枯草芽孢杆菌活菌体外拮抗6种肠道致病菌的研究

对枯草芽孢杆菌BS 3株在体外对 6种常见肠道致病菌 (肠产毒性大肠杆菌、肠侵袭性大肠杆菌、肠致病性大肠杆菌、鼠伤寒沙门菌、福氏志贺菌和宋内志贺菌 )的拮抗作用进行了研究。结果表明 ,枯草芽孢杆菌BS 3株对宋内志贺菌、肠致病性大肠杆菌及肠产毒性大肠杆菌拮抗作用较为明显。     

苏州地区儿童感染志贺菌的耐药监测

目的调查苏州地区2000年至2006年儿童感染志贺菌的耐药情况,了解其耐药趋势,以指导临床合理用药。方法对2000年至2006年苏州大学附属儿童医院临床标本中分离的589株志贺菌（福氏志贺菌470株,宋内志贺菌119株）采用K-B法对氨苄西林、哌拉西林、头孢哌酮、头孢曲松、环丙沙星、SMZ＋TMP、亚胺培南进行药敏试验。结果于7年中470株福氏志贺菌的耐药率：氨苄西林：始终在90．0％以上;哌拉西林：从22．6％逐渐上升到63．2％;头孢哌酮：1．1％～56．1％;头孢曲松：2．2％～43．9％;环丙沙星：一直在10．0％左右;SMZ＋TMP：在70．0％～96．0％波动;对亚胺培南均敏感。119株宋内志贺菌的耐药率：氨苄西林：从7．1％逐渐上升到82．8％;哌拉西林：0～79．3％;头孢哌酮：0～55．2％;头孢曲松：0～51．7％;SMZ＋TMP：在62．5％～100．0％波动;对环丙沙星和亚胺培南均敏感。结论本地区儿童感染福氏志贺菌对氨苄西林严重耐药,同时伴有对SMZ＋TMP的高耐药率,对哌拉西林和3代头孢菌素的耐药率呈逐年上升趋势。宋内志贺菌的耐药率在2004年之前（除对复方新诺明外）,远低于福氏志贺菌,但在2005年其对氨苄西林和3代头孢菌素的耐药率突然上升,大有赶超福氏志贺菌之势。因此苏州地区儿童感染志贺菌的耐药情况不容乐观,对儿童细菌性痢疾的治疗将会面临困境。     

志贺菌的质粒图谱分析

目的：分析志贺菌的质粒图谱及其与细菌药物敏感性的相关性。方法：从菌痢患者粪便标本中分离6株福氏志贺菌和4株宋内志贺菌,分别对其质粒图谱及药物敏感性进行分析。结果：不同菌株的质粒图谱具有明显的差异,但福氏志贺菌的5株以及宋内志贺菌的3株具有分子量23Kb的质粒带。各菌株的质粒图谱与其对头孢三嗪,头孢唑啉,环丙沙星,诺氟沙星,氯霉素的耐药特性无明显相关性。结论：获自患者的福氏志贺菌和宋内志贺菌具有不同的质粒图谱以及抗菌药物敏感性,提示在我市引起菌痢的志贺菌具有不同的来源。     

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。     

分离自腹泻成人志贺菌的血清分群及耐药性分析

目的 调查志贺菌在成人腹泻患者中的主要血清群和耐药性,为临床治疗和预防提供依据.方法 对2008年1月至2012年10月浙江萧山医院临床分离自腹泻成人志贺菌菌株,进行生化鉴定、血清学分群和抗生素敏感性试验,所有数据用WHONET 5.6软件进行回顾性分析.结果 共检出125株志贺菌,其中66(52.8％)株为宋内志贺菌,58(46.4％)株为福氏志贺菌;氨苄西林耐药率最高达95.9％,复方新诺明耐药率达79.8％,头孢噻肟为48.6％,未检出头孢哌酮/舒巴坦、哌拉西林/他唑巴坦、亚胺培南和美罗培南耐药株,福氏志贺菌对环丙沙星和左旋氧氟沙星耐药率为87.0％和57.1％,而宋内志贺菌未检出氟喹诺酮类耐药株;福氏志贺菌和宋内志贺菌耐药率在哌拉西林、头孢他啶、头孢噻肟、头孢吡肟、复方新诺明和氟喹诺酮间差异有统计学意义(P＜0.01).结论 萧山地区成人志贺菌感染以宋内和福氏两种血清群为主,青霉素类和复方新诺明耐药率太高已不适合临床使用,含酶抑制剂抗生素是治疗志贺菌感染的首选药物.     

2002年至2007年太原地区儿童细菌性腹泻病原菌分布及耐药分析

目的了解太原地区近6年儿童细菌性腹泻病原菌分布及耐药情况。方法对临床诊断细菌性腹泻病,便培养已分离到病原菌1080例作回顾性分析,分析其病原菌的分布及耐药情况。结果埃希菌属486株（45％）,居于首位,前5位的病原菌依次为埃希菌属、肠球菌属、酵母样真菌、志贺菌属、假单胞菌属。各年均以大肠埃希菌为主要检出菌,志贺菌逐年减少。年龄分布中,婴儿的构成比最高（44．4％）。埃希菌属、志贺菌属、假单胞菌属、沙门菌属、气单胞菌属此5种杆菌对13种抗生素的平均耐药率依次为舒普深、痢特灵、头孢他啶、庆大霉素、环丙沙星、头孢哌酮、头孢曲松、丁胺卡那、头孢噻肟、诺氟沙星、头孢呋辛、哌拉西林、头孢唑啉。从埃希菌属近6年的耐药性变迁资料可以看出,对13种抗生素的耐药率均有不同程度上升。结论传统的致病菌志贺菌属、沙门菌属较少,而肠球菌属、假单胞菌属、枸橼酸杆菌属、克雷伯杆菌属、肠杆菌属、酵母样真菌等条件致病菌肠炎占有相当比例。各种致病菌的耐药性增加,第三代头孢除头孢他啶的耐药率较低外,其余都较高。提示应严格掌握抗生素用药指证,合理选用抗生素。     

志贺菌流行株药物敏感性及质粒图谱分析

目的：分析志贺菌流行株的质粒图谱及其与细菌药物敏感性的相关性。方法：从菌痢患者粪便标本中分离6株 福氏志力和4株宋内志贺菌,分别对其质粒图谱与药物敏感性进行检测和对其相关性进行分析。结果：不同菌株的质粒图谱具有明显的差异,各菌株的质粒图谱与其对头孢三嗪、头孢唑林、环丙沙星、诺氟沙星、氯霉素的耐药特性无明显相关性。结论：获自患者的福氏志贺菌和宋内志贺菌具有不同的质粒图谱以及抗菌药物敏感性,提示在我市引起菌痢的志贺菌具有不同的来源。     

昭通地区痢疾菌群变迁及控制对策

1964－1995年共检测到志贺氏菌四个群353株;其中：福氏志贺氏菌312株,痢疾志贺氏菌29株,宋内氏志贺氏图9株,鲍氏志贺氏菌3株,分别占总数的88．38％,8．22％,2．55％和0．85％。各年度分离菌群中,福氏志贺氏菌比例最大,为本地区流行的主要菌群。在153株福氏志贺氏菌中,福氏Ⅱ型占60．13％;福氏I型占19．61％和福氏Ⅳ型占13．72％。根据菌群监测结果,对细菌性痢疾防治,选用针对B群福氏志贺氏菌的菌苗进行研制开发,广泛开展易感人群预防接种;同时加强疫情、病源监测防止疫情暴发,并结合实际开展改水、卫生宣传教育和食品卫生监督等,可对痢疾起到有效的控制。     

第三代头孢菌素对4666株医院致病菌的耐药情况分析

分析该院３年来分离的临床细菌４６６６株及其对５种第三代头孢菌素的耐药性情况。发现第三代头孢菌素对医院致病菌的平均耐药率为３４．２９％，其中头孢哌酮＋舒巴坦的耐药率仅为６．８９％，低于平均耐药率（Ｐ＜０．０１）。不动杆菌属、肠杆菌属、枸橼酸杆菌属和假单孢菌属对三代头孢的耐药率分别为５８．８３％、５６．３５％、５２．００％和４９．８４％，均显著高于平均耐药率（Ｐ均＜０．０１）；沙门菌属和变形杆菌属对第     

汉中市中心医院细菌性痢疾志贺菌16S rRNA序列分析、毒力基因与耐药检测

目的对汉中市中心医院细菌性痢疾患者分离的70株志贺菌进行16S rRNA序列分析、毒力基因与耐药检测。方法对2018年6月至2018年12月我院收治的细菌性痢疾患者进行病原菌分离鉴定,并进行16S rRNA遗传进化分析;PCR法检测其6种毒力基因;K-B法检测其对8种抗生素的敏感性。结果 16S rRNA测序结果显示,福氏志贺菌感染率为57.14%(40/70),宋内志贺菌感染率为42.86%(30/70)。16S rRNA系统进化分析结果显示,40株福氏志贺菌与参考菌株(NR_026331.1)同源性为95.2%～99.0%,30株宋内志贺菌与参考菌株(NR_104826.1)同源性为96.3%～99.9%。毒力基因检测结果表明,70株志贺菌均可以检测出6个相关毒力基因set1A、set1B、sen、Ial、ipaH、virA,毒力基因检出率最高的为ipaH,达到100.00%,其次为Ial、virA,均达到90.00%;其中福氏志贺菌set1A、set1B、Ial基因的检出率高于宋内志贺菌,sen和virA基因的检出率低于宋内志贺菌,二者ipaH基因的检出率都为100.00%。药敏试验结果表明,70株志贺菌耐药率最高的抗生素为氨苄西林,耐药率达到80.00%,其次为强力霉素,耐药率达到75.71%,耐药率最低的为头孢吡肟,耐药率为20.00%;其中40株福氏志贺菌耐药率最高的抗生素为强力霉素,其次为氨苄西林,最低的为头孢吡肟;30株宋内志贺菌耐药率最高的抗生素为氨苄西林,其次为哌拉西林,最低的为氧氟沙星。结论 2018年下半年汉中市中心医院从细菌性痢疾患者身上分离得到的志贺菌主要为福氏志贺菌与宋内志贺菌,毒力基因检测和耐药性试验结果显示分离菌株有较强致病性,提示对细菌性痢疾的监测、防控与治疗应进一步加强。     

神经内外科院内泌尿道感染病原菌分布及耐药性比较

目的研究我院神经内外科院内泌尿道感染的菌群分布和药敏情况,为临床合理应用抗菌药物提供依据。方法回顾性分析2004年1月至2005年6月神经内外科院内泌尿道感染的菌群分布、药敏情况及易感因素。结果神经内科和神经外科均以革兰阳性菌感染为主,分别占48.59%、40.19%,而阳性菌中又以肠球菌为主;神经外科院内泌尿道真菌的院内感染比例(21.39%)明显高于神经内科(14.06%)(P<0.05)。药敏结果显示:神经内外科大肠埃希菌较敏感的抗菌药物为头孢替坦、亚胺培南等。检出肠球菌125株,除对万古霉素和替考拉宁敏感以外,对其他抗菌药物均有较高的耐药。结论神经内外科院内泌尿道感染病原菌正发生变迁,以阳性菌为主,抗菌药物的使用不同可能是造成神经内外科菌群分布不同的重要原因。     

宋内Ⅰ相O抗原及霍乱毒素B亚基在福氏2a痢疾菌中的表达及其免疫保护效果的观察

本文利用基因重组的方法,将宋内Ｉ相Ｏ抗原基因以及霍乱毒素Ｂ亚单位基因（ｃｔｘ－Ｂ）克隆至带链球菌的ａｓｄ基因的表达载体,然后转化至ａｓｄ－痢疾菌苗株福氏２ａＴ３２。脂多糖银染以及Ｗｅｓｔｅｒｎｂｌｏｔｔｉｎｇ实验证实以上两基因都能在宿主菌中稳定表达。动物（小白鼠）保护实验表明,该重组菌对福氏２ａ、宋内氏痢疾菌的保护效率达１００％,对霍乱弧菌的保护效率也达７０％。该菌具有稳定、无抗生素标记、多价的特点。     

Frequency of serovars and antimicrobial resistance in Shigella spp. from Brazil

A total of 296 Shigella spp. were received from State Public Health Laboratories, during the period from 1999 to 2004, by National Reference Laboratory for Cholera and Enteric Diseases (NRLCED)--IOC/Fiocruz, Rio de Janeiro, Brazil. The frequency of Shigella spp. was: S. flexneri (52.7%), S. sonnei (44.2%), S. boydii (2.3%), and S. dysenteriae (0.6%). The most frequent S. flexneri serovars were 2a and 1b. The highest incidence rates of Shigella isolation were observed in the Southeast (39%) and Northeast (34%) regions and the lowest rate in the South (3%) of Brazil. Strains were further analyzed for antimicrobial susceptibility by disk diffusion method as part of a surveillance program on antimicrobial resistance. The highest rates of antimicrobial resistance were to trimethoprim-sulfamethozaxole (90%), tetracycline (88%), ampicillin (56%), and chloramphenicol (35%). The patterns of antimicrobial resistance among Shigella isolates pose a major difficulty in the determination of an appropriate drug for shigellosis treatment. Continuous monitoring of antimicrobial susceptibilities of Shigella spp. through a surveillance system is thus essential for effective therapy and control measures against shigellosis.     

福氏志贺菌CTX-M型产超广谱β-内酰胺酶的检测及耐药性

目的 产超广谱β-内酰胺酶( extended-spectrum β-lactamases,ESBLs)福氏志贺菌的耐药性及其基因型.方法 K-B法检测福氏志贺菌对抗菌药物的敏感性,改良三维试验检测菌株是否产生ESBLs,ESBLs的基因型通过PCR扩增、DNA测序的方法进行.结果 148株福氏志贺菌检测出6株产ESBLs,其基因型为CTX-M-3和CTX-M-14;产ESBLs福氏志贺菌对氨苄西林、头孢噻肟、复方新诺明、四环素均耐药,对头孢西丁、亚胺培南、环丙沙星敏感.结论 应加强对福氏志贺菌的耐药性监测,合理使用抗生素,防止产ESBLs福氏志贺菌的流行和传播.     

Acid and base resistance in Escherichia coli and Shigella flexneri: role of rpoS and growth pH.

Escherichia coli K-12 strains and Shigella flexneri grown to stationary phase can survive several hours at pH 2 to 3, which is considerably lower than the acid limit for growth (about pH 4.5). A 1.3-kb fragment cloned from S. flexneri conferred acid resistance on acid-sensitive E. coli HB101; sequence data identified the fragment as a homolog of rpoS, the growth phase-dependent sigma factor sigma 38. The clone also conferred acid resistance on S. flexneri rpoS::Tn10 but not on Salmonella typhimurium. E. coli and S. flexneri strains containing wild-type rpoS maintained greater internal pH in the face of a low external pH than strains lacking functional rpoS, but the ability to survive at low pH did not require maintenance of a high transmembrane pH difference. Aerobic stationary-phase cultures of E. coli MC4100 and S. flexneri 3136, grown initially at an external pH range of 5 to 8, were 100% acid resistant (surviving 2 h at pH 2.5). Aerobic log-phase cultures grown at pH 5.0 were acid resistant; survival decreased 10- to 100-fold as the pH of growth was increased to pH 8.0. Extended growth in log phase also decreased acid resistance substantially. Strains containing rpoS::Tn10 showed partial acid resistance when grown at pH 5 to stationary phase; log-phase cultures showed < 0.01% acid resistance. When grown anaerobically at low pH, however, the rpoS::Tn10 strains were acid resistant. E. coli MC4100 also showed resistance at alkaline pH outside the growth range (base resistance). Significant base resistance was observed up to pH 10.2. Base resistance was diminished by rpoS::Tn10 and by the presence of Na+. Base resistance was increased by an order of magnitude for stationary-phase cultures grown in moderate base (pH 8) compared with those grown in moderate acid (pH 5). Anaerobic growth partly restored base resistance in cultures grown at pH 5 but not in those grown at pH 8. Thus, both acid resistance and base resistance show dependence on growth pH and are regulated by rpoS under certain conditions. For acid resistance, and in part for base resistance, the rpoS requirement can be overcome by anaerobic growth in moderate acid.     

Significance of determination of Shigella antibiotic resistance in bacteriological diagnosis of dysentery]

The results of the Shigella antibiotic susceptibility assay within 1995-2002 are presented. 1472 cultures from 1158 patients with intestinal infections and bacteria carriers were isolated. The isolates were tested for their susceptibility to tetracycline, chloramphenicol, gentamicin, kanamycin, ampicillin and ofloxacin. It was shown that S. flexneri and S. sonnei were resistant to tetracycline. The S. flexneri isolates were highly resistant to chloramphenicol (73.3 to 96.0%) while resistance to it in the isolates of S. sonnei varied from 7.7 to 88.5%. In this connection the Levin medium with tetracycline was used to increase the Shigella isolation. In the study of the culture media efficiency with respect to isolation of Shigella it was observed that the Levin medium with tetracycline provided higher rates of S. flexneri and S. sonnei isolation (2.3- and 1.7-fold increase respectively) vs. the Shigella isolation on the Ploskirev medium without the antibiotic.     

Genetic characterization of atypical Shigella flexneri isolated in Korea

Three types of serotypically atypical Shigella flexneri strains were isolated from 2007 to 2008 in patients at the Korea National Institute of Health (NIH). These strains were characterized and compared with serologically typical S.flexneri. One type of strain either displayed nonreacting typing or grouping sera, reacting strongly only with polyB antisera, which indicates this strain is S. flexneri (polyB:un). The second type displayed reactions with one of the typing sera (IV) and did not bind any grouping sera (IV:un). The remaining type of strain displayed a plural agglutination pattern, reacted with one typing sera (II), and bound with two grouping sera (II:(3)4,7(8)). Among these atypical strains IV:un and II:(3)4,7(8) strains showed higher multi-antibiotic resistance in ampicillin, streptomycin, and trimethoprim-sulfamethoxazole than typical strains. Furthermore, all II:(3)4,7(8) strains harbored integrons. This study suggests that these multiple antibiotic-resistant atypical S. flexneri are new subserotypes of S.flexneri that await further serological classification.     

Phenotypic and molecular characterization of TEM-116 extended-spectrum beta-lactamase produced by a Shigella flexneri clinical isolate from chickens.

Extended-spectrum beta-lactamases (ESBLs) produced by a clinical isolate of Shigella flexneri from chickens were detected with confirmatory phenotypic tests of the Clinical and Laboratory Standards Institute, and minimum inhibitory concentrations of several antibacterial drugs against the isolate were determined by the twofold dilution method. The genotype and subtype of the ESBL-producing S. flexneri isolate were identified by PCR amplifying of ESBL genes and DNA sequencing analysis. The results revealed that the isolate was able to produce ESBLs. They were resistant to third-generation cephalosporins such as ceftiofur and ceftriaxone and showed characteristics of multidrug resistance. The ESBL gene from the S. flexneri isolate was of the TEM type. Sequence analysis indicated that the TEM-type gene had 99.1% and 99.2% identity to TEM-1D ESBL and TEM-1 beta-lactamase, respectively, at the nucleotide level. The amino acid sequence inferred from the TEM-type gene revealed three substitutions compared with the TEM-1 and TEM-1D enzymes: Ser51Gly, Val82Ila and Ala182Val. When it was compared with TEM-116 (99.8% identity), there were only two mutations (A(151)G and T(403)C) in the TEM-type gene, resulting in the substitution of Ser to Gly at position 51 in the amino acid sequence. The TEM type was a TEM-116 derivative.     

慢性阻塞性肺病患者下呼吸道感染革兰阴性杆菌分布及耐药性分析

了解慢性阻塞性肺病(COPD)下呼吸道致病性革兰阴性杆菌的分布及耐药情况。收集江苏省宝应县人民医院2011年1月至2013年7月COPD患者下呼吸道标本,培养分离出的革兰阴性细菌,采用API试剂进行细菌鉴定及药敏试验,统计分析其临床分布及耐药性。共分离出355株革兰阴性细菌,β-内酰胺酶(ESBLs)在大肠埃希菌、肺炎克雷伯菌检出率分别为37.6%和32.9%,碳青霉烯类对肠杆菌科细菌和产ESBLs菌株和鲍曼不动杆菌属的抗菌活性最强,耐药率为0~6.2%,对阿米卡星、头孢哌酮/舒巴坦和哌拉西林/舒巴坦较敏感。铜绿假单胞菌对碳青霉烯类耐药率为23.7%;嗜麦芽窄食单胞菌对碳青霉烯类高度耐受,耐药率为100%。革兰阴性杆菌为COPD患者临床最常见致病菌,碳青霉烯类对除嗜麦窄食单胞菌外的其他革兰阴性细菌具有较好的抗菌活性。     

临床分离4544株革兰阴性杆菌的耐药分布与变迁

目的了解玉溪市革兰阴性杆菌的耐药分布与变迁,为临床用药提供依据。方法对玉溪市人民医院1999—2004年临床各科送检的各类标本中培养分离出的4544株革兰阴性杆菌作回顾性分析。结果9种（属）细菌对25种药物的药敏结果耐药率〉50％者72种次（40．9％）,〈20％者44种次（25．0％）。总的耐药情况为不动杆菌和阴沟肠杆菌最高,铜绿假单胞菌和大肠埃希菌次之,甲型副伤寒沙门菌和福氏志贺菌最低。亚胺培南对多种细菌有较高的敏感覆盖率。有4种细菌对10种抗菌药物耐药率的上升具有临床意义（P〈0.01或P〈0．05）,其中以甲型副伤寒沙门菌对氟喹诺酮类上升最为显著。结论临床分离革兰阴性杆菌的耐药形势十分严峻,应定期监测区域内细菌的耐药变化．指导临床合坪用药。