氟喹诺酮类药物对临床分离金黄色葡萄球菌的防耐药变异浓度

目的测定氟喹诺酮类(FQ)药物对金黄色葡萄球菌临床分离菌的防耐药变异浓度(mutant prevention concentration,MPC). 方法肉汤法富集1010CFU/ml金黄色葡萄球菌临床分离菌54株,采用琼脂平板稀释法分别测定莫西沙星、加替沙星、帕珠沙星和环丙沙星对金黄色葡萄球菌的MIC及MPC,并计算MIC90、MPC90. 结果莫西沙星、加替沙星、帕珠沙星和环丙沙星对42株环丙沙星敏感的金黄色葡萄球菌临床分离菌的MPC90值,分别为0.5 μg/ml、0.5 μg/ml、4 μg/ml 和8 μg/ml,细菌耐药选择指数(MPC90/MIC90比值)分别为4、4、16和16;对12株环丙沙星耐药而莫西沙星和加替沙星敏感的金黄色葡萄球菌临床分离菌,莫西沙星和加替沙星的MPC90值均为16 μg/ml,MPC90/MIC90比值均为8. 结论对环丙沙星敏感的金黄色葡萄球菌,莫西沙星和加替沙星限制耐药突变株选择的能力优于帕珠沙星和环丙沙星;结合药代动力学参数,莫西沙星和加替沙星单药能有效限制耐药突变株的选择,而环丙沙星则容易选择出耐药突变株;而对环丙沙星耐药但莫西沙星和加替沙星敏感的金黄色葡萄球菌,莫西沙星和加替沙星单药则不能限制耐药突变株的选择.     

利奈唑胺对结核分枝杆菌体外抗菌活性的研究

目的 对比研究利奈唑胺对敏感及耐药结核分枝杆菌的体外抗菌活性,为今后的治疗提供依据.方法 选取临床分离的敏感及耐药结核分枝杆菌各36株,分别在含有特定浓度的利奈唑胺等药物培养基内培育,采用B-D培养基比例法测定各菌株在体外试验的最低抑菌浓度(MIC).结果 利奈唑胺对敏感及耐药结核分枝杆菌的MIC均在0.25～0.50 μg/ml,其中0.125 μg/ml浓度敏感株占63.89％,耐药株全部存活;在0.25 μg/ml浓度下敏感株占33.33％、耐药株占36.11％,在0.5 μg/ml浓度下敏感株占2.77％、耐药株占63.88％;＞1 μg/ml全部无细菌生长.结论 常规剂量的利奈唑胺在体外有较好的抗结核分枝杆菌活性,虽然异烟肼、利福平对耐药结核分枝杆菌仍有较好的抗菌活性,但是需要增加剂量.     

临床分离结核分枝杆菌耐药性分析

目的：分析临床分离结核分枝杆菌的耐药特点。方法：用改良罗氏培养基间接药敏实验绝对浓度法检测结核分枝杆菌的耐药情况。结果：结核分枝杆菌总耐药率79．6％，耐多药率为58．2％。其中初治耐药率60．5％，初治耐多药率34.2％，复治耐药率91.7％，复治耐多药率80．0％。结论：耐药结核分枝杆菌感染是临床治疗结核病的一个严重问题。分析临床分离结核分枝杆菌菌株的耐药特点，对控制结核病传染及指导临床合理用药具有重要意义。     

河南省滑县耐多药结核分枝杆菌的防控现状

目的了解河南省滑县耐多药结核分枝杆菌的防控现状,为制定结核病防控措施提供参考。方法对2013年1月至2016年12月滑县中心医院结核病耐药监测点收集的经痰结核分枝杆菌培养呈阳性的菌株224株进行一线抗结核药物敏感试验,收集患者人口学资料,分析耐多药的影响因素。结果 1 752例肺结核患者中痰培养阳性928例。进一步行酸性罗氏培养,分离菌株263株。其中人型结核分枝杆菌224株、非结核分枝杆菌31株、牛型分枝杆菌8株。224株结核分枝杆菌中,对抗结核一线药物耐多药菌株31株,占13.84%。初治患者耐多药菌株比例明显低于复治患者,差异有统计学意义(P0.01);多药耐药率排前4的组合分别为:异烟肼+链霉素、异烟肼+利福平、链霉素+利福平、异烟肼+利福平+链霉素。不同年龄、治疗史、户籍的患者分离出的结核分枝杆菌多药耐药率之间差异有统计学意义(P0.05)。结论河南省滑县复治结核患者耐多药率明显高于国内平均水平,防控现状较为严峻,年龄、治疗史、户籍为耐多药的影响因素,应对复治患者根据药敏结果和影响因素做好分类管理,制定合理化给药方案,控制耐多药的发生率。     

5种氟喹诺酮类药物对大肠埃希菌防耐药变异选择浓度测定

目的研究5种氟喹诺酮类药物对大肠埃希菌耐药突变株的选择能力,比较其防耐药变异能力. 方法肉汤法富集1010CFU/ml大肠埃希菌(ATCC25922)和25株临床分离菌,采用平板稀释法测定莫西沙星、加替沙星、帕珠沙星、左氧沙星和环丙沙星对大肠埃希菌的MIC99、暂定防变异浓度(MPCpr)及MPC. 结果莫西沙星、加替沙星、左氧沙星、帕珠沙星、环丙沙星对大肠埃希菌(ATCC25922)的MPC分别为0.072、0.048、0.09、0.09、0.06μg/ml.细菌耐药选择指数(MPC/MIC99)分别为4、6.8、6.9、9、12.环丙沙星、加替沙星、帕珠沙星、莫西沙星对25株大肠埃希菌临床分离菌MPCpr90值分别为2、1、2、1μg/ml, 选择指数(MPCpr90/MIC90)分别为16、4、16、2. 结论莫西沙星和加替沙星限制大肠埃希菌耐药突变菌株的选择能力强于环丙沙星和帕珠沙星.     

平远县2009-2014年结核分枝杆菌检出及耐药情况

目的 了解2009-2014年期间广东省平远县结核分枝杆菌的检出和耐药情况。 方法 收集2009-2014年期间广东省平远县慢性病防治站收治的结核病患者或疑似结核病患者痰标本1 682份,对样品抗酸染色、采用改良罗氏培养基对结核分枝杆菌进行培养,并对异烟肼、利福平、乙胺丁醇、链霉素四种抗结核病药物进行药敏试验。 结果 共分离到结核分枝杆菌191株, 其中166株来自初治患者、25株来自复治患者。总耐药率为35.1%,对四种药物耐药率分别为19.8%、 25.7%、7.3%和18.3%,初治患者和复治患者的菌株耐多药率分别为22.9%和48.0%,差异有统计学意义(P<0.05)。 结论 平远县结核病人耐药形势严峻,应加强耐药监测和检测,并合理使用药物。     

结核分枝杆菌gyrA基因突变与氧氟沙星耐药水平的相关性研究

目的探讨结核分枝杆菌耐药相关基因gyr A突变与氧氟沙星耐药水平之间的相关性。方法采用微孔板Alamar blue显色法检测经比例法确认的39株氧氟沙星耐药和32株氧氟沙星敏感的结核分枝杆菌临床分离株对氧氟沙星的最小抑菌浓度(minimun inhibitory concentration,MIC),基因DNA测序法检测氟喹诺酮耐药相关基因gyr A的突变情况,并用卡方检验检测gyr A基因突变与氧氟沙星耐药水平的相关性。结果 32株氧氟沙星敏感株MIC均2.000μg/ml且gyr A未发现耐药相关位点突变。氧氟沙星耐药结核分枝杆菌氧氟沙星MIC≥4.000μg/ml的菌株gyr A 94位的突变率(18/24,75%)高于MIC≤2.000μg/ml(6/15,40%)的菌株(P=0.017);5/7的gyr A 91单突变菌株MIC均为2.000μg/ml;两株gyr A94和gyr A90或91位联合突变株氧氟沙星MIC明显高于其它菌株,分别为16.000μg/ml和64.000μg/ml。结论氟喹诺酮耐药菌株gyr A基因94位突变和双位点联合突变与氧氟沙星高水平耐药明显相关,gyr A 91突变与氧氟沙星低水平耐药有关。     

左氧氟沙星和莫西沙星对鼠疫耶尔森菌最低抑菌浓度的测定

目的 根据美国临床和实验室标准协会（CLSI）药敏试验方法中的琼脂稀释法,测定美国食品和药物监督管理局( FDA)批准治疗鼠疫的2种药左氧氟沙星和莫西沙星对鼠疫耶尔森菌的最低抑菌浓度,确定鼠疫菌对这2种药物的敏感性及MIC90（可抑制90%细菌生长的药物浓度）,掌握这2种药物对鼠疫菌的抑菌浓度,为鼠疫的临床治疗提供基线数据。方法 利用琼脂平板稀释法测定左氧氟沙星和莫西沙星这2种抗生素分别对1 010株鼠疫菌的最低抑菌浓度（minimal inhibitory concentration,MIC）。结果 所测的1 010株鼠疫菌中未发现对左氧氟沙星和莫西沙星具有单个或2种抗菌药物抗性的鼠疫菌株,其最低抗菌药物浓度MIC50分别为0.06和0.12 μg/ml,MIC90均为0.25 μg/ml。结论 利用琼脂稀释法测定左氧氟沙星和莫西沙星对鼠疫耶尔森菌最低抑菌浓度,有效的评价了鼠疫耶尔森菌对氟喹诺酮类代表药物左氧氟沙星和莫西沙星的敏感性,实验数据支持我国在鼠疫临床治疗中可以采用左氧氟沙星和莫西沙星为治疗药物。     

泰州市209例肺结核患者耐药情况分析

目的了解泰州市肺结核病耐药情况,为提高耐药结核病防治工作质量提供依据。方法收集本地区2012年结核病患者209株临床分离株,按WHO推荐的比例法进行药物敏感性试验和菌型鉴定。结果 209株临床分离株中检出结核分枝杆菌200株、非结核分枝杆菌9株。200株结核分枝杆菌总耐药率28.00%、耐多药率9.50%、广泛耐药率2.00%;9株非结核分枝杆菌全部为广泛耐药。200株结核分枝杆菌中,分离自初治患者的154株菌株总耐药率19.48%,耐多药率4.55%,无广泛耐药;复治患者46株菌株中总耐药率56.52%,耐多药率26.09%,广泛耐药率8.70%。初治患者总耐药率、耐多药率均低于复治患者,差异均有统计学意义(P值均0.01)。200株结核分枝杆菌耐药率以耐异烟肼(H)最高(19.00%),耐卷曲霉素(Cpm)最低(6.50%),其他药物为7.50%~15.00%,差异有统计学意义(P0.01)。结论泰州市结核病初治患者的耐药情况明显好于全国,但复治患者耐药情况不容乐观,且结核分枝杆菌总耐多药率和广泛耐药率均较高,应引起高度重视。结核病患者以结核分枝杆菌感染为主,耐药水平与近年来相关报道数据基本一致。应采取多种措施,进一步降低结核病耐药水平。     

涂阳患者分离分枝杆菌的种类及耐药性

目的了解吴江市痰涂片抗酸杆菌阳性（简称涂阳）患者分离分枝杆菌的种类及耐药状况,为今后结核病的防治工作提供参考依据。方法对新鲜痰涂阳性标本进行分离培养、菌种鉴定及药敏试验,比较不同菌种及初治与复治结核病患者的耐药性。结果纳入研究的分枝杆菌共103株,其中有13株为非结核分枝杆菌,其耐药率为100.00%,耐多药率为84.62%;结核分枝杆菌90株,其中人型结核分枝杆菌81株（90.00%）。结核分枝杆菌耐药率为35.56%,耐多药率为14.44%。70例初治涂阳结核患者中,耐药14例,耐药率为20.00%,耐多药率为4.28%（3/70）;20例复治涂阳结核患者中,耐药18例,耐药率为90.00%,耐多药率为50.00%（10/20）。结论该市涂阳患者分离菌株以结核分枝杆菌为主;非结核分枝杆菌耐药率及耐多药率均非常高。复治涂阳结核患者分离的结核分枝杆菌耐药率、耐多药率较初治结核患者高。     

替加环素与米诺环素对多药耐药及泛耐药鲍氏不动杆菌的体外抗菌活性分析

目的 通过检测替加环素和米诺环素对多药耐药(MDR)及泛耐药(PDR)鲍氏不动杆菌(ABA)的最低抑菌浓度(MIC),探讨两种抗菌药物对多药耐药鲍氏不动杆菌(MDRAB)及泛耐药鲍氏不动杆菌(PDRAB)的体外抗菌活性,从而指导临床用药.方法 收集2010年7月-2011年6月临床分离的60株MDRAB和67株PDRAB,用E-test法测定替加环素和米诺环素对其体外抗菌活性及其MIC值分布.结果 127株鲍氏不动杆菌对替加环素和米诺环素的敏感率分别为40.9％、30.7％,对替加环素的中介率为14.2％,略高于米诺环素的7.1％;60株MDRAB对替加环素的敏感率为51.7％,对米诺环素敏感率为41.7％,两种药的MIC50为2、8 μg/ml,MIC90为16、64 μg/ml;31株耐头孢哌酮/舒巴坦MDRAB对替加环素和米诺环素的敏感率为35.5％、29.0％,其MIC50为4、24 μg/ml,MIC90为32、96 μg/ml;67株PDRAB对替加环素敏感率为31.3％,对米诺环素敏感率为20.9％,MIC50为8、32 μg/ml,MIC90为48、96 μg/ml.结论 替加环素对多药耐药及泛耐药鲍氏不动杆菌的抗菌活性稍强于米诺环素,该地区两药的敏感率均不高,应引起临床重视.     

利奈唑胺联用对耐甲氧西林金黄色葡萄球菌体外抗菌活性的研究

目的 探讨利奈唑胺与3种常用抗菌药物(利福平、左氧氟沙星、庆大霉素)分别联用对临床分离的MRSA的体外抗菌活性,为临床有效地治疗MRSA感染提供理论依据.方法 常规方法培养分离细菌,获得纯培养后用VITEK全自动微生物分析仪鉴定金黄色葡萄球菌,再根据CLSI(2006年)标准,微量肉汤法进行最低抑菌浓度(MIC值)的测定及药敏试验,并计算分级抑菌浓度(FIC)指数.结果 利奈唑胺、左氧氟沙星、利福平、庆大霉素对30株MRSA的MIC50分别为0.5～4、16～256、8～256、128～1024 μg/ml,MIC90分别为4、256、256、1024μg/ml;利奈唑胺与左氧氟沙星联用MIC90降为2μg/ml,利奈唑胺与利福平联用MIC90降为1μg/ml,利奈唑胺与庆大霉素联用MIC90降为2 ug/ml.结论 利奈唑胺对MRSA有较高敏感性,利奈唑胺与利福平联合应用以协同作用为主,利奈唑胺与左氧氟沙星、庆大霉素联合应用以协同和相加作用为主,二者均无拮抗作用.     

Minimum inhibitory (MIC) and minimum microbicidal concentration (MMC) of polihexanide and triclosan against antibiotic sensitive and resistant Staphylococcus aureus and Escherichia coli strains

Background: An in-vitro study was conducted investigating the antimicrobial efficacy of polihexanide and triclosan against clinical isolates and reference laboratory strains of Staphylococcus aureus and Escherichia coli.Methods: The minimal inhibitory concentration (MIC) and the minimal microbicidal concentration (MMC) were determined following DIN 58940-81 using a micro-dilution assay and a quantitative suspension test following EN 1040. Polihexanide was tested in polyethylene glycol 4000, triclosan in aqueous solutions.Results: Against all tested strains the MIC of polihexanide ranged between 1-2 μg/mL. For triclosan the MICs varied depending on strains ranging between 0.5 μg/mL for the reference strains and 64 μg/mL for two clinical isolates. A logRF >5 without and logRF >3 with 0.2% albumin burden was achieved at 0.6 μg/mL triclosan. One exception was S. aureus strain H-5-24, where a triclosan concentration of 0.6 μg/mL required 1 minute without and 10 minutes with albumin burden to achieve the same logRFs. Polihexanide achieved a logRF >5 without and logRF >3 with albumin burden at a concentration of 0.6 μg/mL within 30 sec. The exception was the North-German epidemic MRSA strain, were an application time of 5 minutes was required. Conclusion: The clinical isolates of E. coli generally showed higher MICs against triclosan, both in the micro-dilution assay as well in the quantitative suspension test than comparable reference laboratory strains. For polihexanide and triclosan strain dependant susceptibility was shown. However, both antimicrobial compounds are effective when used in concentrations common in practice.     

Antibacterial activity against foodborne Staphylococcus aureus and antioxidant capacity of various pure phenolic compounds

Six pure phenolic compounds (hydroquinone, thymol, carvacrol, butylated hydroxyanisole, gallic acid, and octyl gallate) were tested for their minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) against several strains of Staphylococcus aureus isolated from dairy and meat products. In addition, S. aureus reference strains (American Type Culture Collection) for antimicrobial studies and/or isolated from human infections and outbreaks of food poisoning were included in the study. Of the compounds tested, octyl gallate and hydroquinone were the most effective against S. aureus (mean MIC values of 20.89 and 103.05 μg/mL, respectively) and carvacrol and thymol the least (mean MIC values of about 413 μg/mL). The mean MBC values were 40.84, 194.37, 417.46, and 581.90 μg/mL for octyl gallate, hydroquinone, carvacrol, and thymol, respectively. Meat isolates were more resistant than those of dairy origin to hydroquinone, gallic acid, and octyl gallate, as well as to penicillin G (used as a control of the methodology used); gallic acid and penicillin G showed the highest differences in MIC values between the groups of strains (about 10 and 200 times, respectively). On the other hand, when we tested the isolates included in each group of strains (dairy, meat, and other/mixed sources) we only detected significant differences (p < 0.05) among dairy and isolates from other/mixed sources for hydroquinone and thymol, respectively. However, strains of meat origin exhibited significant differences among each other (p < 0.05) to most of the phenolic compounds tested (hydroquinone, carvacrol, gallic acid, and octyl gallate). The relationship between MICs and MBCs for each of the phenolic compounds tested suggested a bactericidal mechanism of action against S. aureus. Gallic acid and octyl gallate exhibited the highest antioxidant capacity and thymol and carvacrol the lowest. So, octyl gallate is an agent with both antimicrobial and antioxidant properties, which would be of interest to use in the food industry.     

Healthcare-associated bacteraemia caused by Leuconostoc species at a university hospital in Taiwan between 1995 and 2008

We studied twenty patients with Leuconostoc spp. bacteraemia at a tertiary hospital in northern Taiwan between 1995 and 2008. All isolates were identified to species level using conventional and commercial automated methods in conjunction with 16S rRNA sequencing analysis. Leuconostoc lactis (15/20, 75%) constituted the most common species but required molecular methods for accurate identification. Minimum inhibitory concentrations (MICs) of 10 antimicrobial agents were determined using the broth microdilution method. Among these 20 patients, 19 had healthcare-associated Leuconostoc spp. bacteraemia and 11 patients (55%) had underlying malignancies. Eleven had been hospitalised for more than 30 days (median: 32.5 days; range: 0-252 days) before the bacteraemic episode. At the time of bacteraemia, 11 had a Pitt bacteraemia score of ≥ 4 (median: 4; range: 0-7) and 12 had a modified Acute Physiological Assessment and Chronic Health Evaluation (APACHE II) score of ≥ 20 (median: 22; range: 5-37). Azithromycin (MIC: 0.12 μg/mL), moxifloxacin (MIC: 0.25-0.5 μg/mL), daptomycin (MIC: 0.03-0.25 μg/mL) and tigecycline (MIC: 0.06-0.12 μg/mL) exhibited good in vitro activity against Leuconostoc spp. although bacteraemia due to L. lactis was associated with high mortality in immunocompromised patients.     

显微镜观察药物敏感性试验检测结核杆菌的耐药性

目的 探讨显微镜观察药物敏感性试验(MODS)同时快速检测结核杆菌对4种一线抗结核药物耐药性的效果.方法 用24孔细胞培养板进行结核分枝杆菌(MTB)液体药敏检测,并对最佳检测条件进行探讨;将建立的MODS技术用于测定66株MTB临床分离株对链霉素、异烟肼、利福平、乙胺丁醇的耐药性,并与传统罗氏药敏结果 进行比较,对两法检测结果 不符的菌株进行最低抑菌浓度(MIC)测定.结果 MODS检测链霉素、异烟肼、利福平、乙胺丁醇药敏结果 与罗氏药敏结果 符合率分别为97.0%、90.9%、95.5%、86.4%.如以传统罗氏药敏结果 为判断标准,则MODS检测链霉素的敏感度为96.0%、特异度为97.6%、阳性和阴性预测值(PPV、NPV)及准确性分别为96.0%、97.6%和97.0%;检测异烟肼、利福平和乙胺丁醇的敏感度、特异度、PPV、NPV及准确性分别为100%、85.4%、81.0%、100%、90.9%;96.2%、95.0%、92.6%、97.4%、95.5%和73.7%、91.5%、77.8%、89.6%、86.4%.共有16株菌的20个药敏结果 MODS与传统罗氏药敏结果 不符,MIC检测结果 有14株16个药敏结果 与MODS结果 一致,4株菌4个药敏结果 与罗氏药敏结果 一致.结论 MODS同时检测链霉素、异烟肼、利福平、乙胺丁醇药敏结果 具有快速、操作简便、价廉等优点,与传统罗氏药敏结果 有较高的符合率,可作为MTB耐药性的快速检测方法 之一.     

Antimicrobial susceptibility testing of Shiga toxin-producing Escherichia coli from various samples by using a spiral gradient endpoint technique

Shiga toxin-producing Escherichia coli (STEC) remains a major public health concern. Microbial resistance may be due to use of antimicrobial agents (AAs) as a growth promoter in food animals or overuse of AAs in humans. The objective of the current study was to determine the antimicrobial susceptibility patterns of STEC strains isolated from food, veterinary, and clinical sources against 14 AAs by using the spiral gradient endpoint method. One hundred ten isolates from three sources were characterized. Results of the current study showed that all strains were resistant to the folate pathway inhibiting AAs including tylosin tartrate (gradient minimum inhibitory concentration [GMIC] ranges from ≥180.00 to 256.00?μg/mL; end concentration [EC] ranges from ≥130.00 to 151.22 μg/mL; and tail-end concentration [TEC] ≥145.00 μg/mL). All the strains isolated from three sources were susceptible to the fluoroquinolone class of AAs (GMIC ranges from ≤1.00 to 64.30 μg/mL; EC ranges from ≤3.33 to 72.00 μg/mL; and TEC ranges from ≤12.13 to 45.00 μg/mL). Among the food isolates, less resistance was found within the aminoglycoside and amphenicol group (GMIC ≥256.00 μg/mL; EC=161.00 μg/mL). Eight strains were resistant to one to three, 44 strains were resistant to four to six, and two strains were resistant to seven or more AAs. All the clinical isolates (100%) were susceptible to the fluoroquinolones and gentamycin. Results also showed that antimicrobial resistance was observed between four and six AAs among the isolates. Some veterinary isolates were resistant to five AAs. Least AAs resistance was shown by 3.7% of isolates to gentamycin and 7.45% to chloramphenicol. This study showed an increasing trend of antimicrobial resistant strains of STEC, and we suggest that periodic surveillance of the antimicrobial susceptibility may be a useful measure to detect the antimicrobial resistant pathogens.     

Prevalence of antimicrobial resistance ofStreptococcus pneumoniae in Southwest Germany as determined by the E test

We have studied the prevalence of antimicrobial resistance ofStreptococcus pneumoniae in Southwest Germany. One hundred seventy-four clinical isolates of pneumococci collected from hospitalized patients between October 1992 and April 1994 were used for MIC determinations. MICs for penicillin, ceftriaxone, erythromycin, and rifampicin were assessed by the E test. Eleven of the 174 strains (6.3%) were intermediately resistant to penicillin (MIC between 0.1 and 1.0 µg/ml) and four of the 174 strains (2.3%) were intermediately resistant to ceftriaxone (MIC between 0.1 and 1.0 µg/ml). All four isolates with a reduced susceptibility to ceftriaxone also demonstrated intermediate resistance to penicillin. Six of the 174 strains (3.5%) were highly resistant (MIC 8 µg/ml) to erythromycin. Resistance to rifampicin was not observed. Our results demonstrate that pneumococcal resistance to penicillin and erythromycin has increased markedly in Germany over the last decade. Our findings underline the need for continuous surveillance of antimicrobial resistance ofStreptococcus pneumoniae.     

产ESBLs肺炎克雷伯菌耐药基因检测及对双黄连敏感性的试验研究

目的 检测肺炎克雷伯菌产ESBLs基因型别流行情况,并探讨不同基因型别对双黄连冻干粉敏感性的差异.方法 选择2006年9月-2007年3月自哈尔滨地区连续收集的临床分离肺炎克雷伯菌231株,按照NCCLS表型确证试验检测产ESBLs菌株的发生情况;PCR检测ESBLs的基因型别;肉汤稀释法检测肺炎克雷伯菌对双黄连的敏感性,并对结果进行分析.结果 231株菌检测出产ESBLs菌株121株,阳性率52.4％;携带TEM型基因的有60株,占49.6％,携带SHV的46株占38.0％、CTX-M-1 32株占26.4％、CTX-M-9 36株占29.8％;双黄连冻干粉对肺炎克雷伯菌临床株的MIC90为50 mg/ml,MIC50为25mg/ml;产ESBLs肺炎克雷伯菌与非产ESBLs菌MIC差异无统计学意义;双黄连对产ESBLs各型别之间的MIC差异无统计学意义.结论 哈尔滨地区肺炎克雷伯菌ESBLs发生率为52.4％,以携带TEM型基因菌株最多;双黄连冻干粉对肺炎克雷伯菌的生长具有抑制作用,抑制作用不受菌株是否产ESBLs及产ESBLs基因型别的影响.     

黄芩苷对金黄色葡萄球菌生物膜抑制作用的体外研究

目的 研究黄芩苷对金黄色葡萄球菌早期、成熟生物膜(BF)的抑制作用.方法 以编号为17546金黄色葡萄球菌为试验菌株,构建体外BF模型,分为空白对照组、试验组(黄芩苷组),两倍稀释法测定最低抑菌浓度;荧光显微镜观察载体表面BF形态;连续稀释法行活菌计数.结果 建模3d,荧光显微镜发现黄芩苷终浓度分别为1024、512、256 μg/ml的试验组形成BF明显少于空白对照组,载体表面活菌计数分别为(5.05±0.27)、5.17±0.31)、(5.27±0.55)log10CFU/ml,均少于空白对照组(P＜0.05);建模7d荧光显微镜观察,黄芩苷终浓度分别为1024、512、256 μg/ml的试验组仅见少许散在生物膜,BF结构较空白对照组明显稀薄,其BF内细菌活菌计数分别为(5.19±0.30)、(5.24±0.04)、(5.33±0.22)log10CFU/ml,亦均少于空白对照组(P＜0.05).结论 黄芩苷在体外可以抑制金黄色葡萄球菌生物膜的形成.