小儿细菌性肺炎痰培养物病原菌构成及耐药性分析

目的分析肺炎患儿痰培养物中细菌构成及其耐药情况,为小儿细菌性肺炎治疗提供合理使用抗感染药物的依据。方法对2019年11月至2020年12月济宁市第一人民医院临床送检的肺炎患儿痰液标本进行病原菌的分离鉴定和药敏试验,收集相关资料,并对小儿肺炎病原菌在临床上的分布特点及其耐药情况进一步分析。结果痰液培养阳性患儿183例,其中多重细菌感染患儿16例,共培养出199株细菌(剔除同一患儿的重复菌株),其中革兰阴性菌128株(64.32%),革兰阳性菌71株(35.68%)。主流细菌为肺炎链球菌(19.60%)、金黄色葡萄球菌(16.08%)、卡他莫拉菌(13.57%)、肺炎克雷伯菌(11.06%)和大肠埃希菌(10.05%)。多重细菌感染主要以金黄色葡萄球菌+肺炎克雷伯菌、金黄色葡萄球菌+大肠埃希菌混合为主(共5例,31.25%)。肺炎链球菌和金黄色葡萄球菌对利奈唑胺、万古霉素绝对敏感。卡他莫拉菌对头孢噻肟、头孢曲松、米诺环素等绝对敏感。肠杆菌科中肺炎克雷伯菌和大肠埃希菌药敏结果相似,对阿米卡星、厄他培南、头孢替坦敏感率在95%～100%,对氨苄西林耐药率在95%～100%。肺炎链球菌、金黄色葡萄球菌、卡他莫拉菌对左氧氟沙星敏感率均大于90%,大肠埃希菌、肺炎克雷伯菌对左氧氟沙星不够敏感,但中敏率达到75%以上。结论肺炎链球菌、金黄色葡萄球菌、卡他莫拉菌、肺炎克雷伯菌、大肠埃希菌感染是本地肺炎患儿痰液中常见菌,抗生素耐药状况比较严重,亚胺培南对革兰阴性菌混合感染的效果较好,利奈唑胺对阳性菌效果较好;左氧氟沙星可用于革兰阴性和阳性菌混合感染,合理使用抗生素应注意针对性和用药时间,杀灭致病菌的同时尽可能维护正常菌群的平衡。     

复方蛇床子灌注液对奶牛乳房炎6种主要致病菌的抑杀作用

目的通过实验证明复方蛇床子灌注液对奶牛乳房炎病原菌的抑杀作用。方法复方蛇床子灌注液为受试药物,6种引起奶牛乳房炎的常见病原菌（金黄色葡萄球菌、大肠埃希菌、无乳链球菌、停乳链球菌、白色念珠菌和热带假丝酵母菌）为实验菌株,采用测定抑菌圈的琼脂平板扩散法和测定最小抑菌浓度（M IC）的药物固体培养基法来评价复方蛇床子灌注液的体外抗菌活性。结果复方蛇床子灌注液对6种供试菌株均有较好的抑菌作用,其中0.1 g/mL的原药液对无乳链球菌和金黄色葡萄球菌表现了强大的抑制作用（M IC值达0.0015 g/mL）,抑菌圈直径分别高达33 mm和28 mm。结论复方蛇床子灌注液对奶牛乳房炎6种主要致病菌有较强的抑杀作用,抗菌谱广,药物浓度与抑菌效应呈正相关。     

肛周脓肿患者病原菌结构和耐药性分析

摘要 目的：分析肛周脓肿患者的病原菌结构和其耐药情况,为临床抗菌药物的选择提供依据。方法：收集医院2019年1月~2020年12月期间收治的324例肛周脓肿患者的脓液标本,在实验室进行菌株的培养、鉴定及药敏试验,记录并分析结果。结果：324例患者均送检标本共分离出病原菌516株,其中革兰阴性菌421株,占81.59%;革兰阳性菌95株,占18.41%。421株革兰阴性菌中,以大肠埃希菌的检出率最高,其次是肺炎克雷伯菌;95株革兰阳性菌中金黄色葡萄球菌检出率最高。在革兰阴性菌中,大肠埃希菌整体耐药率较高,其对氨苄西林、头孢吡肟的耐药率均超过60.00%;肺炎克雷伯菌的耐药率相对较低,仅对头孢曲松、氨苄西林的耐药率超过30.00%。在革兰阳性菌中,金黄色葡萄球菌、表皮葡萄球菌和溶血葡萄球菌对氨苄青霉素、红霉素、环丙沙星和左氧氟沙星的耐药率均较高,超过50%,同时三种葡萄球菌均未检出万古霉素和利奈唑胺的耐药菌株。结论：肛周脓肿患者的病原菌以革兰阴性菌为主,大多为大肠埃希菌和肺炎克雷伯菌,病原菌对不同抗菌药物的耐药性差异较大,应根据药敏结果合理选用抗菌药物。     

ICU呼吸机相关性肺炎病原菌分布及耐药性分析

目的探讨ICU呼吸机相关性肺炎(VAP)病原菌的分布及其耐药性,为临床合理治疗提供依据。方法回顾性分析我院2010年1月至2013年12月ICU病房370例VAP患者的临床资料,了解其病原菌的构成及其药物敏感性。结果共分离出病原菌412株,其中革兰阴性菌301株(73.06%),前四位分别为鲍氏不动杆菌、铜绿假单胞菌、肺炎克雷伯菌和大肠埃希菌;革兰阳性菌70株(16.99%),前三位为金黄色葡萄球菌、表皮葡萄球菌和肺炎链球菌;真菌41株(9.95%),以白色假丝酵母菌为主。药敏结果显示,鲍氏不动杆菌和铜绿假单胞菌对大部分常用抗菌药物耐药率较高,肺炎克雷伯菌和大肠埃希菌对左氧氟沙星、阿米卡星、妥布霉素、哌拉西林/他唑巴坦、头孢哌酮/舒巴坦、亚胺培南和美罗培南耐药率较低;金黄色葡萄球菌和表皮葡萄球菌对青霉素G的耐药率90%,对左氧氟沙星、利福平、呋喃妥因、替考拉宁、利奈唑胺和万古霉素的耐药率较低。结论 G-杆菌是ICU中导致VAP的主要病原菌,且对多种抗菌药物耐药率较高,抗菌药物治疗应以病原学和耐药性监测结果为依据。     

糖尿病并发败血症病原菌分布及耐药性

目的分析糖尿病合并败血症患者的病原菌种类及其对抗菌药物的耐药性,为合理选用抗菌药物提供依据。方法对2011年1月至2014年7月在浙江大学医学院附属第二医院确诊的80例糖尿病合并败血症患者的临床资料、血培养和药敏结果进行回顾性分析。结果 80例糖尿病合并败血症患者中原发感染部位以泌尿道感染最多,其次为呼吸道感染。检出病原菌中革兰阴性菌44株,占55.0%,其中大肠埃希菌38株,肺炎克雷伯菌6株;革兰阳性菌36株,占45.0%,其中葡萄球菌属24株,链球菌属12株。药敏试验中大肠埃希菌对环丙沙星、左氧氟沙星、氨苄西林和哌拉西林耐药率达50.0%以上;肺炎克雷伯菌对氨苄西林、环丙沙星、左氧氟沙星、呋喃妥因、哌拉西林、头孢西丁、头孢唑林、头孢呋辛和妥布霉素100.0%耐药;葡萄球菌属对苯唑西林、克林霉素和青霉素G耐药率高达75.0%以上。结论糖尿病并发败血症患者以革兰阴性杆菌感染为主,但革兰阳性菌感染率与以往报道比有上升趋势,可选用碳青霉烯类抗菌药物以及头孢含β-内酰胺酶抑制剂的复合药作为经验性治疗,考虑阳性菌感染时首选万古霉素,同时要尽早行血培养,及时更换为敏感抗生素,减少耐药菌株的出现,降低糖尿病合并败血症的病死率。     

孕产妇产后感染病原菌的构成及耐药性分析

目的了解孕产妇产后感染病原菌的分布及耐药现状,为临床抗感染治疗提供依据。方法采用法国生物梅里埃VITEK-2全自动细菌鉴定分析仪进行鉴定和药敏试验,采用WHONET5.6软件进行数据统计分析。结果 2012年1月至2015年12月我院产科病房孕产妇共60 229例,产后感染336例,感染主要部位为宫腔、切口、血液和尿液。主要病原菌依次为大肠埃希菌、粪肠球菌、B型链球菌和金黄色葡萄球菌。大肠埃希菌对头孢他啶、头孢吡肟、妥布霉素、阿米卡星、头孢替坦、哌拉西林/他唑巴坦、头孢哌酮/舒巴坦、亚胺培南耐药率均15.00%;粪肠球菌和无乳链球菌对氨苄西林、青霉素耐药率为0.00%,耐甲氧西林金黄色葡萄球菌(MRSA)耐药率高达19.05%。结论我院产科病房感染主要部位为宫腔(43.18%),减少剖宫产率可以降低产后感染发生率,感染的主要病原菌为大肠埃希菌和粪肠球菌(63.23%),在预防用药的选择上应选择对大肠埃希菌和粪肠球菌均有效的抗生素以减少产后感染的发生率,同时了解孕产妇产后感染病原菌的构成和耐药性,有助于临床更快速有效地治疗产后感染。     

泰州市奶牛乳房炎调查及其病原菌的分离

奶牛乳房炎是奶牛场的常发病和难以防治的疾病,为进一步了解引起奶牛乳房炎的病原微生物,本研究通过对泰州市3个奶牛场572头泌乳牛的乳房炎发病率进行了调查并对乳房炎主要病原菌进行分离和鉴定。结果表明,奶牛临床型乳房炎的发病率为7.69%,隐性型乳房炎发病率为56.64%,乳区阳性率为33.8%,其中临床型:隐性=1:7.36。从65份确定患有乳房炎的奶样中共分离获得8种细菌、156株分离株,且引起乳房炎的主要病原菌是金黄色葡萄球菌和表皮葡萄球菌,其次是停乳链球菌、大肠杆菌、乳房链球菌和无乳链球菌,其检出率分别为42.31%、23.08%、8.97%、6.41%、5.13%和1.28%。该项调查结果初步明确了泰州市乳房炎发病情况,同时为进一步综合防治奶牛乳房炎和研制乳房炎治疗药物提供了科学依据。     

平湖市第一人民医院儿科患者主要病原菌分布及耐药性分析

目的了解和探讨平湖市第一人民医院儿科感染的常见病原菌的分布状况及耐药情况。方法对该院2012年1月至2012年12月儿科患者送检的合格标本进行细菌培养和药敏试验,并统计分析。结果分离出305株病原菌,其中革兰阳性球菌166株,占54. 5%,革兰阴性杆菌134株,占43. 9%,真菌5株,占1. 6%。革兰阳性球菌中前几位依次为金黄色葡萄球菌82株,占49.4%,人葡萄球菌27株,占16. 3%,表皮葡萄球菌27株,占16. 3%,溶血葡萄球菌17株,占10. 2%。革兰阴性杆菌中前几位依次为肺炎克雷伯菌42株,占30. 2%,大肠埃希菌28株,占20. 1%,鲍曼不动杆菌21株,占15. 1%,阴沟肠杆菌15株,占10. 8%,不同病原菌对常用抗菌药物呈现不同程度的耐药,大肠埃希菌的ESBLs阳性率为28. 6%,肺炎克雷伯菌ESBLs阳性率为11.9%。结论该院儿科患者感染的主要病原菌以革兰阳性球菌为主,最常见为金黄色葡萄球菌,不同病原菌对抗生素的耐药性不同,应加强病原菌的检测及耐药性监测,严格执行消毒灭菌操作的各项规定,尽早进行细菌鉴定和药敏试验,临床应根据药敏结果选择用药,合理使用抗菌药物。     

辽宁省2017年至2021年尿培养主要病原菌分布及临床意义

泌尿系统感染的临床发病率很高,仅次于呼吸系统感染。对分离的细菌进行鉴定以及药敏试验,有助于了解引起感染的各种细菌分布以及耐药情况。研究患者尿培养病原菌的分布以及临床常用抗生素耐药情况,从而为临床正确、合理使用药物提供参考。回顾分析了辽宁省2017年1月至2021年12月共4 865份尿标本感染菌鉴定结果和大肠埃希菌（Escherichia coli）的药物敏感试验结果,数据来自辽宁省各大医院。采用法国梅里埃VITEK MS全自动快速微生物质谱检测系统和/或VITEK 2 Compact全自动微生物鉴定仪进行菌种鉴定,对来自门诊和住院泌尿系统感染患者尿标本中分离的1 411株大肠埃希菌进行药敏试验分析。结果表明,尿培养的病原菌中主要以革兰阴性菌为主占66.2％,其次为革兰阳性菌。在革兰阴性菌当中大肠埃希菌占37.1%。大肠埃希菌对氨苄西林、环丙沙星、复方新诺明、头孢唑啉的耐药性比较高,每年的耐药率均超过50%,对哌拉西林的耐药率在2021年已经达到100%。而对于阿米卡星、呋喃妥英、美罗培南、哌拉西林/他唑巴坦、头孢替坦和亚胺培南则出现较低的耐药性,五年的耐药率均低于10%。对于临床治疗尿路感染选用的左氧氟沙星、头孢呋辛和头孢曲松三个一线药物,大肠埃希菌对左氧氟沙星的耐药率有逐年上升的趋势,但对头孢呋辛和头孢曲松的耐药率变化不大。上述结果表明,辽宁省近五年尿培养的主要致病菌是革兰阴性菌,其中大肠埃希菌占有的比例很高。大肠埃希菌易产生耐药性,需对其加强监测,通过向临床提供最新最快的耐药性分析资料,可以更好地控制大肠埃希菌导致的感染,为临床合理用药及治疗提供帮助。     

临沂市肉鸡致病性大肠埃希菌的分离鉴定及耐药性研究

目的查清临沂市肉鸡大肠埃希菌的优势血清型及耐药情况,为研制疫苗和科学防治本病提供依据。方法对病料进行细菌分离培养,应用形态学检查、生化试验、致病性试验和血清学试验对大肠埃希菌及其血清型进行鉴定,通过药敏试验研究其耐药性。结果从365份病料中,分离出大肠埃希菌311株,分离率为85.2%。优势血清型为O78、O1、O11、O18、O15和O2;对链霉素、氨苄西林、利福平、庆大霉素、恩诺沙星、环丙沙星和左氧氟沙星等药物表现出很高的耐药性,耐药率分别为98.0%、87.3%、86.0%、77.3%、73.4%、70.0%和64.6%,而对大观霉素、头孢噻呋、多黏菌素、氟苯尼考和痢菌净高敏。结论临沂市肉鸡大肠埃希菌的优势血清型有O78、O1、O11、O18、O15和O2,分离菌株对大部分抗菌药物产生耐药性。因此,治疗鸡大肠埃希菌病应通过药敏试验,合理地选择药物。     

Relations Between Udder Infection and Somatic Cells in Camel (Camelus dromedarius) Milk

Quarter milk samples (n = 391) from 101 camels were examined to study the occurrence and causes of mastitis in traditionally managed camels in eastern Sudan and to evaluate the value of the California Mastitis Test (CMT), somatic cell count (SCC) and adenosine triphosphate (ATP) in the detection of subclinical mastitis in the camel. One hundred and seventy (43.5%) of the quarter milk samples yielded pathogenic bacteria. Streptococcus agalactiae, other Streptococcus spp., Staphylococcus aureus, coag–ulase–negative staphylococci, and Escherichia coli were isolated from milk. Thirty–two (8.2%) quarter milk samples yielded mixed cultures, and 189 (48.3%) yielded no growth. Mean values for CMT, SCC and ATP were higher for quarters infected with major pathogens. However, a significant number of quarter milk samples had elevated values in these tests but were from quarters from which no bacteria were isolated. The ability of the tests to predict a positive bacteriology increased slightly when 2 or 3 tests were combined. kw|Keywords|k]inflammation; k]diagnostic tests; k]Mastitis; k]CMT; k]ATP; k]bacteriology; k]Sudan     

Characterization of Staphylococcus aureus strains involved in human and bovine mastitis

Staphylococcus aureus is one of the main etiological agents of mastitis in different mammalian species. At present, it is unknown whether strains isolated from human mastitis cases share phenotypic properties and genetic background with those obtained from animal mastitis cases. Therefore, the objective of this study was to characterize S. aureus strains isolated from women with lactational mastitis and to compare them with the strains responsible for bovine mastitis and noninfectious strains. All the strains were genotyped by both pulsed field gel electrophoresis and multilocus sequence typing and submitted to a characterization scheme that included diverse assays related to pathogenic potential and antibiotic resistance. Apart from siderophore production, no significant association was observed between the strains from bovine and human mastitis. Statistical differences between human- and bovine-mastitis-associated strains were detected for some traits and virulence determinants, such as the presence of prophages and cna and hlb genes, which were more frequently found within the bovine group. On the contrary, resistance to penicillin was significantly higher among strains isolated from human lactational mastitis, probably related to the common presence of the blaZ gene. A high genetic diversity was found among the strains involved in mastitis in breastfeeding women.     

Mastitis Whey — a Good Medium for Bacteria?

Growth of mastitis pathogenic bacteria was measured in bovine whey samples by a turbidometric microtechnique. Whey from mastitis cows supported growth as compared with whey prepared from normal milk. Blood proteins leak into milk during mastitis. A study was undertaken to analyze which molecules from blood would promote bacterial growth in whey Fractions containing hemoglobin showed a distinct growth-promoting effect. An inadequate iron supply is one of the restricting growth factors for bacteria in milk. By utilizing heme-compounds the pathogens can by-pass the effect of antimicrobial iron-binding present in milk in the form of lactoferrin.     

Adhesion of Staphylococcus aureus to Bovine Mammary Epithelial Cells Induced by Growth in Milk Whey

Staphylococcus aureus strains isolated from bovine intramammary infection (mastitis) were tested for adhesion to bovine mammary epithelial cells after growth in milk whey or TSB. Bacteria grown in milk whey adhered more efficiently to mammary gland epithelial cells in vitro than the corresponding homologous bacteria grown in TSB. Trypsin treatment of milk whey-grown S. aureus had no effect on their adherence. Whereas, pretreatment with periodate significantly decreased bacterial adherence capacity. Periodate treatment of TSB-grown bacteria had no effect on adhesion to the mammary gland epithelial cells.     

Staphylococcus epidermidis strains isolated from breast milk of women suffering infectious mastitis: potential virulence traits and resistance to antibiotics

Background  

AlthoughStaphylococcus aureusis considered the main etiological agent of infectious mastitis, recent studies have suggested that coagulase-negative staphylococci (CNS) may also play an important role in such infections. The aims of this work were to isolate staphylococci from milk of women with lactational mastitis, to select and characterize the CNS isolates, and to compare such properties with those displayed by CNS strains isolated from milk of healthy women.     

A lysozyme isolated from rainbow trout acts on mastitis pathogens

Abstract The antibacterial effects of two lysozymes purified from rainbow trout kidney (type I and II) were tested on eight bacterial strains isolated from cases of clinical mastitis (staphylococci, streptococci and coliforms). Three other lytic agents were included in the experiments as controls: hen egg-white lysozyme, lysostaphin and mutanolysin. Proliferating bacteria were incubated with the various lytic agents, either in hearts infusion broth or in milk. The type II rainbow trout lysozyme decreased the number of live bacteria (colony forming units) of all the strains tested, but was most efficient against staphylococci. The other two lysozymes had little effect.     

A lysozyme isolated from rainbow trout acts on mastitis pathogens

The antibacterial effects of two lysozymes purified from rainbow trout kidney (type I and II) were tested on eight bacterial strains isolated from cases of clinical mastitis (staphylococci, streptococci and coliforms). Three other lytic agents were included in the experiments as controls: hen egg-white lysozyme, lysostaphin and mutanolysin. Proliferating bacteria were incubated with the various lytic agents, either in hearts infusion broth or in milk. The type II rainbow trout lysozyme decreased the number of live bacteria (colony forming units) of all the strains tested, but was most efficient against staphylococci. The other two lysozymes had little effect.     

Lactic acid bacteria from raw milk as potentially beneficial strains to prevent bovine mastitis

Bovine mastitis produces a wide variety of problems in the dairy farm. The treatment of this disease is based on the use of antibiotics which are not always effective. These drugs are also responsible for the presence of residues in the milk and the increase of antibiotic-resistant strains. Probiotic products were proposed as a valid alternative to antibiotic therapies and are also useful for the prevention of infectious syndromes. With the aim of designing a probiotic product to prevent bovine mastitis, lactic acid bacteria (LAB) were isolated from foremilk samples from different dairy farms in Córdoba-Argentina. One hundred and seventeen LAB were isolated and their beneficial characteristics such as the production of inhibitory substances, surface properties and production of exopolysaccharides (EPS) were assessed. Most of them displayed low degree of hydrophobicity, autoaggregation, EPS negative phenotype and were identified as Enterococcus hirae and Pediococcus pentosaceus. Nine LAB strains inhibited three indicator bacteria. Some isolates were pre-selected and genetically identified according to the results obtained. Antibiotic resistance and virulence factors were studied for the assessment of the safety of the strains. The results obtained were compared to those reported previously from samples obtained in the North-western area of the country and some differences were found.     

Bacterial Analysis of Breast Milk: A Tool to Differentiate Raynaud’s Phenomenon from Infectious Mastitis During Lactation

Lactational Raynaud’s syndrome may be misdiagnosed as infectious mastitis on the basis of the breast pain. The objective of this work was to elucidate if microbiological analysis of milk may contribute to the differentiation of both conditions. Ten lactating women clinically diagnosed by Spanish lactation consultants were included in the study. Of these, five suffered from mastitis and the remaining five suffered from Raynaud’s syndrome. Breast milk samples were inoculated on diverse culture media. Seventy isolates were selected and identified by 16S rDNA PCR sequencing. Parallel, PCR-DGGE and quantitative real-time PCR were used to assess the presence of bacterial DNA in the samples. Neither bacteria nor yeasts could be detected in the milk samples provided by the women suffering from Raynaud’s syndrome. In contrast, large numbers of bacteria were isolated from those with infectious lactational mastitis. Globally, the levels of bacterial DNA were significantly higher in the milk of mastitis-suffering women. Bacteriological analysis of milk can be an useful tool to facilitate the differential diagnosis between the infectious mastitis and Raynaud’s syndrome during lactation.