Clinical experience with the treatment of severe nosocomial infections by inhibitor-protected 3rd generation cephalosporin cefoperazone/sulbactam]

A retrospective analysis of the clinical and microbiological efficacy and safety of cefoperazone/sulbactam in the treatment of 39 cardiosurgical patients operated under the conditions of artificial circulation is presented. The age of the adult patients (n = 28) varied from 44 to 58 years and that of the pediatric patients varied from 4 months to 6 years. Antibacterial therapy of 26 patients was needed because of postoperative infectious complications, such as nosocomial pneumonia in 22 patients and sepsis in 4 patients. The antibacterial therapy with cefoperazone/sulbactam in 9 patients was performed during the operation because of active infectious endocarditis. In 4 patients there were observed clinical and laboratory signs of infection without the infection foci. The initial empirical therapy with cefoperazone/sulbactam was applied to 14 patients (group 1) and the target-aimed therapy based on the data of the pathogen susceptibility to cefoperazone/sulbactam was used in 6 patients (group 2). 19 patients (group 3) were treated with cefoperazone/sulbactam because of the fail of the previous antibacterial therapy, including the 4th generation cephalosporins and carbapenems as well. Cefoperazone/sulbactam was used in the monotherapy of 15 cases (38%). Cefoperazone/sulbactam showed high efficacy in the treatment of severe nosocomial infections and infectious endocarditis (in combination with vancomycin or linezolid). It amounted to 93, 100 and 79% in groups 1, 2 and 3 respectively, the total of 94%. The results of the microbiological assay were evident of the cefoperazone/sulbactam high activity against the problem gram nagative isolates of Klebsiella pneumoniae (n = 12), Acinetobacter baumanii (n = 4), Pseudomonas aeruginosa (n = 4) and Stenotrophomonas maltophilia (n = 5). Adverse reactions were stated in 2 patients (5%), 1 case of urticaria requiring discontinuation of the drug use. Many of the patients proved to be colonized by MRS before the therapy with cefoperazone/sulbactam. The high probability of staphylococcal superinfection required combination of cefoperazone/sulbactam with antistaphylococcal agents, such as rifampicin, fusidin, vancomycin, linezolid. The best results were provided by the target-aimed therapy based on the microbiological monitoring.     

Bacteriostatic or bactericidal effect of linezolid against multiresistant Streptococcus pneumoniae

The nasopharynx plays a critical role as the reservoir of Streptococcus pneumoniae, including drug-resistant strains particularly in children attending day care centers. A total 58 nasopharyngeal, multiresistant isolates of S. pneumoniae collected from healthy pre-school children were susceptible to linezolid (MIC = 0.25-1 mg/l), irrespective of serotype and drug resistance pattern. The majority of them (about 94%) were sensitive to the bactericidal effect of linezolid with MBCs = 0.5-4 mg/l. One isolate was killed at 8 mg/l of linezolid, while two at higher concentrations of this antibiotic with MBCs 16 or 32 mg/l, suggesting tolerance of linezolid. BOX-PCR fingerprinting data imply that two linezolid-tolerant strains belonged to distinct clones. Linezolid tolerance was confirmed by monitoring the viability of these isolates during exposure to 4 or 20 mg/l of this antibiotic. The linezolid-tolerant strains were sensitive to the bactericidal effect of vancomycin. Linezolid tolerance in clinical isolates of pneumococci may represent a potential therapeutic risk, especially in infections in which bactericidal activity of drug is critical for eradication of bacteria.     

Comparison of M.I.C.E. and Etest with CLSI Agar Dilution for Antimicrobial Susceptibility Testing against Oxacillin-Resistant Staphylococcus spp

Objective

The main objective of this study was to comparatively evaluate the performance of M.I.C.E. and Etest methodologies to that of agar dilution for determining the antimicrobial susceptibility profile of oxacillin-resistant Staphylococcus spp.

Methods

A total of 100 oxacillin-resistant Staphylococcus spp. isolates were collected from hospitalized patients at a teaching hospital. Antimicrobial susceptibility testing for vancomycin, teicoplanin and linezolid was performed using the reference CLSI agar dilution method (2009), Etest and M.I.C.E. methodologies. The MIC values were interpreted according to CLSI susceptibility breakpoints and compared by regression analysis.

Results

In general, the essential agreement (±1-log₂) between M.I.C.E. and CLSI agar dilution was 93.0%, 84.0% and 77.0% for linezolid, teicoplanin and vancomycin, respectively. Essential agreement rates between M.I.C.E. and Etest were excellent (>90.0%) for all antibiotics tested. Both strips (M.I.C.E. and Etest) yielded two very major errors for linezolid. Unacceptable minor rates were observed for teicoplanin against CoNS and for vancomycin against S. aureus.

Conclusions

According to our results, linezolid and teicoplanin MICs against all staphylococci and S. aureus, respectively, were more accurately predicted by M.I.C.E. strips. However, the Etest showed better performance than M.I.C.E. for predicting vancomycin MICs against all staphylococci. Thus, microbiologists must be aware of the different performance of commercially available gradient strips against staphylococci.     

白内障术后感染性眼内炎的致病菌分析及影响因素研究

目的:分析白内障术后感染性眼内炎的致病菌分布情况,并对其影响因素进行分析。方法:选取2016年8月~2019年3月期间于我院行白内障手术的患者2936例,统计白内障术后感染性眼内炎的发生情况。分析术后感染性眼内炎患者的病原菌分布情况及病原菌耐药情况。单因素及多因素Logistic回归分析术后感染性眼内炎发生的影响因素。结果:本研究中,共发放2936份调查问卷,回收2931份,回收率为99.83%(2931/2936)。其中53例患者患有感染性眼内炎,发生率为1.81%(53/2931),根据患者是否患有感染性眼内炎分为感染组(n=53)和未感染组(n=2878)。感染性眼内炎的病原菌检出41株,其中革兰阳性菌37株,占90.24%;共检出4株真菌,为白色假丝酵母菌,占比9.76%。37株革兰阳性菌中,头状葡萄球菌、表皮葡萄球菌以及腐生葡萄球菌对利福平、利奈唑胺以及万古霉素的敏感度达100.00%。感染组和未感染组在性别、住院时间、玻璃体溢出方面比较差异均无统计学意义(P>0.05);两组在麻醉药时间、年龄、手术切口、手术时间、高血压、糖尿病方面比较差异均有统计学意义(P<0.05)。多因素Logistic回归分析结果显示:年龄≥66岁、手术切口为透明角膜、手术时间≥15 min、合并糖尿病均是发生感染性眼内炎的危险因素(OR=2.759、2.676、1.601、1.261,P<0.05)。结论:白内障术后感染性眼内炎的致病菌较多,以革兰阳性菌为主,革兰阳性菌对利福平、利奈唑胺、万古霉素的敏感度较高,年龄≥66岁、手术切口为透明角膜、手术时间≥15 min、合并糖尿病均会增加术后感染性眼内炎发生的风险。     

In vitro susceptibility of staphylococci to linezolid and other antimicrobial agents

Linezolid is a member of the new class of antibacterial agents called oxazolidinones that are active against Gram positive organisms and exert their action by protein synthesis inhibition. In this study we investigated the in vitro activity of linezolid versus the other agent against clinical strains of staphylococci: Staphylococcus aureus (n = 82) and S. epidermidis (n = 32) collected in 2002 from hospitalized patients and healthy individuals, isolated from different biological samples. Agar dilution minimum inhibitory concentrations (MICs) were determined by using Mueller-Hinton agar according to the guidelines established by the National Committee for Clinical Laboratory Standards. Linezolid demonstrated excellent in vitro activity against all isolates tested, with MICs values in the range of susceptibility (< or = 8 microg/ml). No associated resistance between linezolid and other agents tested was observed. The resistance among Gram positive bacteria continues to spread and for many patients infected with these resistant organisms antimicrobial therapy is ineffective and linezolid may be a new alternative treatment.     

Buprenorphine detoxification from opioid dependence: a pilot study

Sixteen opioid dependent patients were assigned to treatment with buprenorphine for one month at three doses--2 mg (n = 10), 4 mg (n = 4), 8 mg (n = 2). Treatment retention was excellent--only one patient left due to withdrawal symptoms. Illicit opioid use was infrequent, with only 22% of the urines containing illicit opioids. Although buprenorphine dose was not associated with retention or illicit opioid use, patterns of withdrawal symptoms differed among dosage groups during the 30 day study. The 4 mg group had a substantial decline in symptoms, while the other two groups did not. Symptom levels were comparable to those during successful clonidine detoxification and much lower than those found in clonidine failures.     

Comparison of linezolid and vancomycin in nosocomial pneumonia: results of the multicenter double-blind study]

The results of multicenter, randomized, double-blind comparative study of linezolid and vancomycin efficacy, safety and tolerability in the treatment of nosocomial pneumonia are presented. The trial was performed on 69 patients. Clinical efficacy of linezolid was 83 per cent, of vancomycin--79 per cent. Bacteriological effect (pathogen eradication) was 83 per cent for linezolid group and 86 per cent for vancomycin group. During the study good clinical tolerability of linezolid was demonstrated along with lower side effects incidence and shortened recovery period when compared to vancomycin.     

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.     

Problems of prophylaxis and treatment of infectious complications in reconstructive surgery]

Infectious complications due to polyresistant staphylococci as well as strepto- and enterococci are of serious problem in reconstructive surgery, since the number of such strains isolated within 1999-2004 has amounted to 58.4-59.7% of all the isolates. Susceptibility testing of 195 isolates showed that 100% of them was susceptible to linezolid that was used in the postoperative treatment of 28 patients after reconstructive surgical operations including those with artificial circulation under conditions of a multiprofile surgical hospital. Linezolid proved to be a highly effective agent in the prophylaxis and treatment of infectious complications due to polyresistant grampositive pathogens. Step-by-step therapy with linezolid was shown possible. In the treatment of pediatric cases no side effects of linezolid were recorded.     

环磷酰苷葡胺注射液治疗心功能不全121 例分析

目的：观察环磷酰苷葡胺注射液治疗充血性心力衰竭的疗效。方法：将243例充血性心力衰竭患者随机分为两组：观察组121例,对照组122例。对照组患者给予地高辛0．125-0．25mg或西地兰0．2mg加入注射用水20ml,每日1—2次静推,利尿剂给予速尿20—40mg。隔日口服或静推,同时补钾3次／日,疗程4—8周。观察组在应用上述药物的基础上,给予5％葡萄糖200—500ml加入环磷酰苷葡胺注射液60-80mg,1次／日静点,或25％葡萄糖加入环磷酰苷胺注射液90mg 1次／日静推,疗程4—8周。结果：两组心功能较治疗前明显改善。结论：环磷酰苷胺治疗充血性心力衰竭疗效确切,安全可靠,值得临床推广应用。     

Inhibition of vancomycin-induced nephrotoxicity by targeting superoxide dismutase to renal proximal tubule cells in the rat

Vancomycin, a glycopeptide antibiotic, has a broad spectrum against methicillin-resistant Staphylococcus aureus (MRSA). Because vancomycin induces renal dysfunction, the dose and the duration of its administration are limited. The mechanism of vancomycin-induced renal dysfunction is not known. We recently synthesized a hexamethylenediamine-conjugated cationic superoxide dismutase (AH-SOD) which rapidly accumulates in renal proximal tubule cells and inhibits oxidative injury of the kidney. The present work reports the protective effects of AH-SOD against vancomycin-induced renal dysfunction. Male Wistar rats (200-210 g) were intraperitoneally administered with either 200 or 400 mg/kg of vancomycin twice a day for 7 days. Either 5 mg/kg/day AH-SOD or saline was subcutaneously injected 5 min before every vancomycin injection. Biochemical analysis revealed that plasma levels of blood urea nitrogen and creatinine increased significantly in vancomycin-treated group by an AH-SOD-inhibitable mechanism. Histological examination revealed that vancomycin also elicited a marked destruction of glomeruli and necrosis of proximal tubule by an AH-SOD inhibitable mechanism. These results suggest that oxidative stress underlies the pathogenesis of vancomycin-induced nephrotoxicity and that targeting SOD and/or related antioxidants to renal proximal tubule cells might permit the administration of higher doses of vancomycin sufficient for eradication of MRSA without causing renal injury.     

Impact of Molecular Epidemiology and Reduced Susceptibility to Glycopeptides and Daptomycin on Outcomes of Patients with Methicillin-Resistant Staphylococcus aureus Bacteremia

Background

Methicillin-resistant Staphylococcus aureus (MRSA) bacteremia was associated with high mortality, but the risk factors associated with mortality remain controversial.

Methods

A retrospective cohort study was designed. All patients with MRSA bacteremia admitted were screened and collected for their clinical presentations and laboratory characteristics. Minimum inhibitory concentration (MIC) and staphylococcal cassette chromosome mec (SCCmec) type of bacterial isolates were determined. Risk factors for mortality were analyzed.

Results

Most MRSA isolates from the 189 enrolled patients showed reduced susceptibility to antibiotics, including MIC of vancomycin ≥ 1.5 mg/L (79.9%), teicoplanin ≥ 2 mg/L (86.2%), daptomycin ≥ 0.38 mg/L (73.0%) and linezolid ≥ 1.5 mg/L (64.0%). MRSA with vancomycin MIC ≥ 1.5 mg/L and inappropriate initial therapy were the two most important risk factors for mortality (both P < 0.05; odds ratio = 7.88 and 6.78). Hospital-associated MRSA (HA-MRSA), carrying SCCmec type I, II, or III, was associated with reduced susceptibility to vancomycin, teicoplanin or daptomycin and also with higher attributable mortality (all P < 0.05). Creeping vancomycin MIC was linked to higher MIC of teicoplanin and daptomycin (both P < 0.001), but not linezolid (P = 0.759).

Conclusions

Giving empirical broad-spectrum antibiotics for at least 5 days to treat catheter-related infections, pneumonia, soft tissue infection and other infections was the most important risk factor for acquiring subsequent HA-MRSA infection. Choice of effective anti-MRSA agents for treating MRSA bacteremia should be based on MIC of vancomycin, teicoplanin and daptomycin. Initiation of an effective anti-MRSA agent without elevated MIC in 2 days is crucial for reducing mortality.     

Time-kill study and synergistic activity of cell-wall inhibitor antibiotics in combination with gentamicin against Enterococcus faecalis and Enterococcus faecium

The synergy between gentamicin and vancomycin, teicoplanin, ampicillin and linezolid was studied by time-kill method. Two clinical vancomycin resistant enterococci (VRE) and two vancomycin susceptible enterococci (VSE) isolates were used. Different concentrations of antibiotics were combined. Two VSE strains and the control strain exhibited synergism with the combination of gentamicin, vancomycin, teicoplanin, ampicillin and linezolid. Two VRE strains exhibited synergism with the combination of gentamicin and ampicillin. Synergy between gentamicin and vancomycin, teicoplanin and linezolid was not observed against these isolates. The VRE isolates were positive for vanA, aac (6')-Ie aph (2") and aph (3')-IIIa genes and their vancomycin, teicoplanin and gentamicin MICs were 512 μg/ml, 512 μg/ml and >4000 μg/ml, respectively. In order to treat serious enterococcal infections, further clinical evaluation is needed to examine the in vitro combined effects of gentamicin and vancomycin, teicoplanin and linezolid.     

Hypoglycemia of squirrel monkey neonates: implications for infant survival

Neonatal deaths are a serious problem in breeding colonies of squirrel monkeys. Seriously ill neonates in our colony are always hypoglycemic on presentation. To determine normal glucose values for squirrel monkey infants of various ages, serum glucose determinations were done at 1, 3, 7, 10, 14 days and 1 month of age using a standard laboratory test for serum glucose. Glucose concentration increased from a low of 49 +/- 3 mg/dl (Mean +/- SEM) at 1 day (n = 21) to 109 +/- 4 mg/dl at 1 month of age (n = 17). Glucose values for 1, 3 and 7 day-old infants were significantly lower than 1 month-old infants (P less than .05). To provide a time-averaged indication of blood glucose, glycosylated hemoglobin (GHb) measurements were made at 1 day, 1 week, 2 weeks, 1 month, 2 months, 1 year of age and in adults (greater than 3 years of age). GHb values ranged from 2.6% +/- 0.1 for 1 day old infants (n = 13) to 4.0 +/- 0.2 for adults (n = 10) with a steady increase during the first 2 months of life. Animals 1 year of age and younger had significantly lower glycosylated hemoglobin than adults. These studies indicate that blood glucose concentration is significantly lower in squirrel monkey neonates than in older infants, juveniles and adults. Maternal rejection, trauma, and associated problems occur commonly in socially reared squirrel monkeys. The marginal hypoglycemic state of these infants places them at high risk for clinical hypoglycemia as a sequel to such perturbations.     

An in vitro time-kill assessment of linezolid and anaerobic bacteria

Linezolid is a novel oxazolidinone antibacterial agent active against staphylococci (including methicillin-resistant strains), enterococci (including vancomycin-resistant strains), streptococci (including penicillin-intermediate and -resistant Streptococcus pneumoniae), and other aerobic and facultative bacteria. The agent has also demonstrated activity against a broad spectrum of Gram-positive and Gram-negative anaerobic bacteria. Previous time-kill assessments have shown linezolid to be generally bacteriostatic against staphylococci and enterococci, and bactericidal against streptococci. In this study, an anaerobic glovebox technique was employed to conduct time-kill assessments for four strains of anaerobic Gram-positive, and seven strains of anaerobic Gram-negative bacteria. The time-kill experiment was performed using Anaerobe Broth medium. The drugs were tested at four-fold the minimum inhibitory concentration (MIC), or at the higher concentration of 8mg/L for linezolid, 2mg/L for clindamycin, and 8mg/L for metronidazole. Samples for viable count were taken at 0, 6, and 24h, and plated using the Bioscience International Autospiral DW. Exposure of samples to the aerobic environment during plating was held to less than 30min. Plates were counted after a 48h anaerobic incubation (37 degrees C). The species tested included Bacteroides fragilis (2), B. distasonis, B. thetaiotaomicron, Fusobacterium nucleatum, F. varium, Prevotella melaninogenica, Clostridium perfringens, Eubacterium lentum and Peptostreptococcus anaerobius (2). The activity of linezolid was compared to that of metronidazole and clindamycin, two standard anti-anaerobe agents. As expected, the control agents were very active in these assays. Metronidazole yielded log(10)CFU/mL reductions of 3.0 or greater for nine of ten strains; clindamycin yielded log(10)CFU/mL reductions of 2.0 or greater for six of 11 strains, and 3.0 or greater for three strains. Linezolid also produced significant in vitro killing in this model achieving log(10)CFU/mL reductions of 2.0 or greater for six of 11 strains, and 3.0 or greater for four strains. The profile of activity was similar to that of clindamycin indicating that additional developmental studies of linezolid with anaerobic bacteria are warranted.     

Exposure to Hyperbaric Oxygen Intensified Vancomycin-Induced Nephrotoxicity in Rats

It has been suggested that oxidative stress is a potential mechanism for vancomycin-induced nephrotoxicity and hyperbaric oxygen therapy (HBO) has been shown to be effective in treating renal toxicity that has been pharmacologically induced in animal models. The aim of this study was to investigate the effect of HBO therapy on vancomycin-induced nephrotoxicity in rats. The study group comprised 36 Sprague Dawley male rats. We treated 30 with 500 mg/kg of intraperitoneal vancomycin once a day for 7 days. Half of these rats received a daily 1-hour treatment with HBO at 2 Atmospheres (ATM) on the same 7 days and formed the HBO+ group. The other 15 subjects received no HBO treatment (HBO- group). The remaining six rats served as the control group, three received HBO treatments alone and no treatment was administered to the other three rats. Laboratory results were obtained on day 8 and the intervention and control groups were compared. Rats in the HBO+ group gained less weight than the HBO- group (11.6 grams vs 22.6 grams; P = 0,008) and had significantly higher serum blood urea nitrogen (99.6 vs 52.6 mg/dL; P<0.001), serum creatinine (0.42 vs 0.16 mg/dL; P = 0.001) and magnesium (3.6 vs 3.1mg/dL; P = 0.014). The vancomycin blood levels were also higher in the HBO+ group (27.8 vs 6.7 μg/mL; P = 0.078). There were no pathological kidney changes in the control group. All the kidneys from the treated groups (vancomycin +HBO and vancomycin HBO-) showed moderate to severe histopathological changes with no statistical significance between them. This study demonstrated that exposure to hyperbaric oxygen intensified vancomycin-induced nephrotoxicity in rats.     

Effect of beta-carotene administration on reproductive function of horse and pony mares

The objective of this study was to determine whether supplemental beta-carotene would influence reproductive function in mares maintained on spring and summer pastures and to characterize plasma carotene concentrations during the estrous cycle. Carotene concentrations in plasma did not vary with day of estrous cycle (P = 0.7455). Mares receiving every other day injections of beta-carotene (400 mg; n = 4) or saline (10 ml; n = 4) during proestrus/estrus did not differ in plasma estradiol (E(2)) concentrations (P = 0.6313), follicle development (P = 0.8068), or plasma progesterone (P(4)) concentrations during the following diestrus (P = 0.4954). Moreover, no differences in plasma P(4) concentrations (P = 0.9047) were detected between mares receiving every other day injections of beta-carotene (400 mg; n = 4) or saline (10 ml; n = 4) during diestrus. However, administration of beta-carotene raised plasma carotene concentrations relative to controls when injected during proestrus/estrus (P = 0.0096) and diestrus (P = 0.0099). Pregnancy rates (P = 0.4900) and number of cycles required for pregnancy (P = 0.2880) were similar for mares administered injections of saline (10 ml; n = 37), beta-carotene (400 mg; n = 37), vitamin A (160,000 IU; n = 38), or vitamin A + beta-carotene (160,000 IU + 400 mg; n = 43), on the first or second day of estrus and on the day of breeding. Therefore, these results collectively suggest that supplemental beta-carotene does not affect the reproductive function of mares fed adequate dietary carotene. Whether supplemental beta-carotene would enhance reproductive function in mares on low carotene diets warrants further investigation.     

Age-related specifics of aldosterone reception in distal segments of the rat nephrons and of Na(+), K(+)-ATPase expression induction

The reason of unresponsiveness of young 10-day rats kidney to aldosterone was explored. The aldosterone binding in distal segments of renal nephrons and the influence of hormonal induction on the mRNA of the alpha and beta subunits of the Na+, K(+)-ATPase in 10-day and 2-month old rats were investigated. There was no age related difference in the aldosterone specific binding in presence of RU-38486 (10(-7) M; Russel Uclaf) in the cortical collecting tubules: 0.26 +/- 0.04 (n = 9) and 0.22 +/- 0.03 (n = 8) mMol/mm of tubule lengths in 10 day and adult rats, respectively. By Nozern blot analysis and RT-PCR more then three and two fold increase of the mRNA abundance of both subunits was found in young and adult renal cortex compare to the adrenalectomized control after aldosterone induction (5 micrograms/100 g. v. b. w. 4 times i/p injections in 3 hour interval between injections) (p < 0.01). By RT-PCR no expression of the alpha 2, alpha 3 and beta 2 isoforms has been observed in all experimental conditions. The age difference was discovered when aldosterone was injected together with spironolactone (5 micrograms and 12 mg per 100 g. b. w. respectively). It was shown, that spironolactone inhibits the effect of aldosterone in adults whereas the latter was unaffected in young rats. The scheme of the age-related differences in the aldosterone regulation of the sodium pump induction in the target cell of the distal part of the rat nephrons is presented.     

Glycopeptide antibiotics: eremomycin, vancomycin, and teicoplanin. Comparison of several parameters of pharmacokinetics and antimicrobial activity

Pharmacokinetic parameters of eremomycin (Institute of New Antibiotics, the USSR Academy of Medical Sciences), teichoplanin (Lepetit) and vancomycin (Eli Lilly) were compared after their intravenous administration to rats in the same dose of 50 mg/kg. It was shown that the area under the concentration time curve of eremomycin was 2 times smaller than that of teichoplanin and 6 times larger than that of vancomycin. The mean retention time of eremomycin was close to that of teichoplanin and 1.6 times higher than that of vancomycin. Bioavailability of eremomycin and teichoplanin after their extravascular administration was the same and amounted to 94 per cent. Antibacterial activity of eremomycin against methicillin resistant strains of staphylococci was 4 times higher than that of teichoplanin and vancomycin.     

不同病区血培养病原菌分布及耐药性分析

目的 了解各病区血培养分离病原菌的分布特点及其耐药性,指导临床医生合理有效地使用抗生素.方法 对宁波市泌尿肾病医院·鄞州第二医院2008年8月至2011年7月临床送检的8409例血液标本经Bact/A-lert3D全自动血培养仪培养,分离所得菌用美国德灵公司Walkaway 40系统进行鉴定和药敏.对检测结果进行统计学分析.结果 共检出病原菌853株,其中革兰阴性杆菌422株,革兰阳性球菌396株,真菌35株.血浆凝固酶阴性葡萄球菌占首位,其次分别为大肠埃希菌及肺炎克雷伯菌.检出菌数量居前三位的病区是重症监护病房、消化内科及肾内科.各病区的病原菌分布不尽相同.丁胺卡那、亚胺培南对大肠埃希菌、肺炎克雷伯菌显示出较高的敏感性,未发现耐利奈唑胺及万古霉素菌株.结论 该院血流感染病原菌以革兰阴性杆菌为主,各主要病区病原菌分布不尽相同,临床医生应跟据药敏结果合理有效地使用抗生素.