<i>In Vitro</i>Antibacterial Activity of Flavonoid Extracts of Two Selected Libyan Algae against Multi-Drug Resistant Bacteria Isolated from Food Products

This study aimed to evaluate the antibacterial activity of flavonoids extracted from two Libyan brown algae namely Cystoseira compressa and Padina pavonica using microwave-assisted extraction method against pathogenic bacteria isolated from meat, meat products, milk and dairy products (Staphylococcus aureus subsp. aureus (5 isolates), Bacillus cereus (3 isolates), Bacillus pumilus (1 isolate), Salmonella enterica subsp. enteric (4 isolates) and Enterohaemor-rhagic Escherichia coli O157 (EHEC O157) (4 isolates)). All of these isolates were muti-drug resistant with high MAR index. The results showed that C. compressa extract exhibited better and stronger antibacterial activities against the seventeen tested isolates with inhibition zones diameter ranged from 14 - 22 mm compared to P. pavonica extract which showed positive effect against 9 isolates with low inhibition zone ranged from 11 - 16.5 mm. Flavonoids extracted from C. compressa also displayed the best spectrum of bactericidal effect with a ratio MBC/MIC ≤ 4 obtained on all susceptible tested bacterial strains. Flavonoids and proanthocyanidins significantly contributed to the antibacterial properties. The mode of action of these active extracts is under investigation.

Bacterial contamination of orally-consumed crude herbal remedies:A potential source for multi-drug resistant pathogens in man

Objective:The acceptability of herbal remedies for alleviating discomforts and ill-health has become very popular, on the account of the increasing cost of allopathic medicine for personal health maintenance.The observable non-adherence of herbalists to the established World Health Organization(WHO) / National Agency for Food and Drug Administration Control(NAFDAC) regulations for the quality control of herbal medicines is an issue for concern.In view of this,34 popular and widely consumed crude herbal remedies in southwestern,Nigeria were screened for compliance with standard limits for bacterial contamination,bacteria flora and their antibiotic susceptibility pattern.Methods:Isolates recovered from samples were identified using the cultural, morphological and biochemical characteristics.They were also tested for drug sensitivity using standard procedures. Results:A heavy bacteria load ranging from 3.00×10~3-9.58×10~5 CFU/ML and 1.20×10~5- 5.41×10~5 CFU/ML was observed for water and spirit extracted preparations respectively.The bacteria flora cum contaminants were:Staphylococcus aureus,Bacillus cereus,Bacillus subtilis,Pseudomonas aeruginosa, Micrococcus luteus,Lactobacillus plantarum,Klebsiella pneumoniae,Escherichia coli,streptococcus,Shigella, Neisseria,Arthrobacter,Kurthia and Clostridium species.All the isolates were multi-drug resistant(MDR) strains.Conclusion:The crude herbal preparations consumed in Nigeria failed to comply with the internationally recognized standards regarding bacteria load and flora.The presence of MDR pathogens is of greatest concern. It poses a great risk to consumers health and could be a source of introducing MDR organisms into the human population.There is the need for the enforcement of established guidelines to ensure the safety of these preparations.

Multiple Antibiotic Resistant Index of Gram-Negative Bacteria from Bird Droppings in Two Commercial Poultries in Enugu, Nigeria

Antimicrobial resistance refers to the ability of microorganisms to grow in the presence of an antimicrobial agent at a concentration that will normally kill or inhibit their growth. Antimicrobial resistance has become a major global threat making treatment of infections tougher especially with high cost of treatment in humans and animals. This study was done to determine the Multiple Antibiotic Resistant Index (MARI) of Gram-negative bacteria from bird droppings in two commercial poultries in Enugu. Forty (40) samples were collected from each of the poultries. Isolates were identified by standard microbiological methods. The isolates identified were Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Citrobacter spp, Proteus spp. and, Enterobacter spp. Antibiotic susceptibility testing was carried out using disc diffusion technique. The organisms were tested against pefloxacin, augmentin (amoxicillin and clavulanic acid), ceftazidime, streptomycin, ciprofloxacin, gentamycin, cephalothin, neomycin and ofloxacin. The result of the susceptibility test showed that Proteus spp had the highest resistance and MARI value of 0.5 and 1.0 respectively. The other MARI values were Escherichia coli (0.9), Klebsiella pneumonia (0.9), Pseudomonas aeruginosa (0.8), Citrobacter spp (0.8) and Enterobacter spp (0.7). These results suggest that bacterial organisms from poultry source can contribute significantly to the spread of multi-antibiotic resistant organisms. This could arise from the indiscriminate use of antibiotics in bird feeds in poultries.

Direct and Residual Microbicidal Efficacy of Various Antiseptics against Multi-Drug Resistant Bacteria

Background: Infections in ICU’s patients are known to often originate from the colonization of wounds by the patient’s endogenous microbiota, and to eventually lead to secondary sepsis. Aim: to compare in vitro the direct and residual effects after different exposure times of 4% chlorhexidine, and of 0.1% and 0.04% polyhexanide (in gel and solution forms), on ATCC-microorganisms, and too, on bacterial strains obtained from ICU patients. Methods: We used wild multi-drug resistant strains recently obtained from the wounds of patients hospitalized at ICU and reference strains from the American Type Culture Collection (ATCC). Chlorhexidine 4% was studied as a reference solution. The direct and residual effects of the 0.1% and 0.04% polyhexanide, in gel and solution forms, were analyzed using cotton germ carriers. To evaluate the direct effect, we exposed the strains to the antiseptic. To assess the residual effect, the germ-carriers were impregnated with antiseptic and were allowed to dry before we contaminated them. We inoculated the germ carriers in a culture medium with an inhibitor of antiseptic effect to count the number of surviving microorganisms. Findings: 0.1% Polyhexanide solution proved a direct and residual efficacy after 24 hours equivalent to 4% chlorhexidine. Is very important to highlight that this great efficacy did not change according to whether they were ATCC or multidrug-resistant strains. Conclusions: 0.1% polyhexanide demonstrated a great direct and residual efficacy (like 4% chlorhexidine), against multi-drug resistant strains isolated from ICU’s patients. Moreover, due to its few cytotoxicity against keratinocytes and fibroblasts can be an optimal antiseptic for burns, wounds or ulcers.

Antimicrobial activity of green tea extract against isolates of methicillin-resistant Staphylococcus aureus and multi-drug resistant Pseudomonas aeruginosa

Objective:To evaluate antibacterial activity of the Indonesian water soluble green tea extract,Camellia sinensis,against clinical isolates of methicillin-resistantStaphylococcus aureus (S.aureus)(MRSA)and multi-drug resistant Pseudomonas aeruginosa(MDR-P.aeruginosa).Methods:Antimicrobial activity of green tea extract was determined by the disc diffusion method and the minimum inhibitory concentration(MIC)was determined by the twofold serial broth dilutions method.The tested bacteria using in this study were the standard strains and multi-drug resistant clinical isolates of S.aureus and P.aeruginosa,obtained from Laboratory of Clinical Microbiology,Faculty of Medicine,University of Indonesia.Results:The results showed that the inhibition zone diameter of green tea extracts forS.aureus ATCC 25923 and MRSA were(18.970依0.287)mm,and(19.130依0.250)mm respectively.While the inhibition zone diameter forP.aeruginosa ATCC 27853 and MDR-P.aeruginosawere(17.550依0.393)mm and(17.670依0.398)mm respectively.The MIC of green tea extracts againstS.aureus ATCC 25923 and MRSA were 400μg/mL and 400μg/mL,respectively,whereas the MIC for P.aeruginosa ATCC 27853 and MDR-P.aeruginosawere 800μg/mL,and 800μg/mL,respectively.Conclusions:Camellia sinensisleaves extract could be useful in combating emerging drug-resistance caused by MRSA andP.aeruginosa.

A New Evaluation Method for Antibiotic-Resistant Bacterial Groups in Environment

In the present manuscript it was presented whether spreading of antibiotic resistant bacterial groups in environment could be monitored by our newly developed method by enumerating antibiotic resistant bacterial groups in various biological wastes and composts. Although the numbers were not so high, diverse kinds of colistin resistant bacteria (25 mg·L-1) were included in row cattle feces (1.78 × 104 MPN g-1) and cattle feces manure (>3.84 × 104 MPN g-1). Compost originated from leftover food (>44.8 × 104 MPN g-1) and shochu lee (>320 × 104 MPN g-1) included higher numbers of chlortetracycline resistant Pseudomonas sp., (25 mg·L-1), and row cattle feces included higher numbers of chlortetracycline resistant Enterobacteriacea (15.7 × 104 MPN g-1), which mostly consisted from Pantoea sp. or Xenorhobdus doucetiae. Numbers of multi drug resistant bacteria, resistant to 25 mg·L-1 of ciprofloxacin, streptomycin, chloramphenicol, and ampicillin, were the highest in row cattle feces (>143.6 × 104 MPN g-1), followed by cattle feces manure (4.19 × 104 MPN g-1), and shochu lee (0.36 × 104 MPN g-1), which included diverse kinds of bacterial group. The present results indicated that higher numbers of multi drug resistant bacteria were typically found in row cattle feces, and the method was found suitable to enumerate and identify them. These results suggested that the method might become their environmental risk evaluation method.

Management of Multi-Drug Resistant Methicillin Resistant <i>Staphylococcus aureus</i>Induced Pneumonia with New Antibiotic Adjuvant Entity: A Retrospective Study

Aim/Objective: Increase in incidences of pneumonia due to multi-drug resistant methicillin resistant Staphylococcus aureus (MRSA) in both community and health care settings is of great concern globally. Present study aims to retrospectively analyze the efficacy of new fixed dose combination with antibiotic adjuvant entity (FDC) in comparison with vancomycin to treat patients with multi-drug resistant MRSA pneumonia. Materials and Methods: During this retrospective study, case sheets of patients who were treated for MRSA pneumonia with vancomycin or fixed dose combination of vancomycin + ceftriaxone + adjuvant (FDC) between 20 March 2010 to 20 October 2014 at tertiary care center, were analyzed. Various demographic features, antibiotic therapy, length of treatment duration and the resulting efficacy were evaluated. Microbiological success was measured in terms of bacterial eradication, while clinical success was monitored in terms of complete omission of systemic signs and symptoms. Results: Among 136 patients analyzed, 113 cases were having positive culture for MRSA, and hence were further analyzed. Out of these 113 patients, empirical treatment with vancomycin was given in 59 patients and 54 patients were treated with FDC empirically. After initial culture reports, 22 patients showing resistance to vancomycin were shifted to FDC. Amidst all the patients, 24 (64.86%) of 37 from vancomycin group and 62 (81.57%) of 76 from FDC group achieved clinical success. 9 patients out of these failure cases were cured with FDC + colistin combination therapy. Failure rates in FDC treated patients were significantly low (6.57%) as compared to vancomycin group (13.51%). Conclusion: For the treatment of different types of multi-drug resistant MRSA pneumonia, the empirical intravenous FDC therapy was safe and well tolerated with higher efficacy than vancomycin. Most of the vancomycin failure cases responded to FDC therapy and were cured. This retrospective study also concludes that an alternative option of FDC + colistin is safe and effective to treat the patients which fail to respond to FDC monotherapy.

Prevalence and Antimicrobial Resistance of Gram-Negative Bacteria Isolates in Shellfish Samples from Two River Estuaries in South-South Nigeria

Antibiotic resistant bacteria pathogens remain the leading cause of shellfish borne diseases and a major health threat to humans worldwide. The objectives of this study were to isolate, identify, and determine the antibiotic resistance patterns of Gram-negative bacteria from shellfish. We analyzed a total of 540 shellfish (117 clams, 88 oysters, and 136 periwinkles) samples collected from different vendors at Iko and Douglas Creeks in Akwa Ibom State, South-South Nigeria. Conventional cultural techniques, morphological, biochemical characteristics, and PCR amplification were used to identify the bacterial isolates. Antibiotic susceptibility tests (Kirby-Bauer disk diffusion method) and ESBL phenotype (disk) of the isolates were performed. One hundred and thirty-five (135) Gram-negative bacteria comprising 5 genera and 14 species were detected at a prevalence of: Alcaligenes faecalis TRB-7 38 (28.2%), Pseudomonas oryzihabitans strain KCB005 16 (11.9%), Paenalcaligenes retgerii strain B5 12 (8.9%) Pseudomonas aeruginosa JB2 10 (7.4%), Providencia stuartii DMC-28b 9 (6.7%), Alcaligenes species TLT151 8 (5.9%), Pseudomonas aeruginosa CIFRI DTSB1 7 (5.2%), Paenalcaligenes species UN24 7 (5.2%), Alcaligenes faecalis BT10 7 (5.2%), Vibrio species strain PrVy108 6 (4.4%), Pseudomonas xiamenensis C10-2 5 (3.7%), Providencia vemicola Bu15_38 4 (2.9%), Pseudomonas anguillisceptica 4029 3 (2.2%), and Pseudomonas aeruginosa N15-01092 3 (2.2%). All tested isolates showed various degrees of resistance to the thirteen antimicrobials evaluated. High levels of resistance (100%) to cefepime and imipenem were expressed by all isolates except the Providencia species. For the EBSL indicators, all isolates apart from Alcaligenes species were resistant (100%) to ceftriaxone. All Vibrio species were susceptible to norfloxacin, nalidixic acid, and ceftazidime. The identification of antibiotic resistant Gram-negative bacteria (GNARB) from shellfish in this study highlights the risk of disseminated multi-drug resistance—a serious public health concern.

Current concepts and future strategies in the antimicrobial therapy of emerging Gram-positive spontaneous bacterial peritonitis

Spontaneous bacterial peritonitis(SBP) is the most common infection in end-stage liver disease patients.SBP is defined as an ascitic fluid infection with a polymorphonuclear leucocyte count ≥ 250/mm^3 without an evident intra-abdominal surgically treatable source.Several mechanisms contribute to SBP occurrence,including translocation of gut bacteria and their products,reduced intestinal motility provoking bacterial overgrowth,alteration of the gut's barrier function and local immune responses.Historically,Gram-negative enteric bacteria have been the main causative agents of SBP,thereby guiding the empirical therapeutic choice.However,over the last decade,a worryingly increasing prevalence of Gram-positive and multi-drug resistant(MDR) SBP has been seen.Recently,the microbiological spectrum of SBP seems to have changed in Europe due to a high prevalence of Gram-positive bacteria(48%-62%).The overall proportion of MDR bacteria is up to 22%-73% of cases.Consequently,empirical therapy based on thirdgeneration cephalosporins or amoxicillin/clavulanic acid,can no longer be considered the standard of care,as these drugs are associated with poor outcomes.Theaim of this review is to describe,with an epidemiological focus,the evidence behind this rise in Gram-positive and MDR SBP from 2000 to present,and illustrate potential targeted therapeutic strategies.An appropriate treatment protocol should include daptomycin plus ceftaroline and meropenem,with prompt stepdown to a narrower spectrum when cultures and sensitivity data are available in order to reduce both cost and potential antibiotic resistance development.

The Five Years Surveillance and Trends of Antibiotic Resistance in Some Common Gram Negative Bacteria at the Vietnam Military Hospital

The study is to identify trends and levels of antibiotic resistance of some common Gram-negative strains over time. The samples were collected from Vietnam Military Hospital 103 between 2014 and 2019. A total of 405 Acinetobacter baumannii., 528 Pseudomonas aeruginosa, 741 Escherichia coli, and 352 Klebsiella pneumoniae strains were identified and antimicrobial susceptibility was by Vitek system and Etest method. The multi-drug resistance (MDR) was major proportion of four common bacteria. In particular, there is a tendency to shift from MDR to Extended drug resistance (XDR) or possibly Pan drug resistant (pPDR). A. baumannii had the highest level of antibiotic resistance, namely, carbapenem (61.5% - 82.5%) and cephalosporin (72.7% - 88.7%). P. aeruginosa resisted most of commonly antibiotics, ranging from 50% to 70%. E. coli had a high resistance with antibiotics like ampicillin (87.2% - 97.6%) and the 3rd generation cephalosporins (up to 79.6%). K. pneumoniae resisted carbapenem from 14.7% to 44.4%, and other antibiotics with the higher rate of 40%. The collected data will be a prerequisite for further studies on mechanisms and factors related to antibiotic resistant bacteria, in order to find out a rational and effective using strategy of antibiotics.

2019-2021年重症监护病房多重耐药菌医院感染特点分析

目的分析2019-2021年重症监护病房多重耐药菌医院感染的特点。方法回顾性选取2019年1月至2021年12月我院重症监护病房收治的2126例患者的临床资料。分析2019-2021年重症监护病房多重耐药菌医院感染的发生情况与多重耐药菌医院感染病原菌的构成情况以及不同部位多重耐药菌医院感染的发生情况。结果2019-2021年多重耐药菌医院感染率呈逐年降低趋势。2021年的多重耐药菌医院感染率低于2019年,差异具有统计学意义(P=0.019)。2019-2021年共检出菌株数64株,其中耐碳青霉烯类鲍曼不动杆菌在多重耐药菌医院感染的病原菌构成中占比最高(62.50%)。重症监护病房多重耐药菌医院感染以呼吸机相关为主,占比为48.44%;下呼吸道次之,占比为32.81%;泌尿道、尿管相关、上呼吸道占比均较低,分别为7.81%、7.81%、3.13%。耐碳青霉烯类鲍曼不动杆菌、耐碳青霉烯类肠杆菌科细菌对头孢吡肟、亚胺培南、美罗培南、阿米卡星及左氧氟沙星的耐药性较高(超过80%),耐碳青霉烯类铜绿假单胞菌对亚胺培南的耐药性较高。结论重症监护病房多重耐药菌医院感染是医院感染控制的难点及重点,应根据重症监护病房多重耐药菌医院感染的特点在诊疗中采取针对性防控措施,尤其需重视耐碳青霉烯类鲍曼不动杆菌及呼吸机相关患者重症监护病房医院感染的监测与防控,并合理使用抗菌药物。

2019--2021年某三甲医院多重耐药菌检出情况与对策

目的了解某三甲医院2019—2021年多重耐药菌检出、分布、隔离医嘱下达情况,探索下一阶段防控措施。方法调查2019年1月至2021年12月住院患者多重耐药菌检出率、变化趋势、科室分布、隔离医嘱下达率。结果2019—2021年共检出多重耐药菌1861株,检出率分别为31.94%、30.19%、26.374%,在2019、2020、2021年呈逐年下降趋势。大肠埃希菌、鲍曼不动杆菌、肺炎克雷伯菌检出率在2019、2020、2021年呈上升趋势,分别是17.21%~52.42%、58.63%~71.02%和29.03%~30.04%;金黄色葡萄球菌、铜绿假单胞菌检出率在2019、2020、2021年呈下降趋势,依次为23.02%~36.29%、25.31%~47.73%。分布集中在呼吸科20.63%、胸部肿瘤科15.42%、RICU 12.84%、ICU 12.63%、泌尿外科7.58%。隔离医嘱下达率只有58.03%,其中儿科最低(15.79%),骨科为31.25%,泌尿外科为34.04%;2021年较2019年有较大幅度提高(χ2=8.499,P=0.004);较2020年略有上升,但差异无统计学意义(χ2=0.329,P=0.566)。结论多重耐药菌检出率近三年呈持续下降趋势,表明防控措施取得成效;但大肠埃希菌、肺炎克雷伯菌、鲍曼不动杆菌检出率呈波动上升趋势,隔离医嘱下达率较低,对防控提出新要求。

Quantification of multi-antibiotic resistant opportunistic pathogenic bacteria in bioaerosols in and around a pharmaceutical wastewater treatment plant

Pharmaceutical wastewater treatment plants（WWTPs） are thought to be a ＂seedbed＂ and reservoirs for multi-antibiotic resistant pathogenic bacteria which can be transmitted to the air environment through aeration. We quantified airborne multi-antibiotic resistance in a full-scale plant to treat antibiotics-producing wastewater by collecting bioaerosol samples from December2014 to July 2015. Gram-negative opportunistic pathogenic bacteria（GNOPB） were isolated, and antibiotic susceptibility tests against 18 commonly used antibiotics, including 11 β-lactam antibiotics, 3 aminoglycosides, 2 fluoroquinolones, 1 furan and 1 sulfonamide, were conducted.More than 45% of airborne bacteria isolated from the pharmaceutical WWTP were resistant to three or more antibiotics, and some opportunistic pathogenic strains were resistant to 16 antibiotics, whereas 45.3% and 50.3% of the strains isolated from residential community and municipal WWTP showed resistance to three or more antibiotics. The calculation of the multiple antibiotic resistance（MAR） index demonstrated that the air environment in the pharmaceutical WWTP was highly impacted by antibiotic resistance, while the residential community and municipal WWTP was less impacted by antibiotic resistance. In addition, we determined that the dominant genera of opportunistic pathogenic bacteria isolated from all bioaerosol samples were Acinetobacter, Alcaligenes, Citrobacter, Enterobacter, Escherichia, Klebsiella, Pantoea, Pseudomonas and Sphingomonas. Collectively, these results indicate the proliferations and spread of antibiotic resistance through bioaerosols in WWTP treating cephalosporin-producing wastewater, which imposed a potential health risk for the staff and residents in the neighborhood, calling for administrative measures to minimize the air-transmission hazard.

多重耐药菌中β-内酰胺酶的基因型研究

目的调查β-内酰胺酶在临床分离的多重耐药大肠杆菌和肺炎克雷伯菌中的流行状况,并分析不同基因型的分布特征。方法针对2009～2010年间收集的59株多重耐药大肠杆菌和肺炎克雷伯菌,采用VITEK-2全自动细菌鉴定仪检测大肠杆菌和肺炎克雷伯菌对抗菌药物的耐药性。用煮沸法提取菌株的总DNA,并用多重聚合酶链反应(PCR)对21种β-内酰胺酶基因进行检测。结果 59株多重耐药菌对青霉素类、头孢菌素类和喹诺酮类抗菌药物耐药性非常严重,耐药率均达90%以上。多重PCR共检出含TEM基因菌株32株,CTX-M-G9基因31株,SHV基因27株,CTX-M-G1基因19株,CTX-M-G2基因14株,DHA基因4株,MOX基因2株,CMY基因、OXA-1基因和ACT基因各1株。未检测到含GES、VEB、IMP、VIM、KPC、CTX-M-G8/25、ACC、FOX、PER、OXA-48等基因的菌株,多个菌株发现携带两种以上耐药基因。结论多重耐药菌中β-内酰胺酶种类分布非常广泛,其中以TEM、CTX-M和SHV基因最为常见,某些菌株同时携带多种β-内酰胺酶基因,临床进行抗菌治疗时应引起重点关注。

第三四代头孢菌素对细菌产超广谱β-内酰胺酶的影响

目的 了解第 3 ,4代头孢菌素的使用及其与细菌产超广谱 β 内酰胺酶的关系 ,以指导临床合理用药。方法 选取江汉大学附属医院确诊为下呼吸道感染的住院患者 44 3例 ,对每例患者送检的晨痰标本经涂片筛检合格后再培养分离 ,共培养出 473株致病菌 (真菌除外 )。采用Kirby Bauer扩散法进行药敏分析。对每例患者使用第 3 ,4代头孢菌素情况进行统计。结果 2 0 0 1,2 0 0 2 ,2 0 0 3年第 3 ,4代头孢菌素使用率分别为 3 6 67% ,41 46%及 46 67% ;大肠埃希菌产超广谱 β 内酰胺酶分别为 17 65 % ,3 8 0 0 % ,3 9 0 2 % ;肺炎克雷白杆菌产超广谱 β 内酰胺酶分别为 19 2 3 % ,43 90 % ,44 74%。结论 第 3 ,4代头孢菌素的使用率增加 ,细菌产超广谱 β 内酰胺酶亦逐年增加。

某医院2011-2014年临床分离革兰阴性杆菌分布及耐药性分析

目的探讨医院感染革兰阴性杆菌的种类分布及耐药现状,为临床控制感染、合理使用抗生素提供科学依据。方法收集我院2011-01至2014-12临床住院患者送检标本,进行细菌鉴定和耐药性分析。结果连续4年临床分离非重复革兰阴性杆菌共12 437株,肠杆菌科细菌6243株,占50.2%;非发酵菌5920株,占47.6%。主要检出菌中不动杆菌属2626株,占21.1%;铜绿假单胞菌2412株,占19.4%;肺炎克雷伯菌2093株,占16.8%;大肠埃希氏菌1049株,占8.5%。临床标本来源以呼吸道为主,其次为泌尿系统;脑外康复科以及ICU为感染高危科室。连续4年多重耐药细菌监测发现产ESBLs大肠埃希菌、肺炎克雷伯菌分别为(64.9%、64.3%、62.1%、55.4%)、(50.1%、47.7%、43.4%、45.7%)均呈现下降趋势。碳青霉烯类耐药大肠埃希杆菌、肺炎克雷伯菌分别为(0.8%、1.5%、1.3%、2.6%)、(17.4%、30.8%、27.1%、34.1%),呈逐年上升趋势。广泛耐药不动杆菌属4年平均检出率为40.3%。结论临床分离病原菌以革兰阴性杆菌为主,多重耐药细菌上升趋势明显;医院应合理规范使用抗生素,减少耐药菌产生。同时,应加强细菌耐药监测,重视感染患者的隔离及护理,预防多重耐药菌导致的医院感染暴发流行。

重组人β-防御素3对多耐药细菌的抑菌活性分析

目的研究重组人β-防御素3(rhBD-3)对临床多耐药菌株(铜绿假单胞菌、鲍曼不动杆菌、大肠埃希菌、金黄色葡萄球菌)的抗菌活性。方法采用比浊法测定不同浓度rhBD-3下4种细菌液OD值,确定最低抑菌浓度(MIC)和最低杀菌浓度(MBC),并与对照组比较。结果 rhBD-3对所测菌株菌均有抑菌活性,在一定的浓度范围内,rhBD-3的浓度增高抑菌活性增强。rhBD-3的MIC、MBC与对照组比较有统计学差异(P<0.05)。结论 rhBD-3对临床多耐药细菌具有显著的抑菌活性,给解决临床细菌耐药带来新希望。

某综合医院2013-2016年医院感染病原菌的分布特征及耐药性

目的了解某综合性医院感染病原菌的分布特征及耐药性特点,为临床医护人员合理选用抗菌药物及控制医院感染提供参考依据.方法收集该院2013年1月至2016年12月医院感染病例,对其主要病原菌分布情况及耐药性进行统计分析.结果医院感染病原菌共检出2849株,各科室中ICU检出最多,为1124株,占39.5%.所检样本中以痰液检出最多,为1470株,占51.6%.检出最多的五种病原菌依次是：大肠埃希菌（807株,28.3%）,肺炎克雷伯菌（512株,18.0%）,铜绿假单胞菌（288株,10.1%）,白色念珠菌（149株,5.2%）和鲍曼不动杆菌（148株,5.2%）,其中前三种病原菌所占比例最大,合计1607株（56.4%）.本研究选取的26种抗菌药耐药率监测显示：大肠埃希菌耐药率低于30%的抗菌药有8种;肺炎克雷伯菌耐药率低于30%的抗菌药有10种;铜绿假单胞菌耐药率低于30%的抗菌药有10种.其中三种病原菌的耐药率都低于30%有5种.位列前五位的多重耐药菌依次是大肠埃希菌（43.7%）、肺炎克雷伯菌（20.9%）、鲍曼不动杆菌（7.9%）、铜绿假单胞菌（7.6%）和金黄色葡萄球菌（4.1%）.结论医院感染的病原菌对各抗菌药物的耐药率具有较大差异,且存在-定的地域性差异,应持续监测病原菌的耐药率,合理选择针对性的抗菌药物,有效控制病原菌的感染.

某三甲医院2019-2020年多重耐药菌检出及分布特点

目的了解该院2019年1月—2020年12月多重耐药菌检出以及分布情况,探索下一阶段多重耐药菌防控工作重点。方法回顾性分析2019年1月—2020年12月所有住院患者中多重耐药菌检出情况,对其检出率、菌种分布等进行统计汇总。结果该院共检出多重耐药菌1537株,其中检出较多的是ESBLs(+)类多重耐药菌,占总检出的70.70%,其次是多重耐药的鲍曼不动杆菌和耐碳青霉烯类的鲍曼不动杆菌。相较于2019年,2020年检出的多重耐药菌种类增多,分布更为复杂。将近79.19%的多重耐药菌是在呼吸道类、泌尿道类等类型标本中检出。并且多重耐药菌的检出具有科室特异性,不同科室主要检出菌株不同,但同一科室内中两年检出主要耐药菌种类基本保持不变。结论近两年该院多重耐药菌检出率呈下降趋势,多重耐药菌防控工作取得良好效果;但多重耐药菌种类趋于复杂,这为下一步防控工作提出新要求。

某教学医院2011-2021年血培养常见耐药菌临床分布及其药敏结果分析

目的 研究该院近11年血培养分离的多重耐药菌(MDROS)的临床分布情况及其对常用抗菌药物的耐药性,旨在为院内防控及抗感染方案的选择提供指导。方法 收集2011年1月至2021年12月该院的住院患者血流感染临床送检标本分离菌株的临床资料,采用法国梅里埃公司的VITEK2 Compact全自动细菌鉴定和药敏系统对MDROS的临床分布特点及其交叉耐药情况进行统计分析。结果 (1)该院住院患者所送检血清标本中,共检出非重复病原菌14 918株,MDROS 4 081株,占27.4%。检出的病原菌排前5位的分别是大肠埃希菌(占21.4%)、鲍曼不动杆菌(占14.1%)、肺炎克雷伯菌(占8.9%)、金黄色葡萄球菌(占7.4%)和铜绿假单胞菌(占6.1%)。(2)药敏结果提示:超广谱β-内酰胺酶的大肠埃希菌(ESBL)对亚胺培南、厄他培南、阿米卡星敏感,耐药率在2011-2021年均<5.0%;对头孢呋辛、氨曲南、美罗培南的耐药率呈现逐年升高趋势;(3)泛耐药鲍曼不动杆菌(PDR-AB)耐药率最高,对头孢类抗菌药物的耐药率由2011年的70.0%~80.0%升高为2021年全耐药(100.0%);对米诺环素的耐药率由12.5%升高至30.5%,对替加环素较为敏感,耐药率为0.1%;(4)耐碳青酶烯类铜绿假单胞菌(CR-PAE)对替加环素、呋喃妥因、亚胺培南的耐药率由2011年的88.0%、78.0%、92.3%逐年升高到100.0%;(5)耐甲氧西林金黄色葡萄球菌(MRSA)对大环内酯类、头孢类、青霉素类抗菌药物的耐药率均在80.0%以上,年份间无明显变化趋势;对环丙沙星的耐药率由88.2%逐年降低至62.2%,对万古霉素、利奈唑胺敏感,未发现耐药菌株;(6)耐碳青酶烯类肺炎克雷伯菌(CR-KPN)对氨曲南、甲氧苄啶/复方磺胺甲噁唑、黏菌素的耐药率由77.2%、49.1%、4.0%升高至97.0%、83.9%、12.8%;对阿米卡星、左氧氟沙星的耐药率呈现逐年降低趋势。结论 由于严峻的细菌耐药形势及抗菌药物的广泛使用,使得该院MDROS检出率较高,耐药情况严重。因此,应制订并落实有效的MDROS防控措施,加强临床对MDROS感染的持续监控,以防止耐药菌株的播散。