Sensitivity to selected beta-lactam antibiotics of clinical strains of Escherichia coli and Klebsiella pneumoniae

The studies aimed at analysing the resistance to some beta-lactam antibiotics among E. coli and K. pneumoniae clinical isolates and at evaluating. The extended spectrum of beta-lactamases (ESBL) production in the isolates. The analysis included 137 E. coli strains and 52 K. pneumoniae strains, isolated from hospitalized patients and out-patients treated in the first trimester of 1998. The strains were identified using the ATB computer system. Antibiotic sensitivity of the isolates was determined by disc-diffusion tests. ESBL production capacity of E. coli and K. pneumoniae strains was estimated by double-disc and ATB BLSA tests. Most of the analysed E. coli strains were found to exhibit significant sensitivity to compound penicillin preparations containing beta-lactam inhibitor (Augmentin, Tazocin) and to the third generation cefalosporins, in contrast, K. pneumoniae strains much more frequently were resistant to the drugs. Among the obtained isolates, 3 (2.2%) E. coli strains and 21 (40.4%) K. pneumoniae strains produced ESBL but all the isolates proved sensitive to imipenem. In evaluation of ESBL production-detecting tests, the double-disc test was found to be more reliable than ATB BLSA test.     

Antibiotic sensitivity pattern; experience at University Hospital, Riyadh, Saudi Arabia

Results of sensitivity testing were discussed based on examination of 5192 isolates of the various bacteria isolated from clinical specimens from King Khalid University Hospital in Riyadh, Saudi Arabia. Streptococcus pyogenes and Streptococcus pneumoniae were sensitive to penicillin and erythromycin. The sensitivity pattern of Staphylococcus aureus was also predictable as they were fairly sensitive to both methicillin (98%) and erythromycin (96%). Neisseria gonorrhoeae (27%) showed a high level of resistance to penicillin. The resistance of Haemophilus influenzae to ampicillin and chloramphenicol was low. Brucella species was sensitive to tetracycline and rifampicin; resistance to streptomycin and cotrimoxazole was minimal being 1% and 6% respectively. The resistance of E. coli, Klebsiella species and Proteus species to second and third generation cephalosporins and amikacin was fairly low ranging from 1.3% to 3%. The gentamicin resistance for these organisms was also within the acceptable range (3%-10%). Gentamicin and amikacin resistance for Pseudomonas aeruginosa was low (2-8%). Salmonella typhi was sensitive to ampicillin, cotrimoxazole, and chloramphenicol. Salmonella enteritidis, Shigella species, and enteropathogenic E. coli were highly resistant to various antibiotics. Campylobacter jejuni was sensitive to gentamicin but 6% of isolates were resistant to erythromycin. Ninety six percent of Gram-negative rods except P. aeruginosa isolated from urine of patients having urinary tract infections were sensitive to amoxycillin-clavulanic acid. In addition, P. aeruginosa showed fairly low resistance to norfloxacin which is given orally to treat cystitis caused by this organism.     

社区获得性泌尿系感染病原菌分布及耐药性分析

目的分析社区获得性泌尿系感染病原菌的种类及对常用抗生素的耐药性。方法收集2008年5月至2013年3月分离自社区获得性泌尿系感染患者中段尿的菌株,分析病原菌种类并测试主要病原菌对常用抗生素的体外敏感性。结果在215株细菌中,以革兰阴性杆菌155株（72. 1% ）为主。分离前5位的细菌为大肠埃希菌（48.4% ）、肠球菌属（10. 7% ）、肺炎克雷伯菌（7.4% ）、链球菌属（6. 0% ）、假丝酵母属（6. 0% ）。大肠埃希菌和肺炎克雷伯菌中,共63株产ESBL,占52. 5%。产ESBL菌株对头孢替坦、哌拉西林/他唑巴坦、阿米卡星、呋喃妥因、亚胺培南等5种抗生素的耐药率低于10%,对其他抗生素耐药率则超过70%。不产ESBL的菌株除对氨苄西林、氨苄西林/舒巴坦、环丙沙星、左氧氟沙星和复方新诺明的耐药率超过30%外,对其他常用抗生素的耐药率均在10%以下。肠球菌属和链球菌属分别对呋喃妥因和青霉素的耐药率较低（3/23和0/23）,未发现对万古霉素耐药株。结论引起社区获得性泌尿系感染的病原菌以大肠埃希菌为代表的革兰阴性杆菌为主,但由于不同菌株对抗生素的敏感性差异较大,用药之前进行尿培养是避免因抗生素使用不合理造成感染慢性化的一项重要措施。     

Anaerobic bacteria in bronchoalveolar lavage fluid (BAL) after thoracic surgery

Purpose of this study was to find out what kind of anaerobic bacteria were in lower respiratory tract and how often they were present there considering patients after thoracic surgery. Also, what is susceptibility of bacteria to antibiotics. Research covered 30 patients after operation. Material for research was bronchoalveolar lavage (BAL) taken during bronchoscopy. Collected sample was cultivated in anaerobic and aerobic conditions. Anaerobic bacteria were found in 28 samples (93%). Totally there were 100 anaerobic bacteria strains. The most common Gram-negative rods were from genus Prevotella (24 strains, 24%) and Bacteroides (15 strains, 15%). Gram-negative bacteria except Bacteroides characterised biggest susceptibility to imipenem, piperacillin/tazobactam, amoxicillin/clavulanate, ampicillin/sulbactam, piperacillin, clindamycin and metronidazol. Bacteroides were susceptible to imipenem, piperacillin/tazobactam and metronidazol. Among Gram-positive anaerobic bacteria mostly were isolated from cocci Peptostreptococcus (18 strains, 18%) and were susceptible to all antibiotics. Gram-positive rods were in most cases represented by Actinomyces (12 strains 12%) and were highly susceptible to all antibacterial means except metronidazol (100% is resistant).     

Infectivity and resistance to antibiotics of uropathogenic gram-negative rods

The nature of bacterial isolates from children with clinically suspected urinary tract infections (UTI) was studied. The susceptibility of urinary pathogens to selected antibiotics was determined. The results clearly show that E. coli was identified as the main causative agent of UTI children (67% of isolates). The second commonest pathogen was P. mirabilis (10%). Over half E. coli isolates were resistant to amino-penicilins but almost all isolates (over 80%) were sensitive to antimicrobial agents combined with beta-lactamase inhibitors. We found significantly high percentage (32.5%) of ESBL strains among K. pneumoniae isolates.     

2013年临床分离菌耐药性分析

目的了解南昌大学第二附属医院2013年临床分离菌对抗菌药物的耐药性。方法采用纸片扩散法或自动化仪器法进行药敏试验,参照CLSI 2013年版判读结果,用WHONET5.5软件进行数据分析。结果2013年共收集非重复临床分离菌3996株,其中革兰阴性菌2 623株（65.6%）,革兰阳性菌1 373株（34.4%）。标本来源以痰液为主（23.2%）,其次为血液（21.6%）和尿液（17.8%）。居前5位的菌种依次为大肠埃希菌、肺炎克雷伯菌、金黄色葡萄球菌、铜绿假单胞菌和鲍曼不动杆菌,分别占20.9%、10.1%、9.4%、8.7%和7.4%。甲氧西林耐药金葡菌和CNS（MRSA和MRCNS）分别占各自菌株的21.3%和82.0%,未发现对万古霉素和替加环素耐药的葡萄球菌。肺炎链球菌中青霉素耐药株占16.4%,β溶血性链球菌对红霉素、克林霉素和四环素耐药率较高。屎肠球菌对多数抗菌药物的耐药率高于粪肠球菌,共检测出2株粪肠球菌对万古霉素耐药。大肠埃希菌和克雷伯菌属细菌（肺炎克雷伯菌、产酸克雷伯菌）中ESBLs的检出率分别为60.2%和27.2%,产ESBLs株对大多数抗菌药物的耐药率高于非产ESBLs株。肠杆菌科细菌对厄他培南和亚胺培南的耐药率均低于10%。铜绿假单胞菌对亚胺培南的耐药率为8.7%。鲍曼不动杆菌除对左氧氟沙星耐药率为34.6%外,对其他常用抗菌药物的耐药率均大于50.0%,多重耐药鲍曼不动杆菌的检出率为74.9%。结论我院临床分离菌仍以革兰阴性杆菌为主,细菌耐药性仍是临床重要问题,尤其是耐碳青霉烯类抗生素肺炎克雷伯菌（CRKP）增加较快,应引起临床高度重视。     

Antimicrobial sensitivity of Escherichia coli strains with K1 antigen isolated from pregnant women and newborns

The aim of this study was comparison of the susceptibility to antibiotics of E. coli strains with K1 antigen (E. coli K1+) and non-K1 E. coli strains (E. coli K1-). This study included 67 of E. coli K1+ and 67 of E. coli K1- strains isolated in the time period from June to September of 2008 from pregnant women and newborns hospitalized at dr. J. Biziel University Hospital number 2 L. Rydygier Collegium Medicum in Bydgoszcz Nicolaus Copernicus University in Toruń. Antimicrobial susceptibility of E. coli strains was tested by the disc-diffusion method, on the Mueller Hinton 2 Agar (Becton Dickinson). It was found that 64,2% of E. coli K1+ strains and 53,7% of E. coli K1-strains were susceptible to all tested antibiotics and chemioterapeutics. E. coli K1- strains were more often than E. coli K1+ nonsusceptible to at least one antimicrobial agent. The obtained results indicate that E. coli K1+ strains significant differed in the susceptibility to ampicillin/sulbactam (85,1% versus 95,5%) (p=0,041), cephalothin (70,1% versus 85,1%) (p=0,038) and tetracycline (91,0% versus 74,6%) (p=0,012) from E. coli K1-strains. All tested E. coli K1+ and K1-strains were sensitive to piperacillin/tazobactam, cefoperazone/sulbactam, cefotaxime, ceftazidime, cefepime, imipenem, amikacin, netilmicin and tigecycline. There weren't the ESBL-producing strains among tested E. coli K1+ and K1- rods.     

不同来源标本中大肠埃希菌耐药率的比较分析

目的研究不同标本来源中大肠埃希菌的耐药谱,为临床用药提供治疗参考。方法对温州医学院附属第二医院2010年1月到12月患者送检的体液标本进行培养,用microcsan walkaway 96S微生物自动鉴定仪对菌种鉴定及药敏分析,结果用2分割法进行统计分析。结果分离出大肠埃希菌597株,其中痰液、脓液、血液、分泌物、引流液中分别分离出295、148、102、37、15株。所有分离株均对亚胺培南敏感,对氨苄西林、哌拉西林的耐药率最高。痰液分离株对氨曲南、氨苄西林、氨苄西林/舒巴坦、哌拉西林、妥布霉素及所有头孢类的耐药率显著高于血液分离株的耐药率(P<0.05);痰液分离株对氨曲南、氨苄西林/舒巴坦、除头孢他啶外的所有头孢类的耐药率显著高于脓液分离株的耐药率(P<0.05);脓液分离株对氨苄西林、哌拉西林、妥布霉素的耐药率明显高于血液分离株的耐药率(P<0.05)。痰液中ESBLs阳性率显著高于血液和脓液中ESBLs阳性率。产ESBLs的大肠埃希菌共316株,所占的比例为52.9%;痰液分离的ESBLs阳性株对四环素、环丙沙星、加替沙星、左氧氟沙星、甲氧苄啶/磺胺呷恶唑、阿米卡星的耐药率显著低于脓液分离株的耐药率(P<0.05)。结论痰液分离的大肠埃希菌对β-内酰胺类抗生素的耐药率普遍高于脓液和血液分离株的耐药率,同时认识到该院抗生素的耐药现象很严重,临床上更加合理的使用抗菌药物。     

Antibiotic susceptibility, serum response and surface properties of Klebsiella species

Altogether 130 clinical isolates of five Klebsiella species (K. pneumoniae, K. planticola, K. oxytoca, K. ornithinolytica and K. terrigena) were characterized, for their susceptibility to five antibiotics, for susceptibility to serum bactericidal activity and for their hydrophobic properties. All strains exhibited ampicillin resistance. Ampicillin/sulbactam, gentamicin and ofloxacin showed effectiveness in 63.1, 67.7 and 71.5% of the Klebsiella isolates. K. planticola manifested the highest level of resistance to these antibiotics. The majority of Klebsiella strains (93.9%) were susceptible to cefuroxime. Sixty-four strains (49.2%) were serum resistant and intermediate serum sensitivity was shown by 57 strains (43.8%). A high percentage of serum resistant strains (65%) was found in K. planticola. Moderately hydrophobic properties determined by adherence of bacteria to xylene were demonstrated in 25 strains (19.2%).     

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。     

Prevalence of extended-spectrum beta-lactamases produced by nosocomial isolates of Enterobacteriaceae in Trakya University Hospital,Turkey

The prevalence of extended-spectrum beta-lactamase (ESBL) production by 194 nosocomial isolates of Enterobacteriacea recovered from 1995 to 1999 was investigated. The ESBL production was determined by the double-disk synergy test and was confirmed by the E-test ESBL strip. Twenty-three isolates (21 Klebsiella pneumoniae, one Escherichia coli, one Providencia rettgeri) were found as ESBL-producers (11.8%). These isolates were also usually resistant to non-betalactam antibiotics. Most of them contained a beta-lactamase with a pI of 7.6. All the strains conjugally transferred their ESBLs to recipient E. coli. Contrary to others, ESBL-producing K. pneumoniae strains isolated in 1999 were resistant to ciprofloxacin, and had the identical plasmid profiles suggestive of an outbreak. Ciprofloxacin resistance in these strains could not be transferred. In conclusion, K. pneumoniae was the main ESBL-producing species among nosocomial isolates of Enterobacteriacae in our hospital.     

高龄患者血液感染常见革兰阴性杆菌及其耐药性分析

目的分析本院80~100岁高龄患者血液感染常见革兰阴性杆菌的种类及其耐药状况,为本院合理使用抗生素提供依据。方法采用BacT/Alert 3D血培养仪对血液标本进行阳性鉴定;VITEK-2Compact全自动微生物鉴定仪进行鉴定;K-B纸片扩散法对抗菌药物进行敏感性测定;使用WHONET 5.4分析软件分析数据。结果本院高龄患者血液培养阳性标本中共分离出革兰阴性杆菌108株,以肠杆菌科细菌为主,其次为非发酵菌,前者主要为大肠埃希菌52株(48.15%)和肺炎克雷伯菌37株(34.26%),后者主要包括铜绿假单胞菌10株(9.26%)和鲍曼不动杆菌8株(7.41%)。其中大肠埃希菌和肺炎克雷伯菌对亚胺培南的耐药率分别为1.92%和13.51%,两者对氨苄西林、氨苄西林/舒巴坦、头孢唑林、头孢呋辛的耐药率均高于50.00%;铜绿假单胞菌和鲍曼不动杆菌对亚胺培南的耐药率分别为20.00%和25.00%,后者对其他抗菌药物的耐药率均高于前者。结论碳青酶烯类抗生素可作为本院高龄患者常见革兰阴性杆菌所致血液感染的首选药物;但在治疗中应考虑细菌的耐药特点及患者的代谢特点合理选择抗生素。     

肠杆菌新解释标准指导临床用药的实用性

采用新旧肠杆菌的2种解释标准,分析肠杆菌的耐药性,比较2种解释标准的临床意义。收集本院2009至2010两年临床分离的912株大肠埃希菌、328株肺炎克雷伯菌,用Kirby-Bauer法作药敏试验,用WO-NET5.4软件先设置CLSI推荐的旧的肠杆菌解释标准,分析耐药性。再设置CLSI推荐的新的肠杆菌解释标准[1]修改头孢曲松、头孢他啶、头孢噻肟、氨曲南和亚胺培南的解释标准,分析其耐药性。用肠杆菌旧的解释标准分析常规检测分离出的大肠埃希菌236株产酶株;肺炎克雷伯66株产酶株;产酶株比非产酶株的耐药率高。用新的头孢菌素和氨曲南的解释标准:对于大肠埃希菌头孢曲松的耐药率提高5.2%;头孢他啶提高10.4%;头孢噻肟提高10.2%;氨曲南提高7.1%;对于肺炎克雷伯菌头孢曲松的耐药率提高6.7%;头孢他啶提高4.3%;头孢噻肟提高10.1%;氨曲南提高2.5%;未向临床报产酶株。采用碳青霉烯类抗生素新的解释标准大肠埃希菌和肺炎克雷伯菌对亚胺培南的耐药分别提高了0.4%和0.6%,对美罗培南的耐药率分别提高了0.2%和0.6%。新的肠杆菌解释标准更能客观分析肠杆菌的耐药性,对指导临床合理用药,控制耐药株的蔓延更具实用价值。     

产ESBLs大肠埃希菌和肺炎克雷伯菌呼吸道分离株的基因分型及耐药性分析

目的了解深圳市人民医院大肠埃希菌和肺炎克雷伯菌呼吸道分离株超广谱β-内酰胺酶(ESBLs)的基因型特点及耐药性。方法采用临床实验室标准化协会(CLSI)推荐的表型确证试验筛选出该院呼吸道分离株产ESBLs大肠埃希菌和肺炎克雷伯菌共78株。应用PCR及DNA测序法分析产酶株的TEM、SHV及CTX-M3种β-内酰胺酶基因,用琼脂稀释法测定细菌最低抑菌浓度(MIC)。结果 37株产ESBLs大肠埃希菌中,28株(75.7%)检出CTX-M-14基因,4株(10.8%)检出CTX-M-9基因,其他型较少见。41株肺炎克雷伯菌中,25株(61.0%)检出SHV-12基因,4株(9.8%)检出SHV-11基因,其他SHV型较少。20株(48.8%)检出CTX-M-14基因,5株(12.2%)检出CTX-M-3基因,其他型较少。产ESBL菌株均对亚胺培南敏感,对氨苄西林/舒巴坦的耐药率最高(90%),对其他抗生素有不同程度耐药。结论深圳市人民医院呼吸道分离的产ESBLs大肠埃希菌以CTX-M-14型为主,产酶肺炎克雷伯菌以SHV-12和CTX-M-14型为最常见。     

泌尿系感染病原菌临床调查及耐药性分析

目的了解鹤岗市人民医院2007年1月至2009年12月泌尿系病原菌菌株分布,分析抗菌药的敏感情况,为临床合理应用抗菌药提供实验室依据。方法 2007年1月至2009年12月该院泌尿系感染者2375例中段尿标本分离出776株病原菌进行鉴定和体外药物敏感试验,采用法国生物梅里埃公司ATB鉴定系统对菌株进行鉴定,采用纸片扩散法（即K-B法）进行抗菌药敏感性试验。结果在泌尿系感染大肠埃希菌和肠球菌的检出率分别为40.3%和19.7%;革兰阴性菌对亚胺培南敏感性较高,对氨苄西林、头孢唑林耐药率较高。革兰阳性菌对万古霉素全部敏感,对氨苄西林、青霉素耐药率较高。真菌检出率为16.1%,真菌对两性霉素、氟康唑敏感性高。结论泌尿系感染以大肠埃希菌和粪肠球菌为主,耐药呈上升趋势。临床医师应严格依照泌尿道感染致病菌的种类及药敏结果合理应用抗菌药物。     

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。     

379株血培养病原菌的临床分布及耐药性分析

目的了解血培养病原菌种类、临床分布及耐药情况。方法对2008年6月至2009年6月的379株血培养病原菌及其药敏情况用WHONET5.4软件进行统计分析。结果 379株病原菌中,分离率从高到低依次是凝固酶阴性葡萄球菌(133/35.1%)、大肠埃希菌(44/11.6%)、肺炎克雷伯菌(32/8.4%)、鲍曼不动杆菌(30/7.9%)、铜绿假单胞菌(25/6.6%)、金黄色葡萄球菌(18/4.7%)、肠球菌(13/3.4%)和其他(75/22.2%)。这些菌株主要分布在ICU和普外科。药敏结果分析显示:革兰阳性球菌中,未发现利奈唑胺和万古霉素耐药株。金黄色葡萄球菌和凝固酶阴性葡萄球菌对苯唑西林的耐药率分别为61.1%和89.5%;屎肠球菌对多数抗生素耐药率超过80%,粪肠球菌对青霉素类抗生素敏感性较高。革兰阴性杆菌中,大肠埃希菌和肺炎克雷伯菌中产ESBLs菌株比例分别为36.4%和31.3%,且发现2株耐亚胺培南的肺炎克雷伯菌;鲍曼不动杆菌除对卡那霉素保持敏感外,对其他抗生素的耐药率为50%~100%;铜绿假单胞菌对头孢曲松的耐药率为100%,对其他β-内酰胺类抗生素、氨基糖苷类和喹诺酮类抗生素的耐药率相对较低。结论临床上应规范血培养标本留取方法以减少污染,加强细菌耐药监测、严格抗生素使用,以延缓细菌耐药情况的发生和发展。     

Antimicrobial susceptibility and molecular mechanisms of resistance to beta-lactams of gram-negative microorganisms--causative agents of nosocomial infections

Profiles and mechanisms of resistance to beta-lactam antibiotics of isolates of Gram-negative microorganisms, which are causative agents of infections in Intensive Care Unit of hospital surgery department, were studied. Two hundred and ten clinical isolates were studied: Pseudomonas aeruginosa--86 strains (40.9%), Acinetobacter baummanii--45 strains (21.4%), Klebsiella pneumoniae--52 strains (24.8%), Escherichia coli--23 strains (11%), Enterobacter spp.--4 strains (1.9%). Profiles of antibiotic resistance were studied by the method of serial microdilutions; detection of most widespread and clinically significant genes of beta-lactamases of Gram-negative bacteria was performed by polymerase chain reaction. Carbapenems and cefoperazone/sulbactam were the most active antibiotics. Local features of distribution of beta-lactamase coding genes (TEM, SHV, CTX) in K. pneumoniae and E. coli isolates were revealed. Eleven strains of P. aeruginosa resistant to carbapenems and possessing genetic determinants of VIM-group, which codes metallo-beta-lactamases, were isolated. Obtained data allows to assess the parameters of resistance to beta-lactam antibiotics and to reveal the main mechanisms of such resistance in etiologic agents of nosocomial infections, that, in its turn, allows to choose preparations for etiotropic therapy.     

Comparative study of apramycin-resistant microorganisms isolated from man and animals

Apramycin-modifying strains isolated from pigs with coli bacteriosis, from humans and hospital environment were studied comparatively. Production of enzymes modifying the aminoglycoside was estimated with the radioactive cofactor procedure. E. coli isolates from the animals were phenotypically resistant to apramycin and a number of other aminoglycosides. They produced acetyltransferase AAC(3)IV, phosphotransferase APH(3')(5"), APH(3") and other enzymes. Resistance of the strains to gentamicin was also conditioned by AAC(3)IV since these strains did not produce AAD(2") and AAC(6'). In the resistant strains of E. coli and their transconjugates there were detected plasmids with a relative molecular weight of 60-80 MD. Some of the belonged to the compatibility group I1, the others belonged to the compatibility group H1. Strains of S. marcescens, K. pneumoniae. K. oxytoca and S. aureus isolated from humans and hospital environment were sensitive to apramycin. Only isolates of P. aeruginosa were resistant to this antibiotic. However, all the isolates produced AAC(3)IV. Some of them additionally produced AAC(6'), an enzyme modifying amikacin, kanamycin and other antibiotics and not acetylating apramycin. Almost all the strains produced kanamycin- and streptomycin phosphotransferases. Possible coselection of strains resistant to apramycin and gentamicin using one of these aminoglycosides is discussed.     

不同病区血培养病原菌分布及耐药性分析

目的 了解各病区血培养分离病原菌的分布特点及其耐药性,指导临床医生合理有效地使用抗生素.方法 对宁波市泌尿肾病医院·鄞州第二医院2008年8月至2011年7月临床送检的8409例血液标本经Bact/A-lert3D全自动血培养仪培养,分离所得菌用美国德灵公司Walkaway 40系统进行鉴定和药敏.对检测结果进行统计学分析.结果 共检出病原菌853株,其中革兰阴性杆菌422株,革兰阳性球菌396株,真菌35株.血浆凝固酶阴性葡萄球菌占首位,其次分别为大肠埃希菌及肺炎克雷伯菌.检出菌数量居前三位的病区是重症监护病房、消化内科及肾内科.各病区的病原菌分布不尽相同.丁胺卡那、亚胺培南对大肠埃希菌、肺炎克雷伯菌显示出较高的敏感性,未发现耐利奈唑胺及万古霉素菌株.结论 该院血流感染病原菌以革兰阴性杆菌为主,各主要病区病原菌分布不尽相同,临床医生应跟据药敏结果合理有效地使用抗生素.