重度颅脑损伤患者并发肺部感染的病原菌及耐药性研究

目的:观察重度颅脑损伤患者并发肺部感染的病原菌特点及耐药性,为临床诊治提供参考依据。方法:对我院2010年2月~2012年2月收治的62例重度颅脑损伤患者的病例资料进行回顾性分析,观察其病原菌分布特点及药敏检查结果。结果:重度颅脑损伤患者62例,发生肺部感染者28例,肺部感染发生率45.16%。共分离病原菌31株,其中革兰阴性杆菌21株,占67.74%;革兰阳性球菌6株,占19.35%;真菌4株,占12.9%。经药敏试验分析,革兰阴性杆菌对亚胺培南高度敏感;革兰阳性球菌对利福平、万古霉素、呋喃妥因高度敏感。经单因素分析,气管切开操作史、住院天数延长、基础疾病、休克、呼吸机使用均是导致重度颅脑损伤发生肺部感染的危险因素(P0.05)。结论:重度颅脑损伤患者并发肺部感染病原菌以革兰阴性杆菌为主,临床发生率较高,针对病原菌特点采用敏感抗生素对提高治疗效果具有重要作用。     

2010~2012年老年肺部感染患者病原菌分布及耐药监测

目的探讨肺部感染的老年患者病原菌分布变化及耐药状况,指导临床合理用药。方法对2010~2012年在呼吸内科住院的老年肺部感染患者痰培养阳性的4 709株病原菌及药敏结果进行回顾性分析。结果在4 709株病原菌中,革兰阴性杆菌2 469株,占52.4%,比例呈上升趋势(38.9%~59.7%);其中肺炎克雷伯菌、铜绿假单胞菌、鲍氏不动杆菌分别占11.4%、11.8%和11.9%,比例也呈上升趋势。真菌1 904株,占40.4%,主要为白假丝酵母菌、光滑假丝酵母;革兰阳性球菌336株,占7.1%,金黄色葡萄球菌、溶血葡萄球菌分别占3.7%、2.6%;革兰阴性杆菌对阿米卡星、头孢哌酮/舒巴坦、亚胺培南耐药率较低;革兰阳性球菌对万古霉素、替加环素、利奈唑胺、呋喃妥因100%敏感。结论老年肺部感染以革兰阴性杆菌为主,对抗菌药物出现了不同程度的耐药,临床应结合药敏结果合理使用抗生素     

住院患者导管相关性血流感染病原菌分布与耐药分析

目的 探讨住院患者血管导管相关性血流感染的病原菌分布及耐药情况,为医院感染的控制提供依据.方法 对2011年1月至2012年2月住院患者中导管相关性血流感染病例的643株细菌的耐药性进行统计分析.结果 导管相关性血流感染发生率为4.1％,其中多重耐药细菌感染发生率为3.0％,分离病原菌以革兰阴性杆菌为主,占55.4％,革兰阳性球菌占43.2％.革兰阴性杆菌以肺炎克雷伯菌、大肠埃希菌为主,对头孢哌酮/舒巴坦、哌拉西林/他唑巴坦、阿米卡星耐药率低,鲍曼不动杆菌对亚胺培南耐药率增高;革兰阳性球菌以耐甲氧西林凝固酶阴性葡萄球菌为主,未出现耐万古霉素肠球菌.结论 加强细菌耐药检测,合理使用抗菌药物,对减少医院导管相关性血流感染的发生和耐药菌株产生有重要意义.     

684例胆道感染患者胆汁病原菌分布及耐药性分析

目的研究胆道感染患者胆汁病原菌的分布及其耐药性,为临床合理使用抗菌药物提供依据。方法对684例胆道感染患者胆汁进行培养,应用Micro Scan Walk Away40细菌鉴定及药敏分析系统对分离菌进行鉴定及药敏测定,用WHONET 5.6软件进行数据分析。结果从684例患者胆汁中分离出315株病原菌,革兰阴性杆菌占65.1%,革兰阳性球菌占34.3%,真菌占0.6%。革兰阴性杆菌对亚胺培南、美罗培南、头孢哌酮/舒巴坦、哌拉西林/他唑巴坦、左氧氟沙星、头孢吡肟、庆大霉素耐药率较低。肠球菌属、葡萄球菌属对喹诺酮类耐药率较低,未发现耐万古霉素、利奈唑胺的革兰阳性球菌。结论胆道感染仍以革兰阴性杆菌为主,病原菌分布广泛,耐药情况较严重,治疗使用抗生素需要进行病原菌检测及耐药性分析。     

重症监护病房中心静脉导管相关性血流感染的病原菌分布及耐药性分析

摘要：目的 探讨重症监护病房（ICU）患者中心静脉导管相关性血流感染（CRBSI）病原菌的分布特点及其耐药性,为临床合理选用抗菌药物提供依据。方法 回顾分析杭州市西湖区第二人民医院2010年1月至2014年12月ICU病房收治的CRBSI患者的临床资料,了解其病原菌的构成及其药物敏感情况。结果 共分离出病原菌152株,其中革兰阴性杆菌占53.95%,革兰阳性球菌占40.13%,真菌占5.92%。药敏结果显示,主要革兰阴性杆菌对阿米卡星、哌拉西林/他唑巴坦、头孢哌酮/舒巴坦、亚胺培南耐药率较低,主要革兰阳性球菌对利福平、阿米卡星、呋喃妥因、替加环素、利奈唑胺和万古霉素耐药率较低。结论 加强CRBSI细菌耐药性监测,合理使用抗菌药物,有助于CRBSI的早期诊治和降低患者死亡率。     

血流感中的病原菌分布及耐药性分析

目的了解血流感染中的病原菌种类、分布及耐药性,为临床合理选用抗菌药物提供依据。方法按照无菌操作方法采集疑为血流感染患者的血液标本进行血培养,采用美国BD公司PHOENIX-100全自动细菌鉴定药敏系统进行细菌鉴定及药敏试验,并对结果进行统计分析。结果共检出1080株病原菌,其中革兰阴性杆菌630株（占58．3％）,革兰阳性球菌428株（占39．6％）,真菌22株（占2．1％）。药敏结果显示：革兰阳性球菌对万古霉素、利奈唑胺敏感率最高,对青霉素、红霉素、头孢菌素等耐药率较高。革兰阴性杆菌对碳青霉烯类、哌拉西林／他唑巴坦、头孢哌酮／舒巴坦敏感率较高,对青霉素类、头孢菌素类和喹诺酮类耐药率较高。结论引起血流感染的病原菌分布复杂,耐药率较高,临床应提高血培养送检率,根据药敏结果合理选用抗菌药物,以减少多重耐药菌的发生和传播。     

重症监护病房中心静脉导管相关性血流感染的病原菌分布及耐药性

目的探讨重症监护病房(ICU)患者中心静脉导管相关性血流感染(CRBSI)病原菌的分布特点及其耐药性,为临床合理选用抗菌药物提供依据。方法回顾分析杭州市西湖区第二人民医院2010年1月至2014年12月ICU病房收治的CRBSI患者的临床资料,了解其病原菌的构成及其药物敏感情况。结果共分离出病原菌152株,其中革兰阴性杆菌占53.95%,革兰阳性球菌占40.13%,真菌占5.92%。药敏结果显示,主要革兰阴性杆菌对阿米卡星、哌拉西林/他唑巴坦、头孢哌酮/舒巴坦、亚胺培南耐药率较低,主要革兰阳性球菌对利福平、阿米卡星、呋喃妥因、替加环素、利奈唑胺和万古霉素耐药率较低。结论加强CRBSI细菌耐药性监测,合理使用抗菌药物,有助于CRBSI的早期诊治和降低患者死亡率。     

人工肝支持系统留置静脉导管相关性感染的护理

目的了解人工肝支持系统（ALSS）留置静脉导管相关性感染（CRI）的临床、病原学特点,探讨护理措施。方法对行ALSS治疗的肝衰竭患者留置的静脉导管尖端和外周血进行细菌学培养及药物敏感试验,实施相应护理。结果61例CRI中共分离出64株病原菌,其中革兰阳性菌56株,革兰阴性菌2株,真菌6株。最常见的是凝固酶阴性葡萄球菌,该菌对万古霉素敏感率为100%。结论严格无菌操作,及时拔除感染导管是防治CRI的有效方法,临床应以预防为主,万古霉素是治疗CRI的首选药物。     

慢性支气管炎患者下呼吸道感染病原菌分布及耐药性分析

目的:研究老年慢性支气管炎患者合并下呼吸道感染病原菌分布以及耐药性。方法:选取2009年1月到2013年12月我院收治的老年慢性支气管炎患者合并下呼吸道感染患者261例,采集所有患者的痰液,然后进行病原菌鉴定和药敏试验。结果:261例患者中,144例革兰阴性杆菌感染(55.2%),51例革兰阳性杆菌感染(19.5%),66例真菌感染(25.3%),其中混合感染者36例(13.8%)。革兰阴性杆菌以肺炎克雷伯菌最多(18.4%),革兰阳性杆菌以金黄色葡萄球菌最多(9.2%)。革兰阴性杆菌对亚胺培南的耐药性最低,其次是头孢哌酮和阿米卡星,对氨苄西林耐药率最高。金黄色葡萄球菌和表皮葡萄球菌对青霉素的耐药率均为100.0%,均对万古霉素敏感,其次是对环丙沙星敏感。结论:老年慢性支气管炎患者合并下呼吸道感染以革兰阴性杆菌感染为主,真菌和混合感染也占一定的比例,应该引起注意。     

泌尿系感染常见病原菌的分布及耐药性分析

【摘 要】 目的 探讨解放军第44医院住院患者泌尿系感染病原菌的分布及耐药性,为临床合理应用抗菌药物提供参考。方法 通过法国生物梅里埃VITEK 2 compact及ATB-Expression细菌鉴定分析仪对2012年该院收治的698例住院患者送检中段尿标本进行细菌鉴定,并用K-B法对分离病原菌进行体外药敏试验。结果 698例患者中有512例培养阳性,其中女性患者阳性率为81.5%,男性患者阳性率为19.0%,二者比较差异有统计学意义(P＜0.05)。512例阳性患者中段尿标本中共分离出病原菌536株,其中革兰阴性杆菌占68.8%,革兰阳性球菌占22.8%,真菌占8.4%。分离病原菌对常用抗菌药物呈现多重耐药性,革兰阴性杆菌对氨苄西林、哌拉西林、头孢噻吩、复方新诺明的耐药率高于60.0%,对亚胺培南、阿米卡星敏感。革兰阳性球菌对克林霉素、红霉素、青霉素的耐药率高于70.0%,对万古霉素、替考拉宁高度敏感。结论 泌尿系感染病原菌对常用抗菌药物耐药严重,及时了解泌尿系感染病原菌的分布特点及耐药性,对临床合理选用抗菌药物具有重要意义。     

Direct methylation from mouse plasma and from liver and brain homogenates

The analysis of fatty acid composition of plasma and tissue is important as a method for studying lipid nutrition. We investigated the possibility of direct methylation of fatty acids by BF(3)-methanol from plasma and from liver and brain homogenates without lipid extraction. There were no ghost peaks in the chromatogram produced by the direct methylation method. The 18:0 percentages were significantly higher in the direct methylation method than in the lipid extraction method. There were not remarkable differences in fatty acid composition in the direct methylation and methylation after lyophilization methods. Furthermore, the recovery ratio of the internal standard in the direct methylation method was higher than that in the lipid extraction method. The difference of fatty acid composition with lipid extraction may be caused by the change of lipid class extraction. Therefore, the direct methylation method without lipid extraction is the most suitable for determining fatty acid composition in plasma and tissue.     

Furanoheliangolides from two Eremanthus species and from Chresta sphaerocephala

The investigation of Eremanthus crotonoides afforded in addition to known compounds three new furanoheliangolides, while from E. glomerulatus six new furanoheliangolides and eremantholides were isolated. From the aerial parts of Chresta sphaerocephala a new guaianolide was obtained, while the roots contained known furanoheliangolides. The chemotaxonomy of the subtribe Lychnophorinae is discussed briefly.     

Contact allergy from Frullania and respiratory allergy from Thuja

Occupational allergic contact dermatitis in 52 forest-workers was caused by sesquiterpene lactones from liverworts (Frullania) and by usnic acid from lichens which grow on various trees including cedar (Thuja). Occupational asthma and rhinitis in 35 wood-workers was caused by wood dust of western red cedar (Thuja plicata). Characteristically, the respiratory symptoms occurred in the evening and at night and not during working hours; inhalation challenge with plicatic acid from the wood provoked immediate, late or dual (combined immediate and late) asthmatic reactions. Another class of compounds, tropolones, derived from Thuja plicata wood, was responsible for dermatitis in a wood-worker. These distinct industrial hazards in two groups of workers at the tree-felling and wood-working levels in the forest-products industry can be identified by clinical history and examination supplemented by specific cutaneous or respiratory clinical investigation.     

Chemiluminescence from an erythrocyte folic acid oxidase from normal individuals and from cancer patients

Folic acid oxidase from erythrocytes oxidatively cleaves folic acid at the C-9-N-10 bond to yield pterin-6-aldehyde and p-aminobenzoyl glutamic acid, with the concomitant generation of singlet oxygen. The emission from singlet oxygen is proportional to the enzyme activity. DABCO was used as a singlet oxygen emission enhancer to increase the sensitivity of the measurement. In general, pregnant women show high enzymatic activity, but the emission is strongly quenched by DABCO. This is contrary to normal and cancer cases in which an increase in the emission was observed. This effect is larger in cancer cases. These results are presented as a potential method for detecting physiological and pathological human conditions.     

Cadmium- and mercury-resistant Bacillus strains from a salt marsh and from Boston Harbor

Bacteria resistant to cadmium or mercury or both were isolated from the Great Sippewissett Marsh (Cape Cod, Mass.) and from Boston Harbor. Many of these metal-resistant isolates were gram-positive aerobic sporeformers, although not necessarily isolated as spores. Although several of the isolated strains bore plasmids, cadmium and mercury resistances appeared to be, for the most part, chromosomally encoded. DNA sequence homology of the gram-positive cadmium- and mercury-resistant isolates was not demonstrable with metal resistance genes from plasmids of either gram-positive (pI258) or gram-negative (pDB7) origin. Cadmium resistance of all the marsh isolates tested resulted from reduced Cd2+ transport. On the other hand, three cadmium-resistant harbor isolates displayed considerable influx but no efflux of Cd2+. Hg-resistant strains detoxified mercury by transforming Hg2+ to volatile Hg0 via mercuric reductase.