双歧杆菌DM9227和乳酸杆菌DM8121质粒的检测及药敏试验

应用分子克隆常规质粒提取方法（略作修改）,对一株Ｂｉｆ．ｉｎｆａｎｔｉｓＤＭ９２２７及另一株Ｌａｃｔｏ．ｃａｓｉｅ．ＤＭ８１２１进行质粒提取及分析,并用固体培养基药敏纸片法测定此两株菌对１７种常用抗生素的敏感性。结果发现,ＤＭ８１２１及ＤＭ９２２７中无质粒的存在。药敏结果显示,ＤＭ８１２１对强力霉素、链霉素、庆大霉素较敏感,而对头孢菌素、氨苄青霉素、青霉素耐药。ＤＭ９２２７对头孢菌素、先锋霉素、庆大霉素、卡那霉素较敏感,对氨苄青霉素、羧苄青霉素、青霉素、强力霉素等耐药。     

临床分离的革兰阴性细菌的耐药谱及耐药机制的研究

目的 了解前临床上分离G^－细菌的药敏状况和耐药机制及提供合理使用抗生素的依据。方法 主要使用MICROSCAN WALKAWAY／－40全自动微生物分析仪对1999年3月－2000年3月全院住院病人的尿、痰、腹水、脓液、创面、前列腺液、血液等培养呈阳性的标本进行细菌鉴定和药敏试验,结果共检出G^-菌1152株包括27个菌属80个菌种,觉细菌是大肠埃希菌（16.1％）、铜绿假单胞菌（6.5％）、肺炎克雷伯菌（5.3％）等。G^-杆菌（除不动杆菌外）对第三代头孢霉素敏感率已降到（3.0%-76.1%)、对亚胺培南（80.7%-92%)、头孢哌酮／舒巴坦（58.8％－100％）、阿米卡星（41.4%-93.2%)、环丙沙星（30.5％－67.3％）较敏感;对第三代头孢霉素产生超广谱β－内酰胺酶（ESBLs）,肺炎克雷伯菌高达35.0%-36.9%,大肠5埃希菌达21.8％－23％。对常用β-内酰胺类抗生素产诱导酶（IB）,铜绿假单胸菌高达51％－60.9％,弗劳地枸橼酸菌达4.5％－63.6％,阴沟肠杆菌达8.7%-35.3％。结论 目前G^－杆菌对β-内酰胺类抗生素药的主要机制是产生ESBLs和IB0G^-杆菌引起的感染首选亚胺培南单用或第三代浆孢霉素复合制剂（头孢哌酮／舒巴坦）联合阿米卡星或氟喹酮类,第三代头孢霉素除非药敏提示否则不宜选用。     

开封市鼓楼区健康人群大肠埃希菌耐药性调查

目的对开封市鼓楼区从业人员开展大肠埃希菌耐药性调查。方法对2300名健康从业人员分离到2010株大肠埃希菌用14种抗生素进行药敏试验。结果75．0％以上菌株对青霉素、氨苄西林、氯林克霉素和红霉素耐药,80％以上对先锋V、头孢三嗪、头孢哌酮敏感。71．0％菌株呈多重耐药性,耐药谱以青霉素类、大环内酯类、氨基糖苷类为主。结论导致大肠埃希菌高耐药性的原因是：（1）本地区抗生素使用造成的选择性压力;（2）抗生素的滥用;（3）不良卫生习惯。     

183株志贺菌的菌群分布及药敏分析

目的了解本地区细菌性痢疾菌群分布及药敏情况。方法对183株志贺菌进行菌群分型及药敏分析。结果183株志贺菌有福氏志贺菌168株（91．8％）;宋内志贺菌9株（4．9％）;痢疾志贺菌4株（2．2％）;鲍氏志贺菌2株（1．1％）。药敏试验显示志贺菌对四环素、氨苄西林、复方新诺明耐药严重;对头孢他啶、阿米卡星、诺氟沙星比较敏感。结论本地区志贺菌主要是福氏志贺菌Ⅱa,应根据药敏试验结果选择合适抗菌药物。     

晚期肺癌患者肺部绿脓杆菌感染的临床分析

研究５２例晚期肺癌肺部绿脓杆菌感染的药敏试验与临床疗效。药敏结果显示绿脓杆菌对氟嗪酸、氧哌嗪青霉素、头孢噻甲羧肟有良好的敏感性,分别为５１．９％、５３．８％和７６．９％,但选择一种敏感的药物进行为期７ｄ的治疗,效果却不满意,痰菌阴转率分别为４４．５％、３６．４％和５６．３％。考虑为体内外环境不同及病情（如机体状况、阻塞性炎症等）而影响疗效。     

纤维堆囊菌生理生化及药敏特征

对纤维堆囊菌模式菌DSM14627的生理生化和药敏性进行了系统的考察,研究显示该茵能利用葡萄糖及纤维素,不能分解利用麦芽糖、蔗糖等12种碳源;磷酸酶、β-葡萄糖苷酶及明胶液化实验为阳性,过氧化氢酶、β-木糖苷酶等13项实验均阴性;对丙氟哌酸、万古霉素、多粘霉素B等15种抗生素敏感,对氨苄西林及苯唑青霉素等10种抗生素有极强抗性.     

女性泌尿生殖道支原体感染及耐药性分析

目的通过分析深圳市人民医院2009年9月至2010年4月女性泌尿生殖道支原体感染状况及耐药性变迁,指导临床合理用药。方法采用法国生物梅里埃公司MyeoplasmaIST2支原体鉴定及药敏试剂盒,进行支原体检测及药敏分析。结果2135例患者总检出率为54．6％（1166／2135）,其中解脲脲支原体（Uu）阳性1017例（47．6％）;人型支原体（Mh）阳性32例（1．5％）;Uu＋Mh阳性117例（5．5％）。1166例患者支原体对9种抗生素够感性依次为原始霉素（99．8％）、交沙霉素（99．6％）、强力霉素（96．3％）、四环素（94．4％）、克拉霉素（85．6％）、阿奇霉素（77．6％）、红霉素（75．6％）、氧氟沙星（28．4％）和环丙沙星（22．8％）。结论支原体（尤其是Uu）感染已成为女性泌尿生殖系统炎症的主要病原体之一,治疗支原体感染应选择原始霉素、交沙霉素、强力霉素等敏感率高的药物及药敏试验显示敏感的药物,喹诺酮类药物耐药率较高,应引起临床重视。     

产超广谱β-内酰胺酶肺炎克雷伯菌的检测及药敏分析

目的对3年间分离的产超广谱β-内酰胺酶（ESBLs）的肺炎克雷伯菌进行鉴定和药敏试验分析。方法采用1999年NCCLS建议的纸片扩散确证法,从76株肺炎克雷伯菌中分离出14抹产超广谱β-内酰胺酶细菌,检出率为18．4％。结果产超广谱β-内酰胺酶肺炎克雷伯菌对7种常用抗生素的药敏结果可以看出,亚胺培南对肺炎克雷伯菌作用最强,可作为治疗产ESBLs肺炎克雷伯菌感染的首选药物,敏感率高达86％,是控制感染的最有效的药物。其次为头孢哌酮／舒巴坦,敏感率达59．7％,也有一定的抗菌活性。结论产超广谱β-内酰胺酶检测对指导临床合理使用抗生素具有重要意义。     

医院病原菌的分布及耐药趋势的调查分析

通过对我院１９９４年６月至１９９５年１２月间门诊及住院患者送检的２１６５例阳性标本分析中发现,病原菌感染以呼吸道及肺部感染为最多见,其次为尿路感染和创伤感染。感染菌以革兰氏阴性杆菌为主。病原菌检出率最多的顺序是：大肠埃希氏菌、肠球菌、金黄色葡萄球菌、铜绿假单胞菌、表皮葡萄球菌、变形杆菌、鲍曼氏不动杆菌、肺炎克雷伯氏菌、白色念珠菌等。而引起呼吸道感染的病原菌依次为：鲍曼氏不动杆菌（２７．９７％）、肺炎克雷伯氏菌（２５．６％）、铜绿假单胞菌（１３．５６％）、白色念珠菌（１３．２０％）、金黄色葡萄球菌（１１．２％）、大肠埃希氏菌（７．１％）等。药敏实验结果显示：革兰氏阴性杆菌（简称Ｇ－ｂ）对丁胺卡那和头孢呋新敏感率呈上升趋势（Ｐ＜５％）,头孢三嗪、青霉素、红霉素敏感率稳定,其余七种抗生素敏感率呈下降趋势。革兰氏阳性球菌中（简称Ｇ＋ｃ）首选药为去甲万古霉素,丁胺卡那敏感率稳定,头孢呋新敏感率呈上升趋势,其余抗生素敏感率呈下降趋势（Ｐ＜５％）。     

基层中医院735例女性宫颈分泌物支原体检测及药敏分析

目的了解生殖道支原体感染与年龄、白带清洁度的关系及对抗生素的敏感性,为临床用药提供依据。方法对735例疑似生殖道感染标本采用珠海迪尔生物有限公司生产的试剂盒进行支原体培养和药敏试验,取阴道分泌物作清洁度检查。结果735例标本中检出支原体阳性402例,阳性率为54．7％,解脲脲原体（Uu）、Uu＋Mh混合感染及人型支原体（Mh）分别占75．1％、20．9％、4．0％。Uu、Uu＋Mh阳性患者好发于18～40岁。白带清洁度异常者的Uu、Uu＋Mh、Mh阳性率明显高于白带清洁度正常者。药敏结果显示,支原体对强力霉素、美满霉素敏感性较高,敏感率为85．7％～100．0％。结论白带清洁度异常者为支原体感染的高危人群,诊治时应常规做支原体检测,支原体感染的治疗应根据感染病原体的类型和药敏结果合理应用抗生素。     

Contribution of Pseudomonas Aeruginosa strains to infections in patients of specialistic outpatients clinics of the SP ZOZ in Nidzica

The aim of this study was to examine a frequency of isolation and analysis of drug susceptibility o P. aeruginosa strains cultured from clinical specimens obtained from patients treated in specialistic outpatient clinics of the Samodzielny Publiczny Zespó? Opieki Zdrowotnej (SP ZOZ) in Nidzica durin 40 months (01. 09. 2000 - 31. 12. 2003). Ninety six P. aeruginosa strains were cultured out of 829 clinical samples collected from ambulatory patients and processed in the Bacteriological Laboratory of SP ZOZ in Nidzica during over three years. P. aeruginosa strains were isolated from 11.6% of examined specimens. The greatest number of strains (49.0%) were cultured from urine samples obtained from children. Identification of strains was performed using biochemical tests (Becton Dickinson, Emapol, bio-Merieux). Susceptibility of strains to antimicrobial agents was determined with disc diffusion method according to NCCLS recommendations. Special tests were applied to detect extended-spectrum beta-lactamases (ESBL). The most active in vitro against isolated P. aeruginosa strains was a carbapenem - imipenem. All strains were susceptible to this antibiotic. Ciprofloxacin (94.8% of susceptible strains), ceftazidime (89.6%), gentamicin (86.5%), piperacillin (84.4%) and aztreonam (76.0%) were active against the majority of P. aeruginosa strains isolated from ambulatory patients. Six strains (6.25% of all strains) producing extended--spectrum beta--lactamases (ESBL) were detected. It is alarming, that the majority of P. aeruginosa strains from outpatients were cultured out of pediatric samples (61.5%). Because of an increase in resistance and appearance of new mechanisms of resistance to antibiotics/chemotherapeutics in P. aeruginosa strains, it is necessary to monitor a drug susceptibility of these strains causing infections in ambulatory patients.     

下呼吸道感染耐环丙沙星铜绿假单胞菌的分布与耐药性

目的了解耐环丙沙星铜绿假单胞菌的流行情况,分析耐环丙沙星铜绿假单胞菌的耐药性,比较耐环丙沙星铜绿假单胞菌与环丙沙星敏感铜绿假单胞菌的耐药性差异。方法选择贵阳医学院第三附属医院2011年6月至2014年11月下呼吸道感染标本中分离出的231株耐环丙沙星铜绿假单胞菌与环丙沙星敏感铜绿假单胞菌,按照《全国临床检验操作规程》进行微生物病原菌鉴定。采用Kirby-Bauer琼脂扩散法进行药敏试验,结果使用SPSS 17.0软件进行统计分析。结果下呼吸道感染标本中共分离出铜绿假单胞菌231株,其中耐环丙沙星铜绿假单胞菌检出率25.54%。从科室分布看,神经外科分离率最高,占47.46%,其次ICU、呼吸内科与消化内科分别占18.64%、13.56%、10.17%;下呼吸道感染耐环丙沙星铜绿假单胞菌菌株与环丙沙星敏感铜绿假单胞菌菌株对头孢曲松、阿米卡星、亚胺培南、哌拉西林/他唑巴坦、头孢哌酮/舒巴坦等19种抗菌药物的耐药率分别为95.65%,71.83%;42.86%,7.69%;17.39%,2.70%;33.33%,11.02%;22.22%,8.00%。下呼吸道感染耐环丙沙星铜绿假单胞菌菌株耐药率明显高于环丙沙星敏感铜绿假单胞菌菌株,差异具有统计学意义(P0.05)。结论耐环丙沙星铜绿假单胞菌表现为多重耐药性,给临床治疗带来很大的困难。因此严格掌握抗菌药物的选用是延缓病原菌对抗菌药物耐药的有效方法。     

Antibiotic susceptibility and occurrence of ESBL in Pseudomonas aeruginosa strains isolated from different clinical specimens

The aim of this study was to evaluate the drug susceptibility of 132 P. aeruginosa strains isolated from patients hospitalized in SPSK University Hospital in Bialystok. The isolates were obtained from clinical specimens over an 11-month period in 2001 and 2002. All the strains were identified in automatic ATB system using API 20 NE strips, and their susceptibility to antibiotics was tested by standard disc-diffusion method and agar dilution method. The minimal inhibitory concentration (MIC) was determined for five antibiotics: piperacillin, amikacin, ceftazidime, imipenem and ciprofloxacin. The majority of strains were susceptible to ceftazidime (91.7%), piperacillin combined with tazobactam (85.6%), amikacin (80.3%), meropenem and imipenem (81.8%). Many of our strains were resistant to cefotaxime (73.5%), ticarcillin (53%) and ciprofloxacin (48.5%). Also, the trial was undertaken to detect strains producing extended-spectrum beta-lactamases (ESBL) and inducible beta-lactamases (IBL) among P. aeruginosa rods isolated from different specimens. ESBL-producing strains were detected with double disc test (DDST) and combination double disc (CD) test. Clavulanate was applied as the inhibitor of these beta-lactamases. Strains producing ESBL were not found. On the other hand, as many as 127 P. aeruginosa strains (96.2%) produced inducible beta-lactamases (IBL).     

Drug susceptibility of Pseudomonas aeruginosa strains isolated from patients of a hospital and specialistic outpatients clinics of the SP ZOZ in Nidzica

The aim of this study was to evaluate a frequency of isolation and antimicrobial susceptibility testing (AST) of Pseudomonas aeruginosa strains cultured from clinical specimens collected from patients hospitalized in wards and specialistic outpatients clinics of a hospital in Nidzica (01. 09. 2000 -31. 12. 2003). During over three years 392 Pseudomonas aeruginosa strains were cultured from 16346 clinical samples provided to bacteriological laboratory. P. aeruginosa strains were isolated from 2.5% of examined specimens. Susceptibility of Pseudomonas aeruginosa strains to antimicrobial agents was tested. The highest in vitro activity against clinical P. aeruginosa strains demonstrated imipenem. One strain was resistant to imipenem. This strain was isolated from a patient of a surgical department. Metalo-beta-lactamase was not detected (MBL-negative strain).Twenty nine strains were ESBL producer (7.4% of all strains). The contribution of Pseudomonas aeruginosa strains to the etiology of nosoconial and ambulatory infections increases. In vitro activity of antibacterial agents against P. aeruginosa strains should be monitored during therapy of infections. Resistance to antibiotics/chemothe-rapeutics may be acquired during treatment with antibacterial agent to which P. aeruginosa strain was susceptible according to the antibiogram.     

环丙沙星耐药的铜绿假单胞菌药敏情况分析

目的了解对环丙沙星耐药的铜绿假单胞菌的药敏情况。方法细菌的鉴定及药敏试验,均采用法国生物梅里埃公司的VITEK2微生物鉴定与药敏系统,选择经VITEK2测定耐环丙沙星的铜绿假单胞菌(耐药株)68株及对环丙沙星敏感的铜绿假单胞菌(敏感株)67株,统计分析两者对亚胺培南、阿米卡星、庆大霉素、头孢他啶、哌拉西林和哌拉西林他唑巴坦等几种临床上常用抗生素的药敏情况。结果耐药株对以上6种抗生素的敏感率分别为亚胺培南706%,阿米卡星206%,庆大霉素191%,头孢他啶279%,哌拉西林632%,哌拉西林他唑巴坦721%。而敏感株对6种抗生素的敏感率则分别为925%、328%、687%、657%、881%与896%,明显高于耐药株,经χ2检验,除阿米卡星005相似文献   

Infectivity and resistance to antibiotics of bacterial strains isolated from patients hospitalised in intensive care units

The aim of this study was to evaluate the frequency of isolation and antimicrobial resistance testing of bacterial strains isolated from clinical specimens from patients hospitalized in three Intensive Care Units in Wroc?aw. The susceptibility of bacteria (107 strains) to selected antibiotics was determined. The results clearly show that non-fermentative rods were identified as the main agents causing pneumonia (58% of isolates). The second commonest pathogens were Gram-positive cocci (29%). The P. aeruginosa and E. cloacae strains were resistant to ampicillin, amoxicillin/clavulanate, cefuroxime and cefotaxime. All isolates of A. baumanii were susceptible only to imipenem. The rods of K. pneumoniae and E. coli were resistant to ampicillin, about 55% strains of both bacteria were sensitive to other antibiotics, except piperacillin/tazobactam, imipenem and ciprofloxacin. About 90% of methicillin resistant S. epidermidis strains were resistant to all antibiotics, except vancomycin (100% isolates were sensitive). ESBL were detected among E. cloace, K. pneumoniae and E. coli. We found P. aeruginosa rods producing MBL.     

Antibiotic therapy of cystic fibrosis in children]

It is postulated that P. aeruginosa in monoculture or in association with Staphylococcus aureus keeps its leading position in chronic bacterial inflammatory broncho-pulmonary processes in children with cystic fibrosis. Antibiotic resistant strains of Burkholderia cepacia, Stenotrophomonas maltophila, Alcaligenes xylosoxidans were revealed (7.1% of the strains). P. aeruginosa strains were susceptible to aminoglycosides, ciprofloxacin, and polymixin B. Susceptibility of smooth and mucoid forms of P. aeruginosa to ceftazidime stayed at the level of 49.6-57.1%. Such microbial associations as P. aeruginosa sm. + S. aureus, P. aeruginosa sm. + P. aeruginosa muc. + S. aureus were mainly susceptible to ciprofloxacin, aminoglycosides and resistant to ceftasidime. Meropenem, cefepim and ciprofloxacin are highly effective antibiotics for the treatment of broncho-pulmonary processes exacerbations at children with chronic P. aeruginosa cystic fibrosis. Intravenous use of antibiotics out of hospital for the treatment of the children with cystic fibrosis is clinically effective, and is economically and psychologically reasonable. It should be used more widely in medical practice.     

耐喹诺酮类铜绿假单胞菌的耐药性分析及血清学分型

目的了解广州地区喹诺酮类耐药铜绿假单胞菌的耐药性及泵抑制剂对其耐药水平降低的作用,并调查血清型分布情况。方法用法国生物梅里埃公司的微生物鉴定和药敏分析系统VITEK-2对127株铜绿假单胞菌进行鉴定和药敏检测,并采用羰酰氰基-对-氯苯胺(CCCP)与环丙沙星共同作用,以琼脂稀释法测定耐药菌的最低抑菌浓度(M IC)的变化,同时用玻片凝集法对耐药株进行血清学分型。结果环丙沙星耐药菌对哌拉西林/他唑巴坦(65.5%)的敏感率最高,只有阿米卡星(64.4%)、哌拉西林(51.7%)和妥布霉素(50.6%)的敏感率大于50.0%,而敏感菌对美罗培南(97.5%)及左氧氟沙星(97.5%)的敏感率最高,妥布霉素(95.0%)次之,对临床常用的13种抗生素,耐药菌较敏感菌的敏感性明显降低(P值均<0.001);耐药菌受泵抑制CCCP作用,M IC降低1~4个稀释度;血清分型率为93.1%,耐药菌的血清型以B型(20.7%)和L型(19.5%)为主。结论耐喹诺酮类铜绿假单胞菌对临床常用抗生素的敏感性降低,并呈多重耐药,使用抗生素 泵抑制剂可提高药物对铜绿假单胞菌的敏感性;血清学分型可以快速简单地监测铜绿假单胞菌在医院内的流行情况。     

Antibiotics sensitivity and characteristics of the esculin-positive Pseudomonas aeruginosa biovar]

Strains of Pseudomonas aeruginosa hydrolyzing esculin were isolated for the first time. They amount to 17.1 +/- 2.0% (60 from 325) of the investigated P. aeruginosa strains isolated from the clinical material in St. Petersburg. Esculin hydrolysis was measured by micromethod in plates, results were analysed after 3-hours incubation at 37 degrees C. Esculin-positive strains possesed biovar properties: they are widely spread, demonstrated other characteristic features (absence of triethylamine odour, specific colonies lysis), are stable on ability to hydrolyse esculin while culture storage and after repeated culturing. Typical strain of esculinolytica biovar was deposited into the culture collection of the National Research Institute of Agricultural Microbiology as P. aeruginosa ARRIAM 64-A. Susceptibility testing of the esculin-positive strains by disk-diffusion method revealed that most strains were inhibited by imipenem (86.6%), amikacin (75.0%), ceftazidime (65.0%), meropenem (60.0%), aztreonam (51.6%). The percent of strains susceptible to other antibiotics was lower: azlocillin--33.3%, netilmycin--33.3%, piperacillin--26.6%, ceftriaxon--18.3%. Only small number of strains were inhibited by ciprofloxacin (8.3%), gentamycin (3.4%), cefoperazone (1.7%) and carbenicillin (1.7%). The results may be used for empiric therapy before the isolated strain susceptibility is tested but only according to positive esculin-hydrolysis express-test evaluated in 3-hours period.     

Occurrence of the aacA4 gene among multidrug resistant strains of Pseudomonas aeruginosa isolated from bronchial secretions obtained from the Intensive Therapy Unit at University Hospital in Bialystok, Poland

The aim of this study was to investigate the prevalence of the aacA4 gene in a population of multidrug resistant strains of P. aeruginosa isolated from bronchial secretions obtained from the Intensive Therapy Unit (ITU). Twelve MDR isolates were tested for antibiotic susceptibility and the presence of the aacA4 gene. In this study, 58.3% of the strains contained (6')-Ib' aminoglycoside acetyltransferase gene. All of the studied strains (aacA4-positive and aacA4-negative) were susceptible only to colistine (100%). Among other antibiotics, the lowest resistance rates were those shown against ceftazidime (14.3% to 20%) and imipenem (28.6% to 40%). Our studies frequently revealed the presence of the aacA4 gene as a factor responsible for resistance; it is probable that other mechanisms of resistance to aminoglycoside antibiotics also occurred.