血液科感染患者致病菌耐药性分析

目的：了解血液科病房感染患者常见病原茵的分布情况及其对药物的敏感率和耐药性,为临床诊断及用药提供参考依据。方法：回顾性分析北京友谊医院血液科2008年7月至2011年7月病房送检细菌和真菌培养标本分离出的357株病原菌的药敏试验结果。结果：革兰阳性球菌对克林霉素和各种喹诺酮类抗生素均显示出很高的耐药性,但对利奈唑胺和万古霉素较敏感;革兰阴性杆菌对碳青霉烯类抗生素的敏感率达到90％以上。屎肠球菌耐药较严重,对万古霉素的敏感率仅71．4％,而对利奈唑胺敏感率为100％。铜绿假单胞菌对亚胺培南的耐药率为19％,鲍曼不动杆菌对亚胺培南的耐药率为14．3％,而丁胺卡那霉素和妥布霉素对铜绿假单胞茵和鲍曼不动杆菌的敏感率均为100％。大多数真菌对抗真菌药物敏感。结论：对合并感染的血液病患者应及时留取标本寻找病原学证据,并依据药敏试验调整用药,以便有效的控制感染和防止耐药性的产生。     

Physiological Streptomycin Resistance in a Multiauxotroph of Escherichia coli Strain 15 T

Escherichia coli strain WWU was found to be moderately resistant to streptomycin when grown in a minimal medium, although the strain was sensitive if grown in nutrient broth. Transfer experiments showed that cells grown in minimal medium retain the resistant state for a period of time after dilution into nutrient broth; and conversely, sensitive cells grown in nutrient broth were sensitive after dilution into minimal medium for a period of time. The kinetics of transition from resistant to sensitive and from sensitive to resistant were observed, and kinetics of ³H-dihydrostreptomycin accumulation by resistant and sensitive cells were compared. The data suggested that cells grown in minimal medium were physiologically resistant because they accumulated streptomycin poorly. Inactivation per incorporated antibiotic molecule was the same in resistant and sensitive cells.     

Phagocytosis of chloramine B sensitive and resistant staphylococci isolated from healthy persons and patients

Phagocytic reaction with respect to antibiotic and chloramine B sensitive and resistant staphylococci isolated from healthy persons and patients, air and stock of medical institutions was studied on albino mice. It was shown that the staphylococcal isolates included strains simultaneously sensitive to antibiotics and chloramine, sensitive to antibiotics and resistant to chloramine, resistant to antibiotics and sensitive to chloramine and simultaneously resistant to antibiotics and chloramine. Activity, intensity and completeness of phagocytosis by leucocytes from mouse abdominal cavity exudates with respect to the staphylococcal strains sensitive to antibiotics and resistant to chloramine, resistant to antibiotics and sensitive to chloramine and simultaneously resistant to antibiotics and chloramine were lower than the values of the phagocytic reaction with respect to the isolates simultaneously sensitive to antibiotics and chloramine. This suggested that not only antibiotic resistance of microbes but also their resistance to disinfectants could be referred to complicating factors of hospital infections.     

Sensitivity to antibiotics of bacterial strains isolated from clinical specimens during the years 1985-1986

Sensitivity of 312 strains of staphylococci, 386 strains of streptococci and 1193 strains of aerobic gram-negative bacilli to the selected antibiotics was tested. These strains were isolated from the clinical material at the Clinical Hospital No. 1 in Warsaw within 1985-1986. Staphylococci were sensitive to pristinamycin, cefazolin, fusidic acid, oxacillin, and clindamycin. In 1986, a decrease in the number of strains sensitive to these antibiotics, except cefazolin, was seen. In case of streptococci the most active proved chloramphenicol and gentamicin but a significant decrease in the percentage of sensitive strains was also noted in 1986. The highest number of gram-negative bacilli was sensitive to amikacin, colistin, nalidixic acid, pipemidic acid, and gentamicin. In 1986, a decrease in the percentage of sensitive strains was noted. Amikacin and colistin were the most active against Pseudomonas spp. while amikacin and nalidixic and pipemidic acids--against Proteus spp. Comparison of the results with those obtained in 1981-1984 has shown that the sensitivity of staphylococci changed the most significantly and this change was unfavourable. Gentamicin and amikacin remained the most active against gram-negative bacilli while amikacin and colimycin against Pseudomonas spp. In case of anaerobes the majority of strains was sensitive to chloramphenicol, tetracycline and clindamycin. Metronidazole was active against high percentage of Clostridium spp. and all gram-negative bacilli while the percentage of gram-positive bacilli and cocci was sensitive to metronidazole.     

Regulation of Na/K/Cl cotransport in vascular smooth muscle cells

The regulation of Na/K/Cl cotransport was investigated in vascular smooth muscle cells. That a Na/K/Cl cotransport system exists was established by the finding that the ouabain insensitive K influx was sensitive to the "loop" diuretic bumetanide. Furthermore, bumetanide sensitive K influx was dependent upon the presence of both Na and Cl in the extracellular milieu. Bumetanide sensitive K influx was inhibited by agents which elevate cellular cyclic AMP levels, and to a lesser extent by agents which elevate cellular cyclic GMP levels. When serum, EGF or TPA was added, bumetanide sensitive K influx was enhanced. These results suggest that vascular smooth muscle cells have a ouabain insensitive, bumetanide sensitive Na/K/Cl cotransport system which is stimulated by serum, EGF or TPA and inhibited by cAMP or cGMP.     

Repair-defective mutants of Alteromonas espejiana, the host for bacteriophage PM2

The in vivo repair processes of Alteromonas espejiana, the host for bacteriophage PM2, were characterized, and UV- and methyl methanesulfonate (MMS)-sensitive mutants were isolated. Wild-type A. espejiana cells were capable of photoreactivation, excision, recombination, and inducible repair. There was no detectable pyrimidine dimer-DNA N-glycosylase activity, and pyrimidine dimer removal appeared to occur by a pathway analogous to the Escherichia coli Uvr pathway. The UV- and MMS-sensitive mutants of A. espejiana included three groups, each containing at least one mutation involved with excision, recombination, or inducible repair. One group that was UV sensitive but not sensitive to MMS or X rays showed a decreased ability to excise pyrimidine dimers. Mutants in this group were also sensitive to psoralen plus near-UV light and were phenotypically analogous to the E. coli uvr mutants. A second group was UV and MMS sensitive but not sensitive to X rays and appeared to contain mutations in a gene(s) involved in recombination repair. These recombination-deficient mutants differed from the E. coli rec mutants, which are MMS and X-ray sensitive. The third group of A. espejiana mutants was sensitive to UV, MMS, and X rays. These mutants were recombination deficient, lacked inducible repair, and were phenotypically similar to E. coli recA mutants.     

Serotonin sensitive adenylate cyclase activity in monkey anterior limbic cortex: antagonism by molindone and other antipsychotic drugs.

Serotonin (5-HT) sensitive adenylate cyclase in monkey anterior limbic cortex homogenates was further characterized and the effects of antipsychotic drugs and 5-HT anatagonists investigated. Differences in time course for stimulation by agonists and in responsiveness to receptor anatagonists of 5-HT-and dopamine (DA)-stimulated activities, were observed. Also there was an additivity of 5-HT and DA at maximally effective concentrations. Classical 5-HT antagonists blocked the 5-HT sensitive adenylate cyclase with a rank order of potency: methiothepin > cyproheptadine > methysergide. These 5-HT antagonists also effectively inhibited DA sensitive adenylate cyclase. Most antipsychotic drugs tested antagonized 5-HT stimulated activity although these drugs exhibited greater efficacies in blocking DA stimulated activity. Exceptions were molindone which failed to antagonize DA sensitive adenylate cyclase but effectively blocked 5-HT sensitive cyclase and pipamperone which was inactive in both cyclase systems. Haloperidol was a more selective antagonist of the DA sensitive adenylate cyclase than were the other antipsychotic drugs tested.     

Superoxide dismutase and chilling injury in Chlorella ellipsoidea

The relationship between superoxide dismutase (SOD) and chilling injury was examined in chilling-sensitive and chilling-resistant strains of Chlorella ellipsoidea. The sensitive strain contained less SOD than the resistant strain. Moreover, all of the SOD in the sensitive strain was the H2O2-sensitive, iron-containing SOD, whereas most of the SOD in the resistant strain was the H2O2-resistant, manganese-containing SOD. Illumination further enhanced the disparity in SOD content between the sensitive and resistant strains since the SOD in the former declined during illumination, whereas the SOD in the latter strain did not. It was possible to elevate the SOD content of the sensitive strain and to increase the proportion of MnSOD by prior growth in the presence of 50 microM paraquat. The SOD content of the cultures after 5 h of illumination at 4 degrees C fell in the order sensitive strain less than paraquat-induced sensitive strain less than resistant strain. The resistance of these cultures to chilling injury was related to SOD content. This was the case whether resistance was assessed in terms of growth rate after chilling, bleaching of chlorophyll during chilling, or loss of viability during chilling. It thus appears likely that O2- is an agent of chilling injury.     

DNA, a Possible Site of Action of Aluminum in Rhizobium spp

Al was found to penetrate the cell envelopes of both sensitive and tolerant Rhizobium strains and bind to DNA in vivo. Despite causing a reduction in viability, Al stimulated DNA synthesis in the sensitive strain, which suggested that an excision repair mechanism was operating. The Al-stimulated DNA synthesis was reduced by the simultaneous addition of chloramphenicol. In contrast to the sensitive strain, DNA synthesis was unaffected by Al binding to DNA in the tolerant strain. It is proposed that Al enters the cell and binds to the DNA helix, increasing stabilization and preventing successful replication. Different repair mechanisms appear to operate in response to Al in tolerant and sensitive strains.     

Streptococcal tetracycline resistance mediated at the level of protein synthesis.

The mechanism of tetracycline resistance was examined in strains containing each of the three previously identified resistance determinants in Streptococcus spp. Uptake of tetracycline was measured in tetracycline-sensitive cells as well as in cells containing each of the three resistance determinants. In cells containing tetL, uptake was not observed. However, in sensitive cells and cells containing either tetM or tetN, tetracycline was accumulated approximately 25-fold against a concentration gradient. Furthermore, there was no evidence for modification of intracellular tetracycline recovered from sensitive, tetM, or tetN cells. Protein synthesis in extracts derived from organisms containing tetM or tetN was resistant to tetracycline. In contrast, extracts of sensitive and tetL cells were sensitive to tetracycline.     

Influence of killer strains of Saccharomyces cerevisiae on wine fermentation

The effect of killer strains of Saccharomyces cerevisiae on the growth of sensitive strains during must fermentation was studied by using a new method to monitor yeast populations. The capability of killer yeast strains to eliminate sensitive strains depends on the initial proportion of killer yeasts, the susceptibility of sensitive strains, and the treatment of the must. In sterile filtered must, an initial proportion of 2-6% of killer yeasts was responsible for protracted fermentation and suppression of isogenic sensitive strains. A more variable initial proportion was needed to get the same effect with non-isogenic strains. The suspended solids that remain in the must after cold-settling decreased killer toxin effect. The addition of bentonite to the must avoided protracted fermentation and the suppression of sensitive strains; however, the addition of yeast dietary nutrients with yeast cell walls did not, although it decreased fermentation lag.     

Susceptibility to selected coagulase-negative chemotherapeutic agents of methicillin resistant staphylococci isolated from clinical materials in 1997-1998

The study was aimed at assessment of the sensitivity of methicillin-resistant coagulase-negative staphylococci isolated from clinical material in 1997/1998 to selected chemotherapeutic agents. The investigated material comprised 96 methicillin-resistant coagulase-negative staphylococci from hospital and ambulatory infections isolated during the period from April 1997 to May 1998. Species affiliation was determined by classical identification methods and commercial diagnostic tests for identification of staphylococci. Methicillin resistance was determined by agar disk-diffusion method and screening. Sensitivity to chemotherapeutics was determined by agar disk-diffusion method and agar dilution methods. All the investigated strains were sensitive to nitrofurantoin, furazolidone and vancomycin. To teicoplanin--the second glycopeptide antibiotic--84% strains were sensitive, whereas the percentages of resistant and moderately sensitive strains amounted to 5.2% and 10.4%, respectively. 85% and 82% of coagulase-negative staphylococcal strains were sensitive to fusidic acid and mupirocin. Considerable differences were noted with respect to sensitivity to aminoglycoside group antibiotics. About 35% of strains were sensitive to gentamicin, and 90% sensitive to netilmicin. Ca. 40% of coagulase-negative staphylococci were resistant both to cotrimoxazole and trimethoprim, which, in view of 98% resistance to the second component of cotrimoxazole, may be associated with the activity of only one of the components of the drug--trimethoprim.     

Characterization of versilin-sensitive sites in self-sensitive producer and sensitive non-producer or unrelated organism

Studies on self-sensitivity of producer mutant vs. sensitivity of non-producer parent and unrelated organism showed that versilin inhibited spore germination and sporulation in the self-sensitive producer mutant, non-producer parent Aspergillus versicolor N₅ and the unrelated sensitive Trichophyton rubrum . Sporulation appeared to be more sensitive than spore germination. The inhibition of in vivo synthesis of protein was very marked, but inhibition of RNA and DNA was slight and moderate, respectively. Thus versilin was not specific in its action, but the principal sensitive site was protein synthesis, as further suggested by inhibition of polyU-directed in vitro synthesis of polyphenylalanine. The activation of leucine was unaffected, but the formation of leucyl-tRNA was severely inhibited in all three strains. The differences in sensitivities between the strains were the same, whether as whole cells or as cell-free extracts. Thus the nature of the sensitive site appeared to be identical in the self-sensitive producer and sensitive non-producer or unrelated organism.     

Characterization of versilin-sensitive sites in self-sensitive producer and sensitive non-producer or unrelated organism

Studies on self-sensitivity of producer mutant vs. sensitivity of non-producer parent and unrelated organism showed that versilin inhibited spore germination and sporulation in the self-sensitive producer mutant, non-producer parent Aspergillus versicolor N5 and the unrelated sensitive Trichophyton rubrum. Sporulation appeared to be more sensitive than spore germination. The inhibition of in vivo synthesis of protein was very marked, but inhibition of RNA and DNA was slight and moderate, respectively. Thus versilin was not specific in its action, but the principal sensitive site was protein synthesis, as further suggested by inhibition of polyU-directed in vitro synthesis of polyphenylalanine. The activation of leucine was unaffected, but the formation of leucyl-tRNA was severely inhibited in all three strains. The differences in sensitivities between the strains were the same, whether as whole cells or as cell-free extracts. Thus the nature of the sensitive site appeared to be identical in the self-sensitive producer and sensitive non-producer or unrelated organism.     

Decreased rate of uridine and glycerin uptake in L cells resistant to ethidium bromide

A comparison was made among rates of uptake of 3H-uridine, 3H-glycerol and 3H-D-xylose into mouse fibroblasts of line L sensitive to ethidium bromide (EB), and into EB-resistant cells obtained from this line by selection. Constants of uridine transport and phosphorylation were determined. For EB sensitive L cells Kt was 162 +/- 27 microM, Vt was 7.5 +/- 0.7 microM/sec. For EB resistant cells Kt was 178 +/- 27 microM, and Vt was 4.6 +/- 0.2 microM/sec. Thus, the transport rate of uridine in resistant cells was twice lower than in EB sensitive cells. The rate of uridine phosphorilation in EB resistant cells was by three times lower than in EB sensitive ones. The uptake of glycerol into resistant cells was also lowered. There was no difference in transport of 3H-D-xylose between sensitive and resistant cells. The data obtained may suggest some changes in plasma membrane in the EB resistant cells.     

Comparative study of the cytotoxic effects of anthracycline antibiotics on heterotransplants of human breast cancer cultivated in diffusion chambers in vivo

Cytotoxic activity of doxorubicin, daunomycin, carminomycin and ruboxyl against 50 human breast cancer heterotransplants in diffusion chambers was studied. The effect was estimated autoradiographically on the 6th or the 7th day of the cultivation after the drug administration in the maximum tolerance doses. The tumors were considered sensitive when the labeling index of their transplants after the treatment appeared to be reduced by 50 or less per cent against the control. The number of the tumors sensitive to all the drugs amounted to 72-80 per cent. 19 tumors were sensitive to 4 antibiotics. 14 and 8 tumors were sensitive to 3 and 2 antibiotics, respectively, and only 1 tumor was sensitive to 1 drug. The sensitivity significantly correlated with the initial labeling index of the primary tumors and their heterotransplants. The results suggested that daunomycin and ruboxyl possessed a high cytotoxic activity close to that of doxorubicin and carminomycin and might be recommended for clinical trials in the treatment of patients with breast cancer.     

Determination of killer yeast activity in fermenting grape juice by using a marked Saccharomyces wine yeast strain.

The Escherichia coli beta-glucuronidase gene has been used as a marker gene to monitor a killer Saccharomyces cerevisiae strain in mixed-culture ferments. The marked killer strain was cured of its M-dsRNA genome to enable direct assessment of the efficiency of killer toxin under fermentation conditions. Killer activity was clearly evident in fermenting Rhine Riesling grape juice of pH 3.1 at 18 degrees C, but the extent of killing depended on the proportion of killer to sensitive cells at the time of inoculation. Killer activity was detected only when the ratio of killer to sensitive cells exceeded 1:2. At the highest ratio of killer to sensitive cells tested (2:1), complete elimination of sensitive cells was not achieved.     

Oligonucleotides encapsulated in pH sensitive liposomes are efficient toward Friend retrovirus.

Retroviruses present multiple RNA targets for antisense oligonucleotides. An oligodesoxyribonucleotide (15 mer) complementary to the region of the initiation codon AUG of the env gene mRNA of Friend retrovirus was an inhibitor of the translation of Env protein in vitro. No effect was observed on cells infected with Friend retrovirus. We observed that these oligomers were rapidly degraded in cellular medium. After encapsulation into liposomes, they inhibited the spreading of the virus for chronic or de novo infection. We have compared the efficiency of two compositions of liposomes: pH sensitive and non pH sensitive formulations. Oligomers encapsulated in pH sensitive liposomes were more active that those encapsulated in non pH sensitive liposomes. pH sensitive liposomes could allow to avoid degradation of oligomers by lysosomes.     

Regulation of citric acid production by oxygen: Effect of dissolved oxygen tension on adenylate levels and respiration in Aspergillus niger

Summary The mechanism of the control of citric acid accumulation by oxygen was investigated by means of pilot plant fermentation using Aspergillus niger. The critical dissolved oxygen tension (DOT) for oxygen uptake of this fungus was about 18–21 and 23–26 mbar for trophophase and idiophase, respectively. Minimal DOT for citric acid production was about 25 mbar. Citric acid production increased steadily between 40–150 mbar. Short time changes in the DOT produced immediate, irreversible changes in the rate of product formation. Adenine nucleotides paralleled growth but showed no evidence for control function in the oxygen effect on citric acid fermentation. A branched respiratory system was identified by experiments using specific inhibitors (antimycin, cyanide, azide, rotenone, amytal and salicylhydroxamic acid). Growth was sensitive towards inhibitors of the standard respiratory chain, but only slightly sensitive towards salicylhydroxamic acid (SHAM). Citric acid synthesis was highly sensitive towards SHAM during trophophase, but sensitive towards antimycine during idiophase. Interruptions in aeration cause an impairment of the SHAM sensitive oxidase during trophophase, and of the antimycin sensitive oxidase during idiophase.Dedicated to emeritus Professor Dr. Richard Brunner on the occasion of his 80th birthday     

Hypoxia increases cell death in multidrug-resistant leukemia cells. Differences in viability and ultrastructure between sensitive and multidrug-resistant L1210 mouse leukemic cells under hypoxia

The comparative study of sensitive and multidrug-resistant L1210 cells under 24 hours of hypoxia (2% O2 and 5% CO2 at 37 degrees C) was done to see if differences in energetic metabolism between both cell lines are paralleled by differences in cellular morphology. During the dye exclusion assay the viability of sensitive cells was about 70 to 90%, whereas only 30 to 50% of resistant cells were viable. Electron microscopic study of sensitive and resistant L1210 cells under hypoxia has shown cells of different ultrastructural appearance in both cell lines. Cells with necrotic changes (swollen mitochondria, lysed cells) prevailed in resistant cells. The highest incidence of cells with normal or slightly dense mitochondria was found among the sensitive L1210 cells. Additionally, cells with pyknotic nuclei, shrunken cytoplasm and dense mitochondria, reminiscent of apoptosis, could be found sporadically, especially in the sensitive L1210 cell line. These results are in agreement with flow cytometry measurements: in resistant cells the number of necrotic cells was on the average 2.3 times higher than in sensitive cells. Ultrastructural differences and differences in the numbers of necrotic cells as measured by flow cytometry between sensitive and resistant L1210 cells under hypoxia are consistent with differences in energetic metabolism between these cell lines, as described in earlier studies, and document an increased cell death in the resistant L1210 cell line.