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1.
摘要 目的:探讨与分析不同剂量乌司他丁联合微量推注泵美罗培南对重症肺炎患者的疗效及血管生成素-2的影响。方法:2019年1月到2022年2月选择在本院诊治的重症肺炎患者78例作为研究对象,将其分为研究组与对照组各39例,两组都给予美罗培南微量推注治疗,研究组与对照组分别给予高剂量与低剂量的乌司他丁治疗,连续应用7 d,观察患者的疗效及血清血管生成素2表达变化情况。结果:研究组的ICU住院时间、退热时间、炎症吸收时间与痰液颜色改变时间较对照组少(P<0.05)。研究组的治疗总有效率较对照组高(P<0.05)。两组治疗后的血清白细胞介素-6(IL-6)、白细胞介素-17(IL-17)含量明显低于治疗前(P<0.05),研究组治疗后的血清IL-6、IL-17含量也明显低于对照组(P<0.05)。两组治疗后的血清血管生成素-2含量低于治疗前,治疗后研究组血清血管生成素-2含量低于对照组(P<0.05)。结论:高剂量乌司他丁联合微量推注泵美罗培南在重症肺炎患者的应用能抑制血清血管生成素-2的表达,也可抑制血清IL-6、IL-17的表达,从而能提高治疗效果,促进改善患者的临床症状,有利于患者康复。  相似文献   
2.
Resistance to broad-spectrum beta-lactams, mediated by extended-spectrum beta-lactamase enzymes (ESBL), is an increasing problem worldwide. The present study was undertaken to determine the incidence of ESBL-production among the clinical isolates of Pseudomonas aeruginosa and their susceptibility to selected antimicrobials. A total of one eighty-seven clinical specimens were tested for the presence of ESBL production using the double-disc synergy test. Of these, 25.13% (n = 47) isolates of P. aeruginosa were observed as ESBL positive. The maximum number of ESBL-producing strains were found in sputum (41.67%; n = 24) followed by pus (28.36%; n = 19), cerebrospinal fluid and other body fluids (21.74%; n = 5), urine (20.45%; n = 9) and blood (13.79%; n = 4). ESBL producing isolates exhibited co-resistance to an array of antibiotics tested. Imipenem and meropenem can be suggested as the drugs of choice in our study.  相似文献   
3.
【背景】鲍曼不动杆菌是院内感染的重要病原菌,因其耐药率高、治疗难度大而备受关注。然而,对于该菌的交叉耐药及耐药相关因素尚未完全阐明。【目的】通过体外诱导分别获得耐美罗培南或耐替加环素的鲍曼不动杆菌菌株,并研究其诱导前后的交叉耐药性和细菌呼吸耗氧率差异。【方法】采用多步法对鲍曼不动杆菌ATCC19606进行体外诱导耐药,PCR扩增诱导前后菌株的16S rRNA基因并测序鉴定,微量肉汤稀释法检测诱导前后鲍曼不动杆菌对美罗培南、亚胺培南、替加环素、阿米卡星、头孢吡肟及左氧氟沙星等抗菌药物的最低抑菌浓度变化,Seahorse XF~e96细胞能量代谢实时测定仪对诱导前后菌株的耗氧率进行分析。【结果】通过88d的体外诱导实验,分别获得耐美罗培南或耐替加环素的鲍曼不动杆菌ATCC19606菌株。耐美罗培南鲍曼不动杆菌ATCC19606对替加环素、亚胺培南、阿米卡星、左氧氟沙星仍处于敏感状态,但是对头孢吡肟交叉耐药;耐替加环素鲍曼不动杆菌ATCC19606对美罗培南、亚胺培南、阿米卡星、左氧氟沙星及头孢吡肟仍处于敏感状态。鲍曼不动杆菌ATCC19606被美罗培南或替加环素诱导耐药之后的耗氧率均下降,差异均具有统计学意义。【结论】美罗培南的使用不仅可能诱导鲍曼不动杆菌ATCC19606对美罗培南耐药,也可能会导致该菌对其它一种或几种抗菌药物产生交叉耐药。鲍曼不动杆菌ATCC19606对美罗培南或替加环素耐药后其耗氧率下降,从而说明呼吸耗氧率下降可能是该菌耐药的因素之一。  相似文献   
4.
The activity of β-lactam antibiotics is compromised by metallo-β-lactamases (MBLs). Herein, a series of dithiocarbamate derivatives were designed and synthesized. Their antibacterial activities were tested in combination with meropenem (MEM) against several MBL (NDM and IMP type)-producing clinical isolates. Clinical isolates harboring NDM-1 and IMP-4 became susceptible to MEM when it was combined with dithiocarbamate compounds 4a, 4b or 4f synthesized in this work. Compounds 4a and 4b increased the effectiveness of MEM by up to 2560 times against strains. In vitro bactericidal dynamics tests showed that bacteria died within 24?h when they were treated with compound 4f?+?MEM. Compounds 4a, 4b and 4f were non-hemolytic and exhibited low toxicity toward HeLa cells in vitro. These data show that compounds containing dithiocarbamate functional group may be helpful in the development of MBL inhibitors.  相似文献   
5.
A transformation procedure for phalaenopsis orchid established by using immature protocorms for Agrobacterium infection was aimed at the introduction of target genes into individuals with divergent genetic backgrounds. Protocorms obtained after 21 days of culture on liquid New Dogashima medium were inoculated with Agrobacterium strain EHA101(pIG121Hm) harboring both -glucuronidase (GUS) and hygromycin resistance genes. Subculture of the protocorms on acetosyringone-containing medium 2 days before Agrobacterium inoculation gave the highest transformation efficiencies (1.3–1.9%) based on the frequency of hygromycin-resistant plants produced. Surviving protocorms obtained 2 months after Agrobacterium infection on selection medium containing 20 mg l–1 hygromycin were cut transversely into two pieces before transferring to recovery medium without hygromycin. Protocorm-like bodies (PLBs) proliferated from pieces of protocorms during a 1-month culture on recovery medium followed by transfer to selection medium. Hygromycin-resistant phalaenopsis plants that regenerated after the re-selection culture of PLBs showed histochemical blue staining due to GUS. Transgene integration of the hygromycin-resistant plants was confirmed by Southern blot analysis. A total of 88 transgenic plants, each derived from an independent protocorm, was obtained from ca. 12,500 mature seeds 6 months after infection with Agrobacterium. Due to the convenient protocol for Agrobacterium infection and rapid production of transgenic plants, the present procedure could be utilized to assess expression of transgenes under different genetic backgrounds, and for the molecular breeding of phalaenopsis.  相似文献   
6.
目的:探讨丙种球蛋白联合美罗培南治疗新生儿败血症的疗效及对血清白介素-6 (IL-6)、粒细胞巨噬细胞集落刺激因子(GM-CSF)、降钙素原(PCT)水平的影响。方法:选择2017年1月至2018年12月我院接诊的80例新生败血症患儿作为本研究对象,通过随机数表法将其分为观察组和对照组,每组40例。对照组在常规处理基础上给予美罗培南治疗,观察组在对照组的基础上联合丙种球蛋白治疗。比较两组的临床疗效、症状改善时间、住院时间、治疗前后血清免疫球蛋白G(IgG)、IL-6、GM-CSF、PCT水平的变化及不良反应的发生情况。结果:治疗后7d,观察组临床疗效总有效率显著高于对照组(95%vs. 80%,P0.05);观察组拒奶改善时间、皮肤颜色及体温正常时间、住院时间均短于对照组(P0.05);观察组血清Ig G高于对照组,血清IL-6、GM-CSF、PCT均低于对照组(P0.05)。两组治疗治疗期间均无死亡病例和严重不良反应发生。结论:丙种球蛋白联合美罗培南治疗新生儿败血症的疗效显著优于单用美罗培南治疗,其可有效降低血清IL-6、GM-CSF、PCT的表达,促进患儿恢复。  相似文献   
7.
摘要 目的:探讨呼吸机辅助美罗培南及胸腺法新治疗重症肺炎的临床疗效及血清炎症因子水平的影响。方法:选取2018年8月至2020年2月我院收治的96例重症肺炎患者作为研究对象,将其随机均分为两组。对照组48例给予美罗培南治疗,研究组48例给予呼吸机辅助美罗培南及胸腺法新治疗,观察和比较两组患者的疗效、肺部症状的改善情况、治疗前后血清白细胞介素(IL,Interleukin)-6、IL-10、肿瘤坏死因子(Tumor Necrosis Factor-α,TNF-α)水平的变化及不良反应的发生情况。结果:治疗后,研究组总有效率为97.96 %,显著高于对照组(85.41 %,P<0.05);研究组肺部啰音消失时间及炎症吸收时间明显短于对照组(P<0.05),IL-6、IL-10、TNF-α明显低于对照组(P<0.05)。治疗过程中,研究组不良反应率为2.08 %,显著低于对照组(31.25 %,P<0.05)。结论:呼吸机辅助美罗培南及胸腺法新用于治疗重症肺炎患者的临床疗效明显优于单用美罗培南治疗,其能有效减轻炎症反应,且安全性高。  相似文献   
8.
The antimicrobial activity of eight cationic, two neutral and three anionic liposome compositions containing meropenem and gentamicin was tested in vitro in broth and serum medium. The cationic formulations showed better antibacterial efficacy against both Gram-positive and Gram-negative bacteria than the anionic and neutral ones, regardless of the encapsulated drug. The most effective formulations were the cationic PC/DOPE/DOTAP 3:4:3 and PC/Chol/DOTAP 3:4:3, as the MICs with meropenem were 2 to 4 times lower than those of the free drug.  相似文献   
9.
Extended spectrum beta-lactamases (ESBLs) usually associated with multiple drug resistance, including beta-lactam and non-beta-lactam antibiotics. This resistance can cause Limitation in the choice of drugs appropriate for using in clinical practice, especially in life-threatening infections. In this study we aimed to investigate in vitro activity of meropenem, ciprofloxacine and amikacin against ESBL-producing and non-producing blood isolates of Escherichia coli and Klebsiella pneumoniae strains. Fifty-eight E. coli (21 ESBL-producing, 37 non-ESBL producing) and 99 K. pneumoniae (54 ESBL-producing, 45 non-ESBL producing) strains were included in the study. The presence of ESBL was investigated by double disk synergy test and E-test methods. Antibiotic susceptibility test was done by microdilution method according to NCCLS guideline. In vitro susceptibilities of ESBL producing E. coli and K. pneumoniae strains were found as 100% for meropenem, 33.3% and 25.9% for ciprofloxacine, 94.5% and 83.3% for amikacin. It was observed that; meropenem was equally active agent in both ESBL-producing and non-producing strains, and its activity was not affected by ESBL production. Whereas amikacin activity was minimally affected and ciprofloxacine activity was markedly decreased by ESBL production. In conclusion, meropenem seems to be better choice of antibiotic should be used for ESBL positive life-threatening infections, because of remaining highest activity.  相似文献   
10.
目的评价美罗培南治疗儿童急性白血病化疗期间中性粒细胞减少合并院内感染时的临床疗效及安全性。方法52例儿童急性白血病患者强化疗后骨髓抑制期合并院内感染,开始感染时即使用美罗培南28例,在其他广谱抗生素无效的情况下改用美罗培南24例,美罗培南用法每次20mg/kg,每8小时1次,评价治疗效果及不良反应。结果美罗培南在治疗儿童急性白血病中性粒细胞减少合并院内感染的有效率为82.7%(43/52),且副作用少。开始使用美罗培南组起效时间明显低于更换使用美罗培南组(P〈0.05),且使用抗生素的时间在开始即使用美罗培南组明显少于更换使用美罗培南组(P〈0.05)。两组的治疗效果差异无显著性。结论美罗培南治疗儿童急性白血病患者化疗后骨髓抑制期合并感染效果明显且较安全,可作为儿童急性白血病患者化疗后骨髓抑制期合并感染的首选药物之一。  相似文献   
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