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The Mechanism of Resistance of Pseudomonas Aeruginosa toβ-lactam Antibiotics and Clinical Significance 被引量:4
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作者 宋建新 阮秋蓉 +2 位作者 齐俊英 高美英 王以光 《Journal of Huazhong University of Science and Technology(Medical Sciences)》 SCIE CAS 2002年第4期339-342,共4页
To study the resistant mechanism and clinical significance of pseudomonas aeruginosa toβ- lactam antibiotics,the outer mem brane permeability rate of30 P.aeruginosa strains to5 β- lactam antibiotics was m easured ... To study the resistant mechanism and clinical significance of pseudomonas aeruginosa toβ- lactam antibiotics,the outer mem brane permeability rate of30 P.aeruginosa strains to5 β- lactam antibiotics was m easured and their production ofβ- lactamase and theβ- lactam ase genes they carried detected. Furthermore,the relationship between the perm eability,β- lactam ase and the clinical effects ofβ- lactam antibiotics was observed. By using 1 4C- penicillin and liquid- scintillant isotope assay,the affinity of penicillin binding proteins(PBPs) was m easured and their roles in the resistant m echanism studied.Itwas revealed thatthe perm eability rate was higher in sensitive strains than in resistantones(P<0 .0 5 ) .All strains harbored1- 4 β- lactamase genes and produced β- lactam ase.Higher permeability rate and higher degree of stability toβ- lactamase indicated better clinical therapeutic effects. The affinity of PBPs changed little without regard to the perm eability andβ- lactam ase. These results suggested that the permeability of outer mem brane andβ- lacta- mase,but not PBPs,played im portant roles in the resistant mechanism of P. aeruginosa toβ- lac- tam antibiotics and affected the clinical therapeutic effectiveness of som e patients. 展开更多
关键词 Pseudom onas aeruginosa β- lactamase antibiotics outer membrane
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Resistance to Beta Lactam Antibiotics of <i>Pseudomonas aeruginosa</i>Isolated in Community Infections within HIV Infected Persons in Lomé-Togo
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作者 Majesté Ihou Wateba Kanyni Ekoue-Kouvahey +2 位作者 Abago Balaka Komivi Tsatsu Ousseni Tidjani 《World Journal of AIDS》 2014年第1期81-84,共4页
Objective: Describe resistance to beta lactam antibiotics of Pseudomonas aeruginosa in community infection within HIV-1 infected persons. Methods: We have studied prospectively from June 15th to December 31st 2013 int... Objective: Describe resistance to beta lactam antibiotics of Pseudomonas aeruginosa in community infection within HIV-1 infected persons. Methods: We have studied prospectively from June 15th to December 31st 2013 inthe Clinic Hotel-Dieu and NGO VISA of Lomé, adult HIV-1 infected patients under anti retroviral therapy combining tenofovir, lamivudine and efavirenz for at least one year. The technique of agar diffusion susceptibility using discs of Ticarcillin + clavulanic acid is used to study the β-lactamase production. The diagnosis of species was performed by the chloroform test and the test for sensitivity to kanamycin and colistin. Results: Thirty five strains of Pseudomonas aeruginosa were obtained. The T-lymphocytes CD4 mediane was 575 cells/mm3 of blood. Urine represented 15 cases, skin abscesses 11 cases, externa suppurate otitis 7 cases and vaginal swab for 2 cases. The phenotypes were: wild phenotypes 23 cases (65.7%), resistant phenotypes 12 cases. Among resistant phenotypes, 4 were complex phenotype;5 were ESBL phenotypes;2 were hyper productive cephalosporinases phenotypes and 1 was a specific phenotype with impermeability to imipenem. Conclusion: The acquisition of resistance of Pseudomonas aeruginosa to beta lactam antibiotics in community infections among HIV-1 infected person incentives controls and promotes the rational use of antibiotics. 展开更多
关键词 HIV-1 Pseudomonas AERUGINOSA RESISTANCE Phenotypes Beta lactam antibiotic
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高效液相色谱法测定β-内酰胺抗生素中残留乙酸的含量
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作者 冯艳春 裴文莉 +6 位作者 王晨 朱俐 田冶 崇小萌 宋暤昀 姚尚辰 宁保明 《中国抗生素杂志》 CAS CSCD 北大核心 2024年第4期388-393,共6页
目的建立测定β-内酰胺类抗生素原料中乙酸残留量的HPLC方法。方法采用多因素组内设计方法,确定色谱流动相的组成、比例和pH值。参考ICH Q2,从专属性、检出限和定量限、线性、准确度、精密度和耐用性等6个方面对方法进行验证。用所建立... 目的建立测定β-内酰胺类抗生素原料中乙酸残留量的HPLC方法。方法采用多因素组内设计方法,确定色谱流动相的组成、比例和pH值。参考ICH Q2,从专属性、检出限和定量限、线性、准确度、精密度和耐用性等6个方面对方法进行验证。用所建立的方法对19种β-内酰胺类抗生素原料进行了测定。结果采用C_(18)色谱柱,流动相:甲醇-0.02 mol/L磷酸二氢钾,梯度洗脱;柱温25℃;检测波长220 nm。供试品、溶剂和流动相对乙酸测定没有明显干扰;乙酸的最低检出限约为0.029μg,最低定量限约0.12μg;从定量限到限度2倍浓度范围内,方法的线性关系良好,拟合直线方程为y=388866.7186x-177.5720,r2=0.9999;低中高浓度加样回收率平均分别为93%,96%和99%;方法的重复性和中间精密度分别为2.37%和2.11%;在3根不同C_(18)色谱柱上的耐用性良好。19种β-内酰胺抗生素原料中有3种筛查出残留乙酸。结论所建方法可以实现对β-内酰胺类抗生素原料中残留乙酸的准确定量,为该类原料的生产过程控制和标准物质研制提供了依据。 展开更多
关键词 Β-内酰胺类抗生素 原料 乙酸 反相高效液相色谱法
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β-内酰胺类抗菌药物皮试阴性患者出现过敏反应的临床特征及影响因素分析
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作者 吕慧 王梦芝 谢家隆 《中国处方药》 2024年第6期84-87,共4页
目的探讨β-内酰胺类抗菌药物皮试阴性患者出现过敏反应的临床特征及影响因素分析。方法回顾性分析2021年10月~2023年2月β-内酰胺类抗菌药物皮试检测为阴性的230例患者的临床资料,根据患者过敏反应发生情况将其分为过敏反应组和非过敏... 目的探讨β-内酰胺类抗菌药物皮试阴性患者出现过敏反应的临床特征及影响因素分析。方法回顾性分析2021年10月~2023年2月β-内酰胺类抗菌药物皮试检测为阴性的230例患者的临床资料,根据患者过敏反应发生情况将其分为过敏反应组和非过敏反应组,记录过敏反应组患者的临床特征,并采用单因素以及多因素Logistic回归分析筛选β-内酰胺类抗菌药物皮试阴性患者出现过敏反应的相关危险因素。结果本研究过敏反应发生率为15.65%,以瘙痒、皮疹、风团为主;两组患者年龄、慢性呼吸系统疾病史、联合用药、低蛋白血症、慢性肾功能不全、恶性肿瘤等一般资料对比差异有统计学意义(P<0.05);多因素Logistic回归分析结果显示,年龄、慢性呼吸系统疾病史、联合用药、低蛋白血症、慢性肾功能不全、恶性肿瘤均是β-内酰胺类抗菌药物皮试阴性患者出现过敏反应的独立危险因素(P<0.05)。结论β-内酰胺类抗菌药物皮试阴性患者过敏反应受年龄、慢性呼吸系统疾病史、联合用药、低蛋白血症、慢性肾功能不全、恶性肿瘤等多种因素影响。 展开更多
关键词 Β-内酰胺类抗菌药物 皮试阴性 过敏反应 临床特征 影响因素
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β-内酰胺类抗生素/β-内酰胺酶抑制剂复方制剂点评标准的建立及应用分析
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作者 童隆财 刘萌 李荣 《临床合理用药杂志》 2024年第13期36-40,共5页
目的建立β-内酰胺类抗生素/β-内酰胺酶抑制剂复方制剂的点评标准,结合临床应用情况,分析其应用效果,促进临床合理使用β-内酰胺类抗生素/β-内酰胺酶抑制剂复方制剂。方法参照相关指南及专家共识,制订β-内酰胺类抗生素/β-内酰胺酶... 目的建立β-内酰胺类抗生素/β-内酰胺酶抑制剂复方制剂的点评标准,结合临床应用情况,分析其应用效果,促进临床合理使用β-内酰胺类抗生素/β-内酰胺酶抑制剂复方制剂。方法参照相关指南及专家共识,制订β-内酰胺类抗生素/β-内酰胺酶抑制剂复方制剂的药物利用评价(DUE)标准。通过建立的DUE标准,采用回顾性研究方法,评价2019年7—12月南华大学附属第二医院使用头孢哌酮/舒巴坦和哌拉西林/他唑巴坦的894例病例的用药合理性。结果894例病例中,适应证合理率为93.62%,给药剂量合理率为90.49%,用药疗程合理率为89.37%,微生物送检合理率为75.84%。结论建立的头孢哌酮/舒巴坦和哌拉西林/他唑巴坦DUE标准能够作为临床合理用药的重要参考,该院头孢哌酮/舒巴坦和哌拉西林/他唑巴坦使用基本合理。 展开更多
关键词 β-内酰胺类抗生素/β-内酰胺酶抑制剂复方制剂 头孢哌酮/舒巴坦 哌拉西林/他唑巴坦 药物利用指数
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猪源链球菌对β-内酰胺类抗生素的耐药性研究进展
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作者 散仁 董鹏 +2 位作者 朝博 红英 杨洺扬 《现代畜牧兽医》 2024年第4期77-81,共5页
猪链球菌病是生猪养殖中比较常见且危害较大的动物疫病,该病的病原是球菌科链球菌属的多种链球菌,其中猪链球菌2型是重要的人畜共患病原菌。β-内酰胺类抗生素一直是治疗猪链球菌病的首选药物,但受长期选用的影响,猪源链球菌对β-内酰... 猪链球菌病是生猪养殖中比较常见且危害较大的动物疫病,该病的病原是球菌科链球菌属的多种链球菌,其中猪链球菌2型是重要的人畜共患病原菌。β-内酰胺类抗生素一直是治疗猪链球菌病的首选药物,但受长期选用的影响,猪源链球菌对β-内酰胺类抗生素的耐药性逐渐增强,给猪链球菌病的临床治疗带来威胁。文章对猪链球菌病的流行性及病原特点、猪源链球菌对β-内酰胺类抗生素的耐药机制和耐药现状进行概述,以期为指导临床用药和新药研发提供参考。 展开更多
关键词 猪源链球菌 Β-内酰胺类抗生素 耐药性 耐药机制
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Rapid Detection of β-lactam Antibiotic Residue in Milk Using Biolayer Interferometry
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作者 Xiaojun LIU Hui FU +3 位作者 Feng XUE Tao MA Xiangxiang ZENG Hai ZHU 《Agricultural Biotechnology》 CAS 2014年第1期9-11,15,共4页
[ Objective] This study aimed to establish a high-sensitivity method for rapid detection of^-lactam antibiotic residue in milk. [Method] Based on bio- layer interferometry technology, ampicillin-BSA conjugate was fixe... [ Objective] This study aimed to establish a high-sensitivity method for rapid detection of^-lactam antibiotic residue in milk. [Method] Based on bio- layer interferometry technology, ampicillin-BSA conjugate was fixed on the bottom of APS fiber optic biosensor probe through hydrophobic interaction and bound to 40 mn colloidal gold-labeled/3-1actam antibiotic receptor, to detect β-lactam antibiotics in milk. [ Result] The sensitivity of colloidal gold-labeled BLI method was twice as high as that of immunechromatographic test strip in detection of β-1actam antibiotic residue in milk. Colloidal gold-labeled BLI method exhibited good speci- ficity and had no cross-reaction with 1 000 ng/ml aflatoxin M1, gentamicin, kanamycin, streptomycin, tylosin, chloromycetin and melamine. [Condusion] The colloidal gold-labeled BLI method is not suitable for quantitative detection in actual production due to its small quantitative range in detection of β-lactam antibiot- ics, but it is a simple and rapid qualitative detection method that can be used in rapid detection of β-1actam antibiotic residue in milk. 展开更多
关键词 Bialayer interferometry β-lactam antibiotics Receptor-colloidal gold conjugate MILK RECEPTOR
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The effect of protective genital care protocol on preventing diaper dermatit development in 0 - 18 month old children using antibiotics
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作者 Gulbeyaz Baran Saniye Cimen 《Open Journal of Nursing》 2013年第1期153-161,共9页
Diaper dermatit is among the widely seen inflamatory skin diseases in neonatals and small 0 - 18 month old children. Control of causative agents as well as providing good genital care may prevent or reduce the risk of... Diaper dermatit is among the widely seen inflamatory skin diseases in neonatals and small 0 - 18 month old children. Control of causative agents as well as providing good genital care may prevent or reduce the risk of the disease. The aim of this study is find out the effect of protective genital care on reducing the diaper dermatit development in 0 - 18 months old inpatient 0 - 18 month old children who are using antibiotic. The study was conducted as prospective half-experimetal using control-experimental groups. Our samples comprise of 0 - 18 month old children admitted at Dokuz Eylul University Practical and Research Hospital, pediatric clinic between January and May 2009, 41 0 - 18 month old children as a control group were not under protective genital care, and 42 0 - 18 month old children as an experimental group were under the protecion and using vaseline. The mothers of the experimental group 0 - 18 month old children were given education. All 0 - 18 month old children were followed-up 3 - 7 days and the collected data were evaluated in computer using Pearson’s chisquare, Fisher’s exact chi-square and Yatest-corrected chi-square tests. The diaper dermatit develop- ment ratio was 34.1% in the control group and 7.1% in the experimental group 展开更多
关键词 Diaper Dermatit Vaseline 0 - 18 Month Old Children antibiotic Protective Genital Care
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β-内酰胺水合物晶体药物
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作者 胡昌勤 《中国抗生素杂志》 CAS CSCD 北大核心 2023年第3期241-249,共9页
β-内酰胺抗生素水合物作为一类重要的晶体药物在药物研发中被广泛关注。在β-内酰胺水合物晶体药物中,结构相似的药物具有相似的分子构型,但其可以和水分子相互作用组成不同的晶胞结构,形成不同的水合物晶体。晶体中的水分子与药物分... β-内酰胺抗生素水合物作为一类重要的晶体药物在药物研发中被广泛关注。在β-内酰胺水合物晶体药物中,结构相似的药物具有相似的分子构型,但其可以和水分子相互作用组成不同的晶胞结构,形成不同的水合物晶体。晶体中的水分子与药物分子通过氢键、配位键等形成较强的相互作用,表现为典型的化学计量特征,通常在维系晶格的稳定性中起关键作用;而与药物分子作用相对较弱的结晶水,表现为非化学计量特征,通常主要作用是维系水合物晶体的稳定性。选择适宜的结晶工艺、优化过程控制条件是得到稳定晶体药物的关键。 展开更多
关键词 Β-内酰胺抗生素 晶体药物 药物水合物 特性
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β-内酰胺类抗生素对临床早产儿血清IL-10、IL-4、IFN-γ的影响
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作者 陈培培 郑芬 +2 位作者 邱世洁 郑佩榆 曾旺 《医学检验与临床》 2023年第11期11-14,共4页
目的:探讨β-内酰胺类抗生素对临床早产儿血清白介素-4(IL-4)、白介素-10(IL-10)、γ干扰素(IFN-γ)等指标的影响.方法:选取2022年1月-2022年12月本院新生儿科的70例感染患儿为研究对象,按照患儿出生胎龄分组,其中出生胎龄在28~37周的... 目的:探讨β-内酰胺类抗生素对临床早产儿血清白介素-4(IL-4)、白介素-10(IL-10)、γ干扰素(IFN-γ)等指标的影响.方法:选取2022年1月-2022年12月本院新生儿科的70例感染患儿为研究对象,按照患儿出生胎龄分组,其中出生胎龄在28~37周的新生儿编入早产儿组(n=40)、足月妊娠的新生儿编入对照组(n=30).两组患儿临床均使用了 β-内酰胺类抗生素治疗,比较两组患儿血清IL-4、IL-10、IFN-γ指标水平及异常率,同时分析药物对患儿免疫球蛋白IgA、IgM、IgG指标水平的影响,最后对比两组患儿的不良反应发生情况.结果:治疗前两组患儿的血清IL-4、IL-10、IFN-γ对比差异不显著(P>0.05);治疗后两组患儿的IL-4、IL-10、IFN-γ均呈现下降的状态,且早产儿组指标水平高于对照组(P<0.05).治疗后早产儿组患儿IL-4、IL-10、IFN-γ异常率高于对照组,对比差异显著(P<0.05).治疗前两组IgA、IgM、IgG指标对比差异不显著(P>0.05);治疗后两组患儿的IgA、IgM、IgG对比差异不显著(P>0.05).早产儿组患儿不良反应发生率高于对照组,对比差异不显著(P>0.05).结论:β-内酰胺类抗生素在治疗早产儿感染患儿中对其机体炎性反应控制有一定积极作用,但作用效果不如足月儿;同时β-内酰胺类抗生素的安全性基本能够保障,不会引起体液免疫水平的异常改变,不良反应发生率也较低,可满足早产儿感染患儿的治疗需要. 展开更多
关键词 早产儿 抗菌治疗 Β-内酰胺类 血清炎性因子 安全性
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《β-内酰胺类抗菌药物皮肤试验指导原则(2021年版)》医疗机构执行情况调研分析 被引量:2
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作者 许译尹 余霞霞 +1 位作者 张学丽 邵华 《中国抗生素杂志》 CAS CSCD 北大核心 2023年第10期1177-1182,共6页
目的 调研分析我国《β-内酰胺类抗菌药物皮肤试验指导原则(2021年版)》颁布后医疗机构执行情况,为推进该类药物皮试规范管理提供参考。方法 设计问卷开展调查并运用Excel汇总整理,SPSS 26.0统计分析。调研覆盖我国18个省(自治区、直辖... 目的 调研分析我国《β-内酰胺类抗菌药物皮肤试验指导原则(2021年版)》颁布后医疗机构执行情况,为推进该类药物皮试规范管理提供参考。方法 设计问卷开展调查并运用Excel汇总整理,SPSS 26.0统计分析。调研覆盖我国18个省(自治区、直辖市)共计143家医疗机构。问卷内容涵盖医院基本信息、院内皮试管理相关规定、β-内酰胺类药物皮肤试验方法等共计42个问题。结果 共收到有效反馈问卷143份。调研显示大部分医疗机构已根据《指导原则》规范院内β-内酰胺类药物皮肤试验流程,在不同发文部门更新率、是否选择皮试、皮试液来源及浓度、判读标准等方面有显著性差异。结论 各医疗机构对于《指导原则》执行情况良好,但仍存在固有观念及流程难以转变,实际操作缺乏统一管理标准等问题。我国皮试相关权威资料应统一修订管理,各级医疗机构皮试规定有待进一步规范化与精细化,流程制定需药学专业人员参与。 展开更多
关键词 Β-内酰胺类抗菌药物 皮肤试验 问卷调查 分析研究
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Cancer Therapy Using Antibiotics 被引量:1
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作者 Biplob Bhattacharya Sreya Mukherjee 《Journal of Cancer Therapy》 2015年第10期849-858,共10页
Anticancer antibiotics have made a successful impact in the field of chemotherapeutics. For most of them, DNA is the molecular target. Some act as DNA intercalators or some prevent DNA repair among other mechanisms of... Anticancer antibiotics have made a successful impact in the field of chemotherapeutics. For most of them, DNA is the molecular target. Some act as DNA intercalators or some prevent DNA repair among other mechanisms of actions, they are seen to have. The major disadvantages of these drugs though are the constant side effects and toxicities. With more focus on discovery of new drugs with newer scaffolds, the urge to discover and modify anticancer antibiotics is being lost. Modifications or even the wider research can yield newer better drugs for clinical use. The review here discusses the current antibiotic therapeutics, newer discoveries in the field as well ideas for future research. 展开更多
关键词 antibiotics lactamS CANCER MECHANISM of Action
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β-内酰胺类抗菌药物不良反应监测及风险预测模型的建立 被引量:1
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作者 蒋俊杰 王法财 +3 位作者 沈炳香 聂松柳 段自皞 朱枝祥 《儿科药学杂志》 CAS 2023年第11期12-16,共5页
目的:通过监测安徽医科大学附属六安医院患儿使用β-内酰胺类抗菌药物所致药物不良反应(ADR),分析ADR发生情况及影响因素,并建立其风险预测模型。方法:选取2018年5月至2022年2月安徽医科大学附属六安医院儿科使用β-内酰胺类抗菌药物的... 目的:通过监测安徽医科大学附属六安医院患儿使用β-内酰胺类抗菌药物所致药物不良反应(ADR),分析ADR发生情况及影响因素,并建立其风险预测模型。方法:选取2018年5月至2022年2月安徽医科大学附属六安医院儿科使用β-内酰胺类抗菌药物的患儿作为ADR监测对象,统计分析ADR患儿临床资料。按使用β-内酰胺类抗菌药物是否发生ADR,分为ADR组和无ADR(nADR)组,并采用Logistic回归分析筛选其独立危险因素,建立列线图预测模型。结果:共监测使用β-内酰胺类抗菌药物的患儿453例,87例发生ADR(ADR组),366例未发生ADR(nADR组)。单因素和Logistic回归多因素分析显示,过敏史、给药频次不合理、高剂量、用药时间≥3 d、联合用药为β-内酰胺类抗菌药物所致ADR的独立危险因素(P<0.05)。据此建立预测β-内酰胺类抗菌药物所致ADR的列线图模型,一致性指数高达0.749(95%CI 0.691~0.807),校正曲线趋近于理想曲线(16%~81%),列线图预测β-内酰胺类抗菌药物引发患儿ADR风险净获益值较高,表明该模型临床预测效用良好。结论:β-内酰胺类抗菌药物所致ADR的危险因素包括过敏史、给药频次不合理、高剂量、用药时间≥3 d、联合用药,据此构建的列线图模型能有效预测β-内酰胺类抗菌药物致ADR的风险概率,具有一定临床价值。 展开更多
关键词 Β-内酰胺类抗菌药物 药物不良反应 危险因素 列线图 模型预测
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高效液相色谱-高分辨质谱法定性筛查牛奶中49种β-内酰胺类抗生素残留 被引量:6
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作者 于倩倩 汪龙飞 鲍蕾 《食品安全质量检测学报》 CAS 北大核心 2023年第4期162-169,共8页
目的开发和验证定性筛查牛奶中49种β-内酰胺类抗生素残留的高效液相色谱-高分辨质谱法(high performance liquid chromatography coupled with high resolution mass spectrometry,HPLC-HRMS)。方法牛奶经磷酸盐缓冲液及乙腈提取后,加... 目的开发和验证定性筛查牛奶中49种β-内酰胺类抗生素残留的高效液相色谱-高分辨质谱法(high performance liquid chromatography coupled with high resolution mass spectrometry,HPLC-HRMS)。方法牛奶经磷酸盐缓冲液及乙腈提取后,加入硫酸钠(Na_(2)SO_(4))和氯化钠(NaCl)进行盐析,离心后取部分上清液经Na2SO4和C18混合的分散式固相萃取填料(dispersive solid phase extraction,d-SPE)净化,净化液浓缩定容后,使用HPLC-HRMS分别以全扫描-数据依赖型二级扫描(full scan-data dependent secondary acquisition,Full MS/dd-MS2)和全扫描-平行反应监测二级扫描(full scan-selected ion monitoring/parallel reaction monitoring,Full MS/PRM)两种模式进行数据采集。结果在Full MS/PRM模式下,45种抗生素通过方法验证,假阳性率和假阴性率都小于5%;在Full MS/dd-MS2模式下,43种抗生素通过方法验证,假阳性率和假阴性率在规定的目标浓度下均低于5%,Full MS/PRM数据采集模式更适用于多兽药残留的定性筛查。结论此方法适用于牛奶样品中β-内酰胺类抗生素的定性筛查,并且高分辨质谱的Full MS/PRM采集模式相较于Full MS/dd-MS2采集模式,抗干扰性更好,更适用于复杂基质中目标物的定性筛查。 展开更多
关键词 内酰胺类抗生素 高分辨质谱法 目标物筛查 牛奶
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Post-appendectomy pelvic abscess with extended-spectrum beta-lactamase producing Escherichia coli : A case report and review of literature 被引量:1
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作者 Andrew Tse Rajkumar Cheluvappa Selwyn Selvendran 《World Journal of Clinical Cases》 SCIE 2018年第16期1175-1181,共7页
BACKGROUND Appendicitis, the inflammation of the appendix, is the most common abdominal surgical emergency requiring expedient surgical intervention. Extendedspectrum beta-lactamases(ESBLs) are bacterial enzymes that ... BACKGROUND Appendicitis, the inflammation of the appendix, is the most common abdominal surgical emergency requiring expedient surgical intervention. Extendedspectrum beta-lactamases(ESBLs) are bacterial enzymes that catalyse the degradation of the betalactam ring of penicillins and cephalosporins(but without carbapenemase activity), leading to resistance of these bacteria to beta-lactam antibiotics. Recent increases in incidence of ESBL-producing bacteria have caused alarm worldwide. Proportion estimates of ESBLEnterobacteriaceae hover around 46% in China, 42% in East Africa, 12% in Germany, and 8% in the United States.CASE SUMMARY The impact of ESBL-producing bacteria on appendiceal abscesses and consequent pelvic abscesses are yet to be examined in depth. A literature review using the search words "appendiceal abscesses" and "ESBL Escherichia coli(E. coli)" revealed very few cases involving ESBL E. coli in any capacity in the context of appendiceal abscesses. This report describes the clinical aspects of a patient with appendicitis whodeveloped a postoperative pelvic abscess infected with ESBL-producing E. coli. In this report, we discuss the risk factors for contracting ESBL E. coli infection in appendicitis and post-appendectomy pelvis abscesses. We also discuss our management approach for postappendectomy ESBL E. coli pelvic abscesses, including drainage, pathogen identification, and pathogen characterisation. When ESBL E. coli is confirmed, carbapenem antibiotics should be promptly administered, as was done efficaciously with this patient. Our report is the first one in a developed country involving ESBL E. coli related surgical complications in association with a routine laparoscopic appendectomy.CONCLUSION Our report is the first involving ESBL E. coli and appendiceal abscesses, and that too consequent to laparoscopic appendectomy. 展开更多
关键词 APPENDECTOMY APPENDICEAL ABSCESS Appendicitis BETA-lactam antibiotic resistance BETA-lactamASE Carbanepem CEPHALOSPORIN Escherichia coli Extended-spectrum BETA-lactamASE Infection Pelvic ABSCESS Penicillin Case report
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β-内酰胺酶抑制剂复方制剂临床应用分析 被引量:1
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作者 杨海燕 华玺 +1 位作者 乔羽君 肖楠 《临床合理用药杂志》 2023年第19期32-35,共4页
目的分析β-内酰胺酶抑制剂复方制剂在兰州大学第二医院的临床应用情况,为合理用药提供参考。方法通过兰州大学第二医院信息管理系统调取2017—2020年β-内酰胺酶抑制剂复方制剂的使用信息,包括药物名称、规格、销售总量及销售总金额。... 目的分析β-内酰胺酶抑制剂复方制剂在兰州大学第二医院的临床应用情况,为合理用药提供参考。方法通过兰州大学第二医院信息管理系统调取2017—2020年β-内酰胺酶抑制剂复方制剂的使用信息,包括药物名称、规格、销售总量及销售总金额。结果2017—2020年,大部分β-内酰胺酶抑制剂复方制剂用药频度总体呈下降趋势,限定日费用均逐渐下降。医院大部分β-内酰胺酶抑制剂复方制剂的使用较合理,而注射用头孢哌酮钠他唑巴坦钠(1.125 g/支)及注射用哌拉西林钠舒巴坦钠(1.5 g/支)的销售金额排序与用药频度排序的比值(B/A值)在一定时期内均偏离1。结论医院需进一步加强β-内酰胺酶抑制剂复方制剂合理使用与规范化管理。 展开更多
关键词 Β-内酰胺类抗生素 Β-内酰胺酶抑制剂 哌拉西林 美洛西林 头孢哌酮 用药频度 限定日费用
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Probabilistic Antibiotic Therapy in the Infectious Diseases Department of the Yalgado Ouédraogo University Hospital (CHU-YO) in Ouagadougou, Burkina Faso
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作者 Savadogo Mamoudou Bonané Faïz 《Advances in Infectious Diseases》 CAS 2022年第4期639-645,共7页
Introduction: In Burkina Faso, as in most developing countries, limited access to biological tests forces practitioners to resort very often to probabilistic antibiotic therapy. The objective of this study is to deter... Introduction: In Burkina Faso, as in most developing countries, limited access to biological tests forces practitioners to resort very often to probabilistic antibiotic therapy. The objective of this study is to determine the extent of this prescription. Patients and Methods: This was a cross-sectional study with retrospective data collection of patients hospitalized in the infectious diseases department in the period from January 1, 2005 to December 31, 2020. The records of patients who received probabilistic antibiotic therapy were included. Results: During the study period, 330 patients had received probabilistic antibiotic therapy. The majority of patients were male (53%), with a sex ratio of 1.12. The mean age of the patients was 33 years ± 14. The age range of 20 to 40 years was the most represented (42%). Fifteen percent (15%) of patients were living with HIV. The majority of patients were from urban areas (56.4%). Forty-nine percent (49%) of the patients worked in the informal sector. Clinically, the reasons for consultation were dominated by fever, alteration of general condition, neurological disorders, digestive disorders, respiratory signs, urinary signs and diffuse pain. The physical examination showed that 48.1% of the patients had meningeal irritation syndrome, 10% had convulsions and 10% had focal signs, trismus was present in 4% of the patients and facial paralysis in 3%. In the digestive system, hepatomegaly was present in 29% of patients and digestive candidiasis in 31%. Respiratory examination showed crepitus and fluid effusion syndrome in 26.83% and 20.62% of patients respectively. The presumptive diagnosis was dominated by bacterial meningitis, salmonellosis and bronchopneumonia with banal germs. In terms of treatment, the beta-lactam family of drugs was the most prescribed. They were followed by aminoglycosides and fluoroquinolones. The evolution was marked by the death of 50 patients (15%). Conclusion: The most prescribed molecules belong to the family of Beta-lactam. And this prescription improved the outcome of patients. Bacterial susceptibility studies will allow better orientation of probabilistic antibiotic therapy in order to limit the emergence of multi-resistant bacteria. 展开更多
关键词 Probabilistic antibiotic Therapy BETA-lactam Infectious Diseases Department of the Yalgado Ouédraogo University Hospital
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血清ALB水平与老年社区获得性肺炎β-内酰胺类抗菌药物治疗无效风险的相关性、预测阈值及其效能
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作者 邓紫薇 舒远路 +6 位作者 史志华 王晋 邓晔 仇成凤 王宏强 段振兴 严妍 《山东医药》 CAS 2023年第33期17-21,共5页
目的分析患者入院时血清白蛋白(ALB)水平与老年社区获得性肺炎(CAP)β-内酰胺类抗菌药物治疗无效风险的相关性,观察其预测阈值、预测效能。方法老年CAP患者86例,采集患者入院当天的血清测定血清ALB,按四分位数分组,分别为Q1组、Q2组、Q... 目的分析患者入院时血清白蛋白(ALB)水平与老年社区获得性肺炎(CAP)β-内酰胺类抗菌药物治疗无效风险的相关性,观察其预测阈值、预测效能。方法老年CAP患者86例,采集患者入院当天的血清测定血清ALB,按四分位数分组,分别为Q1组、Q2组、Q3组和Q4组。患者均接受β-内酰胺类抗菌药物治疗,观察各组患者疗效,计算治疗显效率。收集CAP患者的人口学信息,包括年龄、性别、合并症、实验室指标、临床病情严重程度指标(CURB-65评分),采用单因素logistic回归模型分析老年CAP患者血清ALB水平与β-内酰胺类抗菌药物治疗无效风险的相关性。以单因素分析结果中有统计学差异的变量并加入年龄、性别作为混杂因素,采用多变量logistic回归模型分析老年CAP患者血清ALB水平与β-内酰胺类抗菌药物治疗无效风险的相关性。采用限制性立方样条(RCS)模型分析老年CAP患者血清ALB水平与β-内酰胺类抗菌药物治疗无效风险之间的关系,评估β-内酰胺类抗菌药物治疗无效风险的阈值。以阈值为分组依据,采用分层多因素logistic回归分析法,分析老年CAP患者血清ALB水平与β-内酰胺类抗菌药物治疗无效风险的关系。结果86例CAP患者的血清ALB水平为(29.0±5.1)g/L,59例治疗显效,27例治疗无效,Q1组、Q2组、Q3组、Q4组治疗显效率分别为39.13%、76.19%、71.43%、91.48%。Q1组患者有慢性阻塞性肺疾病(COPD)病史者比例低于其他各组(P<0.05),Q4组患者中性粒细胞(NC)和C反应蛋白(CRP)水平低于其他各组(P均<0.05)。老年CAP患者血清ALB水平与β-内酰胺类抗菌药物治疗无效风险负相关[Q2组OR(95%CI)为0.18(0.04~0.78),Q3组OR(95%CI)为0.19(0.04~0.93),Q4组OR(95%CI)为0.07(0.01~0.46),P for trend=0.019]。老年CAP患者血清ALB水平与β-内酰胺类抗菌药物治疗无效风险间呈现明显的L形非线性关系,老年CAP患者接受β-内酰胺类抗菌药物治疗无效风险的血清ALB水平阈值为30 g/L。老年CAP患者血清ALB水平≤30 g/L时,血清ALB水平每增高1倍标准差(Per-SD),β-内酰胺类抗菌药物治疗无效的风险降低82%[OR(95%CI)为0.18(0.04~0.58),P<0.05];老年CAP患者血清ALB水平>30 g/L,血清ALB水平与β-内酰胺类抗菌药物治疗无效风险间无显著关联(P>0.05)。结论老年CAP患者血清ALB水平与β-内酰胺类抗菌药物治疗无效风险呈负相关关系。老年CAP患者接受β-内酰胺类抗菌药物治疗无效风险的血清ALB水平阈值为30 g/L,当老年CAP患者血清ALB水平≤30 g/L时,β-内酰胺类抗菌药物治疗无效的风险较高。 展开更多
关键词 白蛋白 血清白蛋白 肺炎 社区获得性肺炎 药物疗效 疗效预测 抗菌药物 Β-内酰胺类抗菌药物
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Pathogenicity and Antimicrobial Resistance in Coagulase-Negative Staphylococci
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作者 Debora Brito Goulart 《Journal of Biosciences and Medicines》 CAS 2023年第5期9-29,共21页
The coagulase-negative staphylococci (CoNS) group was considered saprophytic or rarely pathogenic for many years. Since the first case of septicemia caused by CoNS, there has been a progressive increase in the prevale... The coagulase-negative staphylococci (CoNS) group was considered saprophytic or rarely pathogenic for many years. Since the first case of septicemia caused by CoNS, there has been a progressive increase in the prevalence of healthcare-associated infections caused by CoNS. The CoNS group has emerged as one of the main causes of nosocomial infections related to vascular catheters and prostheses, especially among immunocompromised patients. This gradual increase in infections is due to the change in the relationship between patients and procedures since CoNS are closely related to devices implanted in the human body. CoNS are successful in colonizing the host because they have several virulence mechanisms, such as biofilm formation and production of enzymes and toxins, in addition to several mechanisms of resistance to antimicrobials. Despite their great clinical relevance, few studies have focused on CoNS’s pathogenicity and resistance to antimicrobials, which reveals the current need to better understand the factors by which this group became pathogenic to humans and other animals. This review aims to synthesize the aspects related to the pathogenicity and antimicrobial resistance in CoNS. 展开更多
关键词 Coagulase-Negative Staphylococci ANTIMICROBIAL-RESISTANCE BIOFILM Nosocomial Infections Pathogenesis Beta-lactams antibiotics Glycopeptide antibiotics Macrolide antibiotics SEPTICEMIA BACTEREMIA
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1例类鼻疽脓毒症患者的全程个体化药学监护
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作者 王敏 林叶 +4 位作者 赵洁 符香香 吴华 吴琼诗 谢甜 《中国药房》 CAS 北大核心 2024年第1期101-106,共6页
目的为类鼻疽脓毒症(MS)抗菌药物治疗方案的调整、不良反应的识别和个体化药学监护提供参考。方法临床药师利用血药浓度和基因检测全程参与1例MS患者强化期和根除期治疗过程。通过测定β-内酰胺类和复方磺胺甲噁唑(TMP/SMZ)血药浓度并... 目的为类鼻疽脓毒症(MS)抗菌药物治疗方案的调整、不良反应的识别和个体化药学监护提供参考。方法临床药师利用血药浓度和基因检测全程参与1例MS患者强化期和根除期治疗过程。通过测定β-内酰胺类和复方磺胺甲噁唑(TMP/SMZ)血药浓度并计算其药代动力学与药效学(PK/PD)参数,结合文献对MS抗菌药物治疗方案进行调整;同时通过高通量测序检测药物相关基因多态性,对药物不良反应的发生原因进行分析并进行处理。结果临床药师利用血药浓度和基因检测手段,提出了亚胺培南西司他丁钠(IMP)给药剂量调整建议,分析了多种药物不良反应的发生原因;通过测定β-内酰胺类药物和TMP/SMZ血药浓度计算PK/PD靶标,通过查询指南和文献为临床医生解释类鼻疽患者脓毒症期和非脓毒症期状态下的达标情况;利用血药浓度和基因检测分析MS患者神经毒性与IMP cmin的相关性,并发现肾毒性与TMP/SMZ的cmax无关,而与患者饮水量相关。经全程抗菌药物治疗后,患者病情好转出院,不良反应得到有效处理。结论临床药师基于抗菌药物血药浓度和基因检测结果解读情况协助临床医生制定MS治疗方案,并为患者提供全程用药监护,提高了临床药物治疗的安全性和有效性。 展开更多
关键词 类鼻疽脓毒症 Β-内酰胺类抗菌药物 复方磺胺甲噁唑 血药浓度 基因检测 药学监护
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