社区和医院获得性尿道致病性大肠埃希菌耐药性分析

目的了解浙江省社区和医院获得性尿道致病性大肠埃希菌的耐药现状及产超广谱β-内酰胺酶(ESBLs)菌株基因型,为临床合理用药提供科学依据。方法对2014年1月至2014年12月浙江省社区和医院获得性尿道致病性大肠埃希菌耐药情况进行分析,并随机各抽取20株菌株进行CTX-M基因型检测。结果社区和医院获得性大肠埃希菌共收集到93株和992株,产ESBLs菌株的阳性率分别为47.7%和68.5%,差异有统计学意义(P0.05);社区获得性菌株CTX-M基因检出率为30.0%(6/20),其中又以CTX-M-9为主(4/6)。医院获得性菌株CTX-M基因检出率50.0%(10/20),其中CTX-M-9占7/10。医院获得性菌株对头孢呋辛、头孢唑啉、头孢曲松、环丙沙星、左旋氧氟沙星、甲氧苄氨嘧啶/磺胺甲恶唑、呋喃妥因和阿米卡星的敏感率明显低于社区获得性菌株(P0.05)。结论浙江省医院获得性尿道致病性大肠埃希菌对部分抗菌药物的耐药率明显高于社区获得性菌株,ESBLs基因以CTX-M-9为主。     

上海市某三甲医院幽门螺杆菌耐药性和毒力与其生物膜形成能力的相关性研究

为探讨复旦大学附属华东医院(以下简称本院)分离培养的幽门螺杆菌(Helicobacter pylori,H. pylori)的耐药性、毒力和感染特征与其生物膜形成能力的相关性,收集2014年12月-2015年6月于本院消化内镜中心的胃活检组织标本及相应临床病例资料,分离培养获得幽门螺杆菌,分析菌株的耐药性、毒力基因型、临床病例特征。结果显示,从胃活检组织样本中共分离培养28株幽门螺杆菌,对左氧氟沙星(levofloxacin,LEV)、甲硝唑(metronidazole,MTZ)和克拉霉素(clarithromycin,CLA)的耐药率分别为32%、75%和11%,未发现阿莫西林(amoxicillin,AMX)耐药。单一药物耐药17株(17/28,61%),双重耐药10株(10/28,36%)。毒力基因cagA、oipA和vacAs1检出率为100%,未检出vacAs2。基因型vacAs1m1占39%(11/28),vacAs1m2占61%(17/28);iceA1占54%(15/28),iceA2占21%(6/28),iceA1A2占25%(7/28);dupA^＋占36%(10/28)。28株菌株均能形成生物膜,但能力不尽相同。单因素及独立样本t检验分析显示,45～59岁、iceA1^＋dupA^－基因型和甲硝唑敏感菌株形成生物膜的能力较强。结果提示,本院分离的幽门螺杆菌对甲硝唑耐药率最高,双重耐药不容忽视。菌株主要毒力基因型为cagA、oipA、vacAs1m2。幽门螺杆菌的生物膜形成能力与患者年龄有关,45～59岁组较强;携带毒力基因iceA1的菌株生物膜形成能力强;dupA基因型及甲硝唑耐药与菌株生物膜形成呈负相关。     

Conjugative transfer of tetracycline resistance in rumen streptococcal strains

In 11% of testedStreptococcus bovis strains a conjugative transfer of tetracycline resistance was observed when mating experiments were carried out on membrane filters. The recipient strain used wasS. bovis BM114 with chromosomal resistance to rifampicin. In addition, in two strains tetracycline resistance was transferred also to recipient strainEnterococcus faecium AL6. The transfer frequencies were in the range of 10⁻⁶ to 10⁻³. The donor strains were screened for the presence of plasmids and one up to four bands of plasmid DNA in all tested strains were revealed. In spite of that isolation of plasmid DNA was successful only in 53/4/114 transconjugants. Transconjugant 32/114 contained amylase activity which was higher than in the donor strain.     

产β-内酰胺酶鲍曼不动杆菌基因型研究

目的了解临床科室分离的鲍曼不动杆菌耐药状况并分析多重耐药株产β-内酰胺酶基因型,为有效的临床治疗和医院感染控制提供实验室依据。方法采用纸片扩散（K-B）法测定临床分离的312株鲍曼不动杆菌对13种抗菌药物的敏感性,对其中120株多重耐药株用聚合酶链反应（PCR）扩增β-内酰胺酶基因,并对其扩增产物进行基因测序。结果鲍曼不动杆菌对美洛培南、亚胺培南、头孢哌酮/舒巴坦和替卡西林/克拉维酸的耐药率分别为0.0%、1.0%、30.8%和31.4%,其余抗菌药物耐药率在38.5%-80.1%;120株多重耐药菌株中,β-内酰胺酶基因分布AmpC型基因阳性率为66.7%（80/120）、SHV-12型基因阳性率为14.2%（17/120）,PER-1型基因阳性率为16.7%（20/120）,CTX-M-9型基因阳性率为8.2%（10/120）,TEM-1型基因阳性率为9.2%（11/120）;VER-1,CTX-M-1,CTX-M-2,OXA型均阴性。同时携带2种基因型有16株,携带3种基因型有14株。结论临床分离的鲍曼不动杆菌流行株主要是产AmpC酶,且呈多重耐药。     

R-plasmid transfer in Salmonella spp. isolated from wastewater and sewage-contaminated surface waters.

A total of 865 Salmonella isolates from wastewaters and sewage-contaminated natural waters were tested for antimicrobial resistance by using NR10 medium and incubation at 43 degrees C. Of the strains, 12.7% were resistant to one or more of the compounds tested, and 30% transferred resistance to an Escherichia coli recipient. The highest minimal inhibitory concentrations were ca. 1,000 micrograms/ml. Transfer frequencies ranged from 10(-3) to 10(-7).     

泌尿外科住院患者泌尿系感染病原菌分布及其耐药性分析

了解泌尿外科住院患者泌尿系感染病原菌的分布及其对常用抗菌药物的耐药情况。对泌尿外科泌尿系感染住院患者的消毒中段尿培养结果进行回顾性分析,尿培养菌株的鉴定、药敏分析和统计分析采用VITEK2全自动微生物仪。3 a中泌尿外科泌尿系感染住院患者共分离到细菌1 233株,其中革兰阴性杆菌772株,占62.61%,革兰阳性球菌353株,占28.63%,真菌82株,占6.65%。菌株数居前5位的细菌依次为:大肠埃希菌、肠球菌属、洋葱伯克霍尔德菌、假丝酵母菌属和变形杆菌。分离大肠埃希菌产ESBLs率为66.18%,粪肠球菌中未发现VRE菌株,屎肠球菌VRE为0.8%。未发现对美洛培南耐药的大肠埃希菌,对肠埃希菌耐药率在10%以下的有亚胺培南、阿米卡星、哌拉西林/他唑巴坦和呋喃妥因。洋葱伯克霍尔德菌和铜绿假单胞菌对所监测的抗菌药物均有不同程度的耐药。未发现对万古霉素、替考拉宁及氨苄西林耐药的粪肠球菌。泌尿系感染的病原菌以大肠埃希菌和肠球菌为主,非发酵革兰阴性杆菌及假丝酵母菌所占比例超过20%,不容忽视,病原菌的耐药率较高,临床医生应根据尿培养和药敏试验结果合理使用抗菌药物。     

R-plasmid transfer in Salmonella spp. isolated from wastewater and sewage-contaminated surface waters

A total of 865 Salmonella isolates from wastewaters and sewage-contaminated natural waters were tested for antimicrobial resistance by using NR10 medium and incubation at 43 degrees C. Of the strains, 12.7% were resistant to one or more of the compounds tested, and 30% transferred resistance to an Escherichia coli recipient. The highest minimal inhibitory concentrations were ca. 1,000 micrograms/ml. Transfer frequencies ranged from 10(-3) to 10(-7).     

Drug resistance and conjugative R plasmids in fecal Escherichia coli strains isolated from healthy younger animals (chickens, piglets, calves) and children

A total of 11,777 Escherichia coli strains were isolated from 90 chickens, 103 piglets, 96 calves, and 104 children in 1979 in Gunma Prefecture and tested for drug resistance and the presence of conjugative R plasmids. The percentages of individuals that excreted drug-resistant strains were: chickens, 100%; piglets, 99%; calves, 100%; and children, 64%. The frequency of isolation of drug-resistant strains among the total isolates was: chickens, 98%; piglets, 93%; calves, 94%; and children, 41%. Frequency of isolation of R plasmids among the strains tested was: chickens, 48%; piglets, 33%; calves, 38%; and children, 10%. Resistance patterns of the strains isolated most frequently among the four groups were tetracycline (TC), sulfonamides (SA) in single resistance, TC.SA in double resistance, TC.streptomycin (SM).SA in triple resistance and TC.SM.SA. kanamycin (KM) in quadruple resistance. R plasmids were isolated frequently from animals (over 33%) but infrequently from children (about 10%). The high frequency of isolation of drug-resistant strains and R plasmids from animals was caused by the heavy use of chemicals in the period of growth of younger animals.     

Plasmid profiling and curing of Lactobacillus strains isolated from the gastrointestinal tract of chicken

In this study, we assessed the susceptibility of 12 Lactobacillus strains, all of which had been isolated from the gastrointestinal tracts of chicken, to three antibiotics (chloramphenicol, erythromycin and tetracycline) used commonly as selective markers in transformation studies of lactic acid bacteria. Among these strains, 17%, 58%, and 25% were found to exhibit a high degree of resistance to 200 microg/ml of tetracycline, erythromycin, and chloramphenicol, respectively. Seven of the 12 Lactobacillus strains exhibiting resistance to at least 50 microg/ml of chloramphenicol or erythromycin, and five strains exhibiting resistance to at least 50 microg/ml of tetracycline, were subsequently subjected to plasmid curing with chemical curing agents, such as novobiocin, acriflavin, SDS, and ethidium bromide. In no cases did the antibiotic resistance of these strains prove to be curable, with the exception of the erythromycin resistance exhibited by five Lactobacillus strains (L. acidophilus I16 and I26, L. fermentum I24 and C17, and L. brevis C10). Analysis of the plasmid profiles of these five cured derivatives revealed that all of the derivatives, except for L. acidophilus I16, possessed profiles similar to those of wild-type strains. The curing of L. acidophilus I16 was accompanied by the loss of 4.4 kb, 6.1 kb, and 11.5 kb plasmids.     

我国华南沿海海水养殖鱼类病原菌美人鱼发光杆菌(Photobacterium damselae)分离株的毒力基因和耐药性分析

[目的] 为探讨我国华南沿海海水养殖鱼类病原菌美人鱼发光杆菌的非典型毒力基因和耐药性的时空变化,解析影响其毒力和耐药性变化的可能环境因素,为该菌所引起的病害防控提供建议。[方法] 本研究以分离自我国广东和海南沿海患病海水鱼的35株美人鱼发光杆菌为研究对象,利用普通PCR扩增技术,分析5个非典型毒力基因在菌株中的分布情况,并采用纸片扩散法（K-B）分析菌株对15种抗生素的耐药性。[结果] 19株菌含有1–2个被检测的非典型毒力基因,尤其是hlyA和vvh的检出率均高于20%。35株菌多重耐药指数为0.00–0.67,表现出27种耐药谱,多重耐药率（菌株耐抗生素种类>3）达到60.00%,尤其对万古霉素、阿莫西林、麦迪霉素和利福平的耐药率均高于50%,但对庆大霉素、诺氟沙星、环丙沙星、氯霉素和氟苯尼考的耐药率均低于10%。非典型毒力基因含量和耐药性,呈现一定的随年份增加而增强以及海南>广东的时空差异,尤其是耐药性中的谱型丰富度、多重耐药率、某一菌株的最多耐药数量以及多重耐药指数,海南（分别是1.00,69.23%,10,0.32）均大于广东（分别是0.82,54.55%,9,0.25）。[结论] 美人鱼发光菌的非典型毒力基因可能是通过水平基因转移获得,海南与广东区域美人鱼发光菌毒力基因与耐药的差异主要受到温度和抗生素使用的影响。     

Antibiotic resistance genes in anaerobic bacteria isolated from primary dental root canal infections

Fourty-one bacterial strains isolated from infected dental root canals and identified by 16S rRNA gene sequence were screened for the presence of 14 genes encoding resistance to beta-lactams, tetracycline and macrolides. Thirteen isolates (32%) were positive for at least one of the target antibiotic resistance genes. These strains carrying at least one antibiotic resistance gene belonged to 11 of the 26 (42%) infected root canals sampled. Two of these positive cases had two strains carrying resistance genes. Six out of 7 Fusobacterium strains harbored at least one of the target resistance genes. One Dialister invisus strain was positive for 3 resistance genes, and 4 other strains carried two of the target genes. Of the 6 antibiotic resistance genes detected in root canal strains, the most prevalent were blaTEM (17% of the strains), tetW (10%), and ermC (10%). Some as-yet-uncharacterized Fusobacterium and Prevotella isolates were positive for blaTEM, cfxA and tetM. Findings demonstrated that an unexpectedly large proportion of dental root canal isolates, including as-yet-uncharacterized strains previously regarded as uncultivated phylotypes, can carry antibiotic resistance genes.     

2016‒2017年辽宁省沙门菌耐药菌谱与分子分型

摘要：目的 分析2016?2017年辽宁省沙门菌分离株的耐药特性与脉冲场凝胶电泳（PFGE）分子分型特征,为沙门菌引起的食源性疾病暴发、防控及抗生素使用提供参考数据。方法 对分离的54株沙门菌进行血清分型和药物敏感试验。根据PulseNet沙门菌标准PFGE分型技术,选取全部菌株进行PFGE分子分型分析,应用BioNumerics软件对菌株条带进行分析,确定菌株间的特征及相关性。结果 54株沙门菌血清型居首位的是肠炎沙门菌,占46.30％;其次是鼠伤寒沙门菌,占24.07％;共分为10个血清型。对13种抗生素的耐药分析显示多重耐药菌株为36株,占66.7％,其中耐3～5种的13株（24.1%）,耐6～8种的13株（24.1%）,耐9～11种的10株（18.5%）。54株沙门菌经聚类分析获得36种带型,相似度区间为49.7%～100.0％。结论 辽宁省沙门菌分离株多重耐药状况比较严重,相同血清型其PFGE带型相似度相对较高,同时具有较显著的优势带型特点;而且发现同一PFGE型菌株的耐药谱相对比较接近。     

Electrotransformation of Streptococcus pneumoniae

Conditions of electroporation to transform encapsulated strains of Streptococcus pneumoniae with plasmid DNA have been defined. For a heavily encapsulated strain, an electroporation solution of 10–20% (v/v) glycerol and 3.2 kV cm^-1 field strength, 1000 Ω resistance and 25 μF capacitance were optimal. For lightly encapsulated or non-encapsulated strains, optimal conditions were a sucrose-based electroporation solution and 12.5 kV cm^-1 field strength, 200 Ω resistance and 25 μF capacitance.     

Frequency of bacteriocin resistance development and associated fitness costs in Listeria monocytogenes

Bacteriocin-producing starter cultures have been suggested as natural food preservatives; however, development of resistance in the target organism is a major concern. We investigated the development of resistance in Listeria monocytogenes to the two major bacteriocins pediocin PA-1 and nisin A, with a focus on the variations between strains and the influence of environmental conditions. While considerable strain-specific variations in the frequency of resistance development and associated fitness costs were observed, the influence of environmental stress seemed to be bacteriocin specific. Pediocin resistance frequencies were determined for 20 strains and were in most cases ca. 10(-6). However, two strains with intermediate pediocin sensitivity had 100-fold-higher pediocin resistance frequencies. Nisin resistance frequencies (14 strains) were in the range of 10(-7) to 10(-2). Strains with intermediate nisin sensitivity were among those with the highest frequencies. Environmental stress in the form of low temperature (10 degrees C), reduced pH (5.5), or the presence of NaCl (6.5%) did not influence the frequency of pediocin resistance development; in contrast, the nisin resistance frequency was considerably reduced (<5 x 10(-8)). Pediocin resistance in all spontaneous mutants was very stable, but the stability of nisin resistance varied. Pediocin-resistant mutants had fitness costs in the form of reduction down to 44% of the maximum specific growth rate of the wild-type strain. Nisin-resistant mutants had fewer and less-pronounced growth rate reductions. The fitness costs were not increased upon applying environmental stress (5 degrees C, 6.5% NaCl, or pH 5.5), indicating that the bacteriocin-resistant mutants were not more stress sensitive than the wild-type strains. In a saveloy-type meat model at 5 degrees C, however, the growth differences seemed to be negligible. The applicational perspectives of the results are discussed.     

Gentamicin resistance among salmonellae. A ten-year study, 1973–1982

A total of 8579 Salmonella strains received during 1973–1982 were tested for their antibiogram patterns against nine routinely used antibiotics including gentamicin. Of these, 380 strains (4.4%) showed resistance to gentamicin at levels of 10 g/ml and above. A high degree of resistance to gentamicin was recorded in 1979 (18.7%) and 1980 (9.4%). M.I.C. levels of strains received during 1982 were determined and it was found that some strains had levels as high as 160 g/ml. The comparative results of gentamicin resistance from 1973 to 1982 are presented and the public health significance of the alarming increase in two years (1979–1980) is discussed.     

高龄患者血液感染常见革兰阴性杆菌及其耐药性分析

目的分析本院80~100岁高龄患者血液感染常见革兰阴性杆菌的种类及其耐药状况,为本院合理使用抗生素提供依据。方法采用BacT/Alert 3D血培养仪对血液标本进行阳性鉴定;VITEK-2Compact全自动微生物鉴定仪进行鉴定;K-B纸片扩散法对抗菌药物进行敏感性测定;使用WHONET 5.4分析软件分析数据。结果本院高龄患者血液培养阳性标本中共分离出革兰阴性杆菌108株,以肠杆菌科细菌为主,其次为非发酵菌,前者主要为大肠埃希菌52株(48.15%)和肺炎克雷伯菌37株(34.26%),后者主要包括铜绿假单胞菌10株(9.26%)和鲍曼不动杆菌8株(7.41%)。其中大肠埃希菌和肺炎克雷伯菌对亚胺培南的耐药率分别为1.92%和13.51%,两者对氨苄西林、氨苄西林/舒巴坦、头孢唑林、头孢呋辛的耐药率均高于50.00%;铜绿假单胞菌和鲍曼不动杆菌对亚胺培南的耐药率分别为20.00%和25.00%,后者对其他抗菌药物的耐药率均高于前者。结论碳青酶烯类抗生素可作为本院高龄患者常见革兰阴性杆菌所致血液感染的首选药物;但在治疗中应考虑细菌的耐药特点及患者的代谢特点合理选择抗生素。     

Abundance and antibiotic resistance of non-O1 Vibrio cholerae strains in domestic wastewater before and after treatment in stabilization ponds in an arid region (Marrakesh, Morocco)

Abstract: The abundance and antibiotic resistance of non-O1 Vibrio cholerae strains were studied in wastewater before and after treatment in stabilization ponds in an arid Mediterranean climate. The seasonal abundance of non-O1 Vibrio cholerae was the inverse of those of fecal coliforms, with high densities in hot periods and low densities in cold periods. Although the stabilization pond presents a good efficiency in removing fecal coliforms (97.97%), this treatment system did not produce any significant reduction in non-O1 V. cholerae abundances between the inflow and outflow stations. Among the 240 non-O1 V. cholerae strains isolated before and after treatment in the stabilization ponds, 89 (37.1%) isolates were resistant to at least one of 14 tested antibiotics. The levels of antibiotic resistance at the inflow and outflow points of the system were respectively 40 and 34%. High ampicillin, amoxicillin and mezlocillin resistance was observed at all sampling points, followed by resistance to cefalexin, cefoperazone and amikacin. Antibiotic resistance can be transferred from non-O1 V. cholerae to other members of the Enterobacteriaceae family such as Escherichia coli K12. Transfer frequencies in nutrient broth and filtered wastewater were 3 × 10⁻⁵ and 2 × 10⁻⁸, respectively.     

Antibiotic resistance of Salmonella strains isolated from fish and crustaceans

A total of 240 Salmonella strains, 158 from 730 fish samples and 82 from 276 crustacean samples, obtained during a 2 year period, were examined for resistance to 10 antibiotics. More than 90% of the strains were resistant to bacitracin, penicillin and novobiocin. The least resistance was observed to chloramphenicol (6·7%) and nalidixic acid (12%). Multiple antibiotic resistance indexing of the strains showed that more than 95% originated from high risk sources of contamination such as poultry, swine, cattle and human environments where antibiotics are often used.     

Acid resistance variability among isolates of Salmonella enterica serovar Typhimurium DT104

AIMS: Acid resistance could be an indicator of virulence since acid resistant strains are able to better survive the human stomach passage and in macrophages. We studied the acid resistance of several Salmonella Typhimurium DT104 strains isolated from food and humans and identified cellular parameters contributing to the enhanced acid resistance of these isolates. METHODS AND RESULTS: Acid resistance was tested in 37 Salmonella enterica Typhimurium serovar DT104 (S. Typhimurium DT104) strains. Acid adaptation at pH 5 followed by exposure for 2 h at pH 2.5 in the 27 human, nine nonhuman, and in two reference strains, revealed strong variation of acid survival. After 2 h at pH 2.5 six strains of S. Typhimurium DT104 were considered high acid resistant as they displayed a level of survival >10%, 14 strains were considered intermediate acid resistant (level of survival was <10% and >0.01%) and 19 strains were considered low acid resistant (level of survival <0.01%). Six strains were selected for further studies and proteomics revealed a relatively high amount of phase 2 flagellin in an acid-sensitive strain and a relatively high amount of the beta component of the H(+)/ATPase in an acid-resistant strain. Two strains were slightly more heat resistant possibly as the result of increased levels of DnaK or GroEL. CONCLUSIONS: A significant difference could be detected between human and food isolates regarding their acid resistance; all high acid-resistant strains were human isolates. SIGNIFICANCE AND IMPACT OF THE STUDY: S. Typhimurium DT104 is known for two decades and has a great impact on human health causing serious food-borne diseases. Our results suggest the existence of a positive correlation between acid resistance and pathogenicity in S. Typhimurium DT104 as all high acid-resistant strains were isolated from humans.     

高分辨率熔解曲线分析技术检测结核分枝杆菌的耐药性

目的:探讨高分辨率熔解曲线分析(High resolution melting,HRM)技术检测结核分枝杆菌耐药突变位点的可行性。方法:对218株结核分枝杆菌进行利福平(RFP)和异烟肼(INH)的药物敏感性测定,并进行耐药基因位点的PCR扩增和测序,同时采用HRM方法检测RFP和INH耐药基因位点情况,分析HRM的敏感性和特异性。结果:218株结核分枝杆菌药敏试验结果显示,有106株(48.6%)对RFP耐药,100株(45.9%)对INH耐药,81株(37.4%)对RFP和INH均耐药。测序发现,101株(46.3%)存在RFP耐药基因的突变,107株(49.1%)存在INH耐药基因的突变。HRM检测结果显示,100株(45.9%)存在RFP耐药基因的突变,103株(47.2%)存在INH耐药基因的突变。分别以药敏试验和测序结果为标准,HRM检测RFP耐药的敏感性为94.3%(100/106)和99.0%(100/101);特异性为97.3%(109/112)和100%(117/117);INH耐药的敏感性为97.0%(97/100)和98.1%(103/105);特异性为97.3%(109/112)和100%(113/113)。结论:HRM快速检测结核分枝杆菌耐药具有较高的特异性和灵敏度,能够满足临床需求。