2008-2010年舟山某院金黄色葡萄球菌的分布及耐药性变迁

目的 分析舟山医院三年来金黄色葡萄球菌分布及耐药性变迁,并对耐甲氧西林金黄色葡萄球菌(MRSA)与甲氧西林敏感金黄色葡萄球菌(MSSA)的耐药性差异做对比.方法 用ATB Expression半自动微生物分析仪进行菌株鉴定及药敏试验,用K-B法测红霉素、克林霉素、头孢西丁、苯唑西林直径,比较耐甲氧西林金黄色葡萄球菌(MRSA)与甲氧西林敏感金黄色葡萄球菌(MSSA)的耐药性差异.结果 金黄色葡萄球菌对苯唑西林、庆大霉素、红霉素、四环素和克林霉素的耐药率有上升的趋势;MRSA对苯唑西林、庆大霉素、复方新诺明、克林霉素、红霉素、青霉素、喹奴普汀-达福普汀、利福平和四环素的耐药率都明显高于MSSA的耐药率,二者间差异有统计学意义(P＜0.01),D-试验阳性71株,占72.45％.结论 金黄色葡萄球菌的耐药性逐渐升高,特别是对MRSA应引起临床的重视,检测克林霉素诱导型耐药具有重要的临床应用价值.     

类SCC样甲氧西林敏感性金黄色葡萄球菌的基因组学分析

金黄色葡萄球菌(Staphylococcus aureus, S. aureus), 作为一种常见的致病菌常可导致严重感染性疾病. 金黄色葡萄球菌的主要特点是易产生耐药性. 临床上运用多重PCR方法对S. aureus耐药菌株进行分型. SCC作为一种mecA基因的转运载体, 介导金黄色葡萄球菌产生耐药性. 本研究报道了一株新甲氧西林敏感性金黄色葡萄球菌的全基因组序列信息, 即类SCC样MSSA463菌株, 经多重PCR方法, 该菌株被误鉴定为耐甲氧西林金黄色葡萄球菌, 结果与药敏结果相冲突. 为此, 运用焦磷酸测序方法完成了该菌株的全基因组测序, 并与已知金黄色葡萄球菌的基因组序列信息不同, 发现可读框(CZ049; AB037671)存在于attL, attR反向重复序列的临近下游. 这些结果提示, 在金黄色葡萄球菌与其他微生物之间可能存在一种水平基因转移, 并改变了金黄色葡萄球菌对药物的敏感性, 推测attL, attR反向重复序列可能作为外源性基因的插入部位而存在.     

金黄色葡萄球菌病防治研究进展

金黄色葡萄球菌(Staphylococcus aureus, SA)被认为是最常见的食源性致病菌之一,引起人畜的感染性疾病,导致皮肤、软组织和血液感染,引发脓毒症和中毒性休克综合征。随着抗生素的滥用,金黄色葡萄球菌的耐药性逐渐增强,导致耐甲氧西林金黄色葡萄球菌(methicillin resistant Staphylococcus aureus, MRSA)的出现,并且在全球范围内散播,严重危害公共卫生安全。目前亟需有效控制SA感染的新疗法,因此本文对金黄色葡萄球菌防治技术的研究进展进行综述,并对其防治前景进行了分析,以期对金黄色葡萄球菌尤其是MRSA的控制提供理论指导。     

教学中常用的一种实验细菌：—葡萄球菌

葡萄球菌属于微球菌科葡萄球菌属(Stap-lylococcus),是观察球菌个体形态以及简单染色和革兰氏染色中常用的实验材料,同时也是常见的化脓性球菌。在进行实验观察时,如果不注意无菌操作,往往会造成葡萄球菌感染。葡萄球菌的种类繁多,在自然界分布广泛。在人体的皮肤表面及鼻、咽、肠道也常存在。绝大多数的葡萄球菌不致病,仅少数可以引起人和动物的化脓性感染。《伯杰细菌鉴定手册》(第八版)将葡萄球菌分为金黄色葡萄球菌(S.aureus)、表皮葡萄球菌(S.epulermidis)和腐生葡萄球菌(S.saprophytvcus),在教学中最常用的菌种--金黄色葡萄球菌为致病菌。     

253株金黄色葡萄球菌耐药现状分析

目的 了解医院金黄色葡萄球菌临床分布情况及其对常用抗菌药物的耐药率,为临床合理使用抗菌药物提供依据.方法 回顾分析医院2010年5月至2011年4月检出的金黄色葡萄球菌,采用VITEK-AMS全自动微生物分析仪进行菌种鉴定和药敏分析.结果 共检出金黄色葡萄球菌253株,菌株的主要来源为痰130株(51.4％)、血液39株(15.4％)、创面24株(9.5％);菌株主要科室分布前3位是神内科35株(13.8％)、ICU30( 11.8％)、脑外科26株(10.3％);其中耐甲氧西林金黄色葡萄球菌( MRSA)为165株(65.2％),MRSA对多种抗菌药物耐药率＞70.0％,MSSA为88株(34.8％),对除青霉素、红霉素外的大多数抗菌药物敏感,未发现耐万古霉素菌株.结论 MRSA检出率高,耐药现状严重,应加强对金黄色葡萄球菌耐药性的监测,并根据药敏试验结果合理使用抗菌药物.     

耐甲氧西林金黄色葡萄球菌及其肠毒素的检测和耐药性分析

目的评价乳胶结合试验检测耐甲氧西林金黄色葡萄球菌(MRSA)及其肠毒素(SE),并进行耐药性分析.方法收集130株金黄色葡萄球菌临床分离株,通过药敏试验将其分为耐甲氧西林金黄色葡萄球菌和甲氧西林敏感金黄色葡萄球菌(MSSA),用反向间接血凝试验(RPHA)检测金黄色葡萄球菌肠毒素.结果67株MR-SA产肠毒素,19株MSSA产肠毒素,MRSA产肠毒素率为100%,MSSA产肠毒素率为30%.结论实验室应重视金黄色葡萄球菌肠毒素的检测.     

金黄色葡萄球菌耐药基因及新型抗菌药物的研究进展

金黄色葡萄球菌(Staphylococcus aureus,S.aureus),简称金葡菌,是一种临床常见致病菌,可引起皮肤化脓性感染、肺炎、心包炎、败血症及脓毒血症等多种疾病。目前临床上金黄色葡萄球菌的多重耐药情况已十分严峻,特别是耐甲氧西林金黄色葡萄球菌(methicillin-resistant Staphylococcus aureus,MRSA)的出现,已成为临床抗感染治疗的棘手难题,严重危害人类健康。本文主要介绍金黄色葡萄球菌基因水平的耐药性、新型抗菌药物的研发及临床治疗金黄色葡萄球菌感染三方面的进展,为金黄色葡萄球菌的耐药性研究及耐药菌株的临床有效治疗提供科学依据。     

产毒金黄色葡萄球菌鉴定及在百叶中生长与产毒特性分析

从生鲜食品中分离鉴定得到产肠毒素SEA的金黄色葡萄球菌（Staphyloccocus aureus）菌株,研究金黄色葡萄球菌在百叶中的生长变化及产肠毒素特性。将不同浓度的金黄色葡萄球菌同时接种到减菌（样品组）和未减菌（对照组）百叶中,高、低初始接种量分别控制在4.0 lg(cfu/g)和2.0 lg(cfu/g)左右,并定时追踪不同储存温度条件下百叶中金黄色葡萄球菌的活菌数及产毒情况。金黄色葡萄球菌肠毒素的检测采用商业化的ELISA试剂盒。在37 ℃储存过程中,金黄色葡萄球菌在样品组中不但能生长良好并在18 h后菌落数可达到7.0 lg(cfu/g)并被检测出肠毒素,对照组中金黄色葡萄球菌生长良好菌落数可达到7.0 lg(cfu/g)却未检测出产肠毒素。在25、15和5 ℃储存过程中,样品组和对照组百叶都未检测出肠毒素。温度对金黄色葡萄球菌在百叶中是否产肠毒素具有决定性的作用,且百叶中本身存在的杂菌可能可以抑制金黄色葡萄球菌产肠毒素。     

金黄色葡萄球菌对小鼠产生一氧化氮及一氧化氮合酶的影响

目的 :探讨金黄色葡萄球菌对小鼠产生一氧化氮 (NO)及一氧化氮合酶 (NOS)的影响 ,以进一步研究 NO及 NOS在抗感染免疫中的作用。方法 :将不同剂量的金黄色葡萄球菌注入小鼠腹腔 ,10 d后取小鼠血清和腹腔巨噬细胞培养上清 ,用硝酸还原酶法检测其 NO的含量 ,同时测定血清中 NOS的水平及抗金黄色葡萄球菌抗体的效价。结果 :金黄色葡萄球菌注射小鼠后 ,血清中 NO及 NOS的水平明显高于对照组 (P<0 .0 1) ,各组间两两比较亦差异有显著性 (P<0 .0 1)。腹腔巨噬细胞培养上清 NO的水平明显高于对照组 (P<0 .0 1) ,但不同剂量实验组之间差异无显著性 (P>0 .0 5)。结论 :金黄色葡萄球菌可引起小鼠血清中 NO、NOS升高 ,NO及 NOS可能在抗微生物感染免疫中起着重要的作用     

金黄色葡萄球菌D试验和耐药性分析

目的 了解本地区金黄色葡萄球菌中红霉素对克林霉素诱导耐药表型及其对常用抗菌药物的耐药性.方法 用K-B琼脂扩散法检测耐甲氧西林的金黄色葡萄球菌(MRSA)及双纸片法(D试验)检测红霉素对克林霉素诱导耐药表型,用VITEK 2 Compact进行菌株鉴定和药敏试验.结果 156株金黄色葡萄球菌中MRSA有51株,占32.7％.红霉素对克林霉素诱导耐药共29株,占18.6％,其中MRSA有10株,甲氧西林敏感的金黄色葡萄球菌(MRSS)有19株.金黄色葡萄球菌对多种抗菌药物具有不同的耐药性,对青霉素的耐药性超过95％,对万古霉素、奎努普汀/达福普汀、利奈唑烷和替加环素敏感.结论 临床微生物实验室应加强对金黄色葡萄球菌中克林霉素诱导耐药的检测,临床治疗中也应加强抗菌药物的合理应用以防多耐药菌株的产生.     

NADPH-oxidase but not inducible nitric oxide synthase contributes to resistance in a murine Staphylococcus aureus Newman pneumonia model

Staphylococcus aureus is a pathogen that often causes severe nosocomial infections including pneumonia. The present study was designed to examine innate phagocyte mediated immune mechanisms using a previously described murine S. aureus Newman pneumonia model. We found that BALB/c mice represent a more susceptible mouse strain compared to C57BL/6 mice after intranasal S. aureus Newman challenge. Depletion experiments revealed that neutrophils are a crucial determinant for resistance whereas depletion of alveolar macrophages protected mice to some degree from acute pulmonary S. aureus challenge. C57BL/6 mice lacking the subunit gp91phox of the NADPH-oxidase (gp91phox−/− mice) proved to be highly susceptible against the pathogen. In contrast, C57BL/6 inducible nitric oxidase synthase deficient (iNOS−/−) mice did not differ in their clinical outcome after infection. Neither bone marrow macrophages from iNOS−/− nor from gp91phox−/− mice were impaired in controlling intracellular persistence of S. aureus. Our data suggest that neutrophil and NADPH-oxidase mediated mechanisms are essential components in protecting the host against pulmonary S. aureus Newman challenge. On contrary, macrophages as well as NO mediated mechanisms do not seem to play a critical role for resistance in this model.     

Development of a prototype wound dressing technology which can detect and report colonization by pathogenic bacteria

A new methodology for detecting the microbiological state of a wound dressing in terms of its colonization with pathogenic bacteria such as Staphylococcus aureus or Pseudomonas aeruginosa has been developed. Here we report how stabilized lipid vesicles containing self-quenched carboxyfluorescein dye are sensitive to lysis only by toxins/virulence factors from P. aeruginosa and S. aureus but not by a non-toxic Escherichia coli species. The development of the stabilized vesicles is discussed and their response to detergent (triton), bacterial toxin (α-hemolysin) and lipases (phospholipase A₂). Finally, fabrics with stabilized vesicles attached via plasma deposited maleic anhydride coupling are shown visibly responding to S. aureus (MSSA 476) and P. aeruginosa (PAO1) but not E. coli DH5α in a prototype dressing.     

Hoarding behaviors of two wood mouse species: Different preference for acorns of two Fagaceae species

Two species of wood mouse, Apodemus argenteus and A. speciosus, were observed consuming and hoarding acorns of Quercus serrata and Castanopsis cuspidata. When each species of acorn was supplied individually, both species of mice used each species of acorn for eating and hoarding. When both species of acorn were supplied, A. argenteus consumed or hoarded only C. cuspidata, whereas A. speciosus tended to eat C. cuspidata acorns at the feeding site, and disperse or hoard Q. serrata acorns. Apodemus speciosus is unlikely to disperse C. cuspidata acorns (their utilization was biased towards consumption) when Q. serrata acorns are also available. Apodemus argenteus will make almost no contribution to the dispersal of Q. serrata when the two acorn species coexist.     

Rapid screening for putative exported proteins from staphylococcus aureus using alkaline phosphatase as a reporter molecule

Staphylococcus aureus causes a wide range of infections in humans, ranging from superficial skin infections to the more serious toxin-mediated diseases such as toxic shock syndrome. Owing to the increasing resistance of this bacterium to a wide range of antibiotics, the need to determine the virulence factors involved in infection is becoming more important as these molecules are potential therapeutic targets. In this study, we have screened for putative exported proteins from S. aureus on the basis that these proteins are likely to be the first point of contact between the bacterium and host during infection. We have constructed gene fusions between S. aureus DNA and a truncated version of the Escherichia coli phoA gene, and we report on the characterization of the recombinants exhibiting alkaline phosphatase activity. As well as known S. aureus proteins, we have identified a number of putative open reading frames that encode proteins similar to those from nonstaphylococcal species and also unique proteins that do not have any homologues on the current databases.     

Real-time Fluorogenic PCR Assays for the Detection of entA, the Gene Encoding Staphylococcal Enterotoxin A

Staphylococcal enterotoxin A (SEA) is among the most potent of the growing list of known enterotoxins produced by Staphylococcus aureus. SEA, a 27 kDa monomeric protein, is encoded by the entA gene. We have developed two real-time fluorogenic PCR assays for the detection of nucleic acid sequences in entA. The assays are useful in detecting and identifying strains of S. aureus that produce SEA and can serve a confirmatory role in determining the presence of SEA in food samples. The assays were tested in two real-time PCR formats, using either dye-labeled DNA probes corresponding to each primer set that are degraded by the 5′ exonuclease activity of Taq polymerase, or a PCR master mix that contains the DNA-binding dye SYBR Green. In both formats the assays have a limit of detection of between 1 and 13 copies of a S. aureus genome that contains a copy of entA. Neither assay cross-reacted with genomic DNA isolated from other strains of S. aureus or other species. An erratum to this article can be found at     

Antibacterial activities of essential oils from eight Greek aromatic plants against clinical isolates of Staphylococcus aureus

Aromatic plants have been used widely to extend the shelf life of foods but at the same time research is undergoes for their properties as antibacterial agents in clinical use. Although there are promising results for the antimicrobial properties of various essential oils against environmental or food-isolated strains of Staphylococcus aureus, limited work has been done concerning these properties against clinical isolates of this pathogen. S. aureus is responsible for an increase number of nosocomial infections and at the same time exhibits increased resistance to synthetic agents.In this study, essential oils from eight aromatic plants common in Greece were isolated by hydrodistillation, analyzed by gas chromatography (GC) and GC/mass spectrometry (GC/MS) for their chemical components and tested for their antimicrobial activities against 24 clinical isolates of S. aureus. The methods used were disk diffusion and broth dilution in order to determine the Minimum Inhibitory Concentration (MIC).Our results showed that essential oils from Origanum vulgare and Origanum dictamnus were active against S. aureus when tested by disk diffusion, but exhibited increased MIC values (>256 mg/L) with the dilution method. In contrast, the reference strain NCTC 6571 showed to be extremely sensitive in most of the oils tested (MICs 0.25−32.0 mg/L) and resistant only to the essential oil from Ocimum basilicum. Therefore, there is no evidence of a potential clinical use for those essential oils and further research is needed in order to determine if they could substitute efficiently synthetic antibiotics or, perhaps be used in combination.     

Iron Acquisition and Transport in Staphylococcus aureus

Pathogenic Gram-positive bacteria encounter many obstacles in route to successful invasion and subversion of a mammalian host. As such, bacterial species have evolved clever ways to prevent the host from clearing an infection, including the production of specialized virulence systems aimed at counteracting host defenses or providing protection from host immune mechanisms. Positioned at the interface of bacteria/host interactions is the bacterial cell wall, a dynamic surface organelle that serves a multitude of functions, ranging from physiologic processes such as structural scaffold and barrier to osmotic lysis to pathogenic properties, for example the deposition of surface molecules and the secretion of cytotoxins. In order to succeed in a battle with host defenses, invading bacteria need to acquire the nutrient iron, which is sequestered within host tissues. A cell-wall based iron acquisition and import pathway was uncovered in Staphylococcus aureus. This pathway, termed the isd or iron-responsive surface determinant locus, consists of a membrane transporter, cell wall anchored heme-binding proteins, heme/haptoglobin receptors, two heme oxygenases, and sortase B, a transpeptidase that anchors substrate proteins to the cell wall. Identification of the isd pathway provides an additional function to the already bountiful roles the cell wall plays in bacterial pathogenesis and provides new avenues for therapeutics to combat the rise of antimicrobial resistance in S. aureus. This review focuses on the molecular attributes of this locus, with emphasis placed on the mechanism of iron transport and the role of such a system during infection.     

Role of interspecific competition in the coexistence ofApodemus argenteus andA. speciosus (Rodentia: Muridae)

Reciprocal-removal experiments with two replicates were conducted to test for the role of interspecific competition in the coexistence ofApodemus argenteus andA. speciosus. Population density, rate of appearance of new (unmarked) individuals, reproduction, survival rate and habitat use were monitored during pre- and removal periods. In both removal experiments, the removal ofA. argenteus had little effect onA. speciosus, while that ofA. speciosus affected several population characteristics ofA. argenteus. Namely, the removal ofA. speciosus shifted the distribution ofA. argenteus to the habitat with a denser shrub cover in one experiment. Also, the removal increased the population densities and appearance rates of new individuals ofA. argenteus in another experiment. Interspecific interactions between the two species appeared to be a one-way action fromA. speciosus toA. argenteus. In removal periods in both experiments, the rates of appearance of new individuals in each species were the highest on the grid where that species was removed. These results suggest that, though interspecific competition occurred between the two species, intraspecific competition had greater effects than interspecific competition on the abundance and habitat use ofA. argenteus andA. speciosus. This implies that the fundamental niches ofA. argenteus andA. speciosus differ potentially, which may play an important role in the coexistence of the two species.     

Multiplex PCR for simultaneous detection of enterococcal genes vanA and vanB and staphylococcal genes mecA, ileS-2 and femB

The experimental transfer of the vanA gene cluster from Enterococcus faecalis to Staphylococcus aureus has raised fears about the occurrence of such genetic transfer in clinical isolates of methicillin-resistant staphylococci. Recently, infections by a S. aureus strain carrying the enterococcal vancomycin resistance vanA gene cluster were reported. The possible emergence and dissemination of these strains is a serious health threat and makes optimization of prevention strategies and fast detection methods absolutely necessary. In the present study, we developed a PCR protocol for simultaneous detection of enterococcal vanA and vanB genes , the staphylococcal methicillin and mupirocin resistance markers mecA and ileS-2, and identification of S. aureus. As no vancomycin-resistant S. aureus isolates were available for our study, we used mixtures of enterococcal and staphylococcal colonies that harbored the different resistance markers to show that these genes could be detected simultaneously. This protocol could be used to facilitate the detection and identification of predictable S. aureus or methicillin-resistant strains carrying vanA or vanB.