218例表皮葡萄球菌的耐药性分析

目的了解3年内218例表皮葡萄球菌的耐药性,指导临床合理使用抗生素,方便临床采取更有效的治疗措施。方法对2007年1月至2009年12月间盛泽医院218例感染患者的各个感染部位进行表皮葡萄球菌的分离和耐药性检测,根据药物敏感试验结果来分析其耐药性的变化。结果 218株分离的表皮葡萄球菌中,耐甲氧西林菌株(MRSE)160株,占总数的73.4%,甲氧西林敏感菌株(MSSE)58株,占26.6%,未发现对万古霉素耐药的菌株,MRSE对大部分抗生素有较高的耐药率,MSSE则对大多数抗生素保持较低的耐药率。结论表皮葡萄球菌的分布广泛,耐药情况日趋严重,合理使用抗菌药物以延缓细菌耐药性的产生非常重要。     

十二烷基苯磺酸钠对产膜表皮葡萄球菌黏附作用影响初探

目的通过阴离子表面活性剂十二烷基苯磺酸钠针对表皮葡萄球菌生物被膜菌黏附抑制作用的研究,为临床抗表皮葡萄球菌生物被膜菌引起的相关感染探索新的研究方向和可能的治疗途径。方法以红霉素为阳性对照,利用XTT减低法评价十二烷基苯磺酸钠对表皮葡萄球菌初始黏附的影响。结果十二烷基苯磺酸钠在1 000、100mg/L浓度下对表皮葡萄球菌初始黏附均有抑制作用;以浓度为1 000mg/L十二烷基苯磺酸钠对实验材料进行预处理,对表皮葡萄球菌初始黏附有明显抑制作用。结论阴离子表面活性剂十二烷基苯磺酸钠在特定浓度下对表皮葡萄球菌产生物被膜菌的初始黏附有抑制作用。     

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.     

826株临床分离葡萄球菌的鉴定和耐药性研究

目的：研究葡萄球菌感染病原菌的分类、分布特点及对常用抗生素的耐药性。方法：应用MicroScan WalkAway-40全自动微生物分析仪对临床标本中分离的826株葡萄球菌进行鉴定和药敏试验。结果：826株葡萄球菌感染中,其中金黄色葡萄球菌(SA)294株占35．6％,表皮葡萄球菌为主的凝固酶阴性细菌(CNS)532株占65．4％。葡萄球菌分离株主要来源于呼吸道(46％)和泌尿道(23．7％)。MRS的产生率分别为金黄色葡萄球菌77．9％,表皮葡萄球菌80．3％,溶血葡萄球菌74．8％,腐生葡萄球菌82．5％,其他78．5％。MRSA、MRCNS对青霉素G、氨苄西林、苯唑西林几乎全部耐药,对万古霉素、阿米卡星、利福平、头孢哌酮／舒巴坦仍敏感,但发现3例万古霉素低敏株。结论：葡萄球菌感染仍以呼吸道和泌尿道为主,MRS菌株高达70％以上,万古霉素、阿米卡星、利福平、头孢哌酮／舒巴坦仍是治疗的首选药物。     

血流感染患者表皮葡萄球菌与金黄色葡萄球菌的分布与耐药性分析

目的比较血流感染患者表皮葡萄球菌与金黄色葡萄球菌的耐药性差异,为临床合理选用抗菌药物提供参考。方法对贵州医科大学第三附属医院2011年6月至2014年11月血流感染标本中分离出的表皮葡萄球菌与金黄色葡萄球菌共140株进行比较分析,按照《全国临床检验操作规程》进行微生物鉴定,采用K-B纸片法进行药敏试验,药敏结果按美国临床和实验室标准化协会(CLSI)的标准判断,数据采用SPSS 17.0软件进行统计分析。结果血流感染标本共分离出表皮葡萄球菌与金黄色葡萄球菌140株,其中表皮葡萄球菌分离出88株,占62.86%;金黄色葡萄球菌分离出52株,占37.14%。血流感染表皮葡萄球菌与金黄色葡萄球菌对苯唑西林、头孢唑林、头孢噻肟、克林霉素、红霉素、阿奇霉素、环丙沙星、氧氟沙星、利福平、呋喃妥因、头孢噻吩、亚胺培南、左氧氟沙星、麦迪霉素、复方新诺明等耐药率分别为81.82%,45.15%;35.23%,15.38%;20.45%,5.77%;47.73%,26.92%;76.14%,51.92%;69.32%,50.00%;64.77%,9.62%;54.55%,28.85%;14.77%,0.00%;10.23%,0.00%;39.77%,3.85%;11.36%,0.00%;54.55%,28.85%;67.05%,5.77%;79.55%,32.69%;表皮葡萄球菌耐药率明显高于金黄色葡萄球菌,差异有性统计学意义(P0.05)。结论血流感染中表皮葡萄球菌的感染率与耐药率不断上升,耐药率明显高于金黄色葡萄球菌,应引起重视。     

372株溶血葡萄球菌的临床分布及耐药性

目的了解医院4年来溶血葡萄球菌的临床分布特征及耐药性变化,为临床合理用药提供参考依据。方法回顾性分析2010年1月至2013年12月住院患者标本分离的372株溶血葡萄球菌,采用美国BD Phoenix 100全自动细菌鉴定药敏分析仪及其配套GP检测卡进行药敏分析。结果分离的372株溶血葡萄球菌主要分布于ICU、呼吸内科和外科,主要来源于痰液、尿液和伤口分泌物;未检测到万古霉素耐药菌株,对阿莫西林/克拉维酸、氨苄西林、苯唑西林、红霉素、青霉素、头孢西丁均保持90%以上的高耐药性,对其它抗生素均存在不同程度耐药性。结论溶血葡萄球菌耐药现象日益严重,且多重耐药现象呈上升趋势,临床在治疗此类细菌感染时,应根据药敏试验结果制定用药方案,减少经验用药。     

表皮葡萄球菌生物膜形成机制及调控

表皮葡萄球菌已成为目前医源性感染的重要病原体,其致病性得到人们的广泛关注。通过研究发现,表葡主要通过对进入体内的医源性植入物的黏附、聚集、增殖形成有层次的功能性生物膜,把细菌包裹在内,这样细菌不仅可以逃避宿主的免疫损伤,还可以抵御多种抗生素作用。为了保证生物膜的稳定性,表葡还有agr系统,控制生物膜中细菌的数量,当生物膜足够厚时,agr系统就会通过多种方式使表面的生物膜部分脱落,并播散到宿主的其它器官或组织引起感染的扩散。除此之外,表葡之所以成为医源性感染的重要病原体,还有一个原因就是它具有灵活多变的基因,是自然界多种细菌基因的"储存库",它们通过不断的基因片段的传递,使耐药基因等在表葡中广泛传播。     

五倍子水煎剂对表皮葡萄球菌生物膜抑制的研究

通过五倍子水煎剂对表皮葡萄球菌MIC测定和生物膜形成干预的研究,为表皮葡萄球菌引起感染提供新的治疗途径。用微量肉汤稀释法分别测定五倍子水煎剂对表皮葡萄球菌的MIC;刚果红及刚果红红霉素、五倍子水煎剂琼脂平板测定表皮葡萄球菌PIA生成与抑制;五倍子水煎剂、红霉素干预表皮葡萄球菌生物膜形成,于光镜和电镜下观察其生物膜形态。134株表皮葡萄球菌五倍子水煎剂的MIC50为0.488 mg/mL,MIC90为0.977 mg/mL。134株表皮葡萄球菌中有50株为PIA阳性,PIA阳性的50株菌全部产生生物膜,红霉素对表皮葡萄球菌生物膜形成有抑制,而五倍子水煎剂则无。表皮葡萄球菌PIA的相互作用在其生物膜的生成中起主要作用;五倍子水煎剂对表皮葡萄球菌生长有明显的抑制但对生物膜形成无干预作用。     

232株金黄色葡萄球菌的临床分布特征及耐药性分析

目的了解金黄色葡萄球菌(金葡菌)临床分离株的感染分布特点及耐药现状,以便为临床感染治疗及预防提供帮助。方法收集南昌大学第二附属医院2007年1月至2009年12月临床分离的非重复金葡菌232株。常规方法进行菌株分离,血浆凝固酶、金葡菌单克隆抗体及Vitek-32型仪进行菌株鉴定,纸片扩散法测定菌株对抗菌药物的敏感性,头孢西丁法检测耐甲氧西林金葡菌(MRSA),WHONET5.5软件分析数据。结果下呼吸道标本中分离的金葡菌最多,占44.0%,其次是脓液(20.3%)和血液(18.1%)。232株金葡菌中共检测到MRSA 131株(56.6%),金葡菌对青霉素的耐药率最高(90.0%),对庆大霉素、左氧氟沙星、克林霉素、红霉素和四环素的耐药率均50.0%;耐药率在10.0%~50.0%的有阿米卡星、复方磺胺甲噁唑和夫西地酸;对替考拉宁耐药率非常低(1.3%);未出现耐万古霉素的菌株。结论下呼吸道及皮肤软组织是金葡菌的主要感染部位;金葡菌对临床常用抗菌药物的耐药率近3年来趋于稳定,糖肽类抗菌药物对其仍有非常强的抗菌活性。     

纳米银离子对表皮葡萄球菌生物膜形成过程的影响

目的探讨纳米银离子对表皮葡萄球菌(Staphylococcus epidermidis)生物膜(biofilm)形成过程的影响。方法采用摇床法,以纳米银离子含量不同的乙烯-醋酸乙烯酯(Ethylene-Vinyl acetate,EVA)塑料为细菌粘附载体,建立体外生物膜模型;将各个时间点培养好的标本放在扫描电子显微镜(Scanning Electron Microscopy,SEM)及倒置显微镜下观察空白组与纳米银离子干预组中生物膜的形成情况,并结合NIS-Element BR软件计算生物膜覆盖率(biofilm coverage rate,BCR);荧光探针SYTO9/PI标记生物膜内细菌、激光共聚焦显微镜(Confocal LaserScanning Microscopy,CLSM)结合生物膜图形结构分析软件(Image Structure Analyze,ISA)观察纳米银离子作用后各时间点生物膜的结构变化。结果 2 d组生物膜经SEM检测,纳米银离子干预组较空白对照组相比,细菌变稀疏,结构明显受到破坏。BCR检测,0.5 d时纳米银离子干预组较空白对照组相比差异没有统计学意义,但在1 d、2 d时BCR差异有统计学意义(P<0.05)。CLSM结合ISA软件分析结果显示,2 d时空白对照组与0.1%纳米银离子干预组生物膜厚度、平均扩散距离(average diffusion distance,ADD)和结构熵(textual entropy,TE),分别为17.55±2.08和11.33±0.98、3.12±0.30和1.93±0.13、5.79±和3.17±0.16(P<0.05);区域孔率(Areal porosity,AP)为0.90±0.01和0.98±0.01(P<0.05)。但5 d时2组参数之间差异没有统计学意义。0.05%纳米银离子组也有相同的趋势。结论纳米银离子对表皮葡萄球菌的形成有抑制作用,但随着时间的推移,其抗菌作用逐渐减弱。高浓度组较低浓度组抗菌效果更加明显,持续时间更长。     

Induction of resistance with heat-killed unencapsulated strains of Staphylococcus epidermidis against challenge with encapsulated strains of Staphylococcus epidermidis

Active immunization of mice with high doses of heat-killed unencapsulated strains of Staphylococcus epidermidis, which were grown in brain heart infusion media, protected mice against challenge with encapsulated strains of S. epidermidis. The unencapsulated strains were capable of absorbing the protective antibody in rabbit hyperimmune sera prepared with the encapsulated strains. Also, mice treated with rabbit hyperimmune sera prepared with the unencapsulated strains were protected against challenge with the encapsulated strains. The protective activities of these rabbit hyperimmune sera were assumed to be essentially identical to those of the protective antibody induced by the encapsulated strains.     

Insights on evolution of virulence and resistance from the complete genome analysis of an early methicillin-resistant Staphylococcus aureus strain and a biofilm-producing methicillin-resistant Staphylococcus epidermidis strain

Staphylococcus aureus is an opportunistic pathogen and the major causative agent of numerous hospital- and community-acquired infections. Staphylococcus epidermidis has emerged as a causative agent of infections often associated with implanted medical devices. We have sequenced the approximately 2.8-Mb genome of S. aureus COL, an early methicillin-resistant isolate, and the approximately 2.6-Mb genome of S. epidermidis RP62a, a methicillin-resistant biofilm isolate. Comparative analysis of these and other staphylococcal genomes was used to explore the evolution of virulence and resistance between these two species. The S. aureus and S. epidermidis genomes are syntenic throughout their lengths and share a core set of 1,681 open reading frames. Genome islands in nonsyntenic regions are the primary source of variations in pathogenicity and resistance. Gene transfer between staphylococci and low-GC-content gram-positive bacteria appears to have shaped their virulence and resistance profiles. Integrated plasmids in S. epidermidis carry genes encoding resistance to cadmium and species-specific LPXTG surface proteins. A novel genome island encodes multiple phenol-soluble modulins, a potential S. epidermidis virulence factor. S. epidermidis contains the cap operon, encoding the polyglutamate capsule, a major virulence factor in Bacillus anthracis. Additional phenotypic differences are likely the result of single nucleotide polymorphisms, which are most numerous in cell envelope proteins. Overall differences in pathogenicity can be attributed to genome islands in S. aureus which encode enterotoxins, exotoxins, leukocidins, and leukotoxins not found in S. epidermidis.     

表面活性剂溴化十六烷基吡啶对产膜表皮葡萄球菌粘附作用的影响

目的 通过表面活性剂溴化十六烷基吡啶抗表皮葡萄球菌生物被膜菌粘附作用的研究,为临床针对产膜表皮葡萄球菌引起的相关感染提供可能的探索方向和防治途径。方法 以万古霉素为阳性对照,利用XTT减低法,评价溴化十六烷基吡啶对表皮葡萄球菌初始粘附的影响。结果 浓度为4、2和1 mg/L的溴化十六烷基吡啶对表皮葡萄球菌初始粘附均有显著的抑制作用,与阴性对照组比较差异有统计学意义(t=0.4555~34.9664,P<0.01);用浓度为32、16、8和4 mg/L的溴化十六烷基吡啶对实验材料预处理后,对表皮葡萄球菌初始粘附抑制作用明显,与阴性对照组比较差异有统计学意义(t=1.1125~21.9246,P<0.001)。结论 溴化十六烷基吡啶无论是直接作用或是对实验材料预处理,对表皮葡萄球菌形成生物被膜的初始粘附过程具有显著抑制作用。     

The molecular characteristic of Staphylococcus aureus and Staphylococcus epidermidis strains isolated from clinical sources

The aim of study was the molecular characteristic of S. aureus and S. epidermidis isolates obtained from skin surface, wounds, deep tissues of hospitalized patients and from skin surface of non-hospitalized patients. Genes encoding virulence factors were examined using PCR reaction and specific primers. Genes encoding adhesinsfnbA and cna and gene eta for epidermolytic toxin were mostly present in S. aureus isolates coming from wounds and deep tissues compared to these from skin surface. Gene atlE encoding autolysin of S. epidermidis was detected in all studied isolates, whereas gene icaAB was present in almost all isolates. Comparison of results obtained by PCR and conventional method of the resistance to methicillin estimation showed discrepances suggesting the need for using of both methods in some clinically difficult cases of S. aureus infection.     

Effect of allicin on the production of polysaccharide intercellular adhesin in Staphylococcus epidermidis

Aims: Polysaccharide intercellular adhesin (PIA) is the main agglutination agent in the biofilm forming strain Staphylococcus epidermidis. To find an explanation for the observed inhibition of biofilm formation by allicin, we studied the effect of allicin on PIA production in samples treated with sub MIC doses of allicin and compared this with a control culture without allicin. Methods and Results: Bacteria (Staph. epidermidis ATCC 35984) were grown in glass tubes, and PIA was extracted by vortex vibration using microbeads and NN dimethyl acetamide/LiCl as solvent. The extracts were filtered and passed through size exclusion columns. Chromatographic fractions were analysed with an excess of sodium metaperiodate and the excess was determined spectrophotometrically using 2,4,6‐tripyridyl‐s‐triazine. Conclusion: The amount of exopolysaccharides in samples previously treated with allicin is significantly lower than in the control. This finding suggests a specific enzymatic inhibition in PIA synthesis. Significance and Impact of the Study: This study provides an insight into the mechanism of biofilm formation, and is a biochemical model for PIA inhibition by allicin. The analysis proposed may be useful in studies of production of exopolysaccharides responsible for adherence and agglutination of Staph. epidermidis. Prevention of biofilm formation by allicin opens up a new field of in vitro studies and permits us to envisage future clinical applications.     

Staphylococcus epidermidis strains isolated from breast milk of women suffering infectious mastitis: potential virulence traits and resistance to antibiotics

Background  

AlthoughStaphylococcus aureusis considered the main etiological agent of infectious mastitis, recent studies have suggested that coagulase-negative staphylococci (CNS) may also play an important role in such infections. The aims of this work were to isolate staphylococci from milk of women with lactational mastitis, to select and characterize the CNS isolates, and to compare such properties with those displayed by CNS strains isolated from milk of healthy women.