中长期深静脉留置透析的导管相关性感染菌群分布及药敏分析

目的探讨中长期深静脉留置透析的导管相关性感染(CRI)菌群分布及药敏分析。方法回顾性分析39例导管相关性感染患者发生率及感染类型,不同置管部位的感染情况,病原菌的种类分布,药敏试验和疗效。结果 106例中长期导管透析的患者中,39例发生导管相关性感染,占36.7%。其中感染率较高的原发病为狼疮肾及糖尿病性肾病。39例标本菌培养阳性,分离出6种病原菌,41株细菌。病原菌分布:革兰阳性球菌24株,占61.5%;革兰阴性杆菌15株,占38.5%。葡萄球菌属最为敏感的抗生素为万古霉素,对于革兰阴性杆菌,亚胺培南和头孢哌酮最为敏感。结论中长期维持性血液透析患者导管相关性感染的发生率较高,只有医护人员严格进行无菌操作,加强环境卫生,积极开展健康宣教,合理使用敏感抗菌药物,防止创口的污染,才能降低CRI的发生率,最终取得良好的临床效果。     

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。     

双歧醋对常见病原菌的生物拮抗作用研究

目的研究双歧醋对常见病原菌的生物拮抗作用及影响因素。方法采用纸片扩散法(K-B法)、琼脂打孔法和试管稀释法(M IC法)测定双歧醋及其处理物(加热、不同pH)对常见病原菌的拮抗作用,并讨论pH、加热对拮抗作用的影响,同时用某市售醋作为对照。结果双歧醋及其处理物均具有一定的抑菌作用。结论双歧醋对常见病原菌有一定的拮抗作用,抑菌作用强于市售醋。     

上睑退缩患者术后切口感染的危险因素分析及防控

目的探讨上睑退缩患者术后切口感染的危险因素及防控措施。方法选取2009年至2019年我科因各类原因引起的上睑退缩并进行手术治疗的患者606例为研究对象,根据术后是否发生切口感染分为感染组(30例)与非感染组(576例)。分析患者切口感染的发生率与病原菌分布,并利用Logistic回归分析进行危险因素分析。结果共出现30例(4.95%)术后切口感染患者,其中外伤性、Graves眼病与上睑下垂术后源性患者分别为9、12、9例。30例切口感染患者共分离出34株病原菌,其中革兰阳性菌19株(55.88%),革兰阴性菌12株(35.29%),真菌3株(8.82%)。年龄(OR=0.188,P=0.006)、糖尿病(OR=0.234,P=0.005)、BMI(OR=0.151,P=0.001)、住院时间(OR=1.276,P=0.005)与上睑退缩原因(OR=0.177,P=0.006)是术后切口感染的独立危险因素。结论上睑退缩患者术后切口感染病原菌主要为革兰阳性菌。术后切口感染与高龄、合并糖尿病、高BMI指数、住院时间长、外伤性上睑退缩具有显著相关性。     

化脓性中耳炎病原菌感染的研究进展

化脓性中耳炎是耳鼻喉科临床常见疾病,可导致听力下降、鼓膜充血、鼓膜穿孔、耳鸣、耳痛及流脓等。化脓性中耳炎主要由微生物进入中耳引起感染,使中耳黏膜发生化脓性病变,且不同患者感染的病原菌不同。本文从化脓性中耳炎的发病机制、病原菌及其耐药性和治疗方法等几个方面进行综述,以期为临床化脓性中耳炎的诊断及合理用药提供参考。     

A marine killer yeast against the pathogenic yeast strain in crab (Portunus trituberculatus) and an optimization of the toxin production

A pathogenic yeast strain WCY which could cause milky disease in Portunus trituberculatus was identified to be Metschnikowia bicuspidate according to the results of routine yeast identification and 18S rDNA and ITS sequences. After screening of more than 300 yeast strains from different sources in marine environments, it was found that strain YF07b had the highest ability to produce killer toxin against the pathogenic yeast. Strain YF07b was identified to be Pichia anomala according to the results of routine yeast identification and 18S rDNA and ITS sequences. The optimal conditions for killer toxin production by strain YF07b were the production medium with 2.0% NaCl, pH 4.5, cultivation temperature of 20 degrees C and the optimal conditions for action of the crude killer toxin against the pathogenic yeast were the assay medium with 6.0% NaCl, pH 4.5 and temperature 15 degrees C.     

One-pot synthesis of 2-C-glycosylated benzimidazoles from the corresponding methanal dimethyl acetals

A series of 2-glycosyl-benzimidazoles with alpha-d-arabinopyranosyl, beta-d-galactopyranosyl, beta-d-glucopyranosyl, beta-d-mannopyranosyl, and beta-l-rhamnopyranosyl configurations were obtained in 52-73% yields from the corresponding C-glycosylmethanal dimethyl acetals and o-phenylenediamine under catalysis with hydrogen chloride or a strongly acidic cation-exchange resin. Intermediate benzimidazolines were spontaneously oxidized by air to produce the final products in the one-pot procedure. The prepared compounds did not show any inhibitory effect on the growth of 12 strains of five different species of pathogenic yeasts.     

医院获得性肺炎病原菌分布及其耐药性分析

目的了解医院获得性肺炎(HAP)患者病原菌分布及其耐药性分析。方法236例被诊断为医院获得性肺炎(HAP)患者的痰及下呼吸道分泌物进行常规细菌培养鉴定,用NCCIS推荐的K-B法测定病原菌的耐药性。结果236例HAP患者检出病原菌276株,病原菌中革兰阴性杆菌占56.52%,以铜绿假单胞菌和肺炎克雷伯杆菌为主,构成比为24.64%和10.14%,最敏感的药物是碳青霉烯类药物亚胺培南,耐药率均在13.3%以下。革兰阳性球菌占30.44%,以金黄色葡萄球菌为主,构成比为21.02%,在药敏感试验方面除对万古霉素100%敏感外,对其他药物都表现出不同程度的耐药。真菌的检出率为13.04%,以白色念珠菌为主,构成比为9.42%。结论医院获得性肺炎患者应及时送检病原标本做细菌培养,按药敏结果合理选用抗生素。     

Prevalence of antibiotic resistant mastitis pathogens in dairy cows in Egypt and potential biological control agents produced from plant endophytic actinobacteria

Dairy production is threatened by antibiotic resistant pathogens worldwide, and alternative solutions to treat mastitis are not available. The prevalence of antibiotic resistant strains is not well known in less developed countries. The prevalence of pathogenic bacteria and their resistance to 21 commercial antibiotics were studied in milk samples taken from 122 dairy cows suffering from the symptoms of mastitis in Egypt. The bacterial species were identified with molecular methods, and antibiotic resistance was studied with disc diffusion method. The prevalence of Streptococcus aureus, Escherichia coli and Pseudomonas aeruginosa were 30%, 17% and 3.5%, respectively. Most (90%) of the S. aureus strains showed resistance to penicillin whereas only 10% of the strains were resistant to oxacillin. Nearly half (40%) of E. coli strains showed resistance to streptomycin. Six P. aeruginosa strains showed resistance to several antibiotics, including ceftriaxone, enrofloxacin and levofloxacin. This points out that despite P. aeruginosa was not common, it should be followed up carefully. Potential biocontrol agents against antibiotic resistant mastitis bacteria were searched among 30 endophytic actinobacterial strains derived from wild medicinal plants. Three plants, namely Mentha longifolia, Malva parviflora and Pulicaria undulata were chosen for a more detailed study; their endophytic actinobacteria were used to prepare metabolic extracts. The crude metabolites of the actinobacteria were extracted with ethyl acetate. All metabolic extracts inhibited the growth of S. aureus, methicillin-resistant Staphylococcus aureus (MRSA), E. coli and P. aeruginosa in vitro. The 16S rRNA sequence analysis revealed that the most efficient actinobacterial strains were two Micromonospora sp. and one Actinobacteria bacterium. We conclude that the combination of the metabolites of several endophytic actinobacteria derived from several medicinal plants would be the most efficient against pathogens. Different metabolite cocktails should be studied further in order to develop novel biocontrol agents to treat antibiotic resistant mastitis bacteria in dairy cows.     

腹部外伤患者术后感染与血清炎症因子的关联性研究

本研究旨在探讨外伤术后腹腔感染患者血清降钙素原(PCT)、肿瘤坏死因子-α(TNF-α)、C-反应蛋白(CRP)和白细胞介素6 (IL-6)的水平变化与感染程度的相关性,为外伤术后腹腔感染临床治疗、抗菌药物应用提供依据。本研究选取我院2015年1月至2017年5月收治的腹部外伤手术患者150例,其中术后发生感染患者83例,未感染组,未发生感染患者67例,为非感染组。通过检测其术前术后及进行抗感染治疗后的PCT、TNF-α、CRP、IL-6水平,对腹腔感染标本进行菌种鉴定,并分析PCT、TNF-α、CRP、IL-6水平变化与腹腔感染的相关性,本研究发现,感染组患者术后各时间段血清PCT、TNF-α、CRP、IL-6水平明显较术前升高(p<0.05);且在术后12 h、24 h、72 h的PCT、TNF-α、CRP、IL-6水平明显高于未感染组(p<0.05);感染患者标本共检出76株不同的菌株,革兰阴性杆菌45株,革兰阳性菌22株,真菌9株;PCT、TNF-α、CRP在术后12 h、24 h、72 h检出感染的阳性率与病原学诊断结果相关性较高,血清IL-6则在术后72 h检出感染的阳性与病原学诊断相关性较高。本研究初步得出结论,临床检测血清PCT、TNF-α、CRP和IL-6均有助于鉴别是否存在外科腹腔感染,对抗菌药物的应用有一定的指导作用。