重症监护病房鲍曼不动杆菌和铜绿假单胞菌的分布及耐药性监测

目的探讨医院重症监护病房(ICU)鲍曼不动杆菌及铜绿假单胞菌临床分离株的分布及耐药性特点。方法回顾性调查2006年7月至2010年6月ICU患者中分离出的鲍曼不动杆菌和铜绿假单胞菌的临床感染情况,对111株鲍曼不动杆菌和73株铜绿假单胞菌的药敏结果进行统计分析,所有数据采用WHONET 5.5软件进行分析。结果鲍曼不动杆菌及铜绿假单胞菌在呼吸道标本中检出率最高(76.1%),其次是CVP导管尖端(8.7%),鲍曼不动杆菌对临床常用抗菌药物耐药率85%的有8种,对亚胺培南的耐药率也达70.3%,耐药率最低的仅有头孢哌酮/舒巴坦(17.1%);铜绿假单胞菌对替卡西林、亚胺培南有较高的耐药率,分别为45.2%、41.1%,对其他抗菌药物耐药率均25%。结论下呼吸道是ICU患者鲍曼不动杆菌和铜绿假单胞菌感染的主要部位;ICU患者感染以鲍曼不动杆菌和铜绿假单胞菌为主,鲍曼不动杆菌较铜绿假单胞菌耐药及多重耐药性严重。     

Beta-Lactamase Repressor BlaI Modulates Staphylococcus aureus Cathelicidin Antimicrobial Peptide Resistance and Virulence

BlaI is a repressor of BlaZ, the beta-lactamase responsible for penicillin resistance in Staphylococcus aureus. Through screening a transposon library in S. aureus Newman for susceptibility to cathelicidin antimicrobial peptide, we discovered BlaI as a novel cathelicidin resistance factor. Additionally, through integrational mutagenesis in S. aureus Newman and MRSA Sanger 252 strains, we confirmed the role of BlaI in resistance to human and murine cathelidicin and showed that it contributes to virulence in human whole blood and murine infection models. We further demonstrated that BlaI could be a target for innate immune-based antimicrobial therapies; by removing BlaI through subinhibitory concentrations of 6-aminopenicillanic acid, we were able to sensitize S. aureus to LL-37 killing.     

Occurrence of Staphylococcus aureus and Pseudomonas aeruginosa in Israeli coastal water

The occurrence of Pseudomonas aeruginosa and coagulase-positive Staphylococcus aureus in seawater from beaches of central Israel was investigated from June 1983 until June 1985. P. aeruginosa was monitored in 652 samples of seawater from 34 beaches, and S. aureus was monitored in 628 samples. P. aeruginosa was found in 44.8% of samples (6.5% with 1 bacterium per 100 ml of water), and S. aureus was recovered from 60.7% of samples (5.3% with 1 organism per 100 ml), compared with 91.6% of samples with total coliforms (TC) and 82.2% with fecal coliforms (FC). The correlation between the presence of P. aeruginosa to that of TC and FC was 99.1 and 98.3%, respectively, while S. aureus was found in 4.3 and 8% of samples where TC and FC, respectively, were absent. Monitoring of S. aureus as a supplementary indicator in populated beaches is recommended because it will add valuable information on the sanitary quality of the seawater.     

Candida albicans: Molecular interactions with Pseudomonas aeruginosa and Staphylococcus aureus

The fields of mycology and bacteriology have traditionally functioned independently of each other despite the fundamental actuality that fungi and bacteria not only co-exist but also interact within several niches. In the clinical context, these interactions commonly occur within biofilms, which can be composed of single-species communities or mixed-species populations and recent studies have shown that the properties of mixed-species populations differ from those of their individual components. The interacting bacteria and fungi can exert effects on microbial behavior, dissemination, survival, the response to antimicrobials and, ultimately, patient prognosis. Microbes within biofilms exhibit increased resistance to antimicrobial agents, and a significant amount of research has thus focused on gaining an understanding of how inter-domain interactions affect biofilm formation and the response to antimicrobial therapies. Candida albicans, a commensal and opportunistic pathogen of humans, is among the fungi most frequently identified in mixed-species biofilms. Here, we review interactions between C. albicans and bacterial species with which it is commonly isolated, namely Pseudomonas aeruginosa and Staphylococcus aureus in order to look into the spectrum of biologically relevant fungal–bacterial interactions that have been described.     

Occurrence of Staphylococcus aureus and Pseudomonas aeruginosa in Israeli coastal water.

The occurrence of Pseudomonas aeruginosa and coagulase-positive Staphylococcus aureus in seawater from beaches of central Israel was investigated from June 1983 until June 1985. P. aeruginosa was monitored in 652 samples of seawater from 34 beaches, and S. aureus was monitored in 628 samples. P. aeruginosa was found in 44.8% of samples (6.5% with 1 bacterium per 100 ml of water), and S. aureus was recovered from 60.7% of samples (5.3% with 1 organism per 100 ml), compared with 91.6% of samples with total coliforms (TC) and 82.2% with fecal coliforms (FC). The correlation between the presence of P. aeruginosa to that of TC and FC was 99.1 and 98.3%, respectively, while S. aureus was found in 4.3 and 8% of samples where TC and FC, respectively, were absent. Monitoring of S. aureus as a supplementary indicator in populated beaches is recommended because it will add valuable information on the sanitary quality of the seawater.     

Comparison of in vitro antibacterial activities of two cationic peptides CM15 and CM11 against five pathogenic bacteria: Pseudomonas aeruginosa, Staphylococcus aureus, Vibrio cholerae, Acinetobacter baumannii, and Escherichia coli

In recent years, the widespread use of antibiotics has caused many bacterial pathogens resistance to conventional antibiotics. Therefore, generation of new antibiotics to control and reduce the effects of these pathogens is urgently needed. Antimicrobial peptides and proteins are important members of the host defense system in eukaryotes. These peptides are potent, broad-spectrum antibiotics that demonstrate potential as novel and alternative therapeutic agents for the treatment of drug-resistant infections. Accordingly, we evaluated two hybrid peptides CM11 (WKLFKKILKVL-NH2) and CM15 (KWKLFKKIGAVLKVL-NH2) on five important pathogenic bacteria. These peptides are short cecropin?Cmelittin hybrid peptides obtained through a sequence combination approach, which are highly effective to inhibit the growth of important pathogenic bacteria. The activity of these two cationic peptides (CM11 and CM15) in different concentrations (2?C64?mg/L) was investigated against standard and clinical isolates of important hospital infection bacteria by measuring MIC, MBC, and bactericidal assay. These peptides demonstrated the same ranges of inhibitory values: The organisms in early 24?h were more susceptible to polycationic peptides (MIC: 8?mg/L and MBC 32?mg/L), but after 48?h the MIC and MBC remained constant for the CM11 peptide. Bactericidal assay showed that all bacteria strains did not have any growth in agar plates after 40?min. The result showed that these two peptides are more effective than other peptides.     

Anti-infective properties of Lactobacillus fermentum against Staphylococcus aureus and Pseudomonas aeruginosa

Surgical wounds and implant-associated Staphylococcus aureus and Pseudomonas aeruginosa infections are often difficult to treat because of limited susceptibility of several of these strains to conventional antibiotics. As a result, there is a constant need for new alternative drugs. The aim of this study was to investigate the antimicrobial properties of Lactobacillus fermentum, a probiotic bacterium, which we have isolated from colonic biopsies. The inhibition of S. aureus and P. aeruginosa growth was evaluated by coincubating with L. fermentum strains. Growth inhibition was tested for several of their clinical isolates using agar well diffusion assays. For biofilm assay S. aureus and P. aeruginosa were grown on the glass slides and in 96-well plates in presence of 2.5 μg/ml culture filtrate of L. fermentum. Biofilms were photographed using confocal microscope or stained with 0.1% crystal violet. Reduction in the cytotoxicity of S. aureus and P. aeruginosa was observed in presence of 2.5 μg/ml L. fermentum-spent media. Using in vitroexperiments, we showed that L. fermentum-secreted compound(s) inhibits the growth, cytotoxicity and biofilm formation of several S. aureus and P. aeruginosa strains. Compound(s) present in the culture supernatant of L. fermentum may have promising applications in treating hospital-acquired infections.     

Pattern differentiation in co-culture biofilms formed by Staphylococcus aureus and Pseudomonas aeruginosa

Biofilm infections may not simply be the result of colonization by one bacterium, but rather the consequence of pathogenic contributions from several bacteria. Interspecies interactions of different organisms in mixed-species biofilms remain largely unexplained, but knowledge of these is very important for understanding of biofilm physiology and the treatment of biofilm-related infectious diseases. Here, we have investigated interactions of two of the major bacterial species of cystic fibrosis lung microbial communities -Pseudomonas aeruginosa and Staphylococcus aureus- when grown in co-culture biofilms. By growing co-culture biofilms of S. aureus with P. aeruginosa mutants in a flow-chamber system and observing them using confocal laser scanning microscopy, we show that wild-type P. aeruginosa PAO1 facilitates S. aureus microcolony formation. In contrast, P. aeruginosa mucA and rpoN mutants do not facilitate S. aureus microcolony formation and tend to outcompete S. aureus in co-culture biofilms. Further investigations reveal that extracellular DNA (eDNA) plays an important role in S. aureus microcolony formation and that P. aeruginosa type IV pili are required for this process, probably through their ability to bind to eDNA. Furthermore, P. aeruginosa is able to protect S. aureus against Dictyostelium discoideum phagocytosis in co-culture biofilms.     

PA2800 Plays an Important Role in Both Antibiotic Susceptibility and Virulence in Pseudomonas aeruginosa

Pseudomonas aeruginosa is an important human pathogen which causes a variety of infections. P. aeruginosa infections are often difficult to treat due to the pathogen’s resistance to many antibiotics. Previously, it has been reported that a transposon insertion mutant in gene PA2800 of P. aeruginosa PAO1 was more sensitive to tetracycline and ciprofloxacin. Further characterization of this gene, a vacJ homolog, in this study indicated that this gene plays an important role in both antibiotic susceptibility and virulence in P. aeruginosa. The role of PA2800 in antibiotic susceptibility probably signifies its involvement in maintaining outer membrane stability, similar to the role of vacJ in E. coli and Shigella flexneri. However, in contrast to vacJ in other bacteria, PA2800 also affects antibiotic susceptibility by affecting the expression of oprH in P. aeruginosa. As shown by in vivo studies using a Drosophila melanogaster infection model, significantly increased virulence was observed in the PA2800 mutant when compared to the wild type, and such a difference is likely a result of disrupted outer membrane stability and altered expression of znuA in the mutant. The role of PA2800 or vacJ in antibiotic susceptibility and pathogenicity seems to be unique in P. aeruginosa in which it affects both outer membrane stability as well as gene expression.     

鲍曼不动杆菌和铜绿假单胞菌在低碱性氨基酸培养基中对抗菌药物的敏感性

为了探讨鲍曼不动杆菌和铜绿假单胞菌在低碱性氨基酸培养基中对抗菌药物的敏感性,本研究利用常规培养基和低碱性氨基酸培养基,采用琼脂稀释法检测140株鲍曼不动杆菌和60株铜绿假单胞菌对亚胺培南、帕尼培南和罗美培南的最低抑菌浓度,利用K-B纸片扩散法进行药敏实验并计算敏感率。结果显示,在低碱性培养基中,铜绿假单胞菌和鲍曼不动杆菌对三种药物的最低抑菌浓度(MIC)值显著降低,铜绿假单胞菌在低碱性氨基酸培养基中对帕尼培南的敏感率显著上升,而鲍曼不动杆菌对三种药物的敏感性均显著上升。研究表明,在低碱性氨基酸培养基中,鲍曼不动杆菌和铜绿假单胞菌对帕尼培南、亚胺培南和美罗培南的敏感性有所增强,在临床检验中需考虑由培养基导致的敏感性差异。     

Identification of Virulence Genes in a Pathogenic Strain of Pseudomonas aeruginosa by Representational Difference Analysis

Pseudomonas aeruginosa is an opportunistic pathogen that may cause severe infections in humans and other vertebrates. In addition, a human clinical isolate of P. aeruginosa, strain PA14, also causes disease in a variety of nonvertebrate hosts, including plants, Caenorhabditis elegans, and the greater wax moth, Galleria mellonella. This has led to the development of a multihost pathogenesis system in which plants, nematodes, and insects have been used as adjuncts to animal models for the identification of P. aeruginosa virulence factors. Another approach to identifying virulence genes in bacteria is to take advantage of the natural differences in pathogenicity between isolates of the same species and to use a subtractive hybridization technique to recover relevant genomic differences. The sequenced strain of P. aeruginosa, strain PAO1, has substantial differences in virulence from strain PA14 in several of the multihost models of pathogenicity, and we have utilized the technique of representational difference analysis (RDA) to directly identify genomic differences between P. aeruginosa strains PA14 and PAO1. We have found that the pilC, pilA, and uvrD genes in strain PA14 differ substantially from their counterparts in strain PAO1. In addition, we have recovered a gene homologous to the ybtQ gene from Yersinia, which is specifically present in strain PA14 but absent in strain PAO1. Mutation of the ybtQ homolog in P. aeruginosa strain PA14 significantly attenuates the virulence of this strain in both G. mellonella and a burned mouse model of sepsis to levels comparable to those seen with PAO1. This suggests that the increased virulence of P. aeruginosa strain PA14 compared to PAO1 may relate to specific genomic differences identifiable by RDA.     

Specific ion effects on the growth rates of Staphylococcus aureus and Pseudomonas aeruginosa

Motivated by recent advances in the physical and chemical basis of the Hofmeister effect, we measured the rate cell growth of S. aureus--a halophilic pathogenic bacterium--and of P. aeruginosa, an opportunistic pathogen, in the presence of different aqueous salt solutions at different concentrations (0.2, 0.6 and 0.9 M). Microorganism growth rates depend strongly on the kind of anion in the growth medium. In the case of S. aureus, chloride provides a favorable growth medium, while both kosmotropes (water structure makers) and chaotropes (water structure breakers) reduce the microorganism growth. In the case of P. aeruginosa, all ions affect adversely the bacterial survival. In both cases, the trends parallel the specific ion, or Hofmeister, sequences observed in a wide range of physico-chemical systems. The correspondence with specific ion effect obtained in other studies, on the activities of a DNA restriction enzyme, of horseradish peroxidase, and of Lipase A (Aspergillus niger) is particularly striking. This work provides compelling evidence for Hofmeister effects, physical chemistry in action, in these organisms.     

In vitro trials of some antimicrobial combinations against Staphylococcus aureus and Pseudomonas aeruginosa

Staphylococcus aureus and Pseudomonas aeruginosa are rapidly increasing as multidrug resistant strains worldwide. In nosocomial settings because of heavy exposure of different antimicrobials, resistance in these pathogens turned into a grave issue in both developed and developing countries. The aim of this study was to investigate in vitro antibiotic synergism of combinations of β-lactam–β-lactam and β-lactam–aminoglycoside against clinical isolates of S. aureus and P. aeruginosa. Synergy was determined by checkerboard double dilution method. The combination of amoxicillin and cefadroxil was found to be synergistic against 47 S. aureus isolates, in the FICI range of 0.14–0.50 (81.03%) followed by the combination of streptomycin and cefadroxil synergistic against 44 S. aureus isolates in the FICI range of 0.03–0.50 (75.86%). The combination of streptomycin and cefadroxil was observed to be synergistic against 39 P. aeruginosa isolates in the FICI range of 0.16–0.50 (81.28%). Further actions are needed to characterize the possible interaction mechanism between these antibiotics. Moreover, the combination of streptomycin and cefadroxil may lead to the development of a new and vital antimicrobial against simultaneous infections of S. aureus and P. aeruginosa.