重症监护室耐亚胺培南鲍曼不动杆菌的耐药性分析

目的探讨温州医学院附属第一医院重症监护室（ICU）耐亚胺培南鲍曼不动杆菌的耐药特性。方法对2006年1月至2007年12月ICU分离的菌株采用常规方法进行菌株分离,经革兰染色、氧化酶试验等初筛,再经VITEK-32型全自动微生物分析仪进行菌株鉴定和药敏试验。结果共检测到98株鲍曼不动杆菌,其中耐亚胺培南的鲍曼不动杆菌为50株（占51.0%）,标本来源大部分为痰液（占94.9%）。耐亚胺培南鲍曼不动杆菌对常用16种抗菌药物耐药率〉50%的有15种,耐药率〉90%有3种,分别为氨苄西林（98.0%）、头孢唑林（99.0%）和呋喃妥因（99.0%）,对抗菌药物耐药率最低仅为头孢哌酮/舒巴坦（10.2%）,另外检测到对所用抗菌素泛耐为4株（8.0%）;而对亚胺培南敏感的鲍曼不动杆菌对常用16种抗菌药物耐药率〉50%的仅为4种,耐药率〉90%同样为氨苄西林（100%）、头孢唑林（97.9%）和呋喃妥因（97.9%）,耐药率比较低的为美罗培南（10.4%）、妥布霉素（16.7%）和环丙沙星（16.7%）,耐药率最低也为头孢哌酮/舒巴坦（6.3%）。结论 ICU分离耐亚胺培南鲍曼不动杆菌多重耐药性严重,出现了泛耐菌株;临床可根据药敏试验选用抗菌药物,一般条件下耐亚胺培南鲍曼不动杆菌建议选用头孢哌酮／舒巴坦。     

临床分离铜绿假单胞菌对氟喹诺酮类抗菌药物的耐药性检测

目的了解临床分离铜绿假单胞菌对喹诺酮类等抗菌药物的耐药性。方法琼脂稀释法测定86株铜绿假单胞菌对5种氟喹诺酮类抗菌药物以及头孢吡肟、美罗培南的耐药性。结果铜绿假单胞菌对诺氟沙星、氧氟沙星、左氧氟沙星、环丙沙星、加替沙星的耐药率分别为50%、61.6%、51.2%、48.8%、51.2%;对头孢吡肟和美罗培南的耐药率分别为30.2%、23.2%。结论铜绿假单胞菌对氟喹诺酮类抗菌药物耐药显著,临床应加强检测和监测。     

184株铜绿假单胞菌的耐药性分析

目的：研究铜绿假单胞菌的耐药性,以指导临床合理用药。方法：对184株铜绿假单胞菌选用16种常用抗生素进行药敏试验。药敏试验采用WHO推荐的Kirby-Bauer纸片扩散法按NCCLS标准进行,同时对184株铜 绿假单胞菌进行诱导型β－内酰胺酶的检测。结果：184株铜绿假单胞菌中检出诱导酶115株,占62．2％,所有菌株无一例对全部抗生素敏感。亚胺培南、氨曲南、庆大霉素、阿米卡星、环丙沙星、诺氟沙星、哌拉西林、头孢哌酮、头孢他啶对铜绿假单胞菌的抗菌活性较强,敏感率为76．1％－92．9％,而三代头孢中的头孢噻肟和头孢曲椴的敏感率仅为8．7％和12．0％。诱导酶株组对三代头孢中的头孢哌酮、头孢他啶的耐药率比非产酶株组低、尤其头孢他淀的耐药率比产酶株组明显降低,仅为3．4％;亚胺培南和派拉西林的耐药率也比非产酶株组低,耐药率分别为6．5％和5．1％。结论：对于产诱导型β－内酰胺酶的铜绿假单胞菌株应选用亚胺培南、氟喹诺酮类及氨基糖甙类抗生素,常规的体外药敏试验不能完全正确的反映细菌的耐药性。通过诱导酶的检测,可以较好地弥补敏试验的不足。     

临床分离奇异变形杆菌耐药性及产ESBLs菌株的流行现状

【摘 要】 目的 了解临床分离奇异变形杆菌的耐药性及产超广谱β-内酰胺酶(ESBLs)的流行情况,为临床治疗提供实验室依据。方法 收集临床分离的奇异变形杆菌共33株, 用琼脂稀释法检测其对14种抗菌药物的耐药性,并用超广谱β-内酰胺酶确证试验筛选出产ESBLs细菌。结果 33株奇异变形杆菌对亚胺培南耐药率为0、对头孢唑啉耐药率为100%,对哌拉西林、头孢呋辛、头孢他啶、头孢噻肟、头孢吡肟、氨曲南、阿米卡星、庆大霉素和氯霉素耐药率分别为12.1%、30.3%、24.2%、27.3%、18.2%、21.2%、12.1%、18.2%和48.5%,氟喹诺酮类抗菌药物耐药率较高,加替沙星、环丙沙星和左氧氟沙星耐药率分别为45.5％、39.4％和39.4％;产ESBLs菌株检出率为18.2%(6/33),除了头孢唑啉、哌拉西林、亚胺培南外,产ESBLs菌株的耐药率比非产ESBLs菌株都有不同程度地增加（P<0.01）。结论 临床分离奇异变形杆菌对亚胺培南均敏感,对头孢唑啉均耐药,对其他抗菌药物均有不同程度耐药,产ESBLs菌株的检出率高,且对抗菌药物的耐药程度比非产ESBLs菌株高。     

156例尿路感染大肠埃希菌耐药性分析

目的探讨大肠埃希菌尿路感染的临床发病特点及对抗生素的耐药情况。方法对2001年1月至2005年12月尿路感染患者尿培养分离出的156株大肠埃希菌进行耐药性分析,用纸片扩散法表型确证试验检测ESBLs。结果大肠埃希菌耐药率最低的抗菌药物是亚胺培南、美罗培南、头孢哌酮/舒巴坦、氧哌嗪青霉素/他唑巴坦,分别为1.28%、1.92%、3.21%、5.13%;对氨苄西林、氟喹诺酮类、庆大霉素、复方新诺明耐药率均>70%。产ESBLs的大肠埃希菌对亚胺培南、美罗培南、头孢哌酮/舒巴坦、氧哌嗪青霉素/他唑巴坦的耐药性均<10%,对氨苄西林、头孢菌素类、氟喹诺酮类均表现出很强的耐药性。结论治疗大肠埃希菌感染时,需根据药敏结果选用碳青霉烯类、β-内酰胺类/β-内酰胺酶抑制剂等。     

铜绿假单胞菌的临床分布和耐药性变迁

目的调查温州医学院附属第一医院铜绿假单胞菌的临床分布和耐药性及其变迁情况,指导临床合理用药和控制耐药菌的产生。方法对该院2003年至2005年437株铜绿假单胞菌进行回顾性分析,用17种抗菌药物进行体外药敏试验。结果铜绿假单胞菌分布以呼吸道感染和创口分泌物感染为主。细菌对第3代头孢菌素耐药率高,对头孢他啶、亚胺培南、头孢哌酮/舒巴坦和氟喹诺酮类药物的耐药率均有逐年增加的趋势。耐药率增加与临床广谱抗菌药物用药量增加有关。结论铜绿假单胞菌的耐药性十分突出,应在药敏指导下合理选用抗菌药物,应该适当控制碳青霉烯类和第3代头孢菌素的使用,减缓耐药菌株的产生。     

ICU病房产超广谱β-内酰胺酶肺炎克雷伯菌的监测和耐药性分析

了解产超广谱β-内酰胺酶(ESBLs)肺炎克雷伯菌的耐药性,为临床合理使用抗菌药物提供依据。采用自动化细菌鉴定仪(法国生物梅里埃公司Vitek-2和BD Phonenix 100)进行细菌鉴定和药敏试验,应用WHO-NET5.4软件进行耐药性分析。ICU病房共分离出100株肺炎克雷伯菌,其中产ESBLs株48株,占48%,药敏结果显示产ESBLs菌株的耐药率普遍高于不产ESBLs株,产ESBLs株对氨苄西林、头孢呋辛、头孢唑啉等全部耐药,对头孢曲松、头孢噻肟的耐药率也大于80%,对氨基糖苷类的庆大霉素、四环素,对喹诺酮类的环丙沙星、左氧氟沙星以及磺胺类中的复方新诺明耐药率较高(均大于55%),对哌拉西林/他唑巴坦、阿米卡星、头孢西丁等耐药率较低,对亚胺培南、美洛培南高度敏感。产ESBLs肺炎克雷伯菌耐药现象严重,及时监测产ESBLs菌的发生率及其耐药趋势,为临床合理应用抗菌药物,延缓细菌耐药性的产生,控制医院感染具有重要意义。     

头孢他啶耐药褪色沙雷菌β-内酰胺酶检测及耐药性分析

目的了解头孢他啶耐药褪色沙雷菌临床分离株产超广谱β-内酰胺酶（ESBLs）、头孢菌素酶（AmpC）及碳青霉烯酶情况,并分析其对14种常见抗菌药物的耐药性。方法 ESBLs、AmpC采用三维试验进行检测;碳青霉烯酶采用改良Hodge试验进行检测;药物敏感试验采用K-B法测定。结果 112株头孢他啶耐药褪色沙雷菌ESBLs、AmpC检出率较高;未发现同产ESBLs、AmpC及碳青霉烯酶3种酶的菌株。产ESBLs、AmpC褪色沙雷菌对亚胺培南、美罗培南的耐药率低于6.00%,与非产酶菌株相比,差异无统计学意义（P〉0.05）;对头孢哌酮/舒巴坦、哌拉西林/他唑巴坦、头孢比肟的耐药率均明显高于非产酶菌株（P〈0.01）。另外,同产ESBLs＋AmpC头孢他啶耐药褪色沙雷菌分离株与单产酶株相比,对头孢哌酮/舒巴坦、哌拉西林/他唑巴坦、头孢比肟、复方新诺等多种抗生素耐药率差异有统计学意义（P〈0.01或P〈0.05）。碳青霉烯酶株对14种常见抗生素多重耐药或泛耐药。结论我院头孢他啶耐药褪色沙雷菌分离株对常用抗菌药物的耐药性较高,耐药性的产生与细菌产多种β-内酰胺酶有关。     

阴沟肠杆菌感染的临床分布及耐药性变迁

目的:分析阴沟肠杆菌感染的临床分布及耐药性变迁,为临床合理用药提供指导。方法:采用临床微生物指南中的常规方法对医院各类标本进行分离培养,对医院近3年阴沟肠杆菌感染的临床分布及耐药性变迁情况进行总结分析。结果:2009年12月~2011年12月,从临床标本中共分离出165株阴沟肠杆菌,菌株的主要来源为痰液、尿液和其他分泌物,分别占50.3%、32.7%和27%;临床药物敏感试验结果显示,阴沟肠杆菌对头孢菌素类、青霉素类、氯霉素和氨基糖苷类的抗菌药物呈现较高的耐药率,对亚胺培南、头孢吡肟比较敏感,而头孢西丁、氨苄西林及头孢唑林对阴沟肠杆菌无效。结论:阴沟肠杆菌主要导致呼吸道和尿路感染,是一种对多种抗菌素耐药的高耐药性细菌,临床医生应结合临床药敏结果合理地选用抗菌药物,以减少耐药菌株的产生和蔓延。     

2009-2013年某三甲医院感染病原菌分布及耐药性分析

目的了解某三甲综合医院感染性病原菌的构成及细菌耐药性变迁,为抗菌药物的合理使用提供依据。方法对2009-2013年临床分离病原菌及其耐药性进行回顾性分析。结果革兰阴性杆菌对临床常用抗菌药物的耐药性,以氨苄西林、苯唑西林、头孢唑林的耐药率最高;对美罗培南、亚胺培南均较敏感,敏感率均为70%;克雷伯菌属对替卡西林耐药率为60%,不动杆菌属对头孢类和喹诺酮类耐药率很高。革兰阳性球菌对青霉素G、氨卞西林、苯唑西林、喹诺酮类的耐药率很高,都在50%以上。结论细菌耐药性仍是临床面临的严重问题,应加强对细菌耐药性的监测。     

Recent advances in the study of Kaposi's sarcoma-associated herpesvirus replication and pathogenesis

It has now been over twenty years since a novel herpesviral genome was identified in Kaposi's sarcoma biopsies. Since then, the cumulative research effort by molecular biologists, virologists, clinicians, and epidemiologists alike has led to the extensive characterization of this tumor virus, Kaposi's sarcoma-associated herpesvirus(KSHV; also known as human herpesvirus 8(HHV-8)), and its associated diseases. Here we review the current knowledge of KSHV biology and pathogenesis, with a particular emphasis on new and exciting advances in the field of epigenetics. We also discuss the development and practicality of various cell culture and animal model systems to study KSHV replication and pathogenesis.     

The structure, reproduction and taxonomy of Vidalia and Osmundaria (Rhodophyta, Rhodomelaceae)

Comprises species occurring mostly in subtidal habitats in tropical, subtropical and warm-temperate areas of the world. An analysis of the type species, V. spiralis (Sonder) Lamouroux ex J. Agardh, a species from Australia, establishes basic characters for distinguishing species in the genus. These characters are (1) branching patterns of thalli, (2) flat blades that may be spiralled on their axis, (3) width of the blade, (4) primary or secondary derivation of sterile and fertile branchlets and (5) position of sterile and fertile branchlets on the thalli. Application of the latter two characters provides an important basic method for separation of species into three major groups. Osmundaria , a genus known only in southern Australia, was studied in relation to Vidalia , and its separation from the Vidalia assemblage is not accepted. Species of Vidalia therefore are transferred to the older genus name, Osmundaria. Two new species, Osmundaria papenfussii and Osmundaria oliveae are described from Natal. Confusion in the usage of the epithet, Vidalia fimbriala Brown ex Turner has been clarified, and Vidalia gregaria Falkenberg, described as an epiphyte on Osmundaria pro/ifera Lamouroux, is revealed to be young branches of the host, Osmundaria prolifera.     

New or rare chromosome counts in Artemisia L. (Asteraceae, Anthemideae) and related genera from Kazakhstan

Fifteen chromosome counts of six Artemisia taxa and one species of each of the genera Brachanthemum, Hippolytia, Kaschgaria, Lepidolopsis and Turaniphytum are reported from Kazakhstan. Three of them are new reports, two are not consistent with previous counts and the remainder are confirmations of very scarce (one to four) earlier records. All the populations studied have the same basic chromosome number, x = 9, with ploidy levels ranging from 2x to 6x. Some correlations between ploidy level, morphological characters and distribution are noted.     

肝癌中HBV和HCV基因和抗原的分布及意义

采用原位分子杂交方法检测HCV RNA及HBV X基因;采用免疫组织化学方法研究HCV核心抗原,非结构区C33c抗原及HBxAg在肝细胞肝癌中的定位及分布.结果表明(1)HCV RNA、HBV X基因在肝细胞肝癌组织检出率分别为40%(55/136)和82%(112/136).HCV RNA定位于癌细胞的胞浆内,阳性细胞呈散在、灶状及弥漫分布三种形式;HBV X基因在肝癌细胞中的分布呈胞浆型、核型及核浆型,阳性细胞也呈上述三种分布形式;(2)HCV C33c抗原、核心抗原在肝细胞肝癌中的阳性率为81%(133/164)及86%(141/164).C33c抗原定位于癌细胞及肝细胞的胞浆内;核心抗原既定位于癌细胞核中,又可定位于胞浆中.C33c抗原阳性细胞以灶状分布为主;而核心抗原阳性细     

Selection with two alleles and complete dominance

For a plant selection model with frequency-independent viabilities, fertilities and selfing rates, it is shown that apart from global fixation, for certain parameter combinations a protected polymorphism and facultative fixation (either allele may become fixed according to initial frequencies) may both occur. Facultative fixation requires different selling rates for the dominant and recessive type. Protection of the polymorphism requires resource allocation for male and female function. In this connection the problem of purely genetically caused population extinction is discussed.
For general frequency dependence and regular segregation, the chances for establishment of a completely recessive gene are compared to those of a completely dominant gene. It is proven that the process of establishment of the recessive gene, despite a fitness advantage, may be considerably endangered by drift effects if random mating prevails. The recessive gene may reach the same effectivity in establishment as a dominant gene, only if the recessive homozygote mates exclusively with its own type during the period of establishment.