不同标本类型中分离出白念珠菌对抗真菌药物敏感性分析

目的 探讨从不同类型标本中分离的白念珠菌菌株对常用抗真菌药物的耐药谱，为临床白念珠菌感染性疾病诊断和治疗提供理论和实验依据。方法 用真菌鉴定卡及Rosco真菌药敏纸片对分离出的所有白念珠菌作菌种鉴定和药敏实验，采用μ检验分析从男性生殖道分泌物、女性生殖道分泌物和痰液中分离出白念珠菌的药物敏感特点。结果 从痰液中分离出的白念珠菌对5-氟胞嘧啶、两性霉素B、咪康唑、酮康唑和制霉菌素敏感率分别为97．8％、98．9％、83．1％、87．6％和99．9％；男性尿道分泌物中自念珠菌的敏感率分别是76．1％、81．1％、65．3％、71．6％和86．0％；女性生殖道分泌物中菌株分别是58．4％、71．3％、61．4％、62.4％和86.1％，三组之间具有统计学意义（P〈0．01）。结论 不同标本中分离出的白念珠菌对抗真菌的敏感性有显著性差异。     

Antifungal potential of Sideroxylon obtusifolium and Syzygium cumini and their mode of action against Candida albicans

Context The emergence of resistant pathogens and toxicity of antifungals have encouraged an active search for novel candidates to manage Candida biofilms.

Objective In this study, the little known species Sideroxylon obtusifolium T.D. Penn (Sapotacea) and Syzygium cumini (L.) Skeels (Myrtaceae), from the Caatinga biome in Brazil were chemically characterized and explored for their antifungal potential against C. albicans.

Materials and methods We determined the effects of hydroalcoholic extracts/fractions upon fungal growth (minimum inhibitory and fungicidal concentrations, MIC/MFC), biofilm morphology (scanning electron microscopy) and viability (confocal laser scanning microscopy), proposed their mode of action (sorbitol and ergosterol assays), and finally investigated their effects against macrophage and keratinocyte cells in a cell-based assay. Data were analysed using one-way analysis of variance with Tukey-Kramer post-test (α?=?0.05).

Results The n-butanol (Nb) fraction from S. obtusifolium and S. cumini extract (Sc) showed flavonoids (39.11?±?6.62?mg/g) and saponins (820.35?±?225.38?mg/g), respectively, in their chemical composition and demonstrated antifungal activity, with MICs of 62.5 and 125?μg/mL, respectively. Nb and Sc may complex with ergosterol as there was a 4–16-fold increase in MICs in the presence of exogenous ergosterol, leading to disrupted permeability of cell membrane. Deleterious effects were observed on morphology and viability of treated biofilms from concentrations as low as their MICs and higher. Sc was not toxic to macrophages and keratinocytes at these concentrations (p?> 0.05), unlike Nb.

Conclusions Nb and Sc demonstrated considerable antifungal activity and should be further investigated as potential alternative candidates to treat Candida biofilms.     

A representative of arylcyanomethylenequinone oximes effectively inhibits growth and formation of hyphae in Candida albicans and influences the activity of protein kinases in vitro

In this study, we applied various assays to reveal new activities of phenylcyanomethylenequinone oxime-4-(hydroxyimino) cyclohexa-2,5-dien-1-ylidene](phenyl)ethanenitrile (4-AN) for potential anti-microbial applications. These assays demonstrated (a) the antimicrobial effect on bacterial and fungal cultures, (b) the effect on the in vitro activity of the kinase CK2, (c) toxicity towards human erythrocytes, the Caco-2 cancer cell line, and embryonic development of Zebrafish. We demonstrated the activity of 4-AN against selected bacteria and Candida spp. The MIC ranging from 4?µg/ml to 125?µg/ml proved effective in inhibition of formation of hyphae and cell aggregation in Candida, which was demonstrated at the cytological level. Noteworthy, 4-AN was found to inhibit the CK2 kinase with moderate potency. Moreover, at low concentrations, it did not exert any evident toxic effects on human erythrocytes, Caco-2 cells, or Zebrafish embryos. 4-AN can be a potential candidate as a novel drug against Candida infections.     

卡泊芬净对生物膜态白色念珠菌体外抑菌作用的试验研究

目的:检测卡泊芬净对生物膜态白色念珠菌分离株的抑菌作用,探讨临床治疗其相关感染的最适治疗剂量。方法:分别测定卡泊芬净对10株白色念珠菌临床株游离态及生物膜态的半数抑菌浓度(MIC50),并对比观察不同浓度卡泊芬净作用下白色念珠菌的增殖活性。结果:卡泊芬净对游离态白色念珠菌的MIC50为0.125～0.5mg.L-1,对生物膜态白色念珠菌的MIC50为0.25～256mg.L-1,当卡泊芬净浓度高于白色念珠菌MIC50时,全部游离态白色念珠菌的增殖活性几乎完全受到抑制,但有7株生物膜态白色念珠菌的增殖活性再次增强,且大于阳性对照的50%。结论:卡泊芬净对生物膜态白色念珠菌有抑菌作用,但并不呈浓度依赖性,当其用于治疗生物膜态白色念珠菌相关感染时的最适治疗剂量有待临床研究验证。     

侵袭性白念珠菌感染的危险因素及耐药性变迁

目的 分析四川大学华西医院住院患者侵袭性白念珠菌感染的分布情况、可能的危险因素以及真菌耐药性变化,为临床预防和合理用药提供依据.方法 对四川大学华西医院2010年1月到2012年12月100例侵袭性白念珠菌感染患者的临床资料进行回顾性分析,分析并总结其标本来源、科室分布、年龄分布、感染的危险因素、抗菌药物使用情况以及真菌耐药率的变迁.结果 在侵袭性白念珠菌感染中,血流感染最为多见,占55％,感染患者多为ICU重症患者,占35％.年龄分布中位数为53.5岁.可能相关危险因素中外科手术和气管插管/切开、机械通气分别占74.6％和46.5％,有94例(82.5％)使用过抗菌药物.3年来我院白念珠菌对氟康唑、伏立康唑、两性霉素B耐药率为0％,对5-氟胞嘧啶和伊曲康唑的耐药率分别保持在4.1％和27.7％以下.结论 白念珠菌是ICU重症患者的血流侵袭性真菌感染中重要的病原菌,外科手术和气管插管/切开及呼吸机的使用是最显著侵袭性白念感染的两大危险因素.虽然目前临床常用抗真菌药物能覆盖侵袭性白念珠菌的治疗,但仍应加强对重点科室以及有相关危险因素患者的监测,重视培养鉴定与药敏结果对临床用药的指导,以减少耐药菌的出现与流行.     

白色念珠菌酮康唑抗药株的筛选

目的获得白色念珠菌的酮康唑抗药株。方法采用美国国家临床实验标准化委员会 (NC CLS)推荐的最小抑菌浓度 (MIC)测定法 ,从 8株不同来源的白色念珠菌中筛选出YS2 0 1 (MIC为0 0 62 μg/mL)作为出发菌株 ,分别利用紫外线 (UV)和亚硝基胍 (NTG)对其原生质体进行诱变。结果经大量筛选 ,得到抗药突变株UP1 1及NP2 9,其MIC分别达到 3 5 μg/mL和 75 μg/mL。结论获得酮康唑抗药株 ,突变株的抗药特性稳定。     

Antifungal Activity of Plant Extracts against Candida Species from Oral Lesions

Seventy five patients with oral lesions attending the different departments of Rajah Muthiah Medical College and Hospital, Annamalai University were screened for Candida. Forty six (61.3%) Candida strains were isolated from the oral lesions. Of the 46 Candida strains, Candida albicans accounted for 35 (76.08%), Candida glabrata for 5 (10.86%), Candida tropicalis and Candida krusei for 2 (4.34%) each and Candida parapsilosis and Candida guilliermondii for one (2.17%) each. Antifungal activity of ethanol extracts of five plant species that included Syzygium jambolanum, Cassia siamea, Odina wodier, Momordica charantia and Melia azedarach and two algal species, Sargassum wightii and Caulerpa scalpelliformis were tested against 25 isolated strains by disc diffusion method. Antifungal activity was observed at 100 mg/ml for Syzygium jambolanum, Cassia siamea and Caulerpa scalpelliformis and at 10 mg/ml for Sargassum wightii.     

Antimicrobial activity of dequalinium chloride against leading germs of vaginal infections

Dequalinium chloride (CAS 522-51-0) and povidone iodine (CAS 25655-41-8) are known as antiseptic agents and used in the local treatment of vaginal infections. Clotrimazole (CAS 23593-75-1) is an anti-fungal drug and applied primarily in the therapy of vulvo-vaginal candidiasis and to a lesser extent in bacterial vaginosis and trichomoniasis. However, antimicrobial activities of those three agents in comparison to each other have not been reported so far. To address this issue the antimicrobial activities of these agents against 18 germs relevant to vaginal infections were determined. The tested species are representatives of the genera Staphylococcus, Streptococcus, Enterococcus, Listeria, Escherichia, Proteus, Gardnerella, Bacteroides, Prevotella, Porphyromonas, Candida, and Trichomonas. All micro-organisms were susceptible to dequalinium chloride with the exception of Proteus mirabilis. At a given dose, the activity of dequalinium chloride was higher as compared to the other substances. In view of its wide antimicrobial spectrum dequalinium chloride is an efficient alternative in the local therapy of vaginal infections such as fluor vaginalis, bacterial vaginosis, aerobic vaginitis, vulvo-vaginal candidiasis and trichomoniasis.     

Antimicrobial activities of meropenem against clinically isolated strains in 1999]

We determined the antibacterial activity of meropenem (MEPM) and control drugs against clinical isolates of 310 strains of Gram-positive bacteria (14 species), 590 strains of Gram-positive bacteria (21 species), and 120 strains of anaerobic bacteria (10 species) in 1999. We compared the results thus obtained with those in 1993 and 1997. The results were as follows; 1. MEPM showed excellent antibacterial activities against most of the species tested, except for MRSA, E. faecium, E. avium, and methicillin-resistant S. epidermidis (MRSE). 2. MEPM had much higher activity than IPM and PAPM against Gram-negative bacteria including S. marcescens and P. aeruginosa, part of which have been reported to produce metallo-beta-lactamase. 3. There was little difference in the susceptibility of clinical isolates to MEPM between 1993 and 1999. Thus MEPM was shown to retain its potent and broad antibacterial activity now at the same level as before available for use in 1995.     

Antimicrobial activity of dactimicin against aerobic and anaerobic bacteria isolated from intra-abdominal infections

The in vitro antimicrobial activity of dactimicin against aerobic and anaerobic bacteria isolated from intra-abdominal infections was compared to those of gentamicin and metronidazole. The data obtained show that dactimicin is a promising new aminoglycoside covering aerobic bacteria and that it may be used together with an antianaerobic agent in the treatment of these infections.     

聚乙烯亚胺单独及与三种抗菌药物联用对白念珠菌的体外抗菌活性

目的评估多支链的阳离子高分子聚合物——聚乙烯亚胺(PEI)单独及与三种不同类别的常规抗菌药物(两性霉素B、氟康唑和多黏菌素B)联合使用对白念珠菌(MY7245和MY7238)的两种临床分离物的抗真菌活性。方法通过体外实验测定不同分子质量聚乙烯亚胺单独及与三种不同类别的常规抗菌药物联合使用对两株白念珠菌的最小抑菌浓度和杀灭时间,确定PEI单独及联合使用的体外抗真菌活性。结果分子量在2～745ku范围内的PEI均对这两种白念珠菌产生很好的抗真菌活性,且分子量小的PEI比分子量大的PEI的抗菌作用更显著。与单独作用的PEI相比,分子量较大的PEI与常规药物联合使用时可产生较强的协同作用。在体外致死研究实验中可以看到,PEI-两性霉素B和PEI-氟康唑结合物可以提高抑菌作用,但PEI-多黏菌素B结合物却拮抗抑菌作用。结论PEI单独与联合使用均对白念珠菌产生很好的抗菌效果。     

Antimicrobial activity and postantibiotic effect of flurithromycin against Helicobacter pylori strains

The minimal inhibitory concentrations (MIC) of flurithromycin on 49 clinical isolates of Helicobacter pylori was investigated. The MICs were determined using an agar dilution technique. Flurithromycin inhibited the growth of H. pylori strains with MIC(50) and MIC(90) values of 0.156 and 0.625 mg/l, respectively. The postantibiotic effects (PAE) were studied on ten strains, by exposure of the bacteria to flurithromycin at five and ten times MIC for 1 or 2 h. Regrowth was determined by measuring the viable counts after drug removal by a 10(3) dilution procedure. All PAEs increased as a function of concentration and time of exposure. The mean duration of PAEs varied between 1.5 and 6 h. These data are encouraging since macrolides play a key role in the clinical treatment of H. pylori infections, and the strong PAE caused by flurithromycin may contribute to the in vivo efficacy of this drug.     

妊娠期女性外阴假丝酵母菌检测及抗真菌药物敏感性分析

目的 调查女性妊娠期外阴假丝酵母菌检出情况,对引起外阴假丝酵母菌病(WC)的真菌进行鉴定及药敏试验,为临床防治提供依据.方法 采集2009年3月至2010年6月我院产科门诊产前检查的500例妊娠女性阴道分泌物进行假丝酵母菌涂片、培养,分离鉴定及药敏试验;其中涂片采用显微镜观察,培养接种于沙保弱平板,菌株鉴定采用生物梅里埃VITEK-2全自动微生物鉴定仪及配套酵母菌鉴定卡,药敏试验采用ATB FUNGUS真菌药敏条.结果 137例涂片检出芽生孢子或假菌丝,检出率为27.4%;151例培养检出假丝酵母菌,检出率为30.2%;两法综合,共192例检出假丝酵母菌,检出率为38.4%;500例中出现感染症状的VVC患者111例,感染率为22.2%;111株菌株中包括5种假丝酵母菌,以白假丝酵母菌最多,占80.2%(89株),其次为光滑假丝酵母菌,占12.6%(14株);白假丝酵母菌对伏立康唑和两性霉素B的敏感率高,分别为100.0%和94.4%,对氟康唑的敏感率低,为73.0%.结论 妊娠期女性外阴假丝酵母菌感染率较高,菌种以白假丝酵母菌为主;假丝酵母菌对氟胞嘧啶、两性霉素B、伏立康唑敏感性高,对氟康唑敏感性低;临床应普及开展对妊娠期女性外阴假丝酵母菌检测.

Abstract：

Objective To investigate the infection incidence of Candida in pregnant women and to provide evidence for prevention. Methods Candida separation, cultivation, identification and antifungal susceptibility test were performed for vulvovaginal candidiasis ( VVC). Five hundrend samples of vaginal discharge in pregnant women were collected in the department of obstetrics of our hospital from March 2009 to June 2010. Samples were detected by microscopy examination and inoculated on sabnraud medium, identified by Biomerieux VITEK-2, and antifungal susceptibility tested by ATB FUNGUS. Results Among 500 samples, 137 were positive of blastospore and pseud-ohypha (27.4% ) by microscopy examination; 192 were positive of Candidas(38.4% ) by culture. The incidence of VVC was 22. 2% . C. albicans was most frequently( 80. 2% ) isolated, followed by C. glabrata( 12. 6% ) . C. albi-cans susceptibility for voriconazole and amphotericin B were 100. 0% and 94. 4%. Fluconzazole was the lowest ( 73.0% ) . Conclusions The infection rate of vulvovaginal Candida in pregnant women is higher than that in normal people. C. albicans is the major species. Susceptibility results show that Candida infections are susceptible to 5-flucytosine, amphotericin B and voriconazole. Clinical monitor of vulvovaginal Candida infection should be strengthened.     

Antimicrobial activity of meropenem against main bacterial species isolated from patient blood in 2010

We investigated antimicrobial activities of meropenem and other antibiotics against 164 isolates (41 Escherichia coli, 16 Klebsiella pneumoniae, 7 Enterobacter cloacae, 21 Pseudomonas aeruginosa, 14 methicillin-susceptible Staphylococcus aureus (MSSA), 18 methicillin-resistant Staphylococcus aureus (MRSA), 47 Staphylococcus epidermidis) from blood of the patients admitted to Keio University Hospital between January and October in 2010. Meropenem showed the potent antibacterial activity against Gram-negative bacteria especially and it maintained good broad spectrum antimicrobial activity including resistant strains through 13 years since when we started the investigation. These results indicated the validity of choosing meropenem as a first line antimicrobial agent for serious infectious diseases.     

Antimicrobial activity of meropenem against main bacterial species isolated from patient blood in 2006

Using broth micro-dilution method, we studied the susceptibility of 180 clinical isolates of Escherichia coli, Klebsiella pneumoniae, Enterobacter spp., Pseudomonas aeruginosa, Staphylococcus aureus, and Staphylococcus epidermidis to meropenem (MEPM) and reference agents. All strains were isolated from the blood of patients admitted to Keio University Hospital between January 2006 and November 2006. The results were as follows: 1. MEPM showed greater potency against Gram-negative bacteria than the other carbapenems including doripenem in particular. A metallo-beta-lactamase producing multi-drug resistant P. aeruginosa strain was detected. 2. A comparison of the antibacterial activity of MEPM with that in our previous studies 1997-1998, 1999, 2002-2003, and 2004 showed no marked increase in MEPM-resistant clinical isolates. These results suggest that MEPM retains its potency as the agent of choice in treating serious infections.     

Protective efficacy of Psidium cattleianum and Myracrodruon urundeuva aqueous extracts against caries development in rats

This study evaluated the influence of Psidium cattleianum Sabine (Myrtaceae) and Myracrodruon urundeuva Allemão (Anacardiaceae) aqueous extracts on S. mutans counts and dental enamel micro-hardness of rats submitted to a cariogenic challenge. Sixty Wistar rats were distributed in three groups and received water (control) or aqueous extracts of Psidium cattleianum or Myracrodruon urundeuva as hydration solution. Initially the animals had their sublingual and submandibular salivary glands surgically removed and the parotid ducts ligated. Then the rats were inoculated with 10⁶ CFU of Streptococcus mutans ATCC 35668 and were fed with a cariogenic diet. To detect and quantify the presence of S. mutans, oral biofilms were sampled and microbial DNA was extracted and submitted to amplification by means of real-time PCR (Polymerase Chain Reaction). After seven weeks the animals were sacrificed and enamel demineralization was analyzed by cross-sectional micro-hardness. Both extracts produced a significant reduction on S. mutans counts and decreased the enamel demineralization. It can be concluded that the extracts tested had a significant effect on S. mutans in oral biofilm of the rats, decreasing S. mutans accumulation and enamel demineralization.     

In vitro activity of voriconazole against Candida species isolated in Taiwan

The activity of voriconazole was determined against 285 Candida species consisting of 53 resistant isolates, 43 susceptible-dose dependent and 189 isolates susceptible to fluconazole. The MIC(50) and MIC(90) to fluconazole were 8 and 64 mg/l, respectively. The range of minimum inhibitory concentrations (MICs) to voriconazole was from 0.0325 to 2 mg/l and the MIC(50) and MIC(90) were 0.125 and 0.5 mg/l, respectively. Only 3 of 285 tested isolates had MICs to voriconazole equal to 2 mg/l. A total of 38 isolates, consisted of 3 Candida albicans, 5 Candida krusei, 7 Candida tropicalis and 21 Candida glabrata, had >/= 0.5 mg/l to voriconazole. There was correlation between the susceptibility to fluconazole and voriconazole.     

Antimicrobial activities of cefetamet against clinically isolated strains from community acquired respiratory tract infections. Part III]

Antimicrobial activities of cefetamet (CEMT) against clinically isolated strains from patients with community acquired respiratory tract infections were investigated in comparison with those of other oral beta-lactam antibiotics during the period from January to March, 1998. The results are summarized as follows; 1. CEMT showed strong antimicrobial activities against three major pathogens causing community acquired respiratory tract infections, Streptococcus pyogenes, Streptococcus pneumoniae and Haemophilus influenzae. However, antimicrobial activities of CEMT against penicillins (PCs)-intermediate S. pneumoniae (PISP) and PCs-resistant S. pneumoniae (PRSP) were slightly weaker than those of some of the reference antibiotics. 2. No chronological changes of CEMT-MIC level were observed in the antimicrobial activities against S. pyogenes, H. influenzae, Moraxella subgenus Branhamella catarrhalis or Klebsiella pneumoniae subsp. pneumoniae. In contrast to this, due to the increase of PISP and PRSP strains, resistance to CEMT appears increasing with time.