阿奇霉素治疗小儿支原体肺炎的效果观察和安全性分析

目的观察大环内酯类抗生素阿奇霉素治疗小儿支原体肺炎的临床疗效,并对用药安全性进行评价。方法选择我院2012年6月至2014年10月呼吸科收治的96例小儿支原体肺炎患者,随机平均分为观察组和对照组。观察组给予阿奇霉素治疗,对照组给予红霉素治疗,观察两组的临床疗效和不良反应。结果观察组患者治愈37例,显效8例,无效3例,总有效率为93.75%;对照组治愈30例,显效9例,无效9例,总有效率为81.25%,治疗组疗效优于对照组,差异有统计学意义(P0.05)。治疗组患者平均退热、止咳、平喘、肺部啰音消失时间均短于对照组,平均住院时间和住院花费均少于对照组,差异有统计学意义(P0.05)。两组均偶见局部皮疹、注射部分疼痛等轻度不良反应,差异无统计学意义;观察组无胃肠道反应,对照组有4例胃肠道反应。结论阿奇霉素治疗小儿支原体肺炎能有效改善临床症状,较红霉素能提高治疗效果,缩短病程,且无严重不良反应,安全可靠,值得推广应用。     

肺炎支原体P1蛋白的研究进展

肺炎支原体(MP)是引起呼吸系统感染常见的病原微生物,P1蛋白是肺炎支原体上一种与黏附相关的跨膜蛋白,其黏附作用是引发炎症作用的重要原因.目前新发现的一种被称为孤立岛3的P1变异体引起了各学者的广泛关注.另外,还可以利用P1蛋白进行MP感染的实验室诊断.因此,探讨P1蛋白基因结构、致病机制和实验室诊断方法具有重要意义.     

肺炎支原体液体培养法检测的实验评价

目的比较液体培养法和固体培养法平行检测肺炎支原体结果的一致性;评价液体培养法检测肺炎支原体的可靠性。方法采用液体培养基和固体琼脂培养基平行检测1 648份临床标本的肺炎支原体,比较同一份标本在2种培养基上的检测结果。结果液体培养法阳性296例,阳性率为18%;固体培养法阳性244例,阳性率为14.8%;液体培养法阳性而固体培养法阴性57例;固体培养阳性而液体培养法为阴性5例。2种方法的阳性检出率比较差异有统计学意义(P<0.05)。结论肺炎支原体快速液体培养法与固体培养有较好的一致性,具有方便、简单、准确且可以用于早期检测等优点,适合临床大批量标本筛查。需结合患者临床症状等排除真菌和耐药菌造成的假阳性。     

Putative copper- and zinc-binding motifs in Streptococcus pneumoniae identified by immobilized metal affinity chromatography and mass spectrometry

The aim of metalloproteomics is to identify and characterize putative metal-binding proteins and metal-binding motifs. In this study, we performed a systematical metalloproteomic analysis on Streptococcus pneumoniae through the combined use of efficient immobilized metal affinity chromatography enrichment and high-accuracy linear ion trap-Orbitrap MS to identify metal-binding proteins and metal-binding peptides. In total, 232 and 166 putative metal-binding proteins were respectively isolated by Cu- and Zn-immobilized metal affinity chromatography columns, in which 133 proteins were present in both preparations. The putative metalloproteins are mainly involved in protein, nucleotide and carbon metabolisms, oxidation and cell cycle regulation. Based on the sequence of the putative Cu- and Zn-binding peptides, putative Cu-binding motifs were identified: H(X)mH (m=0-11), C(X)(2) C, C(X)nH (n=2-4, 6, 9), H(X)iM (i=0-10) and M(X)tM (t=8 or 12), while putative Zn-binding motifs were identified as follows: H(X)mH (m=1-12), H(X)iM (i=0-12), M(X)tM (t=0, 3 and 4), C(X)nH (n=1, 2, 7, 10 and 11). Equilibrium dialysis and inductively coupled plasma-MS experiments confirmed that the artificially synthesized peptides harboring differential identified metal-binding motifs interacted directly with the metal ions. The metalloproteomic study presented here suggests that the comparably large size and diverse functions of the S. pneumoniae metalloproteome may play important roles in various biological processes and thus contribute to the bacterial pathologies.     

急性肺炎支原体感染儿童白细胞和C 反应蛋白的变化及其临床意义

目的:探讨急性肺炎支原体感染后儿童白细胞及CRP变化的规律,为该病的临床治疗与诊断提供参考。方法:对65例急性肺炎支原体感染儿童和同期65例健康儿童的血常规白细胞和CRP检测结果采用t检验进行统计比较,分析二者的差异。结果:与同期健康儿童相比,急性肺炎支原体感染儿童白细胞计数增高,中性粒细胞比例及绝对值增高,淋巴细胞比例及绝对值下降,嗜酸性粒细胞、嗜碱性粒细胞及单核细胞比例及绝对值均无明显变化,CRP水平明显升高。结论:急性肺炎支原体感染儿童通过白细胞、CRP的变化可以初步判断。     

支原体肺炎合并胸腔积液、肺不张27 例临床分析

目的:探讨肺炎支原体肺炎合并胸腔积液、肺不张的诊断和治疗问题。方法:回顾性分析27例MPP合并胸腔积液、肺不张患儿的临床特征、诊治过程的临床资料,并结合文献进行讨论。结果:在27例MPP患儿中,肺CT表现为胸腔积液17例,肺不张10例;24例治愈,1例胸膜肥厚粘连,2例遗留闭塞性细支气管炎。结论:对MPP合并胸腔积液、肺不张患儿应早诊断,早治疗,除应用大环内酯类药物外,应联合应用头孢菌素,激素及丙种球蛋白,疗效肯定。     

Sortase A contributes to pneumococcal nasopharyngeal colonization in the chinchilla model

Sortase A (SrtA) is required to anchor neuraminidase, beta-galactosidase, and possibly other LPXTG motif proteins to the pneumococcal cell surface. We examined the role of SrtA in Streptococcus pneumoniae nasopharyngeal (NP) colonization in the chinchilla model. The srtA mutant colonized the nasopharynx at a significantly lower level than the D39 parent strain during the second and third week of the carriage, and was eliminated from nasopharynx one week earlier than the D39 pneumococci. Our data indicate that SrtA contributes to pneumococcal NP colonization in this animal model.