the ancient monogeneans with 5 + 5 unhinged marginal hooks were divided into two main lines, one retaining unhinged marginal hooks and the other evolving hinged marginal hooks. Both main lines have recent representatives at different marginal hook evolutionary capacity levels, i.e. monogeneans retaining a haptor with only marginal hooks. For the main line with hinged marginal hooks the name Articulon-choinea n. subclass is proposed. Members with 8 + 8 hinged marginal hooks only are here called Proanchorea n. superord. Monogeneans with unhinged marginal hooks only are here called Ananchorea n. superord. and three new families are erected for its recent members: Anonchohapteridae n. fam., Acolpentronidae n. fam. and Anacanthoridae n. fam. (with 7 + 7, 8 + 8 and 9 + 9 unhinged marginal hooks, respectively). Except for the families of Articulonchoinea (e.g. Acanthocotylidae, Gyrodactylidae, Tetraonchoididae) Bychowsky's (1957) division of the Monogenea into the Oligonchoinea and Polyonchoinea fits the proposed scheme, i.e. monogeneans with unhinged marginal hooks form one old group, the Oligonchoinea, which have 5 + 5 unhinged marginal hooks, and the other group form the Polyonchoinea, which (with the exception of the Hexabothriidae) has a greater number (7 + 7, 8 + 8 or 9 + 9) of unhinged marginal hooks. It is proposed that both these names, Oligonchoinea (sensu mihi) and Polyonchoinea (sensu mihi), will be retained on one side and Articulonchoinea placed on the other side, which reflects the early monogenean evolution. Except for the members of Ananchorea [Polyonchoinea], all members of the Oligonchoinea and Polyonchoinea have anchors, which imply that they are further evolved, i.e. have passed the 5 + 5 marginal hook evolutionary capacity level (Malmberg, 1986). There are two main types of anchors in the Monogenea: haptoral anchors, with anlages appearing in the haptor, and peduncular anchors, with anlages in the peduncle. There are two types of haptoral anchors: peripheral haptoral anchors, ontogenetically the oldest, and central haptoral anchors. Peduncular anchors, in turn, are ontogenetically younger than peripheral haptoral anchors. There may be two pairs of peduncular anchors: medial peduncular anchors, ontogentically the oldest, and lateral peduncular anchors. Only peduncular (not haptoral) anchors have anchor bars. Monogeneans with haptoral anchors are here called Mediohaptanchorea n. superord. and Laterohaptanchorea n. superord. or haptanchoreans. All oligonchoineans and the oldest polyonchoineans are haptanchoreans. Certain members of Calceostomatidae [Polyonchoinea] are the only monogeneans with both (peripheral) haptoral and peduncular anchors (one pair). These monogeneans are here called Mixanchorea n. superord. Polyonchoineans with peduncular anchors and unhinged marginal hooks are here called the Pedunculanchorea n. superord. The most primitive pedunculanchoreans have only one pair of peduncular anchors with an anchor bar, while the most advanced have both medial and lateral peduncular anchors; each pair having an anchor bar. Certain families of the Articulonchoinea, the Anchorea n. superord., also have peduncular anchors (parallel evolution): only one family, the Sundanonchidae n. fam., has both medial and lateral peduncular anchors, each anchor pair with an anchor bar. Evolutionary lines from different monogenean evolutionary capacity levels are discussed and a new system of classification for the Monogenea is proposed.In agreeing to publish this article, I recognise that its contents are controversial and contrary to generally accepted views on monogenean systematics and evolution. I have anticipated a reaction to the article by inviting senior workers in the field to comment upon it: their views will be reported in a future issue of this journal. EditorIn agreeing to publish this article, I recognise that its contents are controversial and contrary to generally accepted views on monogenean systematics and evolution. I have anticipated a reaction to the article by inviting senior workers in the field to comment upon it: their views will be reported in a future issue of this journal. Editor