2014—2016年某院铜绿假单胞菌耐药性监测

摘要：目的 分析铜绿假单胞菌的分布和耐药性变化,为临床防治铜绿假单胞菌感染提供依据。方法 收集成都大学附属医院2014—2016年所分离的铜绿假单胞菌,采用VITEK 2-Compact全自动细菌鉴定系统进行鉴定和药敏试验,采用WHONET 5.6软件对数据进行分析。结果 3年间共分离出1 945株铜绿假单胞菌,多重耐药铜绿假单胞菌分离率为34.2%（666/1945）。标本来源以呼吸道为主,占82.2%（1598/1945）。科室分布以呼吸内科最多,ICU其次。铜绿假单胞菌对头孢曲松和头孢噻肟的耐药率最高,均＞57.0%;对阿米卡星耐药率最低,为2.0%。3年来铜绿假单胞菌对17种抗生素的耐药率呈整体上升的趋势。结论 铜绿假单胞菌对头孢曲松、头孢噻肟、亚胺培南耐药率较高,对阿米卡星耐药率较低。铜绿假单胞菌的耐药率呈整体上升的趋势,应重视细菌耐药性的监测,以延缓耐药性产生、促进临床合理用药。     

Drug susceptibility of Pseudomonas aeruginosa strains isolated from patients of a hospital and specialistic outpatients clinics of the SP ZOZ in Nidzica

The aim of this study was to evaluate a frequency of isolation and antimicrobial susceptibility testing (AST) of Pseudomonas aeruginosa strains cultured from clinical specimens collected from patients hospitalized in wards and specialistic outpatients clinics of a hospital in Nidzica (01. 09. 2000 -31. 12. 2003). During over three years 392 Pseudomonas aeruginosa strains were cultured from 16346 clinical samples provided to bacteriological laboratory. P. aeruginosa strains were isolated from 2.5% of examined specimens. Susceptibility of Pseudomonas aeruginosa strains to antimicrobial agents was tested. The highest in vitro activity against clinical P. aeruginosa strains demonstrated imipenem. One strain was resistant to imipenem. This strain was isolated from a patient of a surgical department. Metalo-beta-lactamase was not detected (MBL-negative strain).Twenty nine strains were ESBL producer (7.4% of all strains). The contribution of Pseudomonas aeruginosa strains to the etiology of nosoconial and ambulatory infections increases. In vitro activity of antibacterial agents against P. aeruginosa strains should be monitored during therapy of infections. Resistance to antibiotics/chemothe-rapeutics may be acquired during treatment with antibacterial agent to which P. aeruginosa strain was susceptible according to the antibiogram.     

Human anti-Pseudomonas aeruginosa outer membrane proteins IgG cross-protective against infection with heterologous immunotype strains of P. aeruginosa.

In order to develop an effective means to treat and prevent Pseudomonas aeruginosa infections, we have purified P. aeruginosa outer membrane protein (Oprs)-specific human IgG antibody using a large-scale affinity column. In this study, we investigated the cross-protective activity of the purified anti-Oprs IgG against various immunotype strains of P. aeruginosa. The anti-Oprs IgG reacted with Oprs isolated from seven Fisher-Devlin immunotype strains of P. aeruginosa and was able to promote opsonophagocytic killing of all seven immunotype strains by human phagocytic cells. Administration of 500 microg anti-Oprs IgG to mice raised the LD50 of the P. aeruginosa strains by 8-250-fold, indicating the protective capacity against heterologous P. aeruginosa strains as well as homologous strains. In contrast, despite high titers against P. (aeruginosa Oprs, total serum IgG isolated from burn patient sera was no better than normal serum IgG in protecting mice from infection with P. aeruginosa. These data demonstrate that the affinity-purified human anti-Oprs IgG could afford protection against heterologous immunotype P. aeruginosa strains and provide a rationale to use anti-Oprs IgG as an adjunct for treatment of P. aeruginosa infections in humans.     

Effect of Pseudomonas aeruginosa melanin on antibiotic activity]

The properties of microbial melanines are very diverse. Melanine of P. aeruginosa is little studied. The pigment was isolated from a strain of P. aeruginosa possessing all characteristic properties of the species. Interaction of P. aeruginosa melanine with various antibiotics was determined by the method of serial dilutions in beaf-peptone broth, using Staph. aureus 209 as a test-microbe, which was added to the medium in an amount of 10(6) cells to each tube. It was found that P. aeruginosa melanine differed from DOPA-melanine in a concentration of 1 mg/ml and did not change the activity of penicillin, tetracycline, oleandomycin, kanamycin and gentamicin with respect to Staph. aureus.     

VITEK－IMSGNS系列药敏卡对~（162）株绿脓杆菌的药敏分析

本文就临床标本中分离的１６２株绿脓杆菌,用ＶＩＴＥＫ－ＩＭＳ全自动微生物系统的ＧＮＳ－ＰＡ等四种药敏卡,共测定２３种抗生素药敏试验．该菌对亚胺硫霉素的敏感度（敏感和中度敏感）最高９７．７８％,其次是哌拉西林、替卡西林、丁胺卡那霉素、妥布霉素、环丙氟哌酸、头孢他啶和头孢哌酮,复方新诺明等八种抗生素耐药率均在９０％以上。分析该菌对１０种抗生素药敏结果发现,几种常用抗绿脓杆菌药物的最小抑菌浓度（ＭＩＣ）值普遍增高,并结合绿脓杆菌生物微膜形成和该菌对β－内酰胺类抗生素抗性机制作了讨论。     

Real-time PCR detection of Pseudomonas aeruginosa in clinical and municipal wastewater and genotyping of the ciprofloxacin-resistant isolates

Real-time quantification of Pseudomonas aeruginosa was performed in various wastewater systems including clinical, municipal wastewaters and inflow from a wastewater treatment plant. The highest concentrations of P. aeruginosa-specific targets were detected in clinical wastewaters. Limitations of the detection system resulting from inhibition or cross-reaction were identified. Ciprofloxacin-resistant P. aeruginosa strains were isolated after specific enrichment from clinical and municipal wastewaters. In some cases they were also cultivated from effluent of a wastewater treatment plant, and from its downstream river water. A total of 119 isolates were phenotypically characterized as ciprofloxacin-resistant via antibiogram testing. Subsequently, the fluoroquinolone-resistance-mediating mutations in the genes gyrA codon positions 83 and 87, gyrB codon position 466 and parC codon positions 87 and 91 were determined by mini-sequencing. Ciprofloxacin resistance was mainly associated with mutations in gyrA codon position 83 and parC mutation in codon positions 87 or 91 of the bacterial gyrase and topoisomerase II genes. All ciprofloxacin-resistant P. aeruginosa strains were compared with genotypes from clinical data of fluoroquinolone-resistant P. aeruginosa infections. The results were in agreement with data from clinical analyses, with the exception that no gyrA 87 and no gyrB mutations were found in ciprofloxacin-resistant P. aeruginosa wastewater isolates.     

Comparison of flagellin genes from clinical and environmental Pseudomonas aeruginosa isolates

Pseudomonas aeruginosa, an important opportunistic pathogen, was isolated from environmental samples and compared to clinically derived strains. While P. aeruginosa was isolated readily from an experimental mushroom-growing unit, it was found only rarely in other environmental samples. A flagellin gene PCR-restriction fragment length polymorphism analysis of the isolates revealed that environmental and clinical P. aeruginosa strains are not readily distinguishable. The variation in the central regions of the flagellin genes of seven of the isolates was investigated further. The strains used included two strains with type a genes (998 bp), four strains with type b genes (1,258 bp), and one strain, K979, with a novel flagellin gene (2,199 bp). The route by which flagellin gene variation has occurred in P. aeruginosa is discussed.     

Routes of the transmission of Pseudomonas aeruginosa infection in resuscitation and intensive therapy departments

To find out if the transfer of P. aeruginosa infection by droplet route is possible in resuscitation and intensive care units, the bacteriological study of air samples taken in different rooms of resuscitation units (altogether 234 air samples) was carried out with the subsequent identification and typing of isolated P. aeruginosa strains. In most cases (70.5%) the microbial contamination of the air in the main rooms of resuscitation units was found not to exceed 500 microbial cells per cu. m, and no P. aeruginosa strains were isolated. The identification and typing of six P. aeruginosa strains isolated from the air of an isolation ward for patients with infectious complications made it possible to find out intraspecific differences of these microorganisms, as all of them belonged to strains of different sero- and pyocinotypes. Thus, the results of these investigations indicate that the droplet route of the transfer of P. aeruginosa hospital infection is not characteristic of resuscitation and intensive care units, as no P. aeruginosa strains are isolated from the main rooms of such units; likewise, no circulation of this microorganism was observed in the air of an isolation ward for patients with infectious complications.     

一株奇异变形杆菌对铜绿假单胞菌多细胞行为的抑制作用*

摘要目的：抗生素耐药性成为了全球性的健康问题。研究发现病原菌的多细胞行为在抗生素的耐药性中起着至关重要的作用 （尤其是生物膜）,因而通过抑制多细胞行为而控制耐药性成为当务之急。本文以奇异变形杆菌（Proteus Mirabilis ）为研究对象,考 察它的发酵滤液对一种机会致病菌———铜绿假单胞菌（ Pseudomonas aeruginose）多细胞行为的作用,以期得到一株多细胞行为抑 制菌：在不影响 P.aeruginosa 生长的前提下,抑制生物膜形成、EPS 产生以及定向丛集运动,解除保护,减缓扩散,为降低P.aeruginosa 耐药性,增强抗生素作用效果提供可能。方法：采用结晶紫生物膜测定法、蒽酮-硫酸法、平板检测法,探究P.aeruginosa 发酵滤 液对P.aeruginosa 生物膜、胞外多聚物、定向丛集运动和生长的影响。结果： P.aeruginosa 发酵滤液能显著抑制生物膜 量,在体积百分比浓度为1 %时,抑制率可达60.9 %。该菌的发酵滤液还能阻碍的定向丛集运动,减弱它的吸附和扩 散运动;同时,也减少了P.aeruginosa 胞外多聚物的产量,在滤液体积百分比浓度为1 %时,抑制率达到45.9%。更重要的是,固体 平板实验证明该发酵滤液对P.aeruginosa 的生长没有影响。结论： 在不影响病原菌生长的前提下,对病原菌的多细胞 行为有一定的控制作用。其发酵滤液中存在着抑制微生物膜、定向丛集运动等的成分,在治疗细菌感染性疾病和降低抗生素耐药 性方面有潜在应用价值。     

Salmonella contamination of vegetables irrigated with untreated wastewater

The irrigation of vegetables with raw wastewater has been practised in El Azzouzia, the wastewater-spreading field of Marrakesh city (Morocco), for many years. This water was found to be contaminated with different serogroups of Salmonella. B and C were the most frequently isolated groups. These same serogroups were detected on vegetables irrigated with these wastewater effluents. The crops whose edible product develops on the ground surface, such as lettuce and parsley, were more contaminated than those which grow, above the soil surface, like tomatoes and pimento. Except on lettuce, Salmonella on crops did not persist beyond 3 days after irrigation.     

Comparison of some adhesive properties of Pseudomonas aeruginosa strains isolated from respiratory and urinary tract infections

The aim of the paper was the comparison of adhesive properties concerning pathogenic potential of P. aeruginosa strains isolated from the patients with respiratory tract infections and from the patients with urinary tract infections. It was stated that P. aeruginosa strains had no haemagglutinating properties when cultured on a solid medium. Bacteria cultured in a liquid medium showed an increase of these properties in 48 h cultures as compared with 24 h cultures. They were not sensitive to heating. The haemagglutinating properties of the most strains were inhibited by D-mannose. These results seem to suggest that in P. aeruginosa strains fimbriae play an important role in adhesion. On the other hand, the mechanism of adhesion is not uniform as shows mannose-sensitivity of some strains and its lack in the other haemagglutinating strains. The most effective agglutination of human erythrocytes seems to be caused by the species specificity of the individual strains isolated from humans. The higher attachment of P. aeruginosa strains isolated from the urinary tract infections than those from respiratory tract infections to "Vero" cells suggests that these two strains populations may differ in their pathogenic potential to various tissues.     

Structural relationship between the polyagglutinable antigen and the core polysaccharide of Pseudomonas aeruginosa

Abstract It has been observed that each strain of the Pseudomonas aeruginosa species harbours the so-called polyagglutinable antigen (PA). Some strains may produce it in a form which is linked to the core moiety of lipopolysaccharide (LPS) and this type of PA can thus be detected by passive haemagglutination using the isolated LPS as coating antigen. Other strains synthesize PA exclusively in a free form, which is also coextractable with LPS, its presence can, however, be demonstrated by the haemagglutination inhibition test. From a polyagglutinable strain of P. aeruginosa an R-type LPS was isolated having the core-linked PA. This LPS preparation was highly immunogenic with regard to its PA moiety. The core-bound PA seems to exert an immunosuppression on the core region, hence, the polyagglutinable strains isolated from cystic fibrosis patients only engender anti-PA antibodies, whereas antibodies against both, side chain and core region of LPS, are not engendered. The mucoid exopolysacharides also contains the PA which could possibly play an important role in the patient by protecting P. aeruginosa cells against anti-PA antibodies.     

The hemagglutinating properties of Pseudomonas aeruginosa strains isolated from patients with nonspecific lung diseases]

To detect d-mannose-sensitive (MS) pili in 31 P. aeruginosa strains isolated from the respiratory tract of patients with inflammatory and purulent destructive pulmonary diseases, the hemagglutination (HA) test was used. The isolated Pseudomonas under study differed in the degree of manifestation of their MS adhesins. Among them microorganisms with pronounced HA activity (high HA titer) occurred, as well as those whose HA activity was less pronounced (low HA titer). P. aeruginosa strains with pronounced HA activity were more frequently isolated from patients with purulent destructive processes in the lungs. A correlation between the state of the patient at the moment of bacteriological examination and the degree of manifestation of MS pili in the P. aeruginosa strain isolated from this patients was established. The value of HA titer in the presence of d-mannose is indicative of the presence of MS adhesins in a P. aeruginosa strain.     

Sprouts as antioxidant food resources and young people's taste for them

To assist our choice of sprouts as healthy foodstuffs, we examined and compared the antioxidant activities of various sprouts. Most sprouts contained higher amounts of vitamin C, polyphenol and DPPH radical-scavenging activity than their mature vegetables. As food materials, young college students preferred sprouts to mature vegetables in case of vegetables whose mature forms are unfamiliar at market. Antioxidant activity of "Toumyo" sprout was highest at the 5th day after germination. Cotyledon and young root of "Toumyo" sprout, though they are usually discarded at kitchen, showed high antioxidant activities. A sensory evaluation by young college students suggested that the cotyledon could be served as meal if it is fried after boiled.     

Structural relationship between the polyagglutinable antigen and the core polysaccharide of Pseudomonas aeruginosa

It has been observed that each strain of the Pseudomonas aeruginosa species harbours the so-called polyagglutinable antigen (PA). Some strains may produce it in a form which is linked to the core moiety of lipopolysaccharide (LPS) and this type of PA can thus be detected by passive haemagglutination using the isolated LPS as coating antigen. Other strains synthesize PA exclusively in a free form, which is also coextractable with LPS, its presence can, however, be demonstrated by the haemagglutination inhibition test. From a polyagglutinable strain of P. aeruginosa an R-type LPS was isolated having the core-linked PA. This LPS preparation was highly immunogenic with regard to its PA moiety. The core-bound PA seems to exert an immunosuppression on the core region, hence, the polyagglutinable strains isolated from cystic fibrosis patients only engender anti-PA antibodies, whereas antibodies against both, side chain and core region of LPS, are not engendered. The mucoid exopolysaccharide also contains the PA which could possibly play an important role in the patient by protecting P. aeruginosa cells against anti-PA antibodies.     

The serological characteristics of the O antigens of Pseudomonas aeruginosa isolated from patients with a Pseudomonas infection during immunotherapy]

Serologic characteristics of P. aeruginosa O-antigens isolated from patients with P. aeruginosa infection were studied over the course of treatment with anti-P. aeruginosa sheep immunoglobulin. The preparation was used in 54 patients with nongeneralized forms of P. aeruginosa infection (infected wounds, pleural empyema) externally or intraperitoneally. From the clinical material collected from the patients a total of 54 P. aeruginosa strains were isolated. Serologic typing of the isolated strains with factor or group diagnostic agglutinating sera has revealed the O-group composition of the isolated strains; 66% of them were classified with O-groups 2,3, and 6. Serologic variants of the strains isolated from patients proved to be stable over the course of the disease immunotherapy. Analysis of the results of bacteriologic control of immunotherapy. efficacy and the clinical data has demonstrated the efficacy of immunotherapy in 61.1% of cases and its partial effect in 20.4% of cases of P. aeruginosa infection.     

圈养林麝铜绿假单胞菌的分离鉴定及耐药性和病原特性分析

【背景】铜绿假单胞菌感染所致的化脓性疾病是困扰林麝驯养的重要因素,是一类较难防治的细菌性疾病,目前尚无疫苗可用来预防该病。【目的】研究林麝源铜绿假单胞菌的感染现状和分子流行病学规律。【方法】对2014年10月至2015年10月四川宝兴和陕西镇坪两个林麝养殖中心发病林麝中铜绿假单胞菌进行分离鉴定,并对其耐药情况进行分析,利用脉冲场凝胶电泳(PFGE)分型技术研究分离菌的PFGE指纹图谱,探究其流行病学趋势,并对部分菌株的致病性进行分析。【结果】分离得到60株铜绿假单胞菌,其中34株来自镇坪,26株来自宝兴。耐药结果表明:60株林麝源铜绿假单胞菌对17种抗菌药物呈现不同程度耐药性,不同地区和不同样本源间分离的铜绿假单胞菌对17种抗菌药物的耐药性总体趋于一致,多重耐药情况严重,以5耐、6耐为主。分型结果显示:60株铜绿假单胞菌PFGE图谱的相似性为49.1%-100%。经聚类分析得到A-O共15种基因簇,其中优势基因簇为C、E、G、J。致病性结果表明,流行菌株的致病力强弱依次为:动物源菌株环境源菌株,且主要流行菌株(基因簇E、F、J)的致病力大于其余菌群。【结论】铜绿假单胞菌在两地区具有水平传播的途径,本研究可为跨地区林麝化脓性炎症的防控提供理论依据。     

Investigations into the survival of Pseudomonas aeruginosa in poloxamer-iodine

Laboratory investigations were conducted to study potential mechanisms for prolonged survival of Pseudomonas aeruginosa in poloxamer-iodine (PxI). P. aeruginosa organisms isolated from PxI and adapted for growth in distilled water or found as part of a mixed microbial population from water in a manufacturing plant did not survive more than 15 s after challenge in stock PxI solution. Batches of PxI were compounded in the laboratory to determine the survival and growth of P. aeruginosa during the various stages of preparation. No P. aeruginosa organisms were recovered from the finished product at 1 min after the addition of iodine-iodide. However, we found P. aeruginosa in PxI 48 h after adding sterile PxI to the inside of a naturally contaminated polyvinyl chloride water distribution pipe. These organisms (10(4) CFU/ml) survived for as long as 98 days in contaminated stock PxI after it was removed from the polyvinyl chloride pipe. Both decreasing the free iodine level through addition of potassium iodide and increasing the free iodine level through dilution of the product resulted in an increased length of survival of P. aeruginosa in contaminated PxI solution. Comparative survival studies with pipes of different composition revealed that other materials may exert an effect similar to polyvinyl chloride. We concluded that polyvinyl chloride and perhaps other materials may play an important role in the survival of P. aeruginosa in iodophors and may be one source of resistant microbial populations when used in manufacturing plants which produce these antimicrobial solutions.     

Investigations into the survival of Pseudomonas aeruginosa in poloxamer-iodine.

Laboratory investigations were conducted to study potential mechanisms for prolonged survival of Pseudomonas aeruginosa in poloxamer-iodine (PxI). P. aeruginosa organisms isolated from PxI and adapted for growth in distilled water or found as part of a mixed microbial population from water in a manufacturing plant did not survive more than 15 s after challenge in stock PxI solution. Batches of PxI were compounded in the laboratory to determine the survival and growth of P. aeruginosa during the various stages of preparation. No P. aeruginosa organisms were recovered from the finished product at 1 min after the addition of iodine-iodide. However, we found P. aeruginosa in PxI 48 h after adding sterile PxI to the inside of a naturally contaminated polyvinyl chloride water distribution pipe. These organisms (10(4) CFU/ml) survived for as long as 98 days in contaminated stock PxI after it was removed from the polyvinyl chloride pipe. Both decreasing the free iodine level through addition of potassium iodide and increasing the free iodine level through dilution of the product resulted in an increased length of survival of P. aeruginosa in contaminated PxI solution. Comparative survival studies with pipes of different composition revealed that other materials may exert an effect similar to polyvinyl chloride. We concluded that polyvinyl chloride and perhaps other materials may play an important role in the survival of P. aeruginosa in iodophors and may be one source of resistant microbial populations when used in manufacturing plants which produce these antimicrobial solutions.     

A Bacteriological Survey of the Domestic Environment

The results of a survey of the bacterial flora in many sites in 21 homes are discussed. In all areas both wet and dry, coagulase negative, Gram positive cocci and Bacillus spp. were found. Wet areas such as kitchen sinks and drains contained large numbers of Escherichia coli and sometimes Klebsiella pneumoniae , Citrobacter and Enterobacter spp. In toilet areas, little evidence was found of contamination with organisms of faecal origin. Of 47 samples taken from teacloths and towels 22 were contaminated with Staphylococcus aureus although the actual numbers of this organism were low. Pseudomonas aeruginosa was isolated from several sites in one home only.