三种方法测定多重耐药菌对替加环素敏感性的评价

目的评价三种方法测定替加环素对多重耐药菌药物敏感的准确性。方法分别采用K-B法、Vitek 2法及MTS法检测临床分离的82株多重耐药细菌(MRSA、VRE、耐碳青霉烯类大肠埃希菌、耐碳青霉烯类肺炎克雷伯杆菌、耐碳青霉烯类鲍曼不动杆菌),比较其结果的差异性。结果 MTS法检测13株MRSA、10株VRE测得的替加环素MIC50和MIC90分别为0.25、0.064 mg/L,0.50、0.125 mg/L;Vitek 2法测MRSA、VRE的MIC50和MIC90分别为0.5、0.25 mg/L,1、0.5 mg/L;MTS法检测15株耐碳青霉烯类大肠埃希菌、19株耐碳青霉烯类肺炎克雷伯杆菌、28株耐碳青霉烯类鲍曼不动杆菌测得的替加环素MIC50和MIC90分别为0.25、0.5、1 mg/L,0.25、1、2 mg/L;Vitek 2法测耐碳青霉烯类大肠埃希菌、耐碳青霉烯类肺炎克雷伯杆菌、耐碳青霉烯类鲍曼不动杆菌分别为0.25、1、2 mg/L,1、1、4 mg/L;K-B法的替加环素对五种多重耐药菌依序的敏感率分别为100.0%、100.0%、66.7%、79.0%、78.0%。与MTS比较,其他两种方法测定MRSA、VRE的分类一致性(categorical agreement,CA)均为100.0%,其他三种CA分别为86.7%/73.3%、89.5%/84.2%、78.6%/89.3%;重大误差(major error,ME)分别为6.7%/6.7%、5.3%/5.3%、0.0%/3.6%;小误差(minor error,Me)分别为13.3%/13.3%、10.5%/10.5%、17.9%/21.4%。结论替加环素对各种多重耐药菌的每种测定方法敏感率存在差异,对耐碳青霉烯类鲍曼不动杆菌,使用K-B法来作为首选,而对耐碳青霉烯类大肠埃希菌、耐碳青霉烯类肺炎克雷伯杆菌及MRSA、VRE来说,Vitek 2法仍作为其敏感性的常规操作。需制定较方便合适的方法来指导临床用药。     

鲍曼不动杆菌体外诱导耐药及其诱导前后交叉耐药和呼吸耗氧率分析

【背景】鲍曼不动杆菌是院内感染的重要病原菌,因其耐药率高、治疗难度大而备受关注。然而,对于该菌的交叉耐药及耐药相关因素尚未完全阐明。【目的】通过体外诱导分别获得耐美罗培南或耐替加环素的鲍曼不动杆菌菌株,并研究其诱导前后的交叉耐药性和细菌呼吸耗氧率差异。【方法】采用多步法对鲍曼不动杆菌ATCC19606进行体外诱导耐药,PCR扩增诱导前后菌株的16S rRNA基因并测序鉴定,微量肉汤稀释法检测诱导前后鲍曼不动杆菌对美罗培南、亚胺培南、替加环素、阿米卡星、头孢吡肟及左氧氟沙星等抗菌药物的最低抑菌浓度变化,Seahorse XF~e96细胞能量代谢实时测定仪对诱导前后菌株的耗氧率进行分析。【结果】通过88d的体外诱导实验,分别获得耐美罗培南或耐替加环素的鲍曼不动杆菌ATCC19606菌株。耐美罗培南鲍曼不动杆菌ATCC19606对替加环素、亚胺培南、阿米卡星、左氧氟沙星仍处于敏感状态,但是对头孢吡肟交叉耐药;耐替加环素鲍曼不动杆菌ATCC19606对美罗培南、亚胺培南、阿米卡星、左氧氟沙星及头孢吡肟仍处于敏感状态。鲍曼不动杆菌ATCC19606被美罗培南或替加环素诱导耐药之后的耗氧率均下降,差异均具有统计学意义。【结论】美罗培南的使用不仅可能诱导鲍曼不动杆菌ATCC19606对美罗培南耐药,也可能会导致该菌对其它一种或几种抗菌药物产生交叉耐药。鲍曼不动杆菌ATCC19606对美罗培南或替加环素耐药后其耗氧率下降,从而说明呼吸耗氧率下降可能是该菌耐药的因素之一。     

米诺环素对泛耐药鲍曼不动杆菌的体外药敏分析

初步探讨米诺环素对泛耐药的鲍曼不动杆菌体外药敏。将各种标本分离获得的鲍曼不动杆菌,进行米诺环素药敏试验,并将检测结果进行统计和分析。2009年1月至2011年9月共检出鲍曼不动杆菌471株,其中米诺环素敏感的鲍曼不动杆菌2009年5株、2010年12株、2011年23株;亚胺培南、美洛培南敏感其他耐药的0株,亚胺培南、美洛培南、米诺环素敏感其他耐药的0株;米诺环素和头孢哌酮/舒巴坦同时敏感的236株,占总数的50.1%。米诺环素对泛耐药的鲍曼不动杆菌在体外有很好的抗菌活性,特别是联合头孢哌酮/舒巴坦治疗泛耐株鲍曼不动杆菌的感染是一个不错的选择。     

耐碳青霉烯类鲍曼不动杆菌OXA基因检测及同源性分析

目的 了解台州地区碳青霉烯类耐药鲍曼不动杆菌的耐药性、碳青霉烯酶基因型以及同源性.方法 63株碳青霉烯类耐药鲍曼不动杆菌经VITEK2 Compact进行细菌鉴定及药敏分析,用K-B法复核药敏结果,采用多重PCR扩增分析碳青霉烯酶的基因型;采用脉冲场凝胶电泳(pulsed field gel electrophoresis,PFGE)分析其同源性.结果 63株菌株为多重耐药菌株,除多粘菌素、阿米卡星、头孢哌酮/舒巴坦外,对其他常用抗生素的耐药率均在70％以上.63株菌株检测出OXA-51基因60株(95.2％),OXA-23基因58株(92.1％),两个基因同时存在的有58株(92.1％).PFGE结果显示碳青霉烯类鲍曼不动杆菌主要分为5个克隆型,其中A、B两个为主型.结论 产OXA酶是台州地区耐碳青霉烯类鲍曼不动杆菌的主要耐药机制之一,其中OXA-23是主要的基因型.     

鲍曼不动杆菌的耐药性及金属酶基因型的分析

目的 探讨本地区鲍曼不动杆菌的耐药性及耐亚胺培南鲍曼不动杆菌(IRAB)金属酶基因型的分布情况,为临床使用抗生素提供帮助.方法 回顾性分析1 614株鲍曼不动杆菌的耐药情况,PCR检测金属酶基因型.结果 (1)1 614株IRAB的检出率为63.82％ (1030/1614),以重症监护室检出率最高占46.22％(746/1614).(2)抗菌药物的耐药率:其中米诺环素(28.51％)和多粘菌素B(6.10％)的耐药率最低,其他药物的耐药率均＞40.0％.(3) IRAB产金属酶基因型的以OXA-23为主.结论 监测鲍曼不动杆菌的耐药率,有助于有效控制鲍曼不动杆菌引起的医院内感染.     

替加环素不敏感鲍曼不动杆菌的分子流行病学及耐药机制

为探讨替加环素不敏感鲍曼不动杆菌Acinetobacter baumannii的耐药机制,为院内感染控制及临床合理用药提供理论依据,采用琼脂稀释法和微量肉汤稀释法检测全国多中心12个城市20家医院临床分离的94株非重复的替加环素不敏感鲍曼不动杆菌的最低抑菌浓度(Minimum inhibitory concentration,MIC),应用多位点序列分型(Multilocus sequence typing,MLST)技术进行分子流行病学研究,应用eBURST软件对MLST结果进行分析;用PCR和测序技术分析常见耐药基因(bla_(OXA-40-like)、bla_(OXA-58-like)、bla_(OXA-23-like)、bla_(OXA-51-like)、bla_(NDM-1)),与替加环素耐药相关的外排泵调控基因adeR和adeS的突变位点、trm的突变位点。经检测94株鲍曼不动杆菌除对多粘菌素B 100%敏感、对米诺环素敏感率25.5%外,其他抗菌药物的敏感率均低于3.5%,亚胺培南和美罗培南敏感率均只有1.1%。MLST分型得到12种ST分型,以ST195(45株,47.9%)、ST208(19株,20.2%)和ST457(10株,10.6%)为主,eBURST分析发现其中8个ST型均属于克隆复合体92(Clonal Complex 92,CC92);99%菌株bla_(OXA-23-like)型碳青霉烯酶基因阳性;均未扩增出bla_(NDM-1)基因;外排泵调控基因adeR和adeS的检出率分别是73.4%和91.5%,Asp26Asn和Ala97Glu分别为adeR和adeS的高频突变位点;在12株鲍曼不动杆菌中检测到了adeS基因的ISAba1,以北部地区为主;trm基因均在第240位核苷酸发生缺失突变。综上所述,替加环素不敏感鲍曼不动杆菌对除多粘菌素B外的大多数抗菌药物具有很高的耐药性,AdeABC外排泵上游的双组分调控系统adeR和adeS的缺失和突变,trm缺失突变是导致鲍曼不动杆菌对替加环素敏感性降低的主要原因。     

鲍曼不动杆菌的耐药性检测及泛耐药菌株的耐药基因研究

目的考察临床分离的鲍曼不动杆菌的耐药性并对泛耐药菌株的耐药基因进行检测。方法用纸片扩散法对60株临床分离鲍曼不动杆菌进行药物敏感试验,并用PCR法检测8株泛耐药菌株携带7种耐药基因OXA-51、OXA-23、OXA-24、OXA-58、aac(3)-Ⅰ、gyr A、abe M的情况。结果所分离的鲍曼不动杆菌对临床常用的β-内酰胺类抗生素、氨基糖苷类抗生素、四环素类抗生素、磺胺类抗菌药及喹诺酮类抗菌药均产生耐药性;在8株泛耐药鲍曼不动杆菌中OXA-51、OXA-23、OXA-58、gyr A、abe M基因检测均全部呈阳性;OXA-24基因检测均呈阴性;aac(3)-I基因检测有5株呈阳性,3株呈阴性。结论鲍曼不动杆菌耐药情况严重,其耐药机制与多种耐药基因密切相关。     

医院内鲍曼不动杆菌感染调查及泛耐药情况分析

目的 了解义乌市妇幼保健院近3年来医院内鲍曼不动杆菌感染现状,及泛耐药情况.方法 对医院2009年至2011年分离的鲍曼不动杆菌分布及耐药情况进行回顾性分析.细菌鉴定采用美国德灵细菌鉴定仪.结果 3年间共分离到鲍曼不动杆菌305株,其中2009年72株,2010年91株,2011年142株,泛耐药菌株感染率呈现出逐年上升趋势,2009年5株(占6.94％),2010年9株(占9.89％),2011年有19株(占13.38％).结论 鲍曼不动杆菌感染呈逐年上升趋势,其泛耐药菌株感染率呈上升趋势.应加强抗生素的合理使用,控制鲍曼不动杆菌在医院内的定值和播散,重视泛耐药鲍曼不动杆菌监测.     

重症监护室耐亚胺培南鲍曼不动杆菌的耐药性分析

目的探讨温州医学院附属第一医院重症监护室（ICU）耐亚胺培南鲍曼不动杆菌的耐药特性。方法对2006年1月至2007年12月ICU分离的菌株采用常规方法进行菌株分离,经革兰染色、氧化酶试验等初筛,再经VITEK-32型全自动微生物分析仪进行菌株鉴定和药敏试验。结果共检测到98株鲍曼不动杆菌,其中耐亚胺培南的鲍曼不动杆菌为50株（占51.0%）,标本来源大部分为痰液（占94.9%）。耐亚胺培南鲍曼不动杆菌对常用16种抗菌药物耐药率〉50%的有15种,耐药率〉90%有3种,分别为氨苄西林（98.0%）、头孢唑林（99.0%）和呋喃妥因（99.0%）,对抗菌药物耐药率最低仅为头孢哌酮/舒巴坦（10.2%）,另外检测到对所用抗菌素泛耐为4株（8.0%）;而对亚胺培南敏感的鲍曼不动杆菌对常用16种抗菌药物耐药率〉50%的仅为4种,耐药率〉90%同样为氨苄西林（100%）、头孢唑林（97.9%）和呋喃妥因（97.9%）,耐药率比较低的为美罗培南（10.4%）、妥布霉素（16.7%）和环丙沙星（16.7%）,耐药率最低也为头孢哌酮/舒巴坦（6.3%）。结论 ICU分离耐亚胺培南鲍曼不动杆菌多重耐药性严重,出现了泛耐菌株;临床可根据药敏试验选用抗菌药物,一般条件下耐亚胺培南鲍曼不动杆菌建议选用头孢哌酮／舒巴坦。     

临床分离鲍曼不动杆菌的外排泵基因检测及同源性分析

目的探讨临床分离鲍曼不动杆菌主动外排基因的分布和菌株克隆相关性,为指导临床合理用药和制定恰当的感染控制措施提供理论依据。方法对临床分离的80株鲍曼不动杆菌采用琼脂稀释法检测对抗菌药物的敏感性,聚合酶链反应(PCR)检测adeB、adeG、adeJ外排泵基因的携带情况,脉冲场凝胶电泳法分析多重耐药鲍曼不动杆菌的同源性。结果 80株临床分离鲍曼不动杆菌中,57株为多重耐药株(MDRAB),且对多粘菌素B、头孢哌酮/舒巴坦和美罗培南较为敏感,对其他临床常用抗生素普遍耐药。adeB、adeG、adeJ外排泵基因分布广泛,在敏感菌株中存在率也很高;PFGE分型结果显示57株MDRAB菌株共分为四大群(A、B、C、D),并以流行克隆A为主。结论临床分离鲍曼不动杆菌耐药形式严峻,其临床分离株普遍存在外排泵编码基因adeB、adeG、adeJ,携带外排泵阳性MDRAB菌株的克隆播散是温州地区鲍曼不动杆菌发生耐药的机制之一。     

黄酮化合物对耐药性鲍曼不动杆菌抑菌作用研究

为探索中药黄酮化合物对耐药性鲍曼不动杆菌的抑菌效果。研究通过微量肉汤稀释法,考察40种中药及天然来源的黄酮化合物对三株耐药性鲍曼不动杆菌菌株的体外抑菌作用,测试其最低抑菌浓度与最低杀菌浓度;采用结晶紫染色法进一步测定目标化合物对鲍曼不动杆菌生物被膜形成的能力;探索黄酮联合头孢哌酮/舒巴坦对鲍曼不动杆菌的抑菌效果。研究表明,黄酮单体对于鲍曼不动杆菌具有不同程度的体外抑菌作用。其中部分具有轻微作用,其最小抑菌浓度仅为0.5 mg/mL;黄芩素和汉黄芩苷具有显著的抑菌作用,其最小抑菌浓度分别为0.062 5和0.125 mg/mL;同时,黄芩素对鲍曼不动杆菌生物被膜形成具有明显的抑制作用。此外,黄芩素和头孢哌酮/舒巴坦联合作用于耐药鲍曼不动杆菌与单用黄芩素或头孢哌酮/舒巴坦比较,浓度有所降低。综上,黄芩素对耐药性鲍曼不动杆菌有较好的体外抑菌效果,这为治疗耐药性鲍曼不动杆菌引发的感染的治疗提供新思路和方向。     

In-vitro activity of polymyxin B, rifampicin, tigecycline alone and in combination against carbapenem-resistant Acinetobacter baumannii in Singapore

Objective

Carbapenem-resistant Acinetobacter baumannii (CR-AB) is an emerging cause of nosocomial infections worldwide. Combination therapy may be the only viable option until new antibiotics become available. The objective of this study is to identify potential antimicrobial combinations against CR-AB isolated from our local hospitals.

Methods

AB isolates from all public hospitals in Singapore were systematically collected between 2006 and 2007. MICs were determined according to CLSI guidelines. All CR-AB isolates were genotyped using a PCR-based method. Clonal relationship was elucidated. Time-kill studies (TKS) were conducted with polymyxin B, rifampicin and tigecycline alone and in combination using clinically relevant (achievable) unbound concentrations.

Results

31 CR AB isolates were identified. They are multidrug-resistant, but are susceptible to polymyxin B. From clonal typing, 8 clonal groups were identified and 11 isolates exhibited clonal diversity. In single TKS, polymyxin B, rifampicin and tigecycline alone did not exhibit bactericidal activity at 24 hours. In combination TKS, polymyxin plus rifampicin, polymyxin B plus tigecycline and tigecycline plus rifampicin exhibited bactericidal killing in 13/31, 9/31 and 7/31 isolates respectively at 24 hours. Within a clonal group, there may be no consensus with the types of antibiotics combinations that could still kill effectively.

Conclusion

Monotherapy with polymyxin B may not be adequate against polymyxin B susceptible AB isolates. These findings demonstrate that in-vitro synergy of antibiotic combinations in CR AB may be strain dependant. It may guide us in choosing a pre-emptive therapy for CR AB infections and warrants further investigations.     

革兰阴性杆菌对头孢哌酮／舒巴坦耐药率的变迁

目的调查革兰阴性杆菌对头孢哌酮／舒巴坦的耐药率变化。方法收集2004年1月至2007年12月从我院住院患者各种临床标本中分离的革兰阴性杆菌,使用VITEK-60全自动微生物分析仪进行菌种的鉴定,采用K-B法对头孢哌酮／舒巴坦进行药敏试验,对结果进行回顾性凋查。结果肠杆菌科细菌对头孢哌酮／舒巴坦的耐药率较低,大肠埃希菌、肺炎克雷伯菌和阴沟肠杆菌对头孢哌酮／舒巴坦的耐药率分别为1．7％,7．7％和5．8％。嗜麦芽窄食假单胞菌、洋葱伯克霍尔德菌、脑膜脓毒性金黄杆菌、铜绿假单胞菌和鲍曼不动杆菌对头孢哌酮／舒巴坦的耐药率分别为27．6％、38．0％、2．3％、23．5％和4．8％。铜绿假单胞菌和鲍曼不动杆菌对头孢哌酮／舒巴坦的耐药率从2004年的35．1％和23．7％下降至2007年的12．4％和0．4％。结论头孢哌酮／舒巴坦对肠杆菌科细菌具有非常强的体外抗菌活性,铜绿假单胞菌和鲍曼不动杆菌对头孢哌酮／舒巴坦的耐药率呈下降趋势。     

Antibiotic resistance of <Emphasis Type="Italic">Stenotrophomonas maltophilia</Emphasis> strains isolated from captive snakes

The minimum inhibitory concentrations (MICs) of 24 antibiotics were determined for 45 Stenotrophomonas maltophilia strains by the microdilution method at 37 and 30 °C (after 24 h and 48 h of incubation). The isolates were obtained from mouth swabs and pus of 116 captive snakes whereas the identical strains (based on PFGE) of the same origin were discarded. At 37 °C, the isolates showed a low frequency of resistance to levofloxacin (0 and 8.9 % of resistant strains after 24 and 48 h, MICs₅₀ 0.5 and 1 mg/L, MICs₉₀ 1 and 2 mg/L) and cotrimoxazole (2.2 % of resistant strains for 24 and 48 h, MICs₅₀ 4 mg/L for both time periods, MICs₉₀ 4 and 8). At 30 °C, the most effective drugs were also cotrimoxazole (2.2 and 6.7 %, MICs₅₀ 4 and 8, MICs₉₀ 8 and 32) and levofloxacin (8.9 and 46.7 %, MICs₅₀ 1 and 2, MICs₉₀ 2 and 4). The isolates were either identically or more susceptible to antibiotics than strains acquired from patients hospitalized at Olomouc University Hospital (the same region) with the exception of ciprofloxacin, cefoperazone, cefoperazone/sulbactam and ceftazidime.     

Effect of Proton Pump Inhibitors on In Vitro Activity of Tigecycline against Several Common Clinical Pathogens

In this study, we evaluated the effect of proton pump inhibitors (PPIs) on in vitro antimicrobial activity of tigecycline against several species of clinical pathogens. Clinical non-duplicate isolates of Acinetobacter baumannii, Staphylococcus aureus, Enterococcus faecalis and three species of Enterobacteriaceae (Escherichia coli, Klebsiella pneumonia and Enterobacter cloacae) were collected from a tertiary hospital and their MICs of tigecycline alone and in combination with PPIs (omeprazole, lansoprazole and pantoprazole) were determined. With one randomly selected isolate of each bacterial species, an in vitro time–kill study was performed for the confirmation of the effect of PPIs on tigecycline activity. The MIC changes after PPIs addition correlated with the PPIs concentrations in the test media. Compared with tigecycline alone, the addition of 5 mg/L PPIs could increase the MICs of tigecycline by 0 to 2-fold and the addition of 50 mg/L PPIs could increase the MICs of tigecycline by 4 to >128-fold. The time–kill study confirmed that the addition of PPIs could affect the in vitro activity of tigecycline. Even at low concentration (5 mg/L) of omeprazole and pantoprazole, antagonistic effect could be observed in E. cloacae and E. faecalis strains. We conclude that In vitro activity of tigecycline can be influenced by the presence of PPIs in a concentration-dependent manner.     

Synergistic effect of Myrtus communis L. essential oils and conventional antibiotics against multi-drug resistant Acinetobacter baumannii wound isolates

Acinetobacter baumannii is a rapidly emerging, highly resistant clinical pathogen with increasing prevalence. In recent years, the limited number of antimicrobial agents available for treatment of infections with multi-drug resistant (MDR) strains reinforced tendency for discovery of novel antimicrobial agents or treatment strategies. The aim of the study was to determine antimicrobial effectiveness of three Myrtus communis L. essential oils, both alone and in combination with conventional antibiotics, against MDR A. baumannii wound isolates. The results obtained highlighted the occurrence of good antibacterial effect of myrtle oils when administered alone. Using checkerboard method, the combinations of subinhibitory concentrations of myrtle essential oils and conventional antibiotics, i.e. polymixin B and ciprofloxacine were examined. The results proved synergism among M. communis L. essential oils and both antibiotics against MDR A. baumannii wound isolates, with a FIC index under or equal 0.50. Combination of subinhibitory concentrations of essential oils and ciprofloxacin most frequently reduced bacterial growth in synergistic manner. The similar has been shown for combination with polymyxin B; furthermore, the myrtle essential oil resulted in re-sensitization of the MDR wound isolates, i.e. MICs used in combination were below the cut off for the sensitivity to the antibiotic. Time-kill curve method confirmed efficacy of myrtle essential oil and polymyxin B combination, with complete reduction of bacterial count after 6 h. The detected synergy offers an opportunity for future development of treatment strategies for potentially lethal wound infections caused by MDR A. baumannii.     

广州儿童医院重症监护病房感染病原菌的分布及耐药性分析

目的探讨儿科重症监护病房（PICU）感染病原菌的分布及耐药情况,为临床合理选用抗菌药提供参考。方法对广州市儿童医院PICU病房2003年11月-2005年10月各类感染标本所分离的病原菌的分布及耐药性进行回顾性分析。结果共检出295株病原菌,其中革兰阴性杆菌213株（72．2％）,主要为铜绿假单胞菌、不动杆菌等非发酵菌;革兰阳性球菌58株（19．7％）,主要为葡萄球菌;真菌24株（8．1％）。药敏结果提示铜绿假单胞菌及不动杆菌对亚胺培南、头孢哌酮／舒巴坦、环丙沙星及阿米卡星较为敏感,铜绿假单胞菌对头孢噻肟耐药率较高,而不动杆菌对头孢哌酮、氨曲南、庆大霉素耐药严藿。肠杆菌科细菌对氨苄西林、氨苄西林／舒巴坦、哌拉西林及多种头孢菌素耐药率较高而对亚胺培南、头孢哌酮／舒巴坦、阿米卡星等较敏感。葡萄球菌对青霉素、红霉素严重耐药,但对万古霉素、替考拉宁及阿米卡星敏感性高。结论铜绿假单胞菌等非发酵菌已成为PICU病房感染的主要病原菌。根据病原菌种类及药敏结果合理应用抗菌药是有效控制危重病患儿感染和减少耐药菌株产生的重要手段。     

心内科患者医院感染鲍氏不动杆菌的耐药性分析

目的了解心内科住院患者医院感染鲍氏不动杆菌的耐药性,为指导临床合理用药提供依据。方法从2010—2012年心内科住院患者送检标本中分离鲍氏不动杆菌,采用PHOENIX-100全自动细菌鉴定药敏系统进行细菌鉴定及药敏试验,并对结果进行统计分析。结果2010-2012年心内科住院患者共分离出166株鲍氏不动杆菌,其中泛耐药菌株34株,检出率为20．5％。药敏结果显示鲍氏不动杆菌对常用抗菌药物的耐药率呈逐年上升趋势,并显示出多重耐药性,对多粘菌素B、头孢哌酮／舒巴坦、亚胺培南和美罗培南等耐药率相对较低。结论鲍氏不动杆菌已成为医院感染重要病原菌,对多种抗菌药物耐药,临床应加强耐药性监测,根据药敏结果合理选用抗菌药物,以控制医院感染的暴发流行。     

Tigecicline susceptibilities of tetracycline-resistant Campylobacter jejuni clinical strains isolated in Poland

Campylobacteriosis is a significant public health problem in many developed countries. Campylobacter jejuni is one of the leading causes of food-borne gastroenteritis and enteritis in humans. Treatment of campylobacteriosis is required in severe clinical infections, extraintestinal infections and in immunocompromised patients. Erythromycin is the proposed drug of choice for the treatment of Campylobacter infections. However, tetracycline and fluoroquinolones (ciprofloxacin) are also clinically effective agents for treating infections caused by Campylobacter spp. High prevalence of C. jejuni resistant to fluoroquinolone and tetracycline have been recently reported in many countries. In human medicine new agents for the treatment of many serious infections are acutely needed in hospital practice. Tigecycline is a member of a new group of antibiotics--the glycylcyclines with an expanded microbiological spectrum. In our study we will determine the susceptibility of polish, resistant to tetracycline clinical C. jejuni isolates to tigecycline. All 94 tetracycline-resistant C. jejuni strains, with MICs between 8 and 256 mg/l, isolated between 2007 and 2008 were susceptible to tigecycline, with MICs 0.06 mg/1. Tigecycline may has potential therapeutic role in the treatment of serious Campylobacter infections.     

赤拟谷盗的磷化氢敏感和抗性品系体内羧酸酯酶的活性比较

本文比较测定了赤拟谷盗Tribolium castaneum(Herbst)的磷化氢抗性(Rf=327)和敏感品系害虫的羧酸酯酶活性,研究了该害虫同一品系不同个体间羧酸酯酶的活性差异,比较了两品系害虫在系列磷化氢浓度下熏蒸24h和6.94×10-2mg/L磷化氢浓度下熏蒸不同时间的羧酸酯酶活性。主要结果为:未熏蒸的抗性害虫幼虫和蛹体内的羧酸酯酶活性分别高于敏感品系的1.37和1.16倍;敏感和抗性害虫同品系内不同个体间羧酸酯酶活性分布频率都存在明显差异,抗性害虫中酶活性大的个体数量占的比例较大;磷化氢浓度分别为0.69×10-2、2.78×10-2、5.56×10-2、8.33×10-2和11.11×10-2mg/L时都可导致敏感害虫羧酸酯酶的活性降低,但活性受抑制的程度不因浓度高低呈相应的增减。浓度分别为5.56×10-2、11.11×10-2、13.89×10-2、20.83×10-2和27.78×10-2mg/L的熏蒸中抗性害虫体内酶活性增加,且活性增高的程度与浓度增减也不呈对应变化。在6.94×10-2mg/L磷化氢浓度下熏蒸不同时间的结果中,敏感害虫的酶活性随时间延长而下降,抗性害虫的活性则随时间延长而增大。研究表明赤拟谷盗对磷化氢的抗性可能与羧酸酯酶的活性增加有关。