伤口分泌物的病原菌分布及耐药性分析

目的调查福建省龙岩市第二医院伤口分泌物病原菌的分布及耐药情况,为合理应用抗生素提供依据。方法收集2012年1月至2013年5月患者伤口分泌物标本,采用常规方法进行分离培养,用VITEK-2 Compact全自动微生物分析仪系统进行鉴定及药敏分析。结果送检503份标本,培养阳性272份,阳性率为54. 1% ;病原菌检出343株,其中革兰阴性菌189株占55. 1%,革兰阳性菌151株占44.0%,真菌3株占0.9% ;前5位的病原菌分别为金黄色葡萄球菌、凝固酶阴性葡萄球菌、铜绿假单胞菌、大肠埃希菌、鲍曼不动杆菌。耐甲氧西林金黄色葡萄球菌（MRSA）和耐甲氧西林凝固酶阴性葡萄球菌（MRCNS）的检出率分别是30.4%、82. 1%。粪肠球菌中耐高浓度氨基糖苷类肠球菌（HLAR）的检出率为55%。革兰阳性菌对万古霉素、替加环素、利奈唑胺未出现耐药菌株。铜绿假单胞菌、肠杆菌科细菌对亚胺培南的耐药率分别为5. 6%、0。大肠埃希菌中超广谱P-内酰胺酶（ESBL）的检出率是42.9%。鲍曼不动杆菌对头孢哌酮/舒巴坦的耐药率最低为25.0%,对其他抗菌药物耐药严重,多数抗菌药物的耐药率均〉45%。结论伤口感染的主要病原菌是革兰阴性菌,多重耐药菌株比例较高,临床应根据药敏结果合理选用抗生素,减少新的耐药菌株出现。     

活性氧在创伤愈合中作用的研究

：创伤愈合是一个复杂的生物学过程,包括出血与凝血、炎症渗出、血管和肉芽组织的形成、再上皮化、纤维化和瘢痕改建等,在这一系列的生物学活动过程中都需要能量支持;高等动物使用氧气作为终端氧化剂,通过对碳水化合物的氧化作用为愈合过程中的各种生命活动提供能量,但该过程却可以产生大量的活性氧,这些活性氧在创伤愈合的过程中扮演着重要的角色,在低浓度情况下可以促进伤口的愈合,而在高浓度时会抑制伤口愈合,而活性量浓度的过高过低都会影响创口的正常愈合过程。     

Actin exposure upon tissue injury is a targetable wound site-specific protein marker

BackgroundIdentification of wound-specific markers would represent an important step toward damaged tissue detection and targeted delivery of biologically important materials to injured sites. Such delivery could minimize the amount of therapeutic materials that must be administered and limit potential collateral damage on nearby normal tissues. Yet, biological markers that are specific for injured tissue sites remain elusive.MethodsIn this study, we have developed an immunohistological approach for identification of protein epitopes specifically exposed in wounded tissue sites.ResultsUsing ex-vivo tissue samples in combination with fluorescently-labeled antibodies we show that actin, an intracellular cytoskeletal protein, is specifically exposed upon injury. The targetability of actin in injured sites has been demonstrated in vivo through the specific delivery of anti-actin conjugated particles to the wounded tissue in a lethal rat model of grade IV liver injury.ConclusionsThese results illustrate that identification of injury-specific protein markers and their targetability for specific delivery is feasible.General significanceIdentification of wound-specific targets has important medical applications as it could enable specific delivery of various products, such as expression vectors, therapeutic drugs, hemostatic materials, tissue healing, or scar prevention agents, to internal sites of penetrating or surgical wounds regardless of origin, geometry or location.     

微生物谷氨酰胺转胺酶对大鼠创伤愈合作用的实验研究

本文研究了微生物谷氨酰胺转胺酶对大鼠创伤的促愈合作用。建立大鼠背部刀割伤模型,用创面照像、透明膜描记扫描记录伤后第5、10、15、20 天创面面积,计算创伤愈合率;并用注水法测量伤腔容积,同时观测肉芽组织再生及其总蛋白、氨基已糖和己糖醛酸的含量变化情况。结果实验组创面愈合时间平均为18.1天,较对照组平均缩短了2-3天(P<0.05);创伤愈合率显著提高(P<0.05或P<0.01);伤腔容积明显缩小(P<0.05);实验组肉芽干湿重较对照组显著增加(P<0.05),肉芽中蛋白质、氨基已糖和己糖醛酸含量增加显著(P<0.05)。结果显示谷氨酰胺转胺酶具有促进大鼠皮肤创伤愈合的作用,其作用机理可能是促进肉芽组织中蛋白质,氨基多糖和胶原的合成有关。     

Prevalence,antimicrobial resistance profile,and characterization of multi-drug resistant bacteria from various infected wounds in North Egypt

Multi-drug resistant (MDR) bacteria associated with wounds are extremely escalating. This study aims to survey different wounds in Alexandria hospitals, North Egypt, to explore the prevalence and characteristics of MDR bacteria for future utilization in antibacterial wound dressing designs. Among various bacterial isolates, we determined 22 MDR bacteria could resist different classes of antibiotics. The collected samples exhibited the prevalence of mono-bacterial infections (60%), while 40% included poly-bacterial species due to previous antibiotic administration. Moreover, Gram-negative bacteria showed dominance with a ratio of 63.6%, while Gram-positive bacteria reported 36.4%. Subsequently, the five most virulent bacteria were identified following the molecular approach by 16S rRNA and physiological properties using the VITEK 2 automated system. They were deposited in GenBank as Staphylococcus haemolyticus MST1 ({"type":"entrez-nucleotide","attrs":{"text":"KY550377","term_id":"1304487819","term_text":"KY550377"}}KY550377), Pseudomonas aeruginosa MST2 ({"type":"entrez-nucleotide","attrs":{"text":"KY550378","term_id":"1304487820","term_text":"KY550378"}}KY550378), Klebsiella pneumoniae MST3 ({"type":"entrez-nucleotide","attrs":{"text":"KY550379","term_id":"1304487821","term_text":"KY550379"}}KY550379), Escherichia coli MST4 ({"type":"entrez-nucleotide","attrs":{"text":"KY550380","term_id":"1304487822","term_text":"KY550380"}}KY550380), and Escherichia coli MST5 ({"type":"entrez-nucleotide","attrs":{"text":"KY550381","term_id":"1304487823","term_text":"KY550381"}}KY550381). In terms of isolation source, S. haemolyticus MST1 was isolated from a traumatic wound, while P. aeruginosa MST2 and E. coli MST4 were procured from hernia surgical wounds, and K. pneumoniae MST3 and E. coli MST5 were obtained from diabetic foot ulcers. Antibiotic sensitivity tests exposed that K. pneumoniae MST3, E. coli MST4, and E. coli MST5 are extended-spectrum β-lactamases (ESBLs) bacteria. Moreover, S. haemolyticus MST1 belongs to the methicillin-resistant coagulase-negative staphylococcus (MRCoNS), whereas P. aeruginosa MST2 exhibited resistance to common empirical bactericidal antibiotics. Overall, the study provides new insights into the prevalent MDR bacteria in Egypt for further use as specific models in formulating antibacterial wound dressings.     

In situ translocation of volicitin by beet armyworm larvae to maize and systemic immobility of the herbivore elicitor <Emphasis Type="Italic">in planta</Emphasis>

Volicitin (N-[17-hydroxylinolenoyl]-l glutamine) present in the regurgitant of beet armyworm (Spodoptera exigua) activates the emissions of volatile organic compounds (VOCs) when in contact with damaged corn (Zea mays L.) leaves. VOC emission in turn serves as a signaling defense for the plant by attracting female parasitic wasps that prey on herbivore larvae. Chemical tracking of volicitin within plants has yet to be reported. Here we present biochemical data that beet armyworm regurgitant serves as a vector for the introduction of volicitin to the site of leaf damage under natural feeding conditions. Corn seedlings were ¹⁴CO₂-labeled in situ, and beet armyworm larvae were allowed to feed on the labeled leaves. Herbivore oral secretions collected from late-third-instar larvae contained approximately 120 pmol volicitin (0.05 nCi pmol^–1) per larva. When radiochemically labeled larvae were placed on unlabeled leaves, the amount of volicitin introduced to the damaged site was approximately 5.0 nCi (calc. 100 pmol/larvae). The mobility of volicitin in leaves was examined by allowing radiolabeled beet armyworms to feed on unlabeled plants. In such tracking experiments, radioactivity was not detected in the upper leaves; however, the exogenous application of 5 nCi of [U-¹⁴C]sucrose to the lower leaf did result in subsequent radioactivity being detected in the upper portion of the plant. The detection of labeled sucrose with the same radioactivity as that of administered volicitin indicated that volicitin was not readily transported to undamaged leaves and that volicitin may not directly serve as a mobile messenger in triggering the emissions of VOCs systemically.Abbreviations BAW Beet armyworm (Spodoptera exigua) - dpm Disintegrations per minute - FAA Fatty acid amide - JA Jasmonic acid - VOC Volatile organic compound     

Keratinocyte growth factor: effects on keratinocytes and mechanisms of action

Keratinocyte growth factor (KGF) is a potent and specific mitogen for different types of epithelial cells, and it can protect these cells from various insults. Due to these properties, it is of particular importance for the repair of injured epithelial tissues, and it is currently therapeutically explored for the treatment of radiation- and chemotherapy-induced mucosal epithelial damage in cancer patients. In this review we summarize the current knowledge on the role of KGF in tissue repair and cytoprotection, and we report on its mechanisms of action in keratinocytes.     

Expression and function of connexins in the epidermis, analyzed with transgenic mouse mutants

Eight different connexins are expressed in mouse epidermis with overlapping expression patterns in different epidermal layers. Analyses of mice with deficiency or modifications of distinct connexins yielded insights into the large variety of connexins in the epidermis. Connexin43 (Cx43) deficiency in mouse epidermis resulted in a significant acceleration of wound closure. Truncation by 125 amino acid residues of the Cx43 C-terminal region led to an altered epidermal expression pattern of Cx43 and defective development of the epidermal water barrier in transgenic mice, although the truncated Cx43 protein could still form open gap junctional channels in transfected HeLa cells. Thus, the phenotypic abnormalities observed in mice with truncated Cx43 protein (Cx43K258Stop) are more likely due to defective regulation of this protein rather than the closed Cx43 channel. Our studies of connexin-deficient mice revealed an extensive redundancy of connexins expressed in mouse epidermis. Epidermal connexins seem to form two functional groups in which deficiency of one connexin isoform can be compensated by other connexin isoforms of the same group.     

Chitosan induces different L-arginine metabolic pathways in resting and inflammatory macrophages

Chitosan is a linear polymer of N-acetyl-D-glucosamine and deacetylated glucosamine widely used as a wound-healing accelerator in clinical and veterinary medicine. Chitosan enhances the functions of inflammatory cells such as macrophages (Mphi), inducing the production of cytokines as well as the expression of activation markers, Fc receptors and mannose receptor. In this work we studied the effects of chitosan on the arginine metabolic pathways of both resident and inflammatory (proteose-peptone elicited) rat Mphi. Our results show that low molecular weight (LMW) chitosan activated moderately both the inducible nitric oxide synthase (iNOS) and arginase pathways in resident Mphi. In inflammatory Mphi treated with chitosan instead, the arginase activity was strongly enhanced. Supernatants of chitosan-stimulated Mphi enhanced the proliferation of the rat cell line C6. These findings suggest that the healing activity of chitosan could rely on the enhanced arginase activity observed in a wound-associated inflammatory milieu.