评价基质辅助激光解析电离飞行时间质谱对葡萄球菌属的鉴定能力

目的评价基质辅助激光解析电离飞行时间质谱(MALDI-TOF MS)在临床鉴定常见葡萄球菌属的能力。方法采用MALDI-TOF MS对2011-2013年收集的151株葡萄球菌属进行分析比较;对鉴定结果不一致的菌株,用16SrRNA测序方法进行最后鉴定,评价MALDI-TOF MS的鉴定能力。结果 151株葡萄球菌属用MALDI-TOF MS与VITEK-2鉴定结果一致的有135株,符合率为89.4%,两种鉴定方法对39株金黄色葡萄球菌、34株表皮葡萄球菌及1株施氏葡萄球菌的鉴定符合率为100.0%;对16株结果不一致的随即用16SrRNA作进一步分析,其中15株鉴定结果与MALDI-TOF MS结果一致,MALDI-TOF MS与16SrRNA测序法对葡萄球菌属的鉴定能力符合率更高。结论与传统的VITEK-2鉴定方法比较,MALOT-TOF MS具有简便、快速、敏感、准确等优点,可用于葡萄球菌属的鉴定。     

厌氧菌微量快速生化鉴定系统A—20的研究

厌氧菌常规生化鉴定是比较复杂的检验方法。国外出现了许多商品化的生化试剂盒,这些微量快速方法不仅给细菌检验工作者提供了一个简明,科学的鉴定程序,而且对提高细菌检验质量也具有一定意义。我们在参考国外文献和实物的基础上,研制了A-20厌氧菌生化鉴定系统。它包括菌株准备,接种培养,生化反应结果,编码检索,确定菌名等。A-20法与常规生化管法相比,经362株厌氧菌验证,其符合率为91.16%,可达国外同类产品的效果。在计算机上对28种厌氧菌进行了系统仿真试验,模拟了50080株菌,平均符合率达92.35%,仅有7.65%不符合,说明这套系统的设计基本上能满足对常见厌氧菌鉴定的要求。     

两种仪器在微生物室间质评中的应用与比较

目的通过VITEK-32和Microscan AS-4微生物鉴定系统对室间质控菌株的鉴定,了解两种仪器的差异性及与质评结果的符合程度。方法对39株不同批次的质控菌株按操作规程进行分离与培养,用VITEK-32和Microscan AS-4进行鉴定并作比较。结果VITEK-32和Microscan AS-4能直接鉴定到种的菌株与39株质控株的符合率分别为76.9%和69.5%,经血清学或进一步生化验证后符合率分别为89.7%和76.9%,其中,二者对22株革兰阴性菌的鉴定符合率分别为90.9%和81.8%,对17株革兰阳性菌的鉴定符合率则分别为88.2%和58.8%。结论VITEK-32对微生物的检出率和准确性均优于Microscan AS-4,尤其在肠球菌属和链球菌属鉴定方面;二者对革兰阴性菌的鉴定准确性较好,对革兰阳性球菌的鉴定准确性稍差,而对需要血清学证实的沙门菌属、志贺菌属都不能鉴定到种。     

革兰阴性细菌编码系统(GN-27)对肠杆菌科细菌的鉴定评价

目的:用常规细菌鉴定方法和API20系统两种方法对我们自行设计的革兰阴性细菌鉴定编码系统(GN-27)进行评价。方法:用3种方法对16株质控菌株(14株全国质控菌株,2株省质控菌株),42株临床菌株进行重新鉴定,分析鉴定结果。结果:GN-27细菌鉴定板与常规鉴定方法符合率为100%,API20E系统与常规鉴定方法、GN-27系统完全符合者55株,符合率为94.83%,3种方法在统计学上无显著性差异(P>0.05)。结论:GN-27系统在肠杆菌科细菌鉴定方面使用较为满意,可作为一种适用于各级医院临床常规细菌鉴定的较为可靠的方法。     

细菌芽孢染色纸片的制备和应用

该项研究工作是结合微生物检验工作的实际,用国产材料研制成的细菌芽孢染色纸片。经对10株芽孢杆菌染色证实,与常规方法所得结果的符合率为100%。经鉴定证明属国内领先水平。本刊选此文章,旨在检验工作者进一步重复、验证、推进微生物检验工作。     

2种细菌鉴定法在革兰阳性菌引起的血培养阳性标本中的实验研究

目的探讨直接细菌鉴定和药敏试验与常规细菌鉴定和药敏试验,在革兰阳性菌引起的血培养阳性标本中的临床应用价值。方法选取革兰阳性菌127株,分别使用直接上机法和常规法进行菌种鉴定和药敏试验,分析比对2种方法的符合率。结果 127株实验菌包括表皮葡萄球菌52株、金黄色葡萄球菌29株、溶血葡萄球菌24株、粪肠球菌12株、屎肠球菌10株。其中正确鉴定122株,未鉴定出1株,错误鉴定4株,符合率为96.06%。药物敏感试验一般错误70次,重大错误12次,严重错误2次,抗菌药物符合率均90%,总符合率为95.91%。结论直接上机法进行菌种鉴定和药敏试验与常规法比较符合率较高,能缩短临床报告时间,对临床具有很好的及时、有效地指引作用。     

数值鉴定法在肠杆菌科,弧菌科细菌鉴定中的应用

本文报告了引进法国Bio Merieux公司1991年版数值编码,利用国产微量生化培养基组成的鉴定系统,对照常规鉴定方法对肠杆菌科、弧菌科的部分标准菌株和1687株临床菌株的鉴定结果。两种方法的定种率分别为94.43％和91.58％,显著性检验无显著意义。在弧菌属鉴定中,微量生化培养基中的赖氨酸、鸟氨酸脱羧酶、精氨酸双水解酶、靛基质,V—P中的NaCl含量需达到1％。50套进口系列培养基和国产微量生化管的性状对比中,1050对生化性状完全符合1031对,符合率98.19％。 实践证明,该技术具有操作简便,鉴定准     

医院供水系统快速生长分枝杆菌污染的调查

目的了解某医院供水系统快速生长分枝杆菌(RGM)污染的状况,为医院水源性感染预防和控制提供依据。方法采集2011年9月某医院部分供水系统(水龙头)水样,过滤后接种7H10培养基培养;疑似菌落经抗酸染色和PCR检测hsp65基因确认为分枝杆菌属后,通过16SrRNA基因测序和基质辅助激光解析/电离飞行时间质谱(MS)鉴定方法进行菌种鉴定。结果共采集66份水样,有62份水样培养出RGM,检出率为93.9%;通过16SrRNA基因测序鉴定,62株RGM中以脓肿分枝杆菌为主49株占79.0%,其次依次为马德里分枝杆菌占6.5%、马西利亚分枝杆菌占3.2%和黏液分枝杆菌占3.2%等,各采样点之间RGM检出率差异无统计学意义;与测序方法相比,60株RGM经MS鉴定至属水平,符合率达96.8%;49株RGM鉴定至种或复合群水平,符合率为79.0%。结论医院供水系统RGM污染严重,部分菌株可能成为医院感染的潜在威胁;MS可用于供水系统中RGM的快速鉴定。     

建立MALDI-TOF MS鉴定的海洋致病性弧菌数据库样本前处理的适宜条件

目的探讨建立基质辅助激光解吸电离飞行时间质谱(matrix-assisted laser desorption/ ionization time of flight mass spectrometry,MALDI-TOF MS)鉴定海洋致病性弧菌数据库前样本处理的适宜条件,为完善MALDI-TOF MS鉴定该菌入数据库提供参考。 方法将32株海洋致病性弧菌培养至24、48、72 h时,分别用直接转移法、扩展的直接转移法、甲酸提取法得到上机样品,然后用MALDI-TOF MS进行采图鉴定,用SPSS20.0软件进行统计学分析,对样本不同培养时间及3种处理方法的鉴定结果进行比较评价。 结果培养24 h鉴定分数平均值为2.321,属水平鉴定正确率为96.88%,种水平鉴定正确率为90.63%;培养48 h鉴定分数平均值为2.315,属水平鉴定正确率为93.75%,种水平鉴定正确率为90.63%;培养72 h鉴定分数平均值为2.316,属水平鉴定正确率为93.75%,种水平鉴定正确率为87.50%,3种不同培养时间的前处理方法鉴定至属(P=0.129)、鉴定到种(P=0.078),差异均无统计学意义。直接转移法鉴定分数平均值为1.986,属水平鉴定正确率为78.13%,种水平鉴定分数为59.38%;扩展的直接转移法鉴定分数平均值为2.135,属水平鉴定正确率为90.63%,种水平鉴定正确率为78.13%;甲酸提取法鉴定分数平均值为2.306,属水平鉴定正确率为96.88%,种水平鉴定分数为90.63%,3种不同上机前样本处理方法鉴定到属时差异有统计学意义(P=0.006);鉴定到种时差异有统计学意义(χ²=8.691,P=0.013)。 结论建立MALDI-TOF MS海洋致病性弧菌数据库时,选择培养时间24 h的甲酸法提取菌体蛋白的前处理方法较适宜,可得到高质量的蛋白指纹图谱和鉴定正确率。     

化脓性关节炎355例厌氧菌培养及药敏结果分析

为提供抗菌药物使用依据,总结了2010年1月-2012年10月化脓性关节炎患者的细菌培养及药敏试验结果. 1材料与方法 标本来源于医院门诊与住院化脓性关节炎患者,共355例.将标本进行涂片、革兰染色,同时采用厌氧菌培养,长菌分纯证实为专性厌氧菌后,分别进行鉴定和药敏试验. 2结果 355例标本有174例培养出厌氧菌,阳性率49.0％;174份标本共分离出厌氧菌181株,见表1.181株厌氧菌对8种常用抗菌药物的敏感性,见表2.     

Comparison of the Microbact-12E and 24E systems and the API-20E system for the identification of Enterobacteriaceae.

The Microbact-24E and the Microbact-12E systems are two new miniaturized identification systems for the identification of organisms belonging to the family Enterobacteriaceae. These two systems were compared to the API-20E system for the identification of 352 fresh clinical isolates of Enterobacteriaceae. All three systems were easy to use and came complete with computerized profile registers to assist with final identification of the isolates. The Microbact-24E identified 98%, the API-20E and MB-12E identifying 94.3% and 88.6% respectively. Where different identifications were obtained with the Microbact-24E and API-20E conventional biochemical tests, motility and serology were performed. The Microbact-24E system proved to be a very accurate and convenient means of identifying members of the family Enterobacteriaceae.     

Biochemical and serological investigations on clinical isolates of klebsiella.

A series of 925 clinical isolates of klebsiella was examined by serological and biochemical typing. To perform serological typing (capsular swelling) 77 capsular antisera were prepared, tested against the type strains and grouped in 13 pools. With this serotyping method 80% of the cultures were typable and 63 distinct types could be recognized. All strains were typable biochemically by means of the numerical coding system of the API-20E system supplemented by digits derived from 15 additional conventional biochemical tests. With the API-20E system 24 different biotypes could be distinguished whereas the combination of API-20E and the 15 additional tests produced 93 biotypes. Maximum discrimination of strains was achieved by the combination of serological and biochemical typing (256 bioserotypes). The reproducibility, typability and discriminating power of the biotyping system was not inferior to serotyping. For epidemiological purposes biotyping can replace serotyping of Klebsiella species, especially in laboratories less well equipped.     

Biochemical and serological investigations on clinical isolates of klebsiella

A series of 925 clinical isolates of klebsiella was examined by serological and biochemical typing. To perform serological typing (capsular swelling) 77 capsular antisera were prepared, tested against the type strains and grouped in 13 pools. With this serotyping method 80% of the cultures were typable and 63 distinct types could be recognized. All strains were typable biochemically by means of the numerical coding system of the API-20E system supplemented by digits derived from 15 additional conventional biochemical tests. With the API-20E system 24 different biotypes could be distinguished whereas the combination of API-20E and the 15 additional tests produced 93 biotypes. Maximum discrimination of strains was achieved by the combination of serological and biochemical typing (256 bioserotypes). The reproducibility, typability and discriminating power of the biotyping system was not inferior to serotyping. For epidemiological purposes biotyping can replace serotyping of Klebsiella species, especially in laboratories less well equipped.     

口腔感染的病原菌及耐药性分析

目的了解口腔感染的病原菌分布及其对常用抗菌药物的耐药性,以便于指导临床用药。方法对医院2008-2011年收治的230例口腔感染患者的分泌物进行病原菌培养及药敏结果进行分析。结果 230例口腔感染患者检出细菌522株,其中厌氧菌344株,占65.9%,需氧菌178株,占34.1%;在厌氧菌中,主要检出的黑色素普氏菌127株,中间普氏菌88株,口腔链球菌34株,牙龈卟啉单胞菌29株,二氧化碳嗜纤维菌22株,核梭杆菌16株,韦荣球菌14株,共生放线杆菌9株,福赛类杆菌5株;药敏试验表明,厌氧菌株对万古霉素、四环素、头孢曲松高度敏感,敏感率均>90.0%。结论口腔感染患者病原体以厌氧菌为主,可选用万古霉素、四环素、头孢曲松等抗菌药物进行治疗。     

两种厌氧血培养瓶对常见厌氧菌的培养效果比较

目的比较BacT/Alert FN瓶与伯泰SN瓶对常见厌氧菌的培养效果。方法选用两种血培养瓶对厌氧菌进行增菌培养,对检出结果进行分析。结果BacT/Alert FN32瓶结果全部阳性,而伯泰SN瓶仅有8瓶结果阳性。结论检测常见厌氧菌首选BacT/Alert FN血培养瓶。     

The frequency distribution and consistency of assimilation biotypes of Candida albicans

Two hundred and fifty clinical strains of Candida albicans and six isolates from a cross-infection outbreak were studied for their ability to assimilate 19 carbohydrates in the API-20C system (APILaboratory Products Ltd., Basingstoke, UK). The assimilation profiles were stable on repeat testing; at intervals in the 72 h duration of the test; and when incubated at different temperatures. Although not a complete system of biotyping, the API-20C system shows high typability, and fair reproducibility and discrimination, having a limited role in indicating which isolates should be typed by more elaborate methods.     

The frequency distribution and consistency of assimilation biotypes of Candida albicans.

Two hundred and fifty clinical strains of Candida albicans and six isolates from a cross-infection outbreak were studied for their ability to assimilate 19 carbohydrates in the API-20C system (APILaboratory Products Ltd., Basingstoke, UK). The assimilation profiles were stable on repeat testing; at intervals in the 72 h duration of the test; and when incubated at different temperatures. Although not a complete system of biotyping, the API-20C system shows high typability, and fair reproducibility and discrimination, having a limited role in indicating which isolates should be typed by more elaborate methods.     

Anaerobic yeast killer systems

The influence of anaerobic conditions on the expression of the killer phenomenon of several yeast isolates belonging to recognized killer systems coded by different genetic determinants (Pichia spp., Kluyveromyces lactis, Saccharomyces cerevisiae) was studied. Anaerobiosis influenced the activity of killer toxins from some individual isolates of the genera Pichia and Saccharomyces on sensitive strains of P. anomala, K. lactis and Candida albicans. However, no influence was detectable on a S. cerevisiae sensitive isolate. Thus, anaerobic conditions seem to interfere more with the metabolic process of sensitive strains than with toxin production by killer yeasts.The selection of a panel of killer yeasts, able to display their activity against reference sensitive yeast isolates under anaerobic conditions in a medium that favored the growth of anaerobes, allowed the use of the killer system to type Bacteroides fragilis isolates for epidemiological purposes.     

Relation between trihalomethane compounds and birth defects

OBJECTIVES—To evaluate the risk of birth defects relative to exposure to specific trihalomethanes in public water supplies.
METHODS—A retrospective cohort study was conducted based on data from a population based perinatal database in Nova Scotia, Canada and from the results of routine water monitoring tests. The cohort consisted of women who had a singleton birth in Nova Scotia between 1988 and 1995 and who lived in an area with a municipal water supply. The birth defects analyzed included neural tube defects, cardiovascular defects, cleft defects, and chromosomal abnormalities. Two of the four trihalomethane compounds occur in large enough concentrations to be analyzed (chloroform and bromodichloromethane (BDCM)).
RESULTS—Exposure to BDCM at concentrations of 20 µg/l or over was associated with an increased risk of neural tube defects (adjusted relative risk (RR) 2.5, 95% confidence interval (95% CI) 1.2 to 5.1) whereas exposure to chloroform was not. Exposure to BDCM of 20 µg/l and over was associated with decreased risks of cardiovascular anomalies (RR 0.3, 95% CI 0.2 to 0.7). There was a suggestion of an increased risk of chromosomal abnormalities associated with exposure to chloroform, and no evidence of any association between either trihalomethane compound and cleft defects.
CONCLUSIONS—In this cohort, differences were found in the RR associated with exposure to chloroform and BDCM for each of the congenital anomalies under study. These findings point to the importance of examining specific byproduct compounds relative to risk for these birth outcomes and in particular implicate BDCM and other correlated disinfection byproducts in the aetiology of neural tube defects.


Keywords: trihalomethanes; birth defects     

全自动微生物鉴定药敏分析仪对临床相关细菌的鉴定能力及应用价值

目的:研究全自动微生物鉴定药敏分析仪对临床相关细菌的鉴定能力及应用价值。方法:从2016年10月~2017年12月,本院各科室患者的分泌排泄物标本中,分离的病原菌110株,其中革兰阳性菌51株、革兰阴性菌59株,及本院实验室中保存的相同菌株96株作为本次研究菌株。使用全自动微生物鉴定药敏分析仪对研究菌株进行鉴定,同时包括链球菌属等4种质控菌株。结果:4种质控菌种在9h内完成鉴定,其中,肠杆菌属的错误率较高;不同分辨率下,革兰阳性菌和革兰阴性菌结果不相同,但革兰阴性菌比革兰阳性菌用时少。对两个菌属、4个菌形的比较结果,数据均显著,具有统计学意义(P<0.05)。结论:全自动微生物鉴定药敏分析仪在对临床相关细菌进行鉴定时,具有很高的鉴定能力及应用价值。