白内障超声乳化术后眼内炎患者的护理

目的探讨白内障超声乳化术后眼内炎的护理。方法平衡液妥布霉素冲洗,置换出前房积脓,玻璃体腔注入万古霉素+地塞米松,严重感染者行玻璃体切除手术治疗眼内炎,防止视力丧失。结果经治疗和精心护理,眼内炎症均得到有效控制,无眼球摘除发生。结论眼内炎患者应做到预防为先,针对患者实际护理问题,争取适当的护理措施,能有效防止眼球摘除及另一眼发病。     

白内障术后感染性眼内炎的致病菌分析及影响因素研究

目的:分析白内障术后感染性眼内炎的致病菌分布情况,并对其影响因素进行分析.方法:选取2016年8月～2019年3月期间于我院行白内障手术的患者2936例,统计白内障术后感染性眼内炎的发生情况.分析术后感染性眼内炎患者的病原菌分布情况及病原菌耐药情况.单因素及多因素Logistic回归分析术后感染性眼内炎发生的影响因素....     

共生真菌Paraconiothyrium brasiliense化学表观遗传修饰研究

对昆虫中华剑角蝗肠道共生真菌Paraconiothyrium brasiliense的发酵产物进行化学表观遗传修饰研究。在马铃薯-葡萄糖培养基的基础上,添加组蛋白去乙酰化酶抑制剂辛二酰双羟肟酸(SBHA)或DNA甲基化转移酶抑制剂(5-氮杂胞苷),结果发现通过添加0.5mmol/L的SBHA,该真菌的发酵产物的结构类型发生较大变化,并从中新发现了1个吡啶酮类化合物(化合物1)。该类型的化合物为首次从该属菌株中获得,推测可能在SBHA的胁迫下,激活了该菌株的沉默基因,从而产生了新的代谢产物。     

藜蒿内生真菌Paraconiothyrium sp.YLHJ01化学成分研究CSCD

利用多种色谱分离技术从藜蒿内生真菌Paraconiothyrium sp.YLHJ01的发酵产物中分离得到7个化合物,并通过NMR、ECD、IR、HR-ESI-MS等波谱技术鉴定了它们的结构,包括一个新化合物2-(1S,3R-dihydroxybutyl)benzene-1,4-diol(1)以及6个已知化合物:6-羟基-2S-甲基-4-色满酮(2)、10-norparvulenone(3)、(S)-7-羟基-3-((S)-1-羟乙基)异苯并呋喃-1(3H)-酮(4)、murranoic acid A(5)、modiolide G(6)、尿嘧啶核苷(7)。体外细胞毒活性结果显示化合物1~7在A549与HepG2细胞上均无明显的抑制活性。对化合物1~7进行金黄色葡萄球菌和大肠杆菌抗菌活性测试,结果显示化合物1、4对金黄色葡萄球菌表现出弱抑制效果,最低抑菌浓度(MIC)分别为400、100μg/mL,化合物2对金黄色葡萄球菌和大肠杆菌表现为弱抑制效果,其MIC分别为800、400μg/mL。     

白内障PHACO术后感染性眼内炎的病原菌分布特征及耐药性分析

目的探讨白内障超声乳化手术(PHACO)术后感染性眼内炎的病原菌分布特征及耐药性分析。方法选择2006年11月至2013年12月来青田县人民医院就诊住院实施白内障PHACO术的患者共4 132例(6 734眼),其中9例(9眼)患者术后发生眼内炎。对其进行细菌、真菌及阿米巴等的培养与鉴定,病原菌的种类分布及体外药敏试验。结果 PHACO术后眼内炎的发生率为0.13%(9/6 734),其中有8眼细菌培养阳性(房水培养2眼,玻璃体培养6眼),阳性率为88.9%:表皮葡萄球菌4眼,粪肠球菌2眼,金黄色葡萄球菌1眼,醋酸不动杆菌1眼。所有标本均未发现真菌感染。8眼细菌培养阳性的标本行药敏试验,表皮葡萄球菌及粪肠球菌等均对万古霉素、利福平、利奈唑胺敏感,对其他抗生素耐药情况则不同。进行术后6个月随访,9例患者术后1~6个月最佳矫正视(BCVA)与术前比较,差异均有统计学意义(P0.05),提示患者术后的BCVA较术前有提高,6个月较1个月有提高。所有患者末次随访时炎症均得到有效控制,无复发眼内炎。结论白内障PHACO术后的感染性眼内炎以表皮葡萄球菌及粪肠球菌为主的条件致病菌为主要致病的菌株,其中万古霉素对这两种菌属以及其他菌属均有良好的药敏性,可以作为临床眼科预防和治疗的参考用药。     

白内障超声乳化联合人工晶状体植入术后感染性眼内炎的影响因素及其预测模型构建

摘要 目的：探讨白内障超声乳化联合人工晶状体植入术后感染性眼内炎的影响因素及其预测模型构建。方法：回顾性分析2015年2月至2023年2月我院收治的12308例白内障患者的临床资料,所有患者均行白内障超声乳化联合人工晶状体植入手术治疗,统计术后感染性眼内炎发生情况。采用多因素Logistic回归模型分析白内障超声乳化联合人工晶状体植入术后感染性眼内炎的影响因素,根据回归模型构建预测模型,采用受试者工作特征（ROC）曲线验证预测模型的预测效能。结果：12308例患者中发生感染性眼内炎32例（0.26%）。单因素分析结果显示感染组年龄≥70岁、合并糖尿病、手术时间≥30 min、手术切口≥3.2 mm、植入PMMA人工晶体、后囊膜破裂比例高于对照组（P＜0.05）,术中预防性使用抗生素、晶状体后冲洗比例低于对照组（P＜0.05）。多因素Logistic回归模型分析显示年龄≥70岁、合并糖尿病、后囊膜破裂、植入PMMA人工晶体是白内障超声乳化联合人工晶体植入术后感染性眼内炎的危险因素（P＜0.05）,术中预防性使用抗生素、晶状体后冲洗是保护因素（P＜0.05）。以Logistic回归模型结果保留变量构建预测模型,Hosmer-Lemeshow拟合优度检验P＞0.05。ROC分析该模型预测白内障超声乳化联合人工晶体植入术后感染性眼内炎的曲线下面积为0.832,灵敏度、特异度分别为81.25%、85.12%。结论：年龄≥70岁、合并糖尿病、后囊膜破裂、植入PMMA人工晶状体是术后感染性眼内炎的危险因素,术中预防性使用抗生素、晶状体后冲洗可降低感染性眼内炎发病风险。根据多因素Logistic回归分析构建的预测模型对感染性眼内炎的预测能效较好。     

高原地区非淋菌性泌尿生殖道炎支原体感染及药敏分析

了解昆明地区支原体引起非淋菌性泌尿生殖道炎的感染状况以及为其治疗提供敏感的抗生素,采用法国生物梅里埃公司的ＭｙｃｏｐｌａｓｍａＩＳＴ试剂盒对７３例非淋菌性泌尿生殖道炎患者分泌物进行支原体培养鉴定及体外药敏试验,结果检出２０株解脲支原体和６株人型支原体;８例为两种支原体混合感染。     

非淋菌性泌尿生殖道炎支原体感染及耐药变迁

目的探讨解脲支原体（Uu）及人型支原体（Mh）在非淋菌性泌尿生殖道炎的感染状况,分析近3年来支原体的感染及耐药变迁。方法采用培养法（Mycoplasma IST）对NGGU的分泌物进行支原体的培养、体外药敏试验及分析。结果支原体阳性率为47．0％,其中Uu阳性率为34．0％,Uu＋Mh阳性率为11．4％,Mh阳性率为1．6％;交沙霉素、强力霉素等药物的敏感率无明显变化,而喹诺酮类的耐药率则呈逐渐上升趋势,环丙沙星及氧氟沙星的耐药率分别从2002年的38．9％及40．0％上升到了2004年的79．2％及66．4％。结论支原体的耐药率正逐步增加,其中喹诺酮类的高耐药率提示其在治疗支原体感染中的地位改变,泌尿生殖道支原体的药物敏感监测对临床治疗具有重要意义。     

我国首例肌曲霉病及其试验研究

目的报道国内首例肌曲霉病,对所分离的黄曲霉进行形态、药敏、rDNA序列分析研究。方法对患者病变肌组织行B超和病理检查;将分离菌株接种于察氏培养基观察形态学特征;微量法测定MIC值;酚氯仿法提取DNA,扩增ITS间区序列并进行多序列分析。结果B超示左腓肠肌不规则回声,病理示肌细胞变性、坏死,肌组织内见分枝分隔菌丝。表型及基因型特征为黄曲霉;分离菌株对多种抗真菌药物耐药;多基因序列分析显示所分离菌株与标准株及自然和临床分离株具有100%的相似性。给予特比萘芬治疗3个月后痊愈。结论黄曲霉可致肌肉感染;药敏试验对临床治疗具有指导意义;环境中普遍存在的真菌可引起免疫低下患者致死性感染。     

盐酸特比萘芬乳膏联合3%硼酸酒精滴耳液治疗真菌性外耳道炎的效果CSCD

目的探究盐酸特比萘芬乳膏(terbinafine hydrochloride cream,THC)联合3%硼酸酒精(boric acid alcohol,BAA)滴耳液治疗真菌病的临床疗效。方法选取144例在我院治疗的真菌性外耳道炎患者作为研究对象,将患者随机分为A组和B组,A组采用3%BAA和THC联合治疗,B组单用BAA治疗。比较分析两组患者的治疗效果及真菌培养结果。结果A组的治疗有效率及临床疗效评分明显优于B组(P<0.05);A组在瘙痒、耳溢、耳鸣这3个症状的改善较B组更明显(P<0.05);真菌培养中曲霉占57.7%,念珠菌占22.5%,并且对特比萘芬的敏感性高。结论THS联合3%BAA滴耳液治疗真菌性外耳道炎的有效方法。     

Identification and characterization of the biotechnological potential of a wild strain of Paraconiothyrium sp

The isolation and characterization of fungal strains from poorly described taxa allows undercover attributes of their basic biology useful for biotechnology. Here, a wild fungal strain (CMU‐196) from recently described Paraconiothyrium genus was analyzed. CMU‐196 was identified as Paraconiothyrium brasiliense by phylogenetic analysis of the rDNA internal transcribed spacer region (ITS). CMU‐196 metabolized 57 out of 95 substrates of the Biolog FF microplates. Efficient assimilation of dextrins and glycogen indicates that CMU‐196 is a good producer of amylolytic enzymes. It showed a remarkably assimilation of α‐d ‐lactose, substrate described as inducer of cellulolytic activity but poorly assimilated by several fungi. Metabolically active mycelium of the strain decolorized broth supplemented with direct blue 71, Chicago sky blue and remazol brilliant blue R dyes. The former two dyes were also well removed from broth by mycelium inactivated by autoclaving. Both mycelia had low efficiency for removing fuchsin acid from broth and for decolorizing wastewater from the paper industry. CMU‐196 strain showed extracellular laccase activity when potato dextrose broth was supplemented with Cu⁺², reaching a maximum activity of 46.8 (±0.33) U L^?1. Studied strain antagonized phytopathogenic Colletotrichum spp. fungi and Phytophthora spp. oomycetes in vitro, but is less effective towards Fusarium spp. fungi. CMU‐196 antagonism includes overgrowing the mycelia of phytopathogens and growth inhibition, probably by hydrosoluble extracellular metabolites. The biotechnological potential of strain CMU‐196 here described warrants further studies to have a more detailed knowledge of the mechanisms associated with its metabolic versatility, capacity for environmental detoxification, extracellular laccase production, and antagonism against phytopathogens. © 2018 American Institute of Chemical Engineers Biotechnol. Prog., 34:846–857, 2018     

三角孢小囊菌导致的心内膜炎1例

本文报道1例继发于植入心脏起搏器所致的三角孢小囊菌(Microascus trigonosporus)心内膜炎,此菌分离自患者起搏器电极表面的赘生物.赘生物组织病理切片显示大量有隔真菌丝,间生膨大的厚壁孢子.小囊菌系帚霉菌(Scopulariopsis)的有性阶段,广泛存在于自然界.目前国外已有短帚霉菌(Scopula...     

棕黑腐质霉(Humicola fuscoatra)导致真菌性腹膜炎1例

报道1例由棕黑腐质霉属(Humicola fuscoatra)导致的真菌性腹膜炎。此菌分离自1名长期腹膜透析患者的腹水。腐质霉属在自然界广泛存在,棕黑腐质霉导致的人类感染罕见。现对棕黑腐质霉的真菌学特点进行研究,并进行分子测序。体外药物敏感性试验结果对伊曲康唑的MIC为0.008μg/mL,伏立康唑的MIC为0.016μg/mL,两性霉素B的MIC为1.5μg/mL。患者拔除腹透管,改行血液透析。口服伊曲康唑0.1 g/12 h,28 d后病情明显改善,出院。     

Devastating endophthalmitis caused by Serratia marcescens in two recipients after transplantation of corneal grafts from the same donor

We report two cases of severe endophthalmitis, which were caused by Serratia marcescens, and developed in the immediate postoperative period in two recipients of corneal grafts from the same donor. The cause of the donor's death was massive CVA. He had been on mechanical ventilation for 12 days before he died, and had shown no sign of infectious disease while in the hospital. Vitrectomies were performed in the recipients' eyes on the third day after corneal transplantation. On the same day, and again 1day later, the transplanted eyes were injected intravitreally with vancomycin and ceftazidime. Two months after surgery, both eyes developed phthisis. These cases are similar to other rare reported cases describing the virulence of S. marcescens. This revised version was published online in July 2006 with corrections to the Cover Date.     

我国首见斑替支孢瓶霉引起脑脓肿1例

目的报道1例斑替支孢瓶霉引起脑脓肿。方法抽取脑脓液作直接镜检和真菌培养,分离菌株行DNA序列分析、KOH耐受试验、温度试验和明胶液化试验。结果脑脓液直接镜检发现大量棕色、分隔或不规则膨胀菌丝,SDA培养出灰黑色、绒状、纽扣样菌落,微量培养可见棕色、单支或分支特长的孢子链结构,DNA序列分析属于斑替支孢瓶霉。菌株具有耐碱性,不能液化明胶,可在25-42℃环境下生长。脓肿穿刺术、两性霉素B脂质体静脉滴注和脓腔内注射等治疗无明显疗效,放弃治疗后死亡。结论根据其形态学特点和DNA序列分析,菌株被鉴定为斑替支孢瓶霉。该菌引起的脑脓肿为国内首例报道,脓肿穿刺术和单用两性霉素B治疗无明显疗效。     

茄病镰刀菌感染致角膜溃疡1例

报告1例由茄病镰刀菌感染引起的角膜溃疡。患者男性,40岁,木工,左眼红、痛、流泪、视力下降10 d。经过角膜清创,系统性及局部抗真菌治疗后好转。致病菌株经真菌学鉴定为茄病镰刀菌,它是真菌性角膜炎的常见致病菌之一。真菌性角膜炎病程进展迅速,能否及早诊治关系预后。真菌学检查是确诊的依据,临床应予重视。     

1例热带念珠菌脓肿误诊分析

报告1例热带念珠菌引起的腹腔脓肿瘘管真菌感染。患者女,78岁,因十二指肠球部穿孔并发腹膜炎,行腹腔镜术,术后伤口反复未完全愈合,有少量分泌物溢出。发现腹壁瘘管及腹腔脓肿入院,两次细菌培养均无菌生长,再次取分泌物直接镜检阳性,真菌培养鉴定为热带念珠菌。手术清理组织,病理示感染性肉芽肿改变,查见大量假菌丝及孢子。经口服伊曲康唑和两性霉素B溶液纱条引流治疗3个月后基本痊愈。     

首次报道中国北方Fonsecaea monophora所致着色芽生菌病1例及其相关实验研究

目的首次报道中国北方1例由Fonsecaea monophora所致着色芽生菌病。方法患者男性,58岁,主因"右腕部皮损伴瘙痒8~9a"就诊。对皮损脓液直接镜检,皮损组织病理检查,真菌培养,并对培养获得菌株进行形态学,分子生物学鉴定等实验室研究。结果脓液直接镜检可见多个圆形、厚壁、棕色硬壳细胞,皮损组织病理表现为慢性肉芽肿样改变,并可见硬壳小体。真菌培养可见暗棕色,橄榄色至黑色菌落生长,生长速度较慢,镜下可见枝孢型和喙枝孢型产孢。ITS区序列分析鉴定为Fonsecaea monophora。依据临床及实验室检查确诊该例为Fonsecaea monophora所致的着色芽生菌病。口服伊曲康唑200mg,1次/d;特比萘芬250mg,1次/d。治疗3个月后,皮损消退痊愈。结论 Fonsecaea monophora感染也可见于我国北方地区的着色芽生菌病患者,而ITS区序列分析是该菌种鉴定的重要手段,伊曲康唑联合特比萘芬治疗本例患者显示较好疗效。     

Endophthalmitis of probable endogenous origin caused by Scedosporium boydii: A case report

BackgroundMycotic ocular infections caused by the Scedosporium apiospermum species complex are challenging to treat because of the delayed diagnoses and poor responses to antifungal drugs and surgical treatment.Case reportA case of a 69-year-old male patient with a history of diabetes mellitus type 2 and prior surgery on the right femur is described. In the 10 days prior to the ophthalmic consultation he started with ocular pain, adding to a previous and progressive loss of visual acuity in his right eye. The diagnosis of endophthalmitis of probable endogenous origin was established. Despite medical treatment, the patient's condition worsened and, due to the imminent risks, an enucleation was performed. Smears of the enucleation tissue revealed fungal cells, and the cultures yielded a fungus belonging to the S. apiospermum species complex, which was identified as Scedosporium boydii by morphological characteristics and sequencing of a PCR amplicon.ConclusionsA diagnosis of endophthalmitis of probable endogenous origin in the right eye was based on a previous right femur surgery. Potential risk to the patient led to enucleation.