慢性肾盂肾炎L型细菌感染及耐药分析

目的了解L型细菌在慢性肾盂肾炎的感染及耐药状况。方法对71例患者清洁中段尿做普通细菌培养(B型)、L型细菌培养(L型)及耐药分析。结果细菌阳性率为77.5%,其中单独L型阳性率为49.3%、B型与L型混合感染为15.5%,而B型阳性率仅为12.7%。主要是大肠埃希菌,其次是葡萄球菌;青霉素及头孢噻肟均有较高的耐药率(88.9%及73.6%)。结论L型细菌在慢性肾盂肾炎感染中占主导,β-内酰胺类药物有较高的耐药性,临床治疗应据药敏结果合理选择及时调整抗生素。     

慢性扁桃体炎与细菌L型感染

通常认为,慢性扁桃体炎主要致病菌是金黄色葡萄球菌和乙型溶血性链球菌。通过50例慢性扁桃体炎的病原微生物培养、组织切片细菌学及电镜等研究,发现慢性扁桃体炎组织中细菌L型也相当常见,L型培养阳性率是88.5％,且组织切片L型感染率与培养阳性率基本一致(P>0.05)。电镜在扁桃体组织间质及上皮细胞、淋巴细胞等多种细胞内均见到细菌L型。提示慢性扁桃体炎与细菌L型感染关系极为密切。并认为,L型侵入组织并在宿主细胞内生长的特性,可能是慢性扁桃体炎反复发作、迁延不愈的重要原因。     

细菌L型感染与慢性子宫内膜炎

本文应用微生物培养、免疫组织化学等方法,对876例子宫内膜进行了组织病理学研究。发现:1.子宫内膜细菌 L 型感染病例中,32.5%的内膜间质有淋巴细胞浸润、淋巴滤泡形成或伴有浆细胞浸润。尚有部分病例虽有感染,但无慢性炎细胞浸润。2.细菌学检查阴性病例,内膜间质无慢性炎细胞浸润。3.病原微生物培养显示70.8%为金黄色葡萄球菌 L 型感染。4.免疫组织化学证明子宫内膜间质细菌型和 L 型的检出率高于腺体。作者提出子宫内膜间质中淋巴细胞浸润或淋巴滤泡形成系细菌 L 型感染的病变特征。故也是慢性子宫内膜炎的诊断依据。     

慢性前列腺炎与细菌L型

本文用自行研制的883L型增菌培养基对51例次慢性前列腺炎患者的前列腺液作L型培养,结果检出L型细菌27例,占52.9％,经返祖和药物敏感性测定,证明本组L型细菌特性与其他来源的L型细菌基本相符,提示慢性前列腺炎的病因、病理机制可能与细菌L型的感染相关。     

牛奶中金黄色葡萄球菌PCR检测方法的建立与应用

目的:建立一种直接从牛奶中检测金黄色葡萄球菌的PCR快速诊断方法.方法:根据已发表的金黄色葡萄球菌16-23SrRNA特异性序列设计并合成一对引物,通过优化反应条件建立从牛奶中直接检测金黄色葡萄球菌的PCR方法.结果:与细菌的常规分离方法相比,PCR法敏感性高,与其它型葡萄球菌无交叉反应,特异性迭100%,检测细菌基因组DNA最低浓度为35ng/μL,能在5h内对送检的牛奶样品直接进行金黄色葡萄球菌的测定,可用于乳制品中金黄色葡萄球菌的检测.结论:成功建立了快速检测牛奶中金黄色葡萄球菌PCR方法.     

从医院使用的新洁尔灭溶液中分离出细菌L型的报告

本文报道,作者采用高渗和等渗牛肉汤试管及平板培养法,从某医院正在使用的新洁尔灭器械浸泡液中分离出4株细菌L型,其中金黄色葡萄球菌L型1株,表皮葡萄球菌L型2株,类白喉杆菌L型1株。上述细菌经形态观察,细胞壁染色,返祖鉴定等一系列细菌L型鉴定程序;并通过电镜观察,菌体细胞图像分析。其结果均提示,细菌L型与原菌之间存在明显差异。作者认为,新洁尔灭器械浸泡液,消毒灭菌的不彻底性,是造成术后感染的重要因素。     

金黄色葡萄球菌L型致间质性肺炎的实验动物模型的建立

目的：观察各实验动物感染金葡萄L型后肺脏和其他重要脏器的病理变化。方法：高渗培养金黄色葡萄球菌L型,经静脉和腹腔人工感染小白鼠,大白鼠等动物,光镜观察相应脏器变化。结果：发现主要脏器实质细胞发生变性,慢性炎细胞浸润和间质细胞增生性改变。结论：细菌L型具有侵入和破坏组织脏器实质细胞的能力,引起脏器发生间质性炎症改变。     

葡萄球菌下呼吸道感染的细菌学分类及抗生素敏感性分析

目的：探讨葡萄球菌下呼吸道感染的细菌学分类情况及抗生素耐药性特点。方法：利用复星公司FOUTUNE IMS细菌鉴定药敏分析系统,凝固酶试验用试管法。结果：47株菌株分离到6种葡萄球菌,排在前3位的是施氏葡萄球菌、金黄色葡萄球菌、木糖葡萄球菌,其中金黄色葡萄球菌占29．8％。耐甲氧西林葡萄球菌（MRS）占78．7％,耐甲氧西林凝固酶阴性葡萄球菌（MRCNS）占凝固酶阴性葡萄球菌（CNS）78．8％;MRS对万古霉素敏感率为81．1％。MRS建议用药依次为万古霉素、呋喃妥因、氯霉素、四环素和喹诺酮类,未发现对万古霉素耐药的耐甲氧西林金黄色葡萄球菌（MRSA）。结论：凝固酶阴性、耐甲氧西林葡萄球菌成为下呼吸道球菌感染的主要菌株,MRS比例上升,MRS治疗首选万古霉素。     

血平板针尖样及云雾状菌落分离与鉴定

采集98份临床标本接种血平板培养,40份生长出针尖样及云雾状菌落。经分离鉴定38株为细菌L型,其中金黄色葡萄球菌（Staphyloeoccusaureus）居首位,占52．1％（20／38）．其返视性与L型平板分离相比较差。但对抗生素的敏感性则无差别。表明血平板可用于分离细菌L型,并保持了传统L型的特性。     

1332例发热患者血液标本菌群及血清学分析

目的：探讨发热患者血液标本中菌群的种类及其分布情况,为临床的诊断与治疗提供实验依据。方法：采用常规细菌学分离培养和L型高渗培养法从1332例感染症患者的血液标本中分离细菌及L型。结果：1332例感染标本共检出细菌486株,检出率为36．5％,检出的细菌包括沙门菌,葡萄球菌,肠道杆菌及奈瑟菌,149例标本中检出细菌L型29株,检出率为19．5％。其中返祖的细菌包括葡萄球菌和奈瑟菌。结论：沙门菌和葡萄球菌及其L型是引起血液感染的常见病原菌。     

Isolation of L-Forms in a Clinical Microbiology Laboratory

Previous studies have demonstrated that L-forms of bacteria may play a role in persistent, chronic, or recurrent urinary-tract infections. A 2-year program was initiated to determine the feasibility of culturing for L-forms on a routine basis, and to determine the effectiveness of such a program. In relation to the total number of specimens, few L-forms were actually isolated. In comparison with the amount of equipment and technician time required, the return was negligible; only 0.5% of all urine specimens were positive for L-forms. An increase to only 1.2% was noted when culturing for L-forms was limited to patients with a diagnosis of bacteriuria or pyelonephritis. It is recommended that this technique be reserved for those patients with a long history of recurrent urinary-tract infections, after other attempts to cure the patient have met with failure.     

L-forms of bacteria in the urine of patients with chronic pyelonephritis]

The authors present the data concerning the study of 200 patients suffering from chronic pyelonephritis; in 28 of these L-forms of bacteria were revealed in the urine. Of 46 L-cultures isolated from these patients 13 reversed into bacterial forms, 8 failed to reverse and were referred to the stable L-forms; the rest 25 L-cultures perished during the 8th--10th passage. This led to a supposition that the relapses and exacerbations of the infectious process in pyelonephritis were associated with the change of the L-forms into bacterial ones, and that the persistence of the L-forms in the kidney tissue promoted the maintenance of the chronic process.     

咽部活组织中细菌L型的检出及意义

应用病原微生物培养、电镜、组织切片细菌学检查及Ｌ型抗体免疫组化染色等方法,检测６４例慢性咽炎组织的细菌Ｌ型。结果有４２例培养出细菌Ｌ型,其阳性率为６５．６％;它与切片革兰氏染色Ｌ型检出阳性率（６７．２％）无显著性差异,Ｐ＞０．０５。透射电镜在慢性咽炎组织的间质及上皮细胞、巨噬细胞等细胞内见皮细菌Ｌ型;且Ｌ型抗体免疫组化染色亦证实组织中有细菌Ｌ型抗原。提示,细菌Ｌ型感染与慢性咽炎关系密切,Ｌ型侵入组织并在宿主细胞内生长的特征,可能是慢性咽炎反复发作,迁延不愈的重要原因。     

Induction, growth and antibiotic production of Streptomyces viridifaciens L-form bacteria

AIMS: To induce, cultivate and investigate the characteristics of L-form bacteria derived from the filamentous actinomycete Streptomyces viridifaciens. METHODS AND RESULTS: L-forms were induced in a liquid medium supplemented with lysozyme and penicillin. A stable culture which no longer required inducing agents but could still revert, was obtained by the twelfth subculture. The specific growth rate of stable L-forms was faster (0.751) than unstable L-forms (0.361). After the exponential growth phase, the cell diameter continued to increase, as did the percentage of vacuoles. Morphologically, the L-forms appeared as spherical bodies with no signs of differentiation and were sensitive to osmotic stress, indicating removal of the cell wall. The L-forms produced secondary metabolites although much lower levels of antibiotic were assayed in the L-forms compared with the cell walled forms. CONCLUSION: Stable L-form bacteria were induced from S. viridifaciens and their growth characterized. The L-forms produced secondary metabolites. SIGNIFICANCE AND IMPACT OF THE STUDY: Stable Streptomyces L-forms were induced and have potential as biocontrol agents.     

Cell fusion between L-forms and protoplasts of Staphylococcus aureus

Mixtures of various combinations of Lysostaphin protoplasts and stable L-forms of Staphylococcus aureus, which have different markers for drug resistance, were treated with polyethylene glycol (PEG) to examine the development of doubly resistant fusion products (fusants). To recover doubly resistant colonies as L-forms, they were incubated in 4.5% NaCl-brain heart infusion (BHI) broth containing penicillin G (PCG) for enrichment culture and cultured in PCG-4.5% NaCl-BHI agar medium (method 1), while to recover doubly resistant fusants as L-forms and coccal forms, they were grown on reversion medium (R medium) which causes reversion of protoplasts or fusants to parent type cells, and then cultured on assay media, i.e., R medium, BHI agar medium or PCG-4.5% NaCl-BHI agar medium (method 2). Under both experimental conditions, doubly resistant fusants developed as L-form cells by PEG treatment of pairs of protoplasts carrying the chloramphenicol (CP)-resistance plasmid and L-forms having chromosomal resistance to streptomycin (SM). In the reverse combinations, i.e., protoplasts showing chromosomal SM-resistance and L-form cells carrying the CP-resistance plasmid, the first method gave no doubly resistant colonies. By the second method, without enrichment culture on R medium, the latter combination gave doubly resistant fusants as L-form, coccal-type and mixed-type colonial forms, while when the PEG-treated mixture was enriched on R medium, fusants were obtained exclusively as the coccal type on either R medium or BHI agar assay medium. Neither of the methods yielded colonies of doubly resistant fusants on PEG-treatment of pairs of protoplasts and L-forms both of which were chromosomal, but with different drug resistances. These results show that PEG-induced cell fusion between protoplasts and L-forms of S. aureus, unlike the fusion between protoplasts or between L-forms, resulted in transfer of the drug resistance controlled by the plasmid to the fusion products. The fusants obtained were L-forms in method 1, and coccal type in the method 2.     

Alterations of the L-forms of a sporebearing bacillus

A large pleomorphic gram-negative bacillus developed as a contaminant on blood-agar. Spores were formed in one culture. L-forms were produced with penicillin on blood-agar with 2.5% NaCl; they grew well when transplanted to agar with 0.5% NaCl. After several transplants and long incubation of the L-forms without penicillin, in three transplants small gram-negative pleomorphic bacilli grew, but no L-forms. This occurred once on blood-agar and twice on 30% gelatin. The growth obtained from these small bacilli was similar in morphology and in the physical properties of the organisms to the altered L-forms of Proteus and Salmonella. Multiplication of the pleomorphic organisms and development of branching filaments from the round forms was apparent. The original large gram-negative bacillus was regularly recovered from the L-forms, and was recovered several times from the descendants of the small bacilli. These observations are essentially similar to those made with L-forms of Proteus and with an L-form studied in 1952, indicating alterations in L-forms of bacteria which do not produce B type L-forms.     

Ultrastructure of Brucella abortus L-forms induced by penicillin in a liquid and in a semisolid medium

Brucella abortus L-forms were induced by 5.0 or 10.0 mug of penicillin/ml in a broth medium containing 0.3 m sucrose, and in a semisolid medium containing 10% calf serum and 20.0, 40.0, or 60.0 mug of penicillin/ml. After 96 hr of incubation, L-forms of various sizes and shapes were observed. Basic structures of the L-forms were similar whether induced in liquid or semisolid medium. L-forms had two "unit" membranes, each consisting of two outer dense layers separated by a lucent layer. A few large, irregularly shaped organisms in penicillin-treated broth cultures had additional surface material and were referred to as "transitional" forms. In contrast with L-forms, the bacterial cells were fairly uniform in size and shape, were smaller, and had a more complex cell wall structure. Small bodies limited by a "unit" membrane were present within and around numerous L-forms from liquid and semisolid medium cultures. Other internal membranous structures were also seen in some L-forms. Most Brucella L-forms described in this paper reverted to bacteria in the absence of penicillin and were structurally characteristic of unstable L-forms.     

Growth and adhesion of Enterococcus faecium L-forms

Abstract Comparisons of growth and surface colonisation of Enterococcus faecium L-forms and their cell-walled forms were undertaken to produce information about their ability to form sessile cells. The growth of L-forms in liquid culture was slower than that of the parent. This was reflected in their longer lag phase and slower specific growth rates: 0.16 h⁻¹ for the L-form and 0.81 h⁻¹ for the parent. Although E. faecium L-forms attached to a silastic rubber surface, the attached population density was 10–100-fold less than that of the parent. Confluent biofilms on the silastic surfaces were not observed for either bacterial form. Comparison of the attachment of E. faecium L-form and parent may provide important information on how bacteria overcome host defence mechanisms and antibiotic treatment.