目的 分析重症监护病房(ICU)腹腔感染临床分离菌的流行病学及耐药性变化,为临床医生管理腹腔感染、优化起始经验性抗感染治疗提供参考。方法 回顾性分析2011年1月—2018年12月南方医院重症医学科收治的腹腔感染病例。将前后4年分为两个...目的 分析重症监护病房(ICU)腹腔感染临床分离菌的流行病学及耐药性变化,为临床医生管理腹腔感染、优化起始经验性抗感染治疗提供参考。方法 回顾性分析2011年1月—2018年12月南方医院重症医学科收治的腹腔感染病例。将前后4年分为两个研究时期,分析两个时期腹腔感染菌群分布的差异及耐药性变化。结果 共调查522例腹腔感染患者,最终纳入431例(前期181例、后期250例),收集腹腔感染病原菌527株。腹腔感染患者分离菌株流行病学特点及耐药性变迁情况如下:革兰阴性菌、革兰阳性菌以及真菌的比率分别为48.2%、34.0%、17.8%;大肠埃希菌、屎肠球菌、肺炎克雷伯菌、白假丝酵母菌及粪肠球菌是居前5位的分离菌,占所有分离菌株的63.0%;后期大肠埃希菌产ESBLs菌株检出率较前期下降(68.1% VS 45.9%,χ^(2)=5.291,P=0.021),对头孢菌素和哌拉西林/他唑巴坦的敏感率上升,对碳青霉烯类抗生素的耐药率维持在较低水平并保持不变;肺炎克雷伯菌产ESBLs菌株检出率虽无变化(28.6% VS 23.1%,χ^(2)=0.212,P=0.645),但耐碳青霉烯类肺炎克雷伯菌的比率却升高(14.3% VS 38.5%,χ^(2)=4.103,P=0.043),药物敏感率普遍呈下降趋势;鲍曼不动杆菌是最常见非发酵菌之一,前期泛耐药情况严重,对亚胺培南及美罗培南的耐药率为100%,后期对两者敏感率恢复至50%左右;在肠球菌中,未发现耐万古霉素的屎肠球菌及粪肠球菌,且前后时期的耐药率无明显变化。结论 ICU成人腹腔感染病原菌以革兰阴性菌为主。产ESBLs的肠杆菌目细菌及泛耐药鲍曼不动杆菌虽然在一定程度上得到控制,但与此同时,耐碳青霉烯类肺炎克雷伯菌却逐渐增多,耐药形势仍不容乐观,监测腹腔感染病原菌的流行病学及耐药趋势工作仍需持续进行。展开更多
The present study was designed to investigate the anti-sepsis effects of physcion 8-O-β-glucopyranoside (POG) isolated from Rumex japonicas and explore its possible pharmacological mechanisms. POG was extracted from ...The present study was designed to investigate the anti-sepsis effects of physcion 8-O-β-glucopyranoside (POG) isolated from Rumex japonicas and explore its possible pharmacological mechanisms. POG was extracted from R. japonicas by bioactivity-guided isolation with the anti-sepsis agents. Survival analysis in septic mouse induced by LPS and heat-killed Escherichia coli were used to evaluate the protective effect of POG(40 mg·kg^(-1), i.p.) on sepsis. Cytokines including TNF-α, IL-1β and IL-6 in RAW 264.7 cells induced by LPS(100 ng·mL^(-1)) were determined by ELISA. In addition, the proteins expressions of TLR2 and TLR4 were determined by Western blotting assay. Our results demonstrated that POG(40 mg·kg^(-1), i.p.) possessed significant protective activity on the endotoxemic mice. The POG treatment(20, 40, and 80 μg·mL^(-1)) significantly decreased the TNF-α, IL-1β and IL-6 induced by LPS(P < 0.01) in a concentration-dependent manner. Furthermore, the TLR4 and TLR2 proteins were also down-regulated by POG at 20(P < 0.01), 40(P < 0.01), and 80 μg·mL^(-1)(P < 0.01). The present study demonstrated that the POG extracted from R. japonicas possessed significant anti-sepsis effect on endotoxemic mice, and can be developed as a novel drug for treating sepsis in the future.展开更多
文摘目的 分析重症监护病房(ICU)腹腔感染临床分离菌的流行病学及耐药性变化,为临床医生管理腹腔感染、优化起始经验性抗感染治疗提供参考。方法 回顾性分析2011年1月—2018年12月南方医院重症医学科收治的腹腔感染病例。将前后4年分为两个研究时期,分析两个时期腹腔感染菌群分布的差异及耐药性变化。结果 共调查522例腹腔感染患者,最终纳入431例(前期181例、后期250例),收集腹腔感染病原菌527株。腹腔感染患者分离菌株流行病学特点及耐药性变迁情况如下:革兰阴性菌、革兰阳性菌以及真菌的比率分别为48.2%、34.0%、17.8%;大肠埃希菌、屎肠球菌、肺炎克雷伯菌、白假丝酵母菌及粪肠球菌是居前5位的分离菌,占所有分离菌株的63.0%;后期大肠埃希菌产ESBLs菌株检出率较前期下降(68.1% VS 45.9%,χ^(2)=5.291,P=0.021),对头孢菌素和哌拉西林/他唑巴坦的敏感率上升,对碳青霉烯类抗生素的耐药率维持在较低水平并保持不变;肺炎克雷伯菌产ESBLs菌株检出率虽无变化(28.6% VS 23.1%,χ^(2)=0.212,P=0.645),但耐碳青霉烯类肺炎克雷伯菌的比率却升高(14.3% VS 38.5%,χ^(2)=4.103,P=0.043),药物敏感率普遍呈下降趋势;鲍曼不动杆菌是最常见非发酵菌之一,前期泛耐药情况严重,对亚胺培南及美罗培南的耐药率为100%,后期对两者敏感率恢复至50%左右;在肠球菌中,未发现耐万古霉素的屎肠球菌及粪肠球菌,且前后时期的耐药率无明显变化。结论 ICU成人腹腔感染病原菌以革兰阴性菌为主。产ESBLs的肠杆菌目细菌及泛耐药鲍曼不动杆菌虽然在一定程度上得到控制,但与此同时,耐碳青霉烯类肺炎克雷伯菌却逐渐增多,耐药形势仍不容乐观,监测腹腔感染病原菌的流行病学及耐药趋势工作仍需持续进行。
文摘The present study was designed to investigate the anti-sepsis effects of physcion 8-O-β-glucopyranoside (POG) isolated from Rumex japonicas and explore its possible pharmacological mechanisms. POG was extracted from R. japonicas by bioactivity-guided isolation with the anti-sepsis agents. Survival analysis in septic mouse induced by LPS and heat-killed Escherichia coli were used to evaluate the protective effect of POG(40 mg·kg^(-1), i.p.) on sepsis. Cytokines including TNF-α, IL-1β and IL-6 in RAW 264.7 cells induced by LPS(100 ng·mL^(-1)) were determined by ELISA. In addition, the proteins expressions of TLR2 and TLR4 were determined by Western blotting assay. Our results demonstrated that POG(40 mg·kg^(-1), i.p.) possessed significant protective activity on the endotoxemic mice. The POG treatment(20, 40, and 80 μg·mL^(-1)) significantly decreased the TNF-α, IL-1β and IL-6 induced by LPS(P < 0.01) in a concentration-dependent manner. Furthermore, the TLR4 and TLR2 proteins were also down-regulated by POG at 20(P < 0.01), 40(P < 0.01), and 80 μg·mL^(-1)(P < 0.01). The present study demonstrated that the POG extracted from R. japonicas possessed significant anti-sepsis effect on endotoxemic mice, and can be developed as a novel drug for treating sepsis in the future.
