临床常见G-致病菌的种类及耐药性的研究

目的:调查我院常见G—致病菌的种类及其对目前常用抗生素的耐药现状,为临床医生合理选用抗生素提供数据资料。方法:从3286个样本中分离到742株G—致病菌,用全自动微生物分析仪--VITEK 32进行菌种鉴定及药敏实验。结果:742株G—致病菌经鉴定属于14大类,其中铜绿假单胞菌,170株,占22．91％;大肠埃希氏菌,145株,占19．54％;鲍曼不动杆菌,100株,占13,48％;产酸克雷伯菌,84株,占11．32％;其它10种G—致病菌所占的比例均小于8％。鲍曼不动杆菌、嗜麦芽假单胞菌、产气肠杆菌三种菌对检测的17种抗生素中的极少数敏感。在对17种抗生素的耐药性实验中,药效普遍较差的抗生素为:替卡西林、头孢呋辛、头孢噻吩三者的平均药敏感率依次为:20．72％、17.21％和11．71％。结论:临床G—致病菌的耐药性问题已非常严峻,降低G—致病菌的耐药性和控制其传播以迫在眉睫。     

临床常见G^＋致病菌的种类及耐药性的研究

目的：调查我院常见G^＋致病菌的种类及其对目前常用抗生素的耐药现状,为临床医生合理选用抗生素提供数据资料。方法：从3286个样本中分离到206株G^＋致病菌,用全自动微生物分析仪-VITEK32进行菌种鉴定及药敏实验。结果：206株G^＋致病菌经鉴定属于6大类,其中金黄色葡萄球菌,74株,占35,9％;溶血葡萄球菌,47株,占22．8％;表皮葡萄球菌,47株,占22．8％;肠球菌属,33株,占16．0％;肺炎链球菌,3株,占1．5％;β-溶血链球菌,2株,占1．0％。肺炎链球菌和β-溶血链球菌仅对检测的14种抗生素中的少数敏感。在对14种抗生素的耐药性实验中,药效普遍较差的抗生素为：青霉素、庆大霉素、苯唑西林。它们三者的平均药敏感率依次为：16．52％、18．42％和21．07％：结论：临床G^＋致病菌的耐药性问题已非常严峻,合理的选择和使用抗生素已十分重要．     

2016‒2017年辽宁省沙门菌耐药菌谱与分子分型

摘要：目的 分析2016?2017年辽宁省沙门菌分离株的耐药特性与脉冲场凝胶电泳（PFGE）分子分型特征,为沙门菌引起的食源性疾病暴发、防控及抗生素使用提供参考数据。方法 对分离的54株沙门菌进行血清分型和药物敏感试验。根据PulseNet沙门菌标准PFGE分型技术,选取全部菌株进行PFGE分子分型分析,应用BioNumerics软件对菌株条带进行分析,确定菌株间的特征及相关性。结果 54株沙门菌血清型居首位的是肠炎沙门菌,占46.30％;其次是鼠伤寒沙门菌,占24.07％;共分为10个血清型。对13种抗生素的耐药分析显示多重耐药菌株为36株,占66.7％,其中耐3～5种的13株（24.1%）,耐6～8种的13株（24.1%）,耐9～11种的10株（18.5%）。54株沙门菌经聚类分析获得36种带型,相似度区间为49.7%～100.0％。结论 辽宁省沙门菌分离株多重耐药状况比较严重,相同血清型其PFGE带型相似度相对较高,同时具有较显著的优势带型特点;而且发现同一PFGE型菌株的耐药谱相对比较接近。     

用纤维支气管镜检查236例肺部感染者的病原学分析

本文报告了２３６例支气管肺部感染者,用纤支镜双塞保护法采样,病原菌培养结果。总阳性率７４．６％。共分离到２２种２９１株病原菌。球茵占１６．７％、肠杆菌科占１１．７％、非发酵菌占３７．１％,厌氧菌占２２．３％、真菌占１２．７％,３９．２％的病例为复合菌感染。还报告了８种带见病原菌对２８种抗生素的敏感试验结果。对近年肺部感染的病原菌谱型变化及复合菌感染等进行了讨论。     

临床常见G+致病菌的种类及耐药性的研究

目的:调查我院常见G 致病菌的种类及其对目前常用抗生素的耐药现状,为临床医生合理选用抗生素提供数据资料.方法:从3286个样本中分离到206株G 致病菌,用全自动微生物分析仪-VITEK 32进行菌种鉴定及药敏实验.结果:206株G 致病菌经鉴定属于6大类,其中金黄色葡萄球菌,74株,占35.9%;溶血葡萄球茵,47株,占22.8%;表皮葡萄球茵,47株,占22.8%;肠球菌属,33株,占16.0%;肺炎链球茵,3株,占1.5%;β-溶血链球菌,2株,占1.0%.肺炎链球茵和β-溶血链球菌仅对检测的14种抗生素中的少数敏感.在对14种抗生素的耐药性实验中,药效普遍较差的抗生素为:青霉素、庆大霉素、苯唑西林.它们三者的平均药敏感率依次为:16.52%、18.42%和21.07%.结论:临床G 致病菌的耐药性问题已非常严峻,合理的选择和使用抗生素已十分重要.     

绿脓杆菌的快速鉴定和耐药谱分型的探讨

本文用绿脓杆菌12群“O”多价血清辅以乙酰胺酶试验对临床分离的118株绿脓杆菌作了快速鉴定,2小时即可获得满意结果,与生物学鉴定的符合率达100%。对10种抗生素的药敏试验结果表明,本菌对丁胺卡那霉素和多粘菌素 B 较敏感,敏感率分别为98.31%和100%。118株菌可用8种抗生素分成20种不同的耐药谱型(A—T),其中属耐药谱 D 型(对多粘菌素、丁胺卡那霉素、新霉素敏感)的菌株在分布上最多,占28.8%(34/118)。     

重症监护病房金黄色葡萄球菌耐药性与流行病学分析

为了解重症监护病房感染金黄色葡萄球菌的耐药性及流行状况,收集重症监护病房2007年9～12月临床分离的金黄色萄萄球菌42株,纸片扩散法检测其对10种抗生素的耐药率,随机引物扩增PCR(Ran- dom amplified polymorphic DNA,RAPD)检测其流行状况。42株金黄色葡萄球菌对氨苄西林的耐药率最高,没有检测到对万古霉素耐药的金黄色葡萄球菌。35株金黄色葡萄球菌为耐甲氧西林的金黄色葡萄球菌(MR- SA),7株为甲氧西林敏感的葡萄球菌(MSSA),除万古霉素外,MRSA对其他9种抗生素的耐药率比MSSA高,42株金黄色葡萄球菌经RAPD分型分为5个基因型,其中Ⅰ、Ⅱ、Ⅲ、Ⅳ、Ⅴ型分别占31.0%、38.1%、14.3%、9.5%、7.1%。重症监护病房临床金黄色葡萄球菌分离株对多种抗生素具有高耐药性,其感染基因型以Ⅰ、Ⅱ型为主。     

2014—2015年大连市伤寒沙门菌耐药性及 分子分型研究

摘要：目的 了解大连市伤寒沙门菌的药物敏感情况及同源性特点,为临床用药和疾病预防提供科学指导。方法 选择15种抗生素、运用微量肉汤稀释法对65株伤寒沙门菌进行抗生素敏感试验;采用脉冲场凝胶电泳（PFGE）法进行聚类分析。结果 65株伤寒沙门菌对阿奇霉素100.00%敏感,对红霉素100.00%耐药,对其他13种药物有不同程度的耐药率（1.54%~73.85%）。发现1株多重耐药菌株。65株菌共产生41种PFGE带型,其中8株菌表现为同一型别。结论 大连地区临床分离伤寒沙门菌耐药形势严峻;聚类分析结果表明其PFGE型别较多,而且其中存在着优势菌株。     

医院内感染的病原菌分布及其耐药谱的分析

本文统计了我院１９９２年８月—１９９４年７月两车间医院内感染病原菌的分离结果,分离出病原菌２５种７５８株,其中革兰氏阳性菌１６３株（占２１．５１％）,革兰氏阴性菌３７８株（占４９．８７％）,真菌２１７株（占２８．６２％）。院感病原菌依次为,白色念珠菌、绿脓假单胞菌表、葡菌、肺炎克雷伯氏菌、酵母菌及大肠艾希氏菌等,显示了真菌及表葡菌在院内感染中已经上升到不可忽略的地位。用１８种常用抗生素,对除真菌外的上述病原菌５４１株做耐药谱测定,并发现除了表葡菌及多数革兰氏阴性菌对喹谱酮类及少数头孢三代抗生素尚属敏感外,大部分均具有越来越广泛的耐药性。     

白念珠菌临床分离调查及基因分型研究

目的 了解白念珠菌临床分离情况,并探讨其药敏结果与基因分型的相关性.方法 回顾性分析本院2011年3～11月间临床分离白念珠菌分布及耐药性;随机选取232株,采用PCR方法扩增白念珠菌25S rDNA基因内含子区进行基因分型研究;采用ATB真菌药敏试剂条进行药敏分析;统计分析药敏结果与基因分型的相关性.结果 期间共检出酵母样真菌973例,占病原菌阳性样本数比率为15.7％ (973/6196);其中分离白念珠菌562株,占58％ (562/973),主要分布科室为呼吸科(39.1％)、老年科(13.2％)、ICU(7.7％)、神经内科(7.5％)、免疫科(6.0％)以及其他科室(26.5％);标本类型以下呼吸道为主(81.7％),其次为尿路(9.4％)、血液(1.8％)等.对氟胞嘧啶、两性霉素B、氟康唑、伊曲康唑及伏立康唑的耐药率分别为0.9％、0％、1.4％、1.6％和1.1％.随机选取的232株白念珠菌经PCR方法可分为3型:A型125株,B型96株,C型11株.各型在5种药物的耐药性上并无差异.结论 临床分离酵母样真菌以白念珠菌为主,感染部位以下呼吸道为主;临床分离株对5种抗真菌药物敏感度较高,主要基因型为A和B型,不同基因分型间药敏结果并无统计学差异.     

Comparative responses of Pseudomonas stutzeri and Pseudomonas aeruginosa to antibacterial agents

The sensitivity of six strains of Pseudomonas stutzeri (NCIMB 568, 10783, 11358, 11359, JM 302, JM 375) to cationic antiseptics, mercury compounds, the parabens, phenolics, EDTA and various antibiotics was compared with Pseudomonas aeruginosa NCIMB 8626. All Ps. stutzeri strains were highly sensitive to chlorhexidine diacetate, organomercurials and triclosan, but rather less so to quarternary ammonium compounds (QACs). They were also sensitive to other biocidal agents and more sensitive to many antibiotics than the strain of Ps. aeruginosa. There was little correlation between uptake of chlorhexidine diacetate or cetylpyridinium chloride by dense suspensions of organisms, leakage of intracellular constituents and loss of cell viability.     

Antibiotic sensitivity and pyocin dependence of clinical strains of Ps. aeruginosa]

The effect of antibiotics on clinical strains of Ps. aeruginosa was analyzed. It shown that 92 per cent of the strains had multiple resistance to the most of the antibiotics used in the clinic. All the strains were sensitive to gentamicin and polymyxin. The apyocinogenic strains of Ps. aeruginosa were more sensitive to the effect of the antibiotics than the pyocinogenic ones.     

Antibiotic sensitivity of the causative agents of suppurative surgical infection]

Sensitivity of 1492 strains of the causative agents of the surgical purulent infections, i. e. pathogenic Staphylococcus, Proteus, Ps. aeruginosa and E. coli to benzylpenicillin, streptomycin, levomycetin, tetracycline, erythromycin, oleandomycin, monomycin, kanamycin, novobiocin, ampicillin, oxacillin, ceporin, gentamicin and rifampicin was studied. Gentamicin was most active against all the bacterial species tested. The staphylococci were in addition sensitive in a high percentage of the cases to rifampicin, novobiocin, ceporin, monomycin and kanamycin. The isolates of E. coli were in addition sensitive to ceporin, monomycin and kanamycin. Sensitivity of the strains of Ps. aeruginosa and Proteus was low to all of the antibiotics except gentamycin. Most of the strains of the causative agents of the surgical purulent infections were multiresistant to 4 antibiotics. The number of the staphylococcal strains sensitive to benzylpenicillin, streptomycin and levomycetin increased in 1976 as compared to 1975 on the background of a limited use of these antibiotics in clinics.     

Synergism of azlocillin, mezlocillin, piperacillin in combination with tobramycin against Klebsiella and Pseudomonas

Fifty-three clinical isolates of Klebsiella and fifty-one clinical isolates of Pseudomonas aeruginosa, twenty-six of which were carbenicillin-(CARB) resistant, were tested for susceptibility to mezlocillin (MEZ), azlocillin (AZL), and piperacillin (PIP), both alone and in combination with tobramycin (TOB) using the microtiter broth diluent method and an inoculum density of 10(6) CFU/ml. The Klebsiella were highly resistant to TOB, MEZ, and PIP (MIC90: 8, greater than 256, greater than 128 micrograms/ml, respectively). Synergy was demonstrated in 53 percent (PIP/TOB) and 51 percent (MEZ/TOB). An indifferent response was observed in 47 percent (PIP/TOB) and 49 percent MEZ/TOB of the Klebsiella. PIP, MEZ, and AZL in combination with TOB showed synergism against CARB-resistant Pseudomonas in less than 10 percent of the strains tested. Synergy could be demonstrated against CARB-susceptible Pseudomonas with the combinations PIP/TOB, AZL/TOB, and MEZ/TOB in 12 percent, 12 percent, and 24 percent, respectively, of the twenty-five strains tested. Indifferent effects were observed in 84 percent, 88 percent, and 76 percent, respectively, of these same CARB-susceptible strains. These data suggest that there is no significant difference in the incidence of synergy with these new penicillins and tobramycin against either Pseudomonas or Klebsiella.     

高龄患者血液感染常见革兰阴性杆菌及其耐药性分析

目的分析本院80~100岁高龄患者血液感染常见革兰阴性杆菌的种类及其耐药状况,为本院合理使用抗生素提供依据。方法采用BacT/Alert 3D血培养仪对血液标本进行阳性鉴定;VITEK-2Compact全自动微生物鉴定仪进行鉴定;K-B纸片扩散法对抗菌药物进行敏感性测定;使用WHONET 5.4分析软件分析数据。结果本院高龄患者血液培养阳性标本中共分离出革兰阴性杆菌108株,以肠杆菌科细菌为主,其次为非发酵菌,前者主要为大肠埃希菌52株(48.15%)和肺炎克雷伯菌37株(34.26%),后者主要包括铜绿假单胞菌10株(9.26%)和鲍曼不动杆菌8株(7.41%)。其中大肠埃希菌和肺炎克雷伯菌对亚胺培南的耐药率分别为1.92%和13.51%,两者对氨苄西林、氨苄西林/舒巴坦、头孢唑林、头孢呋辛的耐药率均高于50.00%;铜绿假单胞菌和鲍曼不动杆菌对亚胺培南的耐药率分别为20.00%和25.00%,后者对其他抗菌药物的耐药率均高于前者。结论碳青酶烯类抗生素可作为本院高龄患者常见革兰阴性杆菌所致血液感染的首选药物;但在治疗中应考虑细菌的耐药特点及患者的代谢特点合理选择抗生素。     

Comparative study of the biological characteristics of mucoid and non-mucoid Pseudomonas aeruginosa strains isolated from chronic respiratory infections

Morphological, culture and enzymatic characteristics, as well as virulence, susceptibility to antimicrobial agents and epidemiological markers, were studied for 100 mucoid and 100 non-mucoid Ps. aeruginosa strains isolated from chronic respiratory infections. For 10 mucoid and 10 non-mucoid strains was performed the active protection test in mice, both with inactivated germs (10(9) germs), and LPS extracted by Westphal method. It was ascertained that mucoid Ps. aeruginosa strains differ from non-mucoid strains by the slow growth on culture media, more reduced proteolytic activity (81% as compared to 99%), slow oxidation of carbohydrates (5-7 days), reduced virulence in mice (8%) or avirulence (92%), higher sensitivity to some antibiotics (amikacin, dibekacin, ticarcillin, tetracycline, cefotaxime, ceftriaxone), lysoresistance (74%) and polyagglutinability (67%). The mucoid strains ensure a reduced active protection in mice, 70% of strains did not protect the mice against the infection with virulent homologous strains, while the non-mucoid strains ensured 80%-100% protection.     

Infectivity and resistance to antibiotics of bacterial strains isolated from patients hospitalised in intensive care units

The aim of this study was to evaluate the frequency of isolation and antimicrobial resistance testing of bacterial strains isolated from clinical specimens from patients hospitalized in three Intensive Care Units in Wroc?aw. The susceptibility of bacteria (107 strains) to selected antibiotics was determined. The results clearly show that non-fermentative rods were identified as the main agents causing pneumonia (58% of isolates). The second commonest pathogens were Gram-positive cocci (29%). The P. aeruginosa and E. cloacae strains were resistant to ampicillin, amoxicillin/clavulanate, cefuroxime and cefotaxime. All isolates of A. baumanii were susceptible only to imipenem. The rods of K. pneumoniae and E. coli were resistant to ampicillin, about 55% strains of both bacteria were sensitive to other antibiotics, except piperacillin/tazobactam, imipenem and ciprofloxacin. About 90% of methicillin resistant S. epidermidis strains were resistant to all antibiotics, except vancomycin (100% isolates were sensitive). ESBL were detected among E. cloace, K. pneumoniae and E. coli. We found P. aeruginosa rods producing MBL.     

Antimicrobial activity of chlorhexidine diacetate and benzalkonium chloride against Pseudomonas aeruginosa and its response to biocide residues

AIMS: The aims of this study were to evaluate the antimicrobial activity of chlorhexidine diacetate (CHX) and benzalkonium chloride (BZK) for strains of Pseudomonas aeruginosa exhibiting increased minimum inhibitory concentrations (MIC) for CHX, and to determine whether residues of chlorhexidine digluconate (CHG) and Hibiscrub (Hib, a formulation containing CHG) affect the susceptibility of P. aeruginosa to these biocides and a number of antibiotics. METHODS AND RESULTS: The bactericidal activity of CHX and BZK was evaluated for strains of P. aeruginosa exhibiting increased MIC for CHX with established suspension and surface disinfection tests. None of the strains of P. aeruginosa exhibiting raised MIC for CHX was less sensitive than the parent strain to CHX or BZK in either method. A test was designed to investigate the effects of dried CHG and Hib residues on P. aeruginosa cells. Exposure of P. aeruginosa to dried residues of CHG or Hib did not result in the organism becoming less sensitive to either biocide or a number of antibiotics. CONCLUSIONS: Pseudomonas aeruginosa strains with raised MIC to CHX were no less sensitive than the parent strain to CHX and BZK in bactericidal investigations. Exposure to dried residues of CHG and Hib did not render P. aeruginosa less sensitive to either of these agents or a number of antibiotics. SIGNIFICANCE AND IMPACT OF THE STUDY: An increase in the MIC for a biocide in a micro-organism does not necessarily result in a failure of the biocide to effectively kill the organism. The residue that remains after the use of an antimicrobial agent can be at a far lower concentration than that initially applied and this study highlights the necessity for further investigations into the effect of residues, at low concentration, on bacterial populations and their role, if any, in the continued problem of antibiotic resistance.     

环丙沙星耐药的铜绿假单胞菌药敏情况分析

目的了解对环丙沙星耐药的铜绿假单胞菌的药敏情况。方法细菌的鉴定及药敏试验,均采用法国生物梅里埃公司的VITEK2微生物鉴定与药敏系统,选择经VITEK2测定耐环丙沙星的铜绿假单胞菌(耐药株)68株及对环丙沙星敏感的铜绿假单胞菌(敏感株)67株,统计分析两者对亚胺培南、阿米卡星、庆大霉素、头孢他啶、哌拉西林和哌拉西林他唑巴坦等几种临床上常用抗生素的药敏情况。结果耐药株对以上6种抗生素的敏感率分别为亚胺培南706%,阿米卡星206%,庆大霉素191%,头孢他啶279%,哌拉西林632%,哌拉西林他唑巴坦721%。而敏感株对6种抗生素的敏感率则分别为925%、328%、687%、657%、881%与896%,明显高于耐药株,经χ2检验,除阿米卡星005相似文献   

耐喹诺酮类铜绿假单胞菌的耐药性分析及血清学分型

目的了解广州地区喹诺酮类耐药铜绿假单胞菌的耐药性及泵抑制剂对其耐药水平降低的作用,并调查血清型分布情况。方法用法国生物梅里埃公司的微生物鉴定和药敏分析系统VITEK-2对127株铜绿假单胞菌进行鉴定和药敏检测,并采用羰酰氰基-对-氯苯胺(CCCP)与环丙沙星共同作用,以琼脂稀释法测定耐药菌的最低抑菌浓度(M IC)的变化,同时用玻片凝集法对耐药株进行血清学分型。结果环丙沙星耐药菌对哌拉西林/他唑巴坦(65.5%)的敏感率最高,只有阿米卡星(64.4%)、哌拉西林(51.7%)和妥布霉素(50.6%)的敏感率大于50.0%,而敏感菌对美罗培南(97.5%)及左氧氟沙星(97.5%)的敏感率最高,妥布霉素(95.0%)次之,对临床常用的13种抗生素,耐药菌较敏感菌的敏感性明显降低(P值均<0.001);耐药菌受泵抑制CCCP作用,M IC降低1~4个稀释度;血清分型率为93.1%,耐药菌的血清型以B型(20.7%)和L型(19.5%)为主。结论耐喹诺酮类铜绿假单胞菌对临床常用抗生素的敏感性降低,并呈多重耐药,使用抗生素 泵抑制剂可提高药物对铜绿假单胞菌的敏感性;血清学分型可以快速简单地监测铜绿假单胞菌在医院内的流行情况。