鲍氏不动杆菌药敏调查及耐药分析

目的 研究2006-2009年临床分离的53株鲍氏不动杆菌的感染特点及耐药情况,探讨抗菌药物的合理使用方法,指导临床合理用药.方法 采用K-B纸片法测定8种抗菌药物对53株鲍氏不动杆菌的抑菌圈大小和耐药率及敏感率进行分析.结果 8种抗菌药物中,以亚胺培南的抗菌活性最高,耐药率为18.9%,敏感率81.1%;其次头孢哌酮/舒巴坦、头孢他啶耐药率分别为30.2%、44.7%;对其他抗菌药物耐药率高达70.0%～80.0%.结论 对亚胺培南、头孢哌酮/舒巴坦及头孢他啶对鲍氏不动杆菌仍有较好的抗菌活性,可作为鲍氏不动杆菌感染的治疗,而对耐碳青酶烯类鲍氏不动杆菌可采取联合用药治疗,效果良好.     

多黏菌素对耐亚胺培南鲍氏不动杆菌的体外抗菌活性

目的评价多黏菌素(多黏菌素B和多黏菌素E)对耐亚胺培南鲍氏不动杆菌的体外抗菌活性。方法2008年1月~2009年4月从临床感染患者送检标本中分离的299株鲍氏不动杆菌,按照对亚胺培南的耐药性分为亚胺培南耐药菌株和亚胺培南敏感菌株,并检测其对多黏菌素B、多黏菌素E等19种抗菌药物的敏感性。结果299株鲍氏不动杆菌主要分离自痰液标本(89.3%),科室中以ICU为主,分离占37.5%;检出耐亚胺培南菌167株,占55.9%;多黏菌素B、多黏菌素E对耐亚胺培南鲍氏不动杆菌的敏感率分别为97.0%和97.6%,显示了高度的敏感性;对耐亚胺培南鲍氏不动杆菌敏感性较高的其他抗菌药物还有头孢哌酮/舒巴坦(敏感率65.9%),其他抗菌药物敏感性均15.0%。结论多黏菌素对耐亚胺培南鲍氏不动杆菌具有良好的体外抗菌活性。     

ICU多药耐药鲍氏不动杆菌金属β-内酰胺酶检测

目的 调查医院ICU痰标本中分离出鲍氏不动杆菌的耐药特点及产金属β-内酰胺酶情况.方法 收集ICU2005年7月-2007年3月经VITEK-32系统GNI<'+>卡鉴定为鲍氏不动杆菌的不重复菌株42株,均为痰标本,用GNS132做常规药物敏感试验,用纸片扩散法(K-B法)补做头孢哌酮/舒巴坦、多黏菌素E、氨曲南的药物敏感试验,用Etest试验检测金属β-内酰胺酶.结果 42株鲍氏不动杆菌对18种抗菌药物的耐药率以头孢哌酮/舒巴坦、多黏菌素E最低,为2.4%,亚胺培南的耐药率为66.7%;对其他药物的耐药率为69.4%～100.0%;Etest检出金属β-内酰胺酶阳性菌9株.结论 产金属β-内酰胺酶是鲍氏不动杆菌耐亚胺培南的重要机制之一,治疗多药耐药鲍氏不动杆菌引起的感染应首选头孢哌酮/舒巴坦和多黏菌素E.     

老年病房下呼吸道分离鲍氏不动杆菌株的耐药性分析

目的 分析老年病房2006-2008年下呼吸道分离鲍氏不动杆菌株对临床常用抗菌药物的耐药特征,为临床用药提供参考.方法 收集老年病房2006年1月-2008年12月住院患者下呼吸道分离的非重复鲍氏不动杆菌株,药敏试验采用K-B扩散法.结果 3年中共分离出178株鲍氏不动杆菌,除头孢哌酮/舒巴坦、亚胺培南的耐药率较低(5.6%～14.0%)外,其他抗菌药物的耐药率相对较高(30.9%～65.2%);亚胺培南耐药组及敏感组鲍氏不动杆菌对头孢哌酮/舒巴坦耐药率均最低,分别为24.0%和2.0%;≥四类药物的多药耐药株占33.1%.结论 加强细菌及耐药性检测,掌握其耐药特征及流行规律,对于防治鲍氏不动杆菌的耐药及传播、控制老年病房的医院感染具有重要的现实意义.     

141株临床分离鲍氏不动杆菌耐药性检测

目的 分析141株临床分离的鲍氏不动杆菌对15种常用抗菌药物的耐药性,为临床合理用药提供依据.方法 琼脂稀释法测定鲍氏不动杆菌对美罗培南、亚胺培南、哌拉西林、哌拉西林/他唑巴坦等15种抗菌药物的最低抑菌浓度(MIC).结果 鲍氏不动杆菌对亚胺堵南的耐药率最低(6.4%)、其次为美罗培南(20.5%)和头孢哌酮/舒巴坦(29.7%),对四环素的耐药率最高(81.5%);其余抗菌药物耐药率均约在50.0%.结论 鲍氏不动杆菌对亚胺培南、美罗培南、头孢哌酮/舒巴坦较敏感,对其他抗菌药物耐药情况严重,临床应加强检测和监测.     

南昌地区耐亚胺培南鲍氏不动杆菌耐药性及碳青霉烯酶基因分析

目的调查和分析南昌地区46株耐亚胺培南鲍氏不动杆菌的耐药性及其产碳青霉烯酶的基因型,探讨其耐药机制。方法用K-B法测定南昌地区临床分离的46株耐亚胺培南鲍氏不动杆菌对10种抗菌药物的耐药性,2-巯基丙酸抑制试验检测金属酶,采用PCR法检测碳青霉烯酶耐药基因型,对扩增的碳青霉烯酶基因进行核苷酸序列测定,通过网上相似性检索确定其编码酶基因的类型。结果 46株鲍氏不动杆菌对头孢哌酮/舒巴坦、氨苄西林/舒巴坦、阿米卡星、左氧氟沙星的耐药率分别为45.7%、52.2%、74.0%及76.1%,对其他抗菌药物的耐药率均>90.0%;有8株菌对10种抗菌药物全部耐药;46株鲍氏不动杆菌金属酶表型筛选试验均为阴性,PCR扩增后有32株产OXA-23型碳青霉烯酶基因,未检出IMP、VIM、OXA-24基因;产OXA-23型鲍氏不动杆菌株对阿米卡星高度耐药。结论 OXA-23型碳青霉烯酶基因是南昌地区鲍氏不动杆菌对亚胺培南耐药的主要因素;头孢哌酮/舒巴坦、氨苄西林/舒巴坦可作为这部分菌株感染的治疗选择。     

鲍氏不动杆菌的临床分布及耐药性分析

目的 了解鲍氏不动杆菌感染及耐药性变化的趋势,为临床合理用药提供依据.方法 采用纸片扩散(K-B)法进行药物敏感试验,并对116株鲍氏不动杆菌的药物敏感试验进行回顾性分析.结果 鲍氏不动杆菌分布以痰液及支气管吸出物为主,其次是脓液及分泌物;科室分布以ICU最多,其次是呼吸内科;鲍氏不动杆菌耐药率高,其对亚胺培南的耐药率最低(6.90%)、其次为美罗培南(13.79%)和头孢哌酮/舒巴坦(23.28%),对庆大霉素的耐药率最高(82.76%),其余抗菌药物耐药率均约为50.0%.结论 鲍氏不动杆菌对亚胺培南、美罗培南、头孢哌酮/舒巴坦较敏感,对其他抗菌药物耐药情况严重,临床应加强检测和监测.     

鲍氏不动杆菌对碳青霉烯类抗菌药物的耐药机制研究

目的探讨临床分离的鲍氏不动杆菌对碳青霉烯类抗菌药物的耐药机制,为医院感染控制、临床合理用药提供依据。方法收集山西医学科学院(山西大医院)临床分离的鲍氏不动杆菌株共84株,其中亚胺培南耐药鲍氏不动杆菌(IRAB)63株,亚胺培南敏感鲍氏不动杆菌(ISAB)21株。用K-B纸片法检测以上细菌对常用抗菌药物的敏感性。PCR法分析10种β-内酰胺酶基因和carO、oprD膜孔道蛋白基因,adeB外排泵基因,并对扩增阳性的基因进行测序,同时应用DNASTAR软件对耐药和敏感菌株的carO、oprD序列进行对比分析。结果 63株亚胺培南耐药鲍氏不动杆菌对替加环素较敏感,对头孢哌酮/舒巴坦(28.6%)和米诺环素(30.2%)耐药率较低外,对其他抗菌药物耐药率均较高,而21株亚胺培南敏感鲍氏不动杆菌对多数抗菌药物较敏感;IRAB与ISAB检出TEM、OXA-23、adeB基因阳性率比较,差异有统计学意义(P<0.05),而ADC阳性率差异无统计学意义;84株细菌中carO、oprD和OXA-51均为阳性。亚胺培南耐药株carO编码基因序列与亚胺培南敏感株相比存在有意义突变。结论本研究中耐碳青霉烯类鲍氏不动杆菌耐药机制主要与β-内酰胺酶、adeB外排泵、carO孔道蛋白突变有关。     

耐亚胺培南鲍氏不动杆菌医院获得性肺部感染危险因素及耐药性分析

目的研究耐亚胺培南鲍氏不动杆菌(IRAB)医院获得性肺部感染(NP)发生的危险因素及其耐药性。方法对34例IRAB及68例亚胺培南敏感鲍氏不动杆菌(ISAB)NP作病例对照研究,采用平板稀释法测定常用抗菌药物对该菌株的最低抑菌浓度(MIC)。结果发生IRAB-NP的危险因素,在分离出鲍氏不动杆菌前15 d接受氟喹诺酮抗菌药物(OR=5.738)、碳青酶烯类抗菌药物治疗(OR=7.129),IRAB耐药率高,但对氨苄西林/舒巴坦及头孢哌酮/舒巴坦的耐药率<30%。结论碳青酶烯类抗菌药物及氟喹诺酮抗菌药物的应用是IRAB-NP的危险因素,IRAB仅对氨苄西林/舒巴坦及头孢哌酮/舒巴坦有相对较高的敏感性。     

多药耐药鲍氏不动杆菌与铜绿假单胞菌对头孢哌酮/舒巴坦的敏感性研究

目的 比较多药耐药鲍氏不动杆菌与多药耐药铜绿假单胞菌产金属β-内酰胺酶的情况和对头孢哌酮/舒巴坦的耐药性,为临床治疗该细菌感染提供实验室依据.方法 用VITEK-32、GNS-132系统常规检测非重复鲍氏不动杆菌42株、铜绿假单胞菌95株,同时用Etest检测金属β-内酰胺酶,用纸片扩散法(K-B法)检测头孢哌酮/舒巴坦和多黏菌素E的药敏试验,分析二者不同耐药表型对头孢哌酮/舒巴坦的敏感性差异.结果 鲍氏不动杆菌、铜绿假单胞菌对亚胺培南耐药率分别为66.7%、31.6%;多药耐药鲍氏不动杆菌、铜绿假单胞菌均有较‘多产金属β-内酰胺酶株;头孢哌酮/舒巴坦耐对亚胺培南非产金属β-内酰胺酶的敏感性差异无统计学意义,头孢哌酮/舒巴坦对耐亚胺培南产金属β-内酰胺酶的敏感性差异有统计学意义(P<0.05).结论 多药耐药鲍氏不动杆菌对头孢哌酮/舒巴坦敏感性高于多药耐药铜绿假单胞菌,治疗耐亚胺堵南的多药耐药鲍氏不动杆菌可选用头孢哌酮/舒巴坦,治疗耐亚胺培南的多药耐药铜绿假单胞菌特别是MBLs应选用多黏菌素E或联合用药.     

Trends in meningococcal disease in Italy in 1988

Meningococcal disease in Italy decreased 15% in 1988 from the previous year (290 vs. 342 cases). The decline was particularly evident in military cases (1.7/100,000 in 1988 vs. 5/100,000 in 1987) reflecting the full coverage of bivalent serogroup (A + C) meningococcal polysaccaride vaccine in army recruits, achieved since January 1988. The highest proportion of cases was seen in people older than 25 years of age (25%). Serogroup C constituted 60% of the isolates, while 19% belonged to serogroup B. The proportion of strains resistant to sulphonamides was 45%, while 15% were resistant to Minocycline and none to Rifampin. Out of the five military cases, only one (due to serogroup C) was attributable to the vaccine failure. A single coprimary case, but no secondary cases occurred among civilians. These findings are consistent with the trends reported in Italy in the previous years.     

Benzene in blood and phenol in urine in monitoring benzene exposure in industry

Determinations of benzene concentration in blood and of phenol in urine were made by head-space gas chromatography techniques on samples taken near the end of the work day from two groups of workers potentially exposed to low levels of benzene in the work-place atmosphere. Preliminary results suggest that benzene in blood is more reliable than phenol tests for assessing both exposure and uptake of benzene. Normal values of phenol in urine (10 mg/liter or less) were found in nearly all those cases in which benzene was detected in the blood.     

2015年郑州市饮用水放射性水平状况调查

目的了解郑州市不同地区、不同季节、不同水源类型的放射性水平。方法分别于丰水期和枯水期采集郑州市区黄河水源水、井水源水、丹江口水源水、出厂水和末梢水各一份;以县为单位,每单位采集出厂水、末梢水、水库水、河水、井水各1份,按《生活饮用水生活标准检验方法》(GB/T 5750.13-2006)检测饮用水中总α和总β放射性水平,依据《生活饮用水卫生标准》(GB 5749-2006)进行判定。结果丰水期、枯水期水体总α、总β放射性水平均低于国家标准限值。结论郑州市不同水源类型均处于正常的天然放射性本底水平。     

2019年中国肿瘤流行病学研究进展

恶性肿瘤已成为中国居民的主要死因之一。近些年来,中国政府积极推进肿瘤预防和控制领域的研究工作,取得了很大的进步。本文简要汇总中国在肿瘤流行病学领域的研究进展,具体包括2019年的肿瘤负担、癌症危险因素及其干预、筛查和早期发现、癌症防治专项行动(2019-2022年)方案等方面,以期为我国肿瘤防治工作的有效开展提供技术支撑和理论依据。     

2012年绵阳市蔬菜中农药残留状况

目的 了解绵阳市2012年市售蔬菜中农药残留情况,为食用蔬菜监管提供依据.方法 全部样品均按照GB/T 5009-2003的方法进行农药的残留检测.依据GB 2763-2005《食品中农药最大残留限量》进行判定.结果 2012年共检测蔬菜165份,农药检出率和超标率分别为72.12％和23.64％.豆类、根茎类、叶菜类、瓜果菜类和食用菌类蔬菜检测农药残留超标率分别为8.00％、23.53％、36.00％、5.26％和27.03％,差异有统计学意义(x2=11.41,P＜0.01).不同种类农药超标率差异有统计学意义(x2 =62.42,P＜0.01).夏季和冬季蔬菜农药超标率差异无统计学意义(x2=3.44,P＞0.05).结论 绵阳市叶菜类蔬菜中农药残留情况较为严重,应采取有效措施,加强蔬菜的监督管理,从源头禁止高毒农药的使用,加大蔬菜种植、销售环节的监测,确保市民食用蔬菜的安全.     

Occupational stress in nurses in psychiatric institutions in Taiwan

Nurses are known to be exposed to occupational stress. However, occupational stress is not well documented for nurses in psychiatric institutions in Taiwan. A cross-sectional study was conducted to explore the work-related stress and risk factors of nurses in psychiatric institutions in Taiwan. A structured questionnaire was distributed to nurses at five state-owned psychiatric hospitals in Taiwan in 2001. Demographic information, working environment, and personal health status were inquired. Occupational stress was assessed based on the Chinese version of Job Content Questionnaire (JCQ). General health status and mental health were evaluated by the International Quality of Life Assessment Short Form-36 (IQOLA SF-36). A total of 573 questionnaires were disseminated to nurses and 518 (90.4%) were satisfactorily completed by nurses, including 408 female full-time nurses who had been in their current work for more than 6 months. In the past one month, 17.2% of nurses reported being under significant stress often or always. Assault episodes were reported by 45.1% of nurses in the past 6 months. Among the nurses, 16.9%, 25.2%, 50.0%, and 7.8% belong to the "High strain", "Low strain", "Active", and "Passive" groups, respectively. Perceived occupational stress was associated with young age, widowed/divorced/separated marital status, high psychological demand, low workplace support, and threat of assault at work. Lower general health score was associated with low job control, high psychological demand, and perceived occupational stress. A lower mental health score was associated with low job control, high psychological demand, low workplace support, and perceived occupational stress. We concluded that nurses in psychiatric institutions are under significant stress related to work factors.     

Changes in nursing administration in supporting transplantation in Brazil

This historical and bibliographic study aimed to understand how Nursing was organized to support care in transplantation. The HISA, LILACS, BDENF, PERIENF and DEDALUS databases were consulted, and thirteen references were found, ten of which were scientific articles, two were master's dissertations and one was a doctoral thesis. The span of time chosen for study ranges from the date of the first kidney transplant in Brazil (1965), to the date of publication of the last scientific article found in the databases mentioned above (2003). After reading these articles, the ones that were similar in topic were grouped together, thus creating the thematic axis for the presentation of the results. The results showed that the Nursing profession has played an important and active role in transplants ever since the first procedure in 1965.