Microbiological characterization of the causative agents of hospital infection in urological patients

The analysis of the etiological structure of hospital infection in 52 urological patients has been carried out. The sensitivity of the causative agents of this infection to different antibiotics has been studied and recommendations on rational antibacterial therapy are given.     

Specific Features of the Formation of a Halo during Pathogenesis as a Response of Cereal Epidermal Cells to Penetration of Powdery Mildew Causative Agents

A cytophysiological study was carried out of the functional status of a halo as a response of the host plant to contact with a powdery mildew pathogen. Interactions of the powdery mildew causative agents with barley, wheat, wheat–wheat-grass hybrids, wheat-aegilops lines, and aegilops with different genotypic resistance lead to the expression of haloes during pathogens, which are induced by infection pegs of the primary growth tubes, appressoria, and hyphal lobes. Haloes are visualized using cytochemical reactions to proteins and scanning electron microscopy. The observed differences in the size of haloes and intensity of their staining (uniform or zonal) are related, to a great extent, to individual reactions of the plant cell at the penetration site and, to a lesser extent, to the level of genotypic resistance. An analysis of electron microscopy and cytochemistry studies suggests that the halo as a physiologically active zone is localized at the level of the plant cell plasmalemma. Active taxis of the cell organelles to the site of infection during the formation of a halo suggests that some kind of informational signals to changes in the cell metabolism are spread from the halo zone, which lead to compatible or incompatible interactions.     

连续5 a临床常见非发酵菌分离率变化及耐药性分析

对中国医科大学附属盛京医院2004～2008年5a间非发酵菌的分离情况及其耐药性进行比较和分析,旨在为临床制定合理有效的抗感染治疗方案提供依据。采用琼脂扩散法药敏试验,测定5a间临床常见非发酵菌菌株的药敏,数据统计分析用WHONET5．4软件进行。5a间分离的非发酵菌在革兰阴性杆菌中的比率呈上升趋势,到2008年占革兰阴性杆菌的46．49％。非发酵菌的耐药率逐年升高,其中耐药最严重的是鲍曼不动杆菌。非发酵菌为医院感染的主要致病菌,且对抗菌药物呈多重耐药,临床医生应注重本地区、本治疗区的细菌耐药监测情况,合理选择抗生素,减少耐药菌出现的机会,采取有效措施减少医院内感染的发生和耐药菌在医院内的传播。     

Detection and characteristics of foci of arbovirus infection in the Kazakh region

Complex studies carried out on the territory of Kazakhstan have allowed one to detect arboviruses, heretofore unknown in the republic, to determine their role in human infectious pathology and to obtain additional data on the ecology of viruses causing tick-borne encephalitis and Crimean hemorrhagic fever under the conditions of different geographical zones in the republic. On the basis of the results thus obtained the map indicating the spread of arbovirus infections and their causative agents on the territory of the Kazakh SSR has been drawn. This map may serve as a practical aid in organizing antiepidemic measures.     

铜绿假单胞菌的临床分布和耐药性变迁

目的调查温州医学院附属第一医院铜绿假单胞菌的临床分布和耐药性及其变迁情况,指导临床合理用药和控制耐药菌的产生。方法对该院2003年至2005年437株铜绿假单胞菌进行回顾性分析,用17种抗菌药物进行体外药敏试验。结果铜绿假单胞菌分布以呼吸道感染和创口分泌物感染为主。细菌对第3代头孢菌素耐药率高,对头孢他啶、亚胺培南、头孢哌酮/舒巴坦和氟喹诺酮类药物的耐药率均有逐年增加的趋势。耐药率增加与临床广谱抗菌药物用药量增加有关。结论铜绿假单胞菌的耐药性十分突出,应在药敏指导下合理选用抗菌药物,应该适当控制碳青霉烯类和第3代头孢菌素的使用,减缓耐药菌株的产生。     

Antibiotic resistance of Streptococcus pneumoniae isolated from patient with home care pneumonia

The monitoring of the resistance of Streptococcus pneumoniae, one of the most important causative agents of extrahospital pneumonia, has been carried out. The data on its sensitivity to antibacterial preparations, widely used in clinical practice, have been summarized.     

糖尿病合并败血症病原菌和耐药性的分析探讨

目的 探讨糖尿病合并败血症菌种分布特点和耐药谱的变化,指导临床用药.方法 回顾性分析了1999年3月至2004年6月所有血培养阳性且经临床资料证实的18例糖尿病合并败血症.结果 共获阳性血培养株26份.G^＋菌4株;G^-菌17株,居前3位的是克雷伯菌、大肠埃希菌、铜绿假单胞菌;真菌5株,且全为院内感染.G^-菌出现多重耐药且耐药水平增高.结论 G^-菌仍占主流,真菌败血症继续升高,细菌耐药形势严峻,应重视细菌耐药性的动态监测,常规开展产酶菌检测,指导抗生素的合理应用,延缓预防耐药菌株的扩散流行.     

改制前后我院G-杆菌下呼吸道感染的细菌学分类及抗生素耐药性变化

目的调查改制前后哈尔滨医科大学附属第四医院G-杆菌下呼吸道感染的细菌学分类及抗生素耐药性变化。方法利用复星公司FOUTUNE. IMS细菌鉴定药敏分析系统进行细菌鉴定药敏分析,室内质控菌株选用ATCC25922、ATCC25923、ATCC27853。结果改制后:(1)葡萄球菌感染率降低,而真菌感染率增高。(2)克雷伯菌属比率增高,而肠杆菌属、不动杆菌属比率降低。(3)对头孢哌酮、头孢曲松、头孢噻肟、庆大霉素、柰替米星、妥布霉素、阿米卡星、环丙沙星、诺氟沙星、氧氟沙星、氯霉素、呋喃妥因、四环素、复合磺胺、氨曲南的总耐药率增高。结论合理使用抗生素,注意抗生素和消毒剂耐药的监控是降低细菌耐药性的方法。     

院内感染复数菌败血症的临床和耐药分析

目的 探讨院内感染复数菌败血症的临床特征、危险因素、致病菌分布及耐药情况。方法 回顾性分析1970～2004年经血培养和临床资料证实的126例院内感染的复数菌败血症。结果 院内感染复数菌败血症均发生在较严重的基础疾病上．创伤性手术和操作、广谱抗菌药物和免疫抑制剂的应用、放疗与化疗为该病的危险因素。院内感染复数菌败血症感染病死率达52％,致病菌以G^-菌占多数,合并真菌感染者死亡率高。致病菌多为耐药菌株。结论 院内感染复数菌败血症病情危重,病死率高,多系耐药菌株感染。应尽早治疗原发基础疾病,避免危险因素,严格掌握侵入性诊疗手段的运用指征,合理应用抗菌药物。并重视院内环境卫生,严格做好洗手、消毒等是防止耐药菌播散的主要措施。     

Identification of infant food as a vehicle in a nosocomial outbreak of Citrobacter freundii: epidemiological subtyping by allozyme, whole-cell protein and antibiotic resistance

A total of 38 Citrobacter freundii strains was isolated from patients and their environment at a neonatal intensive care unit of a large hospital where colonization and clinical diseases due to the agent had been observed. Epidemiological investigations were carried out by subtyping, for which a combination of allozyme, whole-cell protein and resistance pattern analysis was used. Infant formula was identified as a vehicle of nosocomial spread. This shows that the role of foods in the transmission of hospital infections should not be underestimated.
The combination of methods applied, in particular a limited enzyme set, is recommended also for epidemiological investigations of food-borne infections and establishment of their causes.     

A rectifying electrotonic synapse in the central nervous system of a vertebrate

The adductor muscles of the pectoral fins of the hatchetfish Gasteropelecus are innervated by bilateral pools of about 40 motoneurons which lie primarily in the first spinal segment. A pair of giant fibers on each side of the medulla send processes ventroposteriorly to the motoneuron pools. Electrophysiological evidence indicates that giant fibers are presynaptic to ipsilateral motoneurons, but not to contralateral ones. Transmission across the giant fiber, motoneuron synapse is electrically mediated as is indicated by direct measurement of electrotonic spread in either direction across the synapse, and by the extremely short latency of the giant fiber postsynaptic potentials (PSP's) in the motoneuron. The coupling resistance across the synapse was calculated from measurements of input and transfer resistance. The coupling resistance rectifies in such a way as to facilitate spread of depolarization from giant fiber to motoneuron, and to oppose transmission in the opposite direction. As a consequence of rectification, the giant fiber PSP in a motoneuron is augmented by hyperpolarization of the motoneuron. The coupling resistance calculated on the basis of this effect is in good agreement with calculations from input and transfer resistance data. Rectification at the electrotonic synapses may permit the motoneurons to act in small swimming movements as well as to fire synchronously in an extremely fast escape reflex mediated by Mauthner and giant fibers.     

一株污水源多重耐药大肠杆菌的耐药性检测及全基因组测序分析

【背景】水体环境分布广、流动性强,是耐药菌和耐药基因传播的主要媒介。【目的】了解北方污水厂大肠杆菌携带的耐药基因及可移动遗传元件情况。【方法】从北方污水厂筛选出一株多重耐药大肠杆菌,通过药敏试验进行耐药性检验,采用96孔板法测定菌株的最小抑菌浓度,利用酶标仪探究亚抑菌浓度抗生素对菌株生长的影响,并对菌株进行全基因组测序,对其携带的耐药基因及可移动遗传元件进行预测。【结果】大肠杆菌WEC对四环素、环丙沙星、诺氟沙星和红霉素具有耐药性,亚抑菌浓度的四环素、环丙沙星和诺氟沙星能够延缓或抑制菌株的生长。WEC菌株的基因组中包含一条大小为4 782 114 bp的环状染色体和2个大小分别为60 306 bp (pWEC-1)和92 065 bp (pWEC-2)的环状质粒。菌株共携带129个耐药基因,其中128个位于染色体上,在染色体上预测到原噬菌体、基因岛及插入序列的存在,部分可移动遗传元件携带有耐药基因。质粒pWEC-1中无耐药基因,pWEC-2含有1个耐药基因,在质粒基因组中预测到原噬菌体和插入序列。【结论】污水源大肠杆菌WEC是一株多重耐药菌株,其基因组中携带耐药基因和多种可移动遗传元件...     

Isolation and identification of the smallpox virus which caused iatrogenic vaccinia in children in the city of Vladivostok

The comparative study of the specimens of the morphological elements of exanthema obtained from 8 children with the clinical diagnosis of secondary exogenic vaccinia, dried smallpox vaccine and the cultures of other orthopoxviruses (rabbit pox, monkey pox and buffalo pox viruses) was made. The isolation and identification of the causative agents from the specimens was carried out with the use of modern virological, electron microscopic and molecular methods. The study proved the fact that 8 children had orthopoxvirus infection with its causative agent identified as vaccinia virus.     

Studies of antibiotic resistance within the patient, hospitals and the community using simple mathematical models.

The emergence of antibiotic resistance in a wide variety of important pathogens of humans presents a worldwide threat to public health. This paper describes recent work on the use of mathematical models of the emergence and spread of resistance bacteria, on scales ranging from within the patient, in hospitals and within communities of people. Model development starts within the treated patient, and pharmacokinetic and pharmacodynamic principles are melded within a framework that mirrors the interaction between bacterial population growth, drug treatment and the immunological responses targeted at the pathogen. The model helps identify areas in which more precise information is needed, particularly in the context of how drugs influence pathogen birth and death rates (pharmacodynamics). The next area addressed is the spread of multiply drug-resistant bacteria in hospital settings. Models of the transmission dynamics of the pathogen provide a framework for assessing the relative merits of different forms of intervention, and provide criteria for control or eradication. The model is applied to the spread of vancomycin-resistant enterococci in an intensive care setting. This model framework is generalized to consider the spread of resistant organisms between hospitals. The model framework allows for heterogeneity in hospital size and highlights the importance of large hospitals in the maintenance of resistant organisms within a defined country. The spread of methicillin resistant Staphylococcus aureus (MRSA) in England and Wales provides a template for model construction and analysis. The final section addresses the emergence and spread of resistant organisms in communities of people and the dependence on the intensity of selection as measured by the volume or rate of drug use. Model output is fitted to data for Finland and Iceland and conclusions drawn concerning the key factors determining the rate of spread and decay once drug pressure is relaxed.     

On being the right size: the impact of population size and stochastic effects on the evolution of drug resistance in hospitals and the community

The evolution of drug resistant bacteria is a severe public health problem, both in hospitals and in the community. Currently, some countries aim at concentrating highly specialized services in large hospitals in order to improve patient outcomes. Emergent resistant strains often originate in health care facilities, but it is unknown to what extent hospital size affects resistance evolution and the resulting spillover of hospital-associated pathogens to the community. We used two published datasets from the US and Ireland to investigate the effects of hospital size and controlled for several confounders such as antimicrobial usage, sampling frequency, mortality, disinfection and length of stay. The proportion of patients acquiring both sensitive and resistant infections in a hospital strongly correlated with hospital size. Moreover, we observe the same pattern for both the percentage of resistant infections and the increase of hospital-acquired infections over time. One interpretation of this pattern is that chance effects in small hospitals impede the spread of drug-resistance. To investigate to what extent the size distribution of hospitals can directly affect the prevalence of antibiotic resistance, we use a stochastic epidemiological model describing the spread of drug resistance in a hospital setting as well as the interaction between one or several hospitals and the community. We show that the level of drug resistance typically increases with population size: In small hospitals chance effects cause large fluctuations in pathogen population size or even extinctions, both of which impede the acquisition and spread of drug resistance. Finally, we show that indirect transmission via environmental reservoirs can reduce the effect of hospital size because the slow turnover in the environment can prevent extinction of resistant strains. This implies that reducing environmental transmission is especially important in small hospitals, because such a reduction not only reduces overall transmission but might also facilitate the extinction of resistant strains. Overall, our study shows that the distribution of hospital sizes is a crucial factor for the spread of drug resistance.     

Sanitary control of the territory: data bases on the spread of some quarantine infections

The data bases (DB) on the spread of plague, yellow fever and contagious virus hemorrhagic fevers (CVHF) in foreign countries have been created. These DB contain information on the main international air and sea ports and their relationships with natural focal territories. The data base "Sanitary control. Yellow fever" contains information on different species serving as vectors for yellow fever virus. Information on the circulation of the causative agents of Ebola fever, Lassa fever and Marburg disease in African countries has been introduced into DB, the differentiation of countries by the degree of the potential danger of the CVHF spread has been made.     

对安贞医院革兰阴性杆菌的耐药趋势调查

目的分析安贞医院感染菌中,居前5位的革兰阴性杆菌的耐药趋势,为临床合理使用抗生素提供必要依据。方法对2000～2002年该院分离的医院感染菌株中,居前5位的革兰阴性杆菌的耐药性,进行回顾性分析。结果革兰阴性杆菌中前5位细菌,对3代头孢菌素的耐药性增高。大多数细菌对亚胺培南和美洛培南敏感。阿米卡星的耐药性有所下降。大肠埃希菌对喹诺酮类抗生素耐药率在85％以上。结论不规范使用抗生素,使细菌的耐药性越来越高,交替使用抗生素可能是降低细菌对抗生素耐药性的有效方法。医院应宏观控制使用抗生素。     

Development of a data bank for control of antibiotic resistant causative agents of purulent-inflammatory diseases and complications

To provide constant control of drug resistance in causative agents of surgical infections an automatized data bank based on computer SM-4 was filed at the All-Union Research Institute of Antibiotics. The bank includes information on 1500 objects described by 60 indices referring to the isolated pathogens. For every particular strain there are indicated data on the patients, characteristics of the pathogen biochemical profiles and sensitivity to various antibiotics (28 drugs). The data were obtained during identification of the cultures with automatized microbiological systems. The major functions of the data bank and standard information requests performed on its basis during solving particular epidemiological and clinical problems are described.     

2014—2016年某院铜绿假单胞菌耐药性监测

摘要：目的 分析铜绿假单胞菌的分布和耐药性变化,为临床防治铜绿假单胞菌感染提供依据。方法 收集成都大学附属医院2014—2016年所分离的铜绿假单胞菌,采用VITEK 2-Compact全自动细菌鉴定系统进行鉴定和药敏试验,采用WHONET 5.6软件对数据进行分析。结果 3年间共分离出1 945株铜绿假单胞菌,多重耐药铜绿假单胞菌分离率为34.2%（666/1945）。标本来源以呼吸道为主,占82.2%（1598/1945）。科室分布以呼吸内科最多,ICU其次。铜绿假单胞菌对头孢曲松和头孢噻肟的耐药率最高,均＞57.0%;对阿米卡星耐药率最低,为2.0%。3年来铜绿假单胞菌对17种抗生素的耐药率呈整体上升的趋势。结论 铜绿假单胞菌对头孢曲松、头孢噻肟、亚胺培南耐药率较高,对阿米卡星耐药率较低。铜绿假单胞菌的耐药率呈整体上升的趋势,应重视细菌耐药性的监测,以延缓耐药性产生、促进临床合理用药。     

Grigor'ev-Shiga dysentery: a new epidemic threat. Its global tendencies and features of its spread

In this article, based on the data contained in literature, the development of the pandemic of Grigor'ev-Shiga dysentery, which began in 1960-ies, is followed. The stages of the formation of three powerful hyperpandemic foci in Central America, South-East Asia and Central Africa are characterized. The characterization of the epidemiological features of the spread of this disease and its clinical distinction are presented. The biological properties of the causative agent, and in particular its multiple medicinal resistance facilitating the spread of the disease throughout the world, is considered. The stable character of the foci of infection in developing countries, which actually present a threat also for this country, is pointed out. For this reason, the epidemiological surveillance on Grigor'ev-Shiga dysentery should be drastically strengthened.