医院工作人员鼻腔分离葡萄球菌性状及耐药性分析

从２１１名医护人员和辅助科室人员鼻腔取材，应用高盐肉汤和高盐甘露醇平板相结合的方法，检测葡萄球菌带前菌状况及药敏性。共检出各种葡萄球菌１７２株，总带菌率为８１．５％，其中金黄色葡萄球菌带菌率为８．１％。对检出菌株还测定了对１１种抗菌药物耐性，并将本文检测结果与非医院正常人群做了比较分析。     

医院工作人员鼻腔葡萄球菌带菌状况年度推移的调查报告

本文报道1989年从202名医院工作人员鼻腔分离葡萄球菌的带菌状况和药敏性检测结果。并将此结果同作者等于1985年对200名同类人员检测的结果相比较,作了年度推移的调查分析发现1989年度的总带菌率(76.6％)比1985年度(84.5％)略有下降,但其中的金黄色葡萄球菌带菌率却从1985年的7.5％上升为10.4％。从1989年和1985两个年度的调查中,均发现临床科室人员金葡菌带菌率高于其它辅助科室人员,说明医务人员带菌率与接触病人成正相关关系。分离菌株对12种抗菌药物的耐药性检测结果显示,1989年分离菌株对其中9种的敏感性下降,并且从耐药谱显示出对5种抗菌药物耐药的多重耐药菌株明显增多。另从金葡菌的耐药情况,也看出1989年的耐药率高于1985年菌株。还在1989年分离的金葡菌中出现25％的耐甲氧西林菌株。     

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.     

2011～2013年血液分离葡萄球菌的临床分布及耐药性分析

目的了解临床各科发热患者（怀疑细菌感染）血培养中葡萄球菌分布及耐药性,为临床治疗提供参考依据。方法血培养采用BaeT／Alert3D全自动血培养仪（梅里埃）培养5d,采用MicroScanWalk—Away-96plus全自动微生物鉴定和药敏分析系统（西门子）进行细菌鉴定和药敏试验。结果血培养共检出葡萄球菌185株,检出最多的科室是ICU,耐甲氧西林金黄色葡萄球菌（methicillin—resistant Staphylococcus aureus,MRSA）检出率为30．4％,而耐甲氧西林凝固酶阴性葡萄球菌（methicillin—resistant coagulase-negative Staphylococci,MRCNS）的检出率高达80．7％。还检出了1株万古霉素中介的凝固酶阴性葡萄球菌。结论通过血培养检出葡萄球菌的耐药性分析发现,凝固酶阴性葡萄球菌对苯唑西林、氨苄西林、青霉素、红霉素的耐药率在70％以上,而对氯霉素、利福平、四环素的耐药率在30％以下,因此这三种药物应为我院应对凝固酶阴性葡萄球菌血流感染的常用首选药物。     

医院空气中溶血性微生物微生态分布及耐药谱分析

在医院空气中,有１１．２４％的细菌具有溶血能力。溶血性微生物超过５００ｃｆｕ／ｍ３者占４３．４４％。在２０９１株溶血性细菌中,Ｇｒａｍ’ｓ阴性菌占９３．６％,主要为葡萄球菌（１３３３株）．Ｇｒａｍ’ｓ阳性菌占３．３１％,均为不发酵杆菌。葡萄球菌分布于７个种,以中间型葡萄球菌（２７．９８％）和金葡菌（２４．７６％）为主,同时,还检出耐甲氧西林葡萄球菌９１８株。药敏结果的提示,葡萄球菌耐药率高,耐药谱宽。８重以上耐药株占５２．２９％。     

糖尿病足感染的细菌学调查及耐药性分析

目的 了解临床糖尿病足患者感染的细菌分布及耐药性分析.方法 2009年至2010年,共调查135例糖尿病足患者.结果 检出细菌株数为107株,其中革兰阳性菌44株,占41.1％;革兰阴性菌57株,占53.3％;真菌6株,占5.6％.需氧菌感染80例,检出率59.3％.以金葡菌、链球菌、变形杆菌和大肠埃希菌为主要感染菌.金黄色葡萄球菌的耐药率明显低于其他葡萄球菌.大肠埃希菌治疗以亚胺培南首选,也可选用β-内酰胺类加酶抑制剂.结论 检出革兰阴性菌57株,革兰阳性菌44株,应根据药敏情况合理应用抗菌素.     

眼分泌物耐甲氧西林表皮葡萄球菌检测及耐药性分析

目的 探讨眼科分泌物中表皮葡萄球菌耐药特征,指导临床合理使用抗菌药物.方法 用定量接种针挑取单个菌落溶于0.5 McFarland硫酸钡接种液制成混悬液,再用接种器吸取菌液接种于Pos Combo Panel Type20,35℃孵育24 h,应用美国德灵SCAN4微生物分析仪对192株葡萄球菌中的86株表皮葡萄球菌进行鉴定和药敏试验.结果 表皮葡萄球菌检出86株,检出率为44.8％ (86/192);MRSE检出58株,检出率为30.2％ (58/192),MRSE占表皮葡萄球菌的67.4％ (58/86);MRSE对头孢西丁、青霉素、红霉素、阿莫西林/克拉维酸、头孢唑啉、复方新诺明、苯唑西林、左氧氟沙星、庆大霉素、亚胺培南具有显著耐药性,对万古霉素、利奈唑烷、利福平、四环素、氯霉素敏感.结论 眼科分泌物中表皮葡萄球菌耐药性严重,并且MRSE呈现多重耐药,医院应加强对MRSE的检测,依据药敏结果合理选用抗菌药物治疗感染.     

皮肤软组织感染病原菌分布及耐药性分析

目的 调查皮肤软组织感染病原菌的种类及耐药性,为临床合理使用抗菌药物提供科学依据.方法 利用WHONET 5.6对2009年1月至2011年12月皮肤软组织感染患者脓液或分泌物细菌培养及药敏试验结果进行回顾性分析.结果 共分离菌株444株,金黄色葡萄球菌(SAU)分离率居第1位,171株占38.5％;表皮葡萄球菌居第2位,54株占12.2％;铜绿假单胞菌第3位,43株占9.7％;头孢哌酮/舒巴坦、哌拉西林/他唑巴坦、阿米卡星、亚胺培南和美罗培南对革兰阴性杆菌有较好的抗菌活性(耐药率≤3.3％);金黄色葡萄球菌对青霉素和红霉素的耐药率为93.6％和65.0％,对呋喃妥因、利奈唑胺、利福平、莫西沙星和左旋氧氟沙星耐药率为0％、0％、1.4％、2.2％和9.3％,未检出万古霉素耐药株;耐甲氧西林金黄色葡萄球菌(MRSA)检出率25.7％ (44/171);MRSA和甲氧西林敏感金黄色葡萄球菌(MSSA)对氨苄西林/舒巴坦、利福平、莫西沙星三种药物的敏感性差异有统计学意义.结论 引起皮肤软组织感染病原菌以阳性球菌尤其是金黄色葡萄球菌为主,临床上应尽量根据药敏试验结果选用抗生素,合理用药.     

儿童血液凝固酶阴性葡萄球菌的感染情况及耐药性分析

目的了解本院儿童血培养凝固酶阴性葡萄球菌（CNS）的感染率及其药物敏感情况,为儿科合理使用抗生素提供依据。方法对本院2006年1月至2007年12月间住院及门诊儿童血液培养的结果进行回顾性统计分析。结果在1265例儿童血培养中共检出CNS117株,其中表皮葡萄球菌41株（占35．0％）,人葡萄球菌27株（占23．1％）,溶血葡萄球菌21株（占18．0％）,其他凝固酶阴性葡萄球菌28株（占23．9％）;耐甲氧西林凝固酶阴性葡萄球菌（MRCNS）分离率为79．5％;MRCNS药敏结果显示多重耐药。结论CNS已成为儿童血液感染的重要致病菌,MRCNS检出率高且多重耐药,万古霉素、喹宁始霉素-达福普汀、呋西地酸是治疗MRCNS感染的首选药物。     

牛、羊胆囊内肠道菌的分离鉴定

本文对育肥屠宰的牛、羊胆囊进行了细菌学调查,其胆囊内细菌的污染情况是:被检的79例牛羊胆囊,有31例带菌,带菌率为31/79。在32例牛胆囊,有12例带菌,带菌率为12/32;47例羊胆囊,有19例带菌,带菌率为19/47。共分离出菌37株(牛2例、羊4例同时检出2株菌,其余均为1株)。按照Bergey氏《细菌鉴定手册》第8版的分类系统,经鉴定这些菌分别属5科8属中的10种菌(内含1株酵母菌及1株未定菌):大肠埃希氏菌、肠球菌、产气肠杆菌、普通变形杆菌、柠檬酸细菌,粪产硷杆菌、乳酸杆菌、表皮葡萄球菌。调查结果表明:正常情况下牛、羊胆囊内是无菌的。胆囊内检出的细菌是属污染菌,且均为肠道菌。     

变形杆菌的耐药性及接合性R质粒的检测

本文报告了从烧伤病人感染创面分离、鉴定的35株变形杆菌的药敏试验及接合性R质粒的检测结果。35株变形杆菌双测试的6种抗菌药物都具有不同程度的耐药性。其中,对6种药物同时耐受的有26株(74.3％)。对其中的27株做了接合试验,接合性R质粒的检出率为70.4%。     

Circadian rhythms of antibacterial resistance, coagulase and antilysozyme activity of Staphylococcus aureus

AIM: To determine daily dynamics of antibacterial resistance as well as antilysozyme and coagulase activity of S. aureus strains. MATERIALS AND METHODS: On an example of clinical strains of S.aureus isolated from patients with surgical infections daily dynamics of biological characteristics of staphylococci was studied. After 12 hours of incubation strains were tested for coagulase activity by standard method (test tube method), antilysozyme activity by photometric method, and antibacterial resistance by method of serial dilutions in agar. Tests were repeated each 3-hours during a day. RESULTS: Variation of levels of studied biological characteristics of staphylococci during a day was revealed. Structures of coagulase and antilysozyme circadian rhythms had some differences in different S. aureus strains. Alongside with it, similarity in temporal expression of such biological characteristics of staphylococci as antibacterial resistance and antilysozyme activity was noted. CONCLUSION: Obtained data open prospect to use biorhythmological approach in study of biological characteristics of microorganisms during evaluation of their mechanisms of adaptation to changing environmental conditions. Chronobiological approach allows to reveal periods of maximal expression of S. aureus characteristics that could be used for increasing of effectiveness of antibacterial treatment by the choice of optimal time for administration of antibiotic.     

Antibiotic resistance of staphylococci isolated from outpatients

The aim of the study was to determine susceptibility of 587 strains of S. aureus and 85 strains of coagulase-negative staphylococci isolated from outpatients in Poznań to co-trimoxazole, amoxycillin/clavulanic acid, erythromycin, gentamycin, doxycycline, ampicillin, oxacillin, cephradine, clindamycin and neomycin. Also methicillin-resistant strains were determined as well as strains ability to produce beta-lactamases. Susceptibility testing and examination of methicillin-resistant strains were performed by the disc diffusion techniques according to recommendation of NCCLS. Methicillin-resistant strains were additionally examined to their sensitivity to vankomycin and teicoplanin. beta-lactamase production was detected using nitrocefin impregnated discs and iodometric method. Amoxacillin/clavulanic acid, gentamycin, co-trimoxazole, cephradin, oxacillin and clindamycin occurred to be very active against both, S. aureus and coagulase-negative staphylococci. 84.7% to 100% of examined strains were sensitive to these drugs. Doxycyclin, erythromycin and ampicillin were less effective. Nine strains (1.5%) of 587 strains of S. aureus as well as 7 strains (8.7%) of coagulase-negative staphylococci were methicillin-resistant. All of methicillin-resistant strains were sensitive to vancomycin and teicoplanin. More than 75% of S. aureus and close to 50% of coagulase-negative staphylococci were able to produce beta-lactamases.     

Virulent and avirulent encapsulated variants of Staphyococcus aureus

There are at least two serologically distinct capsular types of coagulase-positive Staphylococcus aureus. Until now, unequivocal evidence for encapsulation of the Smith diffuse variant was lacking. However, the data presented in this paper provide definitive details of encapsulation of the Smith strain. A marked difference in ld(50) values for the two serologically distinct capsular types of S. aureus was demonstrated. The paradoxical behavior of these two strains suggested that the host was resistant to one and was susceptible to the other. A survey of the carriage incidence in mice for staphylococci and staphylococcal capsular antibodies disclosed the presence of staphylococci and capsular antibodies in these animals. The capsular antibodies detected were reactive against only one of the capsular types of S. aureus. None of the sera from the mice surveyed possessed capsular antibodies against the Smith diffuse variant, but the average incidence for the capsular antibodies against the wound mucoid type was 46%. We postulated that the susceptibility of the mice to the Smith diffuse variant was caused by the absence of protective, type-specific capsular antibodies. Conversely, the resistance of the mice to the wound mucoid staphylococci may have been a result of the presence of type-specific capsular antibodies.     

Biofilm production, a marker of pathogenic potential of colonizing and commensal staphylococci

Biofilm is one of the known virulence factors of staphylococci, a human and animal pathogen and commensal. Some of the strains become invasive under favorable conditions while others do not cause disease. Early detection and management of potentially pathogenic staphylococci is the essential step to prevent device-associated infections. There is also a need to evaluate one simple method for the detection of potential pathogens. Hence this study was planned to study the difference in potential of commensal, colonizing and invasive strains of staphylococci to produce biofilm. We used one qualitative (Congo red agar) and one quantitative (microtiter plate) method for detection of biofilm production and evaluated the sensitivity and specificity of Congo red agar method by using microtiter plate method as a gold standard. We consecutively enrolled staphylococcal strains isolated from peripheral intravenous device (IVD), venous blood, site of IVD insertion and nasal mucosa of patients admitted to pediatric ward with peripheral intravenous devices in place for more than 48 h. Total 100 invasive, 50 colonizing and 50 commensal isolates were studied. Of 100 invasive isolates 74% (74/100) were biofilm positive while only 68% (34/50) colonizing and 32% (16/50) commensal isolates were biofilm positive. The difference in biofilm production by commensal, colonizing and invasive strains was statistically significant (p<0.0001). Sensitivity and specificity of Congo red agar test for detection of biofilm producers were 90.63% and 90.79% for Staphylococcus aureus and 75.86% and 96.88% respectively for coagulase negative staphylococci. CRA is a method that could be used to determine whether an isolate has the potential for biofilm production or not.     

聚合酶链反应检测耐甲氧西林凝固酶阴性葡萄球菌的研究

收集１３６株ＣＮＳ,用ＰＣＲ法检测ＭＲＣＮＳ,并与普通药敏试验比较,结果不相符的菌株进行诱导和抑制试验。结果表明ｍｅｃＡ基因阳性率为７８．７％,且ＰＣＲ产物经序列分析证明其为ｍｅｃＡ基因特异性产物。对１４株ｍｅｃＡ基因阳性而苯唑西林ＭＩＣ≤２μｇ／ｍｌ的细菌进行诱导试验后,其中８株苯唑西林ＭＩＣ值 提高,对４株ｍｅｃＡ基因阴性而苯唑西林（ＭＩＣ≥４μｇ／ｍｌ的细菌进行抑制试验后,其氨苄西林ＭＩＣ值     

Antimicrobial sensivity and ability to slime production of koagulaze-negative staphylococci

The aim of this study was to assess the ability of slime production ofcoagulase-negative staphylococci (CONS) and evaluate the susceptibility of bacteria to antibiotics. Strains were isolated from clinical specimens obtained from hospitalized patients. The most frequently isolated species were S. epidermidis (51%), S. hominis (18%), S. haemolyticus (13%). The result of this study shows that 61% of S.epidermidis produce slime on CRA (Congo red agar), whereas none of the tested S. haemolyticus strains has this ability. All examined strains were susceptible to vancomycin, linezolid and quinupristin/ dalfopristin. The majority of strains were susceptible to minocycline, fusid acid, nitrofurantoin and rifampicin. Sixty six percent of isolates were determined as methicillin-resistant coagulase-negative staphylococci.     

我国葡萄球菌的耐药性

本报告是利用纸片法对来自我国20个省市百余家医院1091株临床分离的金黄色葡萄球菌对12种常用的抗菌药物敏感性的调查报告,其结果表明99.7%的菌株对RIFAMPICINUM极度敏感,99.8%的菌株对CHLORAMPHENICOLUM和FURAZOLIDONUM高度敏感;29.6%的菌株对CARBENICILLNUM,21.1%的菌株对ERYTHROMYCINUM,18.1%的菌株对KANAMYCINUM,13.7%的菌株对PENICILLINUM NATRICUM耐药.调查结果表明,分布在我国南北方不同纬度的葡萄球菌对12种常用抗菌药物的敏感性基本相同,无明显的地域性差异.     

Bacteria of public health significance in blackcurrant juice

A total of 192 samples of blackcurrant juice were investigated for hygienic quality and drug resistance. The average aerobic bacteria in 1 ml of the blackcurrant juice was 4.8 x 10(8) and the average MPN was 8.4 x 10(2) coliform/100 ml. The percentage of the samples contaminated with coliform bacteria was 23.4. The incidence of Escherichia coli, Klebsiella, Pseudomonas aeruginosa, Staphylococcus aureus and faecal streptococci were 19.8, 9.9, 29.2, 14.0 and 18.2%, respectively. Biochemical and serological studies showed that 10.5% of total Escherichia coli were enteropathogenic E. coli. Of sixty strains tested against six antibacterial drugs, 57% were resistant to one or more of the drugs. The incidence of resistance to ampicillin, chloramphenicol, sulphonamide, streptomycin, tetracyline and gentamycin was 40.0, 25.0, 43.3, 18.3, 20.0 and 8.3%, respectively.