脑卒中患者医院获得性肺炎的病原菌分布及药敏分析

目的:分析脑卒中患者医院获得性肺炎的病原菌分布及药敏性,为临床合理使用抗菌药物提供依据。方法:收集2013年3月-2015年9月我院收治的109例脑卒中并发医院获得性肺炎的临床资料,采用无菌方法收集患者晨痰或者下呼吸道分泌物进行细菌培养,并对阳性病原菌进行药物敏感性试验。结果:对痰标本或者是下呼吸道分泌物进行细菌培养187次,培养阳性152次,阳性率为81.28%,共培养出病原菌283株,其中革兰阴性菌192株占67.84%,革兰阳性菌76株占26.86%,真菌15株占5.30%。革兰阴性菌中的肺炎克雷伯菌,鲍氏不动杆菌,大肠埃希菌,铜绿假单胞菌,阴沟肠杆菌对头孢噻肟,头孢呋辛,美洛西林,美洛西林,头孢呋辛和头孢噻肟的耐药率最高,分别为66.18%,65.31%,70.97%,64.00%,71.43%;对氯霉素,哌拉西林/他唑巴坦,氯霉素,头孢吡肟,氯霉素的耐药率最低,分别为1.47%,6.12%,3.23%,8.00%,7.14%。革兰阳性菌中的金黄色葡萄球菌,肺炎链球菌,粪肠球菌对万古霉素,万古霉素,氨苄西林的耐药率最高,分别100.00%,90.00%,84.62%;对红霉素,红霉素,红霉素的耐药率最低,分别为5.26%,0.00%,0.00%。结论:革兰阴性菌是脑卒中患者医院获得性肺炎的主要病原菌,病原菌耐药性高且存在耐多药现象,临床应合理选用抗菌药物进行治疗。     

脆弱类杆菌与大肠杆菌混合感染的小鼠皮下脓肿模型的定量研究

本文用临床上厌氧菌感染中最常见的B.f(脆弱类杆菌)与兼性菌中最常见的E.c(大肠杆菌)作混合感染致病协同性研究的模式菌株,从定量角度建立小鼠皮下脓肿的感染模型。结果表明,单独在昆明小鼠皮下接种B.f 10~7(CFu/m)后1/10发生脓肿,10~8与10~9菌量分别有3/10及6/10发生脓肿。B.f的CP(荚膜多糖)提取物125μg、250μg、500μg,其脓肿形成率分别为1/10、2/10和4/10。单独注射E.c10~6～10~7菌量时,无脓肿及死亡发生。10~8时3/10小鼠死亡,脓肿不典型。引起感染的菌量阈值B.f为10~7,E.c为10~8。B.f致病特征为引起脓肿,E.c为引起死亡。混合感染两种菌浓度均在10~7时,5/10发生脓肿,2/10发生死亡。在感染灶中两种菌浓度总数分别保持在≥10~7。B.f与E.c混合感染时有明显的协同致死与协同致脓肿效应。     

Pathogenic analysis of coxsackievirus A10 in rhesus macaques

Coxsackievirus A10 (CV-A10) is one of the etiological agents associated with hand, foot and mouth disease (HFMD) and also causes a variety of illnesses in humans, including pneumonia, and myocarditis. Different people, particularly young children, may have different immunological responses to infection. Current CV-A10 infection animal models provide only a rudimentary understanding of the pathogenesis and effects of this virus. The characteristics of CV-A10 infection, replication, and shedding in humans remain unknown. In this study, rhesus macaques were infected by CV-A10 via respiratory or digestive route to mimic the HFMD in humans. The clinical symptoms, viral shedding, inflammatory response and pathologic changes were investigated in acute infection (1–11 day post infection) and recovery period (12–180 day post infection). All infected rhesus macaques during acute infection showed obvious viremia and clinical symptoms which were comparable to those observed in humans. Substantial inflammatory pathological damages were observed in multi-organs, including the lung, heart, liver, and kidney. During the acute period, all rhesus macaques displayed clinical signs, viral shedding, normalization of serum cytokines, and increased serum neutralizing antibodies, whereas inflammatory factors caused some animals to develop severe hyperglycemia during the recovery period. In addition, there were no significant differences between respiratory and digestive tract infected animals. Overall, all data presented suggest that the rhesus macaques provide the first non-human primate animal model for investigating CV-A10 pathophysiology and assessing the development of potential human therapies.     

Manganese and fungal pathogens: Metabolism and potential association with virulence

Nutritional immunity is one of the strategies employed by the host to combat invading pathogens. It consists of actively controlling micronutrient bioavailability in the site of infection to hinder microbial growth. The role of manganese in cell biology and nutritional immunity for bacterial pathogens is well understood, but data regarding fungi are still limited. Fungi have evolved complex regulatory systems to acquire, distribute, and utilize manganese. Therefore, the disruption of manganese homeostasis in pathogenic fungi may lead to severe phenotypes and impact virulence. Because the host presents tools for manganese sequestration, and this condition can reduce the growth of important fungal pathogens such as Candida albicans, Aspergillus fumigatus, and Cryptococcus neoformans, it is feasible to suppose that manganese nutritional immunity could play an important role in fungal infections. However, direct evidence is still lacking, and little is known about manganese homeostasis, nutritional immunity, and specific adaptations in individual species of fungal pathogens. In this opinion, we present the current body of knowledge about these subjects, arguing about manganese importance in host–pathogen interactions.     

口腔种植体周围细菌感染病原菌分布特点及细菌感染的危险因素分析

摘要 目的：观察口腔种植体周围细菌感染病原菌分布特点,分析细菌感染的危险因素。方法：选择360例于2018年7月~2021年5月在我院行口腔种植术的患者。根据是否发生口腔种植体周围细菌感染将患者分为感染组和未感染组。分离鉴定感染组病原菌种类。收集患者的临床资料,引起口腔种植体周围细菌感染的影响因素采用单因素及多因素Logistic回归分析。结果：360例患者中共有35例发生口腔种植体周围细菌感染,发生率为9.72%。共分离出49株病原菌,其中需氧菌14株（28.57%）、厌氧菌32株（65.31%）、有益菌3株（6.12%）;厌氧菌中又以口腔链球菌11株（22.45%）、牙龈卟啉单胞菌9株（18.37%）、产黑色素普雷沃菌7株（14.29%）为主。单因素分析结果显示：口腔种植体周围细菌感染的发生与吸烟史、慢性牙周炎病史、饮酒史、是否合并糖尿病、种植体周围牙槽骨情况以及口腔健康习惯有关（P＜0.05）;多因素Logistic回归分析显示口腔种植体周围细菌感染的危险因素是口腔健康习惯不良、种植体周围牙槽骨不良、合并糖尿病、有饮酒史、有慢性牙周炎病史、有吸烟史（P＜0.05）。结论：口腔种植体周围细菌感染的病原菌以厌氧菌为主,种植体周围牙槽骨不良、有慢性牙周炎病史、有吸烟史、合并糖尿病、饮酒史、口腔健康习惯不良是感染发生的危险因素,应针对上述因素进行适当干预。     

Inhibition of Legionella pneumophila by Bacillus sp.

This study presents the potential of a biological control of Legionella pneumophila. It was verified to what extent the enrichment of various Bacillus species in water may decrease or prevent L. pneumophila from growing in water. During in vitro tests, B. subtilis BS104 was able to induce an average decrease in L. pneumophila numbers of 1.9 + 0.2 log units after 120 h. Furthermore, the spore and cell free filtrate of B. subtilis BS104 also decreased L. pneumophila by 2.6 + 0.4 log units after 120 h. An addition of Bacillus BS104 to a cooling tower test system with a water volume of 8 m³ resulted in a L. pneumophila level below 1000 CFU/L after 3 weeks, whereas the starting point was 5.3 × 10⁴ CFU/L. Further experiments also indicated that B. subtilis BS104 might inhibit the internal replication of L. pneumophila in Acanthamoeba castellanii. This paper demonstrates that certain strains of Bacillus have the potential of reducing the number of viable L. pneumophila in water, or at least prevent its increase. These results are the first indication that a biological abatement of L. pneumophila could be possible.     

成人与儿童下呼吸道标本病原菌分布差异的比对与耐药性分析

目的调查研究温州市中西医结合医院温州市儿童医院成人与儿童病区下呼吸道标本病原菌的分布差异与抗生素耐药性分析。方法对2010年7月至2011年6月的所有成人与儿童下呼吸道感染患者的临床标本（痰,咽拭）进行微生物检验并统计分析。结果成人感染以非发酵细菌为主,并且出现MDR/PDR现象;儿童细菌性感染以肠杆菌细菌为主;G＋菌感染还是以金黄色葡萄为主,也有MRSA菌株出现,未超过15%,远远低于成人水平。铜绿假单胞菌检出率占成人下呼吸道感染的首位,头孢三、四代对成人铜绿假单胞菌耐药性在50%左右;阿米卡星有很好的敏感性,耐药率为5.2%;头孢哌酮/舒巴坦的耐药率已达20.59%;碳青霉烯类抗生素的耐药率在50%左右。成人鲍曼不动杆菌只有米诺环素、头孢哌酮/舒巴坦有较好的敏感性,耐药率在10%左右;并且已经出现全耐药菌株。儿童检出病原菌中对头孢哌酮/舒巴坦、碳青霉烯类抗生素未发现耐药菌株,对头孢三、四代仍有较好的敏感性,还没出现高耐菌株。头孢三、四代对成人肺炎克雷伯菌耐药性已高达75%左右;头孢哌酮/舒巴坦、碳青霉烯类抗生素的耐药率将达20%。儿童中MRSA检出率为13.32%,成人已高达72.15%,未发现对万古霉素、替考拉宁、利那唑胺耐药菌株。结论儿童与成人在下呼吸道感染病原菌分布与耐药性存在明显差异。应杜绝滥用抗生素,做到有的放矢。     

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.     

B．animalis V9对腹泻动物的保护性作用及其机制研究

目的研究益生菌B.animalis V9对腹泻动物的保护作用及其对腹泻致病菌的拮抗效果。方法采用自制的腹泻SPF鼠,喂服B．animalis V9,观察并检测腹泻致病菌,并在体外试验益生菌B．animalisV9对腹泻致病菌的拮抗作用。结果SPF鼠致泻动物模型喂食B．animalisV9,剂量为1．0×10^8CFU/（只·d）,3d后腹泻治愈率为90％,死亡率为9％,对照组自然恢复率为16％,死亡率为41％,其余仍有不同程度的腹泻现象。B．animalis V9在体外对志贺痢疾杆菌、沙门菌、铜绿假单胞菌和大肠埃希菌有不同程度的拮抗作用,共同培养60h后均未检测到上述4种致病菌。结论B．animalisV9可以有效的对腹泻小鼠进行治疗,其机制在于B．animalisV9对致泻菌株具有一定程度的拮抗作用。     

石鲽细菌性败血感染症及其病原细菌研究

2001—2002年,分别对两起养殖的石鲽(Stone flounder,Kareius bicoloratusL.)病害进行了检验,均表现为败血症感染特征。经以20尾病(死)石鲽(每起病例各10尾)做病变组织中细菌检查、细菌分离与鉴定、人工感染试验等的病原学检验,表明两起被检病例均为同种的杀鲑气单胞菌(Aeromonas salmonicida)感染;另在其中1起病例所检10尾石鲽的2尾中,同时检出了呈继发感染的不动杆菌(Acinetobacter)。通过对所分离后做纯培养的60株杀鲑气单胞菌6、株不动杆菌分别进行较系统的表观分类学指征(Phenotypic information)及代表菌株16S rRNA基因序列测定与系统发育学分析,表明其中的杀鲑气单胞菌为一个新亚种,不动杆菌为琼氏不动杆菌(Acinetobacter junii)的一个新形态型;又择代表菌株送中国典型培养物保藏中心(CCTCC)进行了表观性状、DNA中C Cmol%的测定等的复核鉴定,并将其中的杀鲑气单胞菌新亚种定名为杀鲑气单胞菌杀鲽亚种(Aeromonas salmonicidasubsp.flounderacidasubsp.no...