假丝酵母菌尿路感染临床观察及耐药性分析

目的 调查和分析尿路感染假丝酵母菌的分布及耐药情况,为临床合理选用抗菌药物提供依据.方法 尿液采用经典型浸片Uricult培养,使用ATB-Fungus板条进行药敏试验,利用WHONET 5.6对浙江萧山医院2008年1月至2012年12月间尿培养分离菌株及药敏结果进行回顾性分析.结果 共分离出假丝酵母菌273株,其中白假丝酵母菌占37.4％,光滑假丝酵母菌28.9％、热带假丝酵母菌27.8％;临床分离数量以ICU(58)最多,其次为泌尿外科(50)和内科(49).药敏结果显示:两性霉素B、5-氟胞嘧啶对白假丝酵母菌、热带假丝酵母菌和光滑假丝酵母菌仍保持较强的抗菌活性,敏感率≥98.6％,伏立康唑敏感率≥86.3％.结论 尿路感染分离得到的假丝酵母菌以白假丝酵母菌为主,其次为光滑假丝酵母菌和热带假丝酵母菌;两性霉素B、5-氟胞嘧啶对假丝酵母菌保持较强的抗菌活性,是治疗假丝酵母菌感染的首选药物.临床应重视假丝酵母菌的培养和其药敏试验,根据药敏结果科学合理使用抗真菌药物.     

Characteristics ofPseudomonas aeruginosa strains isolated from urinary tract infections

Thirty-three uropathogenic strains ofPseudomonas aeruginosa were investigated for hemolytic activity in both bacterial broth culture filtrates and isolate lyzates, resistance to bactericidal activity of fresh human serum, resistance to six antibiotics and plasmid DNA profile. Twenty-four of the 33 (73%) bacterial filtrates showed lysis of rabbit erythrocytes, as did the three after guinea-pig erythrocyte treatment. Twelve of 33 isolate lysates showed in parallel lysis of both types of erythrocytes used. Serum resistance was found in 17 (52%) isolates, intermediate resistance in 15 (45%) isolates and only one isolate showed serum sensitivity. Resistance to antibiotics was detected as follows (in %): tetracycline 94, kanamycin 79, chloramphenicol 76, septrin 73, ampicillin 64, streptomycin 45, gentamicin 18. None of the isolates investigated showed resistance to colistine. With the exception of one isolate, plasmid DNA was detected in allP. aeruginosa strains.     

Analysis of antibiotic resistance and virulence patterns in Klebsiella pneumoniae isolated from human urinary tract infections in India

In this study, 504 urine samples collected from patients suffering from urinary tract infection (UTIs) were screened for the presence of Klebsiella pneumoniae. The overall occurrence of Klebsiella spp. and K. pneumoniae was found to be 23·2% (117/504) and 16·8% (85/504) respectively. Antibiotic susceptibility testing of 85 K. pneumoniae isolates was carried out by disc diffusion which revealed alarming levels of antibiotic resistance (ABR). Antimicrobial resistance was prominently observed against cefpodoxime (76·47%) followed by ampicillin (70·59%), ceftriaxone (52·94%), cefoxitin (50·59%), amoxyclav (48·24%), ofloxacin (45·88%), cefotaxime (44·71%), cefepime (43·53%) and doxycycline hydrochloride (40%). A small percentage of strains also exhibited resistance to other antimicrobials in the range of 7–35%. Around 77·6% of the isolates were found to be resistant to three or more antibiotic classes and 66·7% of the isolates had multiple antibiotic resistance index values >0·2. Screening of virulence genes in 85 K. pneumoniae isolates revealed that uge gene was the most predominant (11/85, 12·9%), followed by rmpA (9/85, 10·5%), kfu (4/85, 4·7%) and aerobactin genes (2/85, 2·35%). Further, the overall percentage of biofilm producers were found to be 17·65% (15/85). This study warrants hospitals and health care centres to reduce misuse of antibiotics and manage UTI with appropriate treatment after performing antibiotic susceptibility testing.     

Occurrence of p-fimbriae in enteropathogenic E coli (EPEC) and in E. coli strains isolated from patients with urinary tract infections]

The aim of this study was to gain knowledge of prevalence of P+ clones among EPEC strains isolated from children with diarrhoea and E. coli strains isolated from urine. Three hundred eighty four E. coli strains isolated from children with diarrhoea were tested. They belonged to 11 serotypes (018, 025, 026, 044, 055, 0111, 0114, 0119, 0124, 0125, and 0128). Nine hundred thirty colonies of E. coli from Mac Conkey's agar plated quantitatively with urine samples of 178 individuals suffering from urinary tract infections were also tested. All strains were assayed by mannose-resistant active haemagglutination test (MRHA) and by slide agglutination using self prepared latex reagent for detection of P fimbriae. Out of 384 E. coli strains tested 122 (31.8%) showed presence of adhesins detected by mannose-resistant active haemagglutination test (MRHA) and in 90 (23.3%) out of all tested strains the presence of P fimbriae was found. The highest percentage of P fimbriae prevalence was found in E. coli belonging to the following serotypes: 018 (in 68.9% strains), 025 (in 29.2% strains), and 0125 (in 25.0% strains). This type of fimbriae was also detected in serotypes 026 (9.1%), 044 (8.7%), 055 (5.6%), and 0119 (in 2 strains out of 5 isolated). Out of 933 colonies of E. coli, isolated from 178 urine samples, 434 (46.5%) colonies gave positive results in MRHA test, including 133 positive in latex test for P fimbriae. These studies showed that for MRHA adhesins, including P fimbriae, a parallel examination of higher number of E. coli was necessary.(ABSTRACT TRUNCATED AT 250 WORDS)     

Incompatibility group K plasmids in bacteria isolated from a urinary tract infection

Citrobacter freundii and Klebsiella pneumoniae were concurrently isolated from a patient with a urinary tract infection. Transferable drug resistant plasmids were isolated from both strains, pMS434 and pMS435. These plasmids belonged to incompatibility group K and both carried genes governing resistance to various aminoglycoside antibiotics, i.e., kanamycin, gentamicin C complex, streptomycin, and 3',4'-dideoxykanamycin B, in addition to those governing resistance to sulfanilamide and ampicillin. They inactivated kanamycin, gentamicin C complex and 3',4'-dideoxykanamycin by adenylylation and kanamycin by phosphorylation. Electron microscopic observations disclosed that the molecular weights of the plasmids were about 67.8 megadaltons. These results indicated the similarity in genetic constitution of the two plasmids. This was the second isolation of incompatibility group K plasmids, following that reported by Hedges and Datta (Nature 234: 220-221, 1971).     

Taxonomic spectrum and antibiotic resistance of Enterobacteriaceae isolated from bile of patients with cholangitis]

The data on the taxonomic structure and antibiotic resistance of Enterobacteriaceae isolated from bile of patients with various clinical variants of cholangitis are presented. It was shown that bacteriocholia was registered in 53.3-90.9% of the patients during operations and in 88.9-100% of the patients during the postoperative period. Among bilicultures enterobacteria dominated (93.4% of the cases) with predominance of E. coli and Klebsiella spp. (the total about 70%). The enterobacteria isolates were frequently resistant to ampicillin and amoxycillin/clavulanate (92.6 and 70.4% of the strains respectively), gentamicin and amikacin (74.1 and 22.2%), cefazolin and cefotaxime (88.9 and 37.0%). The resistance to imipenem and ciprofloxacin (7.4%) was rare, that should be considered while prescribing drugs for empirical antimicrobial chemotherapy.     

Pathogens isolated from patients with community-acquired lower respiratory tract infections

The aim of the study was to assess the prevalence and antimicrobial susceptibility of pathogens in patients hospitalized in Clinic of Pneumology and Alergology University Clinical Hospital No 1 in ?od? in 2006-2008 period, due to community-acquired lower respiratory tract infections. In this samples of sputum, bronchoaspirate and BAL's were evaluated. The most frequent pathogens isolated from all examinated patients were Gram-negative rods. This bacteria were susceptible in most to imipenem (91%), ceftazydym (71%), amikacin (67%), ciprofloxacin (63%) and to amoxicillin with clavulanic acid only in 18%. This study show high prevalence of Gram-negative rods in patients hospitalized due to community-acquired lower respiratory tract infections.     

Susceptibility of Klebsiella pneumoniae isolated from urinary tract infections to quinolones

Urinary Tract Infections (UTIs) are the most prevalent infections worldwide both in males and females. K. pneumoniae is one of the major pathogens causing UTIs. Fluoroquinolones are effective drugs for treating infections caused by Klebsiella spp. The aim of this study was to evaluated the susceptibility to three fluoroquinolones of K. pneumoniae strains isolated from urine. The MICs of ciprofloxacin was determined by agar dilution method and the MICs of norfloxacin and gatifloxacin by E-test. Among analysed K. pneumoniae strains 86.7% was susceptible to gatifloxacine, 76.7% to norfloxacin and 51.2% to ciprofloxacine.     

社区获得性泌尿系感染病原菌分布及耐药性分析

目的分析社区获得性泌尿系感染病原菌的种类及对常用抗生素的耐药性。方法收集2008年5月至2013年3月分离自社区获得性泌尿系感染患者中段尿的菌株,分析病原菌种类并测试主要病原菌对常用抗生素的体外敏感性。结果在215株细菌中,以革兰阴性杆菌155株（72. 1% ）为主。分离前5位的细菌为大肠埃希菌（48.4% ）、肠球菌属（10. 7% ）、肺炎克雷伯菌（7.4% ）、链球菌属（6. 0% ）、假丝酵母属（6. 0% ）。大肠埃希菌和肺炎克雷伯菌中,共63株产ESBL,占52. 5%。产ESBL菌株对头孢替坦、哌拉西林/他唑巴坦、阿米卡星、呋喃妥因、亚胺培南等5种抗生素的耐药率低于10%,对其他抗生素耐药率则超过70%。不产ESBL的菌株除对氨苄西林、氨苄西林/舒巴坦、环丙沙星、左氧氟沙星和复方新诺明的耐药率超过30%外,对其他常用抗生素的耐药率均在10%以下。肠球菌属和链球菌属分别对呋喃妥因和青霉素的耐药率较低（3/23和0/23）,未发现对万古霉素耐药株。结论引起社区获得性泌尿系感染的病原菌以大肠埃希菌为代表的革兰阴性杆菌为主,但由于不同菌株对抗生素的敏感性差异较大,用药之前进行尿培养是避免因抗生素使用不合理造成感染慢性化的一项重要措施。     

门诊女性泌尿系感染病原菌分布与耐药现状调查

目的 调查门诊女性泌尿系感染患者病原菌的分布及耐药性,为临床合理选用抗菌药物提供依据.方法 采用回顾性调查方法,对浙江萧山医院2007年1月至2011年12月从门诊女性尿培养中分离的菌株进行鉴定及耐药性检测,使用WHONET 5.6软件统计分析数据.结果 共分离病原菌456株,其中革兰阴性菌329株(72.1％),革兰阳性菌108株(23.7％),真菌19株(4.2％);前三位是大肠埃希菌252株(55.3％),表皮葡萄球菌47株(10.3％),奇异变形杆菌和肺炎克雷伯菌各23株(5.0％).大肠埃希菌对氨苄西林耐药率最高(77.1％),其次为哌拉西林(71.3％),其产超广谱β-内酰胺酶(ESBLs)菌株检出率为32.9％,未见亚胺培南、美罗培南、头孢哌酮/舒巴坦耐药株.结论 浙江省萧山地区门诊女性泌尿系感染病原菌以革兰阴性杆菌尤其是大肠埃希菌为主;定期监测和分析泌尿系感染的病原菌分布及耐药性,有助于提高临床经验治愈率及合理用药水平.     

Drug resistance and proticinogenic types of Proteus mirabilis isolated from urinary tract infections

Proteus mirabilis strains (88 isolates) from hospitalised patients with urinary tract infection were tested for antibiotic susceptibility, ESBL production and their ability to produce proticin or on their susceptibility to proticin. Antibiotic susceptibility test was performed by standard disc diffusion method according to NCCLS. Proticin typing was made by the standard strain set from the B. W. Senior collection. Most (59%) strains belonged to ESBL producers and were more resistant to antibiotics than ESBL-negative strains. Predominant proticin patterns among the ESBL (+) strains were: P1,2(6)/SO (23%), P1,2/SO (13.5%). Among the ESBL-negative strains more frequent were P6/SO (16.6%), P1,2/SO (13.8%) and P3,6/SO (13.8%) proticin types.     

Occurrence and antibiotic sensitivity of Listeria monocytogenes strains isolated from oysters, fish, and estuarine water

We analyzed the presence of Listeria spp. in oyster, fish, and seawater samples and tested isolates for antibiotic sensitivity. Listeria monocytogenes was found in 4.5% of fish samples and 8.3% of seawater samples and was not recovered from oysters. Multiresistant environmental strains were found, representing a potential threat to human health.     

Antibiotic sensitivity of Enterobacteriaceae isolated from women vagina and uterine cervix

Based on performed investigation in the group of 200 women treated for recurrent and chronic vaginitis and cervicitis, the characteristic of isolated microorganism was done. There were found series of drug-resistant bacteria in the vagina and uterine cervical canal in women with recurrent vaginitis and chronic cervicitis. In 42.6% of patients with diagnosed chronic cervicitis (Cervicitis chronica n = 50) Escherichia coli strains were isolated, 5% of which produced extended spectrum beta-lactamases (ES beta L). In women with recurrent vaginitis (Colpitis recidivans n = 150) Escherichia coli strains where isolated in 45.6%. Among them 4.5% produced ES beta L. Expression of beta-lactamases with broadened substrate spectrum was done in double-disc-test. CONCLUSIONS: 1. Study of antibiotic sensitivity of isolated bacteria should be a diagnostic standard in bacterial infections of uterine cervix and vagina. 2. The choice of appropriate antibiotics should take into consideration the drug-resistance mechanisms of isolated bacteria. 3. When drug-resistant bacteria are isolated, combined therapy should be applied.