Virulence factors (aerobactin and mucoid phenotype) in Klebsiella pneumoniae and Escherichia coli blood culture isolates

Abstract We examined the presence of two virulence factors in 241 blood isolates of Klebsiella pneumoniae from patients hospitalized during 1989 and 1990 in 7 French hospitals, and 125 blood isolates of Escherichia coli from one hospital. Aerobactin was scored phenotypically and genotypically with an intragenic DNA probe of 2 kb. The mucoid phenotype was assessed by culture on trypticase soy agar and by genotypic analysis (intragenic DNA probe of 235 bp). Only 6% K. pneumoniae isolates were aerobactin-positive with no significant variation according to geographical location while 20% of K. pneumoniae isolates displayed the mucoid phenotype, with a significant variation according to hospital. Aerobactin was always associated with the mucoid phenotype. The frequency of aerobactin production but not mucoid phenotype (14%) was higher among E. coli isolates (48%). They harbored two types of large plasmids. Intraperitoneal injection into mice of 10³ cfu of K. pneumoniae producing both virulence factors demonstrated that capsular serotype K2 was the more virulent K23 and K28.     

乌司他丁联合痰清宁雾化吸入对重症肺炎患者肌钙蛋白水平及心肌酶谱的影响

目的:探讨乌司他丁联合痰清宁雾化吸入对重症肺炎患者肌钙蛋白水平、心肌酶谱的影响。方法:收集2014年3月至2016年3月于我院治疗的104例重症肺炎患者,52例行常规治疗患者作为对照组,52例于常规治疗基础上行乌司他丁联合痰清宁雾化吸入患者作为观察组,比较两组体征及症状消失时间、肌钙蛋白[心肌肌钙蛋白T(cTnT)、心肌肌钙蛋白I(cTnI)]、心肌酶谱[谷草转氨酶(AST)、乳酸脱氢酶(LDH)\氢丁酸脱氢酶(HBDH)、肌酸激酶同工酶(CK-MB)]、临床症状积分、临床疗效及不良反应的发生情况。结果:观察组体征及症状消失时间明显短对照组(P0.05);治疗后,观察组cTnT、cTnI低于对照组,差异有统计学意义(P0.05);观察组AST、LDH、HBDH、CK-CB低于对照组,差异有统计学意义(P0.05);观察组临床症状积分低于对照组(P0.05);观察组有效率96.15%高于对照组82.69%(P0.05);两组不良反应发生率比较无统计学差异(P0.05)。结论:乌司他丁联合痰清宁雾化吸入治疗重症肺炎的临床疗效好,且可有效降低肌钙蛋白及心肌酶谱水平,减轻心肌损伤。     

Development of a selective and sensitive polymerase chain reaction assay for the detection of Mycoplasma pirum

Abstract A new assay using the polymerase chain reaction to amplify a 173-nucleotide DNA fragment within the 16S ribosomal RNA gene of Mycoplasma pirum has been developed. The assay selectively amplified DNA from all strains of M. pirum tested with a high level of sensitivity, even in a context of human DNA. DNA from other mollicute species, including those closely related to M. pirum , from bacteria phylogenetically close to mollicutes ( Clostridium innocuum, C. ramosum and Bacillus subtilis ), from Escherichia coli and from human peripheral blood mononuclear cells, did not produce the amplified DNA product specific for M. pirum .     

A single succinic semialdehyde dehydrogenase is involved in 4-hydroxyphenylacetate and 4-aminobutyrate catabolism in Klebsiella pneumoniae M5a1

Abstract Klebsiella pneumoniae M5a1 grows readily on two compounds, 4-hydroxyphenylacetate and 4-aminobutyrate, whose catabolism produces succinic semialdehyde. A single succinic semialdehyde dehydrogenase was detected, native molecular weight 52000, that has NAD as the preferred cofactor and is induced by succinic semialdehyde functions in the oxidation of succinic semialdehyde during growth on both 4-hydroxyphenyl-acetate and 4-aminobutyrate. This contrasts with the situation for Escherichia coli and Pseudomonas putida where two distinct forms of succinic semialdehyde dehydrogenase have been observed.     

Effect of Seihai-to, a Kampo medicine, in relapsing aspiration pneumonia an open-label pilot study

Two published case reports described palliation of disease after Seihai-to therapy for refractory aspiration pneumonia caused by recurrent laryngeal nerve paralysis and cerebrovascular disease. We undertook an open-label trial in patients with relapsing aspiration pneumonia. Fifteen patients with relapsing aspiration pneumonia were randomly divided into conventional therapy group (n = 8) or Seihai-to group (n = 7). In Seihai-to group, patients were treated with Seihai-to in addition to conventional therapy (Western medicines). Frequency of feverish days and antibiotics-use, CRP value and chest CT or X-ray findings were compared between the two groups during the study period of 16 weeks. In the Seihai-to group, the latency of swallowing reflex was measured in 6 patients before and after administration of Seihai-to. The mean values of fever index, CRP value and antibiotics-use in the Seihai-to group were decreased significantly, compared with those of the conventional therapy group. However, the latency of the swallowing reflex after 4 weeks of treatment was not significantly changed (p = 0.249), compared with the latency before administration of Seihai-to. No adverse reaction was observed in either group. Seihai-to was effective in reducing relapse of aspiration pneumonia in this small group. Seihai-to might not improve the swallowing reflex, but might instead improve a defense mechanism or excessive inflammation caused by pneumonia in the lower airway. Further evaluation of Seihai-to therapy for patients with aspiration pneumonia in a larger population is warranted.     

喜炎平注射液联合阿奇霉素序贯疗法对肺炎支气管肺炎患者血清IL-33、IL-6及TNF-α水平的影响

目的:探讨喜炎平注射液联合阿奇霉素序贯疗法对肺炎支气管肺炎患者血清白介素-6(IL-6)、白介素-33(IL-33)、肿瘤坏死因子-α(TNF-α)水平的影响。方法:收集我院就诊或住院治疗的840例支气管肺炎患者,随机分为实验组和对照组,每组420例。对照组患者给予阿奇霉素治疗。实验组在对照组基础上给予喜炎平静脉滴注治疗。观察并比较两组患者血清白介素-6(IL-6)、白介素-33(IL-33)、肿瘤坏死因子-α(TNF-α)水平以及临床疗效。结果:与治疗前相比,两组患者治疗后血清IL-6、IL-33、TNF-α水平均显著下降(P0.05);与对照组相比,实验组患者的血清IL-6、IL-33、TNF-α水平较低(P0.05),临床治疗有效率较高(P0.05)。结论:喜炎平注射液联合阿奇霉素序贯疗法能够提高肺炎支气管肺炎患者的临床疗效,可能与其降低患者血清IL-33、IL-6及TNF-α水平有关。     

Examination of Induced Sputum In the Diagnosis of Pneumocystis Carinii Pneumonia

The results of the examination of sputum induced by the inhalation of nebulized hypertonic saline in the diagnosis of Pneumocystis carinii pneumonia (PCP) are presented. In suspected cases of PCP in patients who were either HIV antibody positive or were receiving immunosuppressive therapy, 46 induced sputum specimens were stained using both Grocott's modified Gomori methenamine silver nitrate (GMS) and immunofluorescence staining. In 12 specimens P. carinii cysts were detected by both methods, in four specimens by GMS staining only and in five specimens by immunofluorescence only. The sensitivity of induced sputum examination in the detection of P. carinii cysts was increased by using both of these staining methods on each sputum specimen and the need for more invasive methods of diagnosis was reduced.     

肺炎支原体肺炎患儿外周血白介素的表达与肺功能变化的相关性

目的:探讨肺炎支原体(MPP)肺炎患儿外周血中IL-10、IL-17的表达水平与肺功能变化的相关性。方法:选取70例肺炎支原体肺炎患儿为研究对象,以是否有哮鸣音分为喘息组和非喘息组,以30例健康儿童为对照组,空腹采血5ml,分离血清,ELISA检测血清中IL-10、IL-17的表达水平,肺功能检测仪检测受检者的第一秒用力呼气容积(PEV1),最大呼气流量(PEF),用力肺活量(FEV1/FVC)。结果:喘息组中IL-10的表达水平与对照组相比差异显著(P0.05),喘息组中IL-10的表达水平与非喘息组相比差异显著(P0.05),喘息组中IL-17的表达水平与对照组相比差异显著(P0.05),喘息组中IL-17的表达水平与非喘息组相比差异显著(P0.05)。喘息组和非喘息组中IL-10水平均低于对照组,喘息组和非喘息组中IL-17水平均高于于对照组。非喘息组较喘息组PEV1、PEF、PVE1/FVC值高,差异显著(P0.05)。肺炎支原体肺炎患儿血清中的IL-10的水平与PEV1、PEF、PVE1/FVC呈正相关,肺炎支原体肺炎患儿血清中的IL-17的水平与PEV1、PEF、PVE1/FVC呈负相关。结论:肺炎支原体肺炎患儿血清中IL-10、IL-17的表达水平与肺功能密切相关。     

猪支原体肺炎防治研究进展

本文列举了目前临床上用于防治猪支原体肺炎的药物与疫苗的名称和用法用量,并分析了其作用机制及使用效果。抗生素只能抑制支原体生长,无法完全清除,只能解决暂时性问题,且一旦停止用药容易复发,并容易使支原体产生耐药性。国外使用的主要是灭活疫苗,但它无法激发猪体全身免疫系统,需配合优良佐剂使用。国内研制的弱毒疫苗效果很好,但免疫接种方法难度大,不易推广。本文同时综述了目前实验室关于猪支原体肺炎基因工程疫苗的研究进展,并对该病进一步的综合防控措施提出了建议。