Diagnostic efficacy of Ziehl-Neelsen method against fluorescent microscopy in detection of acid fast bacilli

Objective:To investigate the application of Ziehl-Neelsen(Z-N) and fluorescent microscopy in detection of acid fast bacilli(AFB).Methods:Duplicate smears were prepared from 260 sputum samples and stained with Z-N and fluorescent staining(FS) methods.The efficiency of both methods in primary diagnosis of tuberculosis were evaluated.Results:The smears were positive for AFB in 15(5.77%) samples by Z-N staining method and in 16(6.15%) samples by FS method.The sensitivity and specificity of Z-N staining method against FS method were 93.75% and 100%respectively.Conclusions:Though lesser cost-effective than Z-N,FS method is a more sensitive and better case finding tool in detection of AFB.

Experimental Study on the Antibacterial Effect of Origanum Volatile Oilon Dysentery Bacilli In Vivo and In Vitro

To observe the germistatic and germicidal effects of origanum volatile oil (OVI) on the dysentery bacteria, the abdominal cavity of mice was infected with Shigella sonne (Sh. sonnei) and Shigella flexneri (Sh. flexneri) F 2a. After OVI was given to the mice via gastric lavage, the effects of OVI on the infected mice were observed. The minimal inhibitory concentration (MIC) and minimal bactericidal concentration (MBC) for dysentery bacteria were determined in vitro. The results showed that origanum volatile oil showed obvious protective effect on mice infected with Sh. sonnei and Sh. flexneri F 2a. and it had germistatic and germicidal effects on dysentry bacteria. We are led to conclude that origanum volatile oil is an effective medicine against the infection of dysentery bacteria.

Detection of Acid Fast Bacilli in Tuberculous Lymph Node Tissue and Touch Preparations—A Comparative Study

Background: The most common form of extrapulmonary tuberculosis is lymphadenitis. Lymphadenitis is considered mainly a disease of young children and has a peak age of onset at 20 to 40 years. Objectives: The purpose of this study was to detect and compare the presence of acid fast bacilli in lymph node biopsies and their touch preparations using Ziehl Neelsen and fluorescence staining. Materials and Methods: The lymph node biopsies and their touch preparations were prepared and stained with Haematoxylin and eosin to determine their morphology. Slides were stained with ZN staining and fluorescent staining technique using Auramine O and Rohdamine B to demonstrate the presence of acid fast bacilli in tissue and their touch preparations. Results: AFB was detected in 56% of biopsies and 54% of touch preparations. In addition in these cases we observed that fluorescent staining technique using Auramine O and Rohdamine B is superior to ZN stain because low magnification used in fluorescent staining technique makes it possible to scan the smear rapidly and detects the AFB as glowing spots even if it is present in small numbers. Conclusion: The results of AFB in tissue biopsies are in equivalent in their touch preparation.

Detection of oqxA and oqxB efflux pump genes among nosocomial coliform bacilli:An observational cross-sectional study

Objectives:To identify and test the antibiotic susceptibility of nosocomial coliform bacilli and investigate the presence of oqxA and oqxB genes among the multidrug-resistant(MDR)phenotypes.Methods:One hundred and twenty different healthcare-associated infection samples were collected.Coliform bacilli were isolated,identified by conventional methods,and then antibiotic susceptibility tests were done using the VITEK2 system and disk diffusion methods.OqxAB operon was identified using a conventional PCR-based technique.oqxA and oqxB genes were compared between MDR Klebsiella pneumonia(K.pneumonia)phenotypes and MDR Escherichia coli(E.coli)phenotypes.Besides,oqxAB operons were compared between phenotypes of K.pneumonia and E.coli isolates.Results:Seventy coliform bacilli were isolated with the predominance of K.pneumonia and E.coli.Besides,82.1%of K.pneumonia strains and 53.3%of E.coli isolates were MDR phenotypes.Significant more oqxB genes alone were found in MDR E.coli than that in MDR K.pneumoniae phenotypes(χ^(2)=10.160,P=0.003).OqxAB operon was significantly more in MDR phenotypes of E.coli than that in the susceptible phenotypes(P<0.001).There was significantly less of this operon in susceptible E.coli isolates than that in susceptible K.pneumoniae isolates(P<0.001).OqxAB positive isolates that were also resistant to fluoroquinolones,tetracycline,trimethoprim,and chloramphenicol,most probably suggested functional pumps.Conclusions:MDR coliform bacilli are strongly implicated in healthcare-associated infection.Attention should be paid to the presence of oqxAB pump,as an important mechanism in the development of resistance against many antimicrobials because it contributes to co-resistance with other categories;therefore,this pump could be a good target for efflux pump inhibitors.

Obligate aerobic, gram-positive, weak acid-fast, nonmotile bacilli, Tsukamurella tyrosinosolvens: Minireview of a rare opportunistic pathogen

Tsukamurella species are obligate aerobic,gram-positive,weak acid-fast,nonmotile bacilli.They are found in various environments,such as soil,water,sludge,and petroleum reservoir wastewater,and belong to the order Actinomycetales.In 2016,there was a reclassification of species within the genus Tsukamurella,merging the species Tsukamurella tyrosinosolvens(T.tyrosinosolvens)and Tsukamurella carboxydivorans.Tsukamurella species are clinically considered to be a rare opportunistic pathogen,because most reported cases have been related to bacteremia and intravascular prosthetic devices and immunosuppression.To date,it has been isolated only from human specimens,and has always been associated with clinical disease;human infections are very rare.Reported infections have included pneumonia,brain abscesses,catheter-related bloodstream infections,ocular infections,bacteremia,and sepsis presenting with septic pulmonary emboli in patients who are immunocompromised.To date,there is no commercially available test for identification.On the other hand,sequence-based identification,including matrix-assisted laser desorption ionization time-of-flight mass spectrometry,is an alternative method for identifying clinical isolates that are either slow growers or difficult to identify through biochemical profiling.The golden standards for diagnosis and optimal management still remain to be determined.However,newer molecular biological techniques can provide accurate identification,and contribute to the appropriate selection of definitive therapy for infections caused by this organism.Combinations of several antimicrobial agents have been proposed for treatment,though the length of treatment for infections has yet to be determined,and should be individualized according to clinical response.Immunocompromised patients often experience severe cases due to infection,and life-threatening T.tyrosinosolvens events associated with dissemination and/or failure of source control have occurred.Favorable prognoses can be achieved through earlier identification of the cause of infection,as well as successful management,including appropriate antibiotic therapy together with source control.Further analyses of similar cases are required to establish the most adequate diagnostic methods and treatment regimens for infections.

Detection of 16S rRNA Methylase Genes in Gram-Negative Bacilli Isolated from Hospitals in Changchun, China

Methylation of 16S rRNA is an important mechanism of aminoglycoside resistance among gram-negative pathogens. In this report, 16S rRNA methylase genes were amplified using PCR among gram-negative bacillus isolates from hospitals in the Changchun area of China and 16S rRNA methylase genotypes (armA, rmtB, rmtA, rmtC, rmtD, and npmA) were identified by direct sequencing. Fifty of the isolates (43.1%) harbored 16S rRNA methylase genes. The common 16S rRNA methylase genes were armA and rmtB (12.1% and 31.0%, respectively), whereas the rmtA, rmtC, rmtD, and npmA genes were absent from the sample. It suggests that the predominant 16S rRNA methylase genes among gramnegative bacilli in the Changchun area are armA and rmtB.

Detection of the Production of Klebsiella Pneumoniae Carbapenemase, New Delhi Metallo-Beta-Lactamase and Oxacillinase-48-Type Carbapenemases by Gram-Negative Bacilli in Resource-Limited Setting

Background: The increasing resistance of bacteria to various antibiotics is a worldwide public health issue. Carbapenems that have elicited great hope in treating infections caused by multidrug-resistant germs have seen their efficacy narrowed over time with the emergence of other novel resistance mechanisms, notably the production of Carbapenemases. Methods: A prospective cross-sectional study was conducted from May 2017 to May 2018 in Douala (Cameroon) to detect carbapenemase-producing Gram-negative bacilli. Isolated strains were identified using the Vitek2TM system. Antimicrobial susceptibility testing was performed using the Kirby-Bauer disk diffusion method on agar plates with 20 selected commercially available antibiotic discs. The bacterial strains were tested for the production of three Carbapenemases (OXA-48, NDM, KPC), using an immuno-chromatographic technique, with the “RESIST-3 O.K.N. K-SeT” rapid detection kit. Results: During the study period, 1687 strains of Gram-negative bacilli were isolated in selected laboratories with a total of 200 multi-resistant strains identified (11.9%). Among the multi-resistant strains, E. coli was the species most represented in Enterobacteriaceae (27.5%) followed by K. pneumoniae (15.5%) and the non-fermenting Gram-negative bacilli were predominantly P. aeruginosa (20.5%). These strains mainly came from urine and pus, i.e. 41% and 32% respectively. Thirty-two (16%) strains produced one of the Carbapenemases with a higher frequency at the General Hospital (84%). NDM-type carbapenemase was the most frequently identified (8.5%), OXA-48 type 7.5%, and no KPC production was observed. Among the Enterobacteriaceae 22.9% produced Carbapenemases and only 5.1% of the non-fermenting bacilli produced these enzymes. The isolates strains were completely resistant to all antibiotics except Amikacin and Fosfomycin. The strains producing the NDM-type carbapenemase showed higher rates of resistance to almost all of the antibiotics tested. Conclusion: Multidrug-resistant strains are experiencing an increase in evolution. The apparition of strains producing Carbapenemases prominently, the NDM and OXA-48 favor this increase. The activities of antibiotics with high efficacies on these strains are low.

2015—2021年CHINET儿童患者临床分离不发酵糖革兰阴性杆菌耐药性变迁

目的了解CHINET中国细菌耐药性监测网儿童患者临床分离的不发酵糖革兰阴性杆菌的分布和耐药性变迁。方法按CHINET耐药监测统一方案使用纸片扩散法或商品化药敏试验自动测试仪进行药敏试验。按CLSI 2021年版标准判断结果。结果临床分离不发酵糖革兰阴性杆菌26987株中,主要以假单胞菌属和不动杆菌属细菌为主,其他各菌属均有不等检出。下呼吸道标本占51.1%,居于首位,脓液及伤口分泌物占16.5%,尿液标本占9.2%。这些菌株主要分离于内科病房(38.1%)、儿科ICU(26.8%)和外科病房(18.9%)。铜绿假单胞菌对氨曲南耐药率最高,为22.7%,对碳青霉烯类抗生素耐药率为15.6%,对其他抗菌药物耐药率均低于10%。碳青霉烯类耐药鲍曼不动杆菌检出率54.1%,明显高于铜绿假单胞菌的15.6%,2020年和2021年出现下降趋势。碳青霉烯类耐药铜绿假单胞菌在新生儿期患儿的检出率(34.7%)高于其他患儿;碳青霉烯类耐药鲍曼不动杆菌随患儿年龄增长检出率逐渐增高(39.9%~65.4%)。结论儿童分离铜绿假单胞菌和鲍曼不动杆菌对各种抗菌药物的耐药率呈锯齿形变化,对大多抗菌药物的耐药率有下降趋势。不同年龄段患儿中碳青霉烯类耐药菌株的检出率不同。不发酵糖革兰阴性杆菌的分布特征和不同菌属菌株的耐药特征存在差异。因此,在儿科对此类菌进行耐药监测十分必要。

2022年沈阳市某三级甲等医院细菌耐药监测结果分析

目的分析2022年沈阳市某三级甲等医院病原菌分布及其耐药情况,为医院制定抗菌药物应用策略提供依据。方法收集从2022年沈阳市某三级甲等医院就诊患者中分离的病原菌,按照全国临床检验操作规程的要求进行菌株鉴定及药敏试验,使用Whonet 5.6软件进行数据分析。结果2022年共分离4968株病原菌,其中前5位为大肠埃希菌、肺炎克雷伯菌、鲍曼不动杆菌、屎肠球菌和铜绿假单胞菌。大肠埃希菌和肺炎克雷伯菌对碳青霉烯药物耐药率分别为1.9%和17.7%,阴沟肠杆菌对亚胺培南和美罗培南耐药率分别为26.7%和25.0%。耐甲氧西林金黄色葡萄球菌(MRSA)分离率15.6%。万古霉素耐药屎肠球菌、利奈唑胺耐药粪肠球菌分离率分别为7.1%、11.6%。热带念珠菌对氟康唑耐药率>20%。结论该医院病原菌分布及耐药率与国内其他地区监测结果存在差异,有必要进行医院菌株的耐药监测,及时了解病原菌分布及耐药情况,为抗感染诊治提供依据。

2021-2023年某院碳青霉烯类耐药革兰阴性杆菌分布及耐药性分析

目的分析广东省第二中医院临床分离碳青霉烯类耐药革兰阴性杆菌(Carbapenem resistant Gram-negative bacilli,CR-GNB)的分布情况和耐药性特点。方法选取广东省第二中医院2021年1月1日至2023年6月30日经临床分离鉴定检测的2754株CR-GNB;使用WHONET5.6软件分析CR-GNB的分布特征及药敏检测耐药性特点。结果临床分离筛选出CR-GNB 2754株,其中,碳青霉烯类耐药肺炎克雷伯氏菌(Carbapenem resistant Klebsiella pneumoniae,CRKP)843株(30.6%),碳青霉烯类耐药鲍曼不动杆菌(Carbapenem-resistant Acinetobacter baumannii,CRAB)765株(27.8%),碳青霉烯类耐药铜绿假单胞菌(Carbapenem-resistant Pseudomonas aeruginosa,CRPA)679株(24.7%),碳青霉烯类耐药大肠埃希菌(Carbapenem-resistant Escherichia coli,CREC)203株(7.4%),其他CR-GNB 264株(9.5%)。CR-GNB主要标本来源:痰液1702株(61.8%),尿液639株(23.2%),肺泡灌洗液232株(8.4%),血液78株(2.8%),分泌物71株(2.6%)。主要科室分布:呼吸与危重症医学科病区532株(19.3%),重症医学科病区365株(13.3%),针康一区病区325株(11.8%),针康七区病区181株(6.6%)。针康病区合计分离出1330株(48.9%)。CR-GNB普遍对抗生素存在多重耐药或泛耐药,对少数药物敏感率较高;CRKP对替加环素的敏感率是100.0%;CRAB对阿米卡星、妥布霉素、米诺环素的敏感率分别是73.9%、59.0%、49.3%;CRPA对阿米卡星、妥布霉素、多黏菌素B的敏感率分别为78.1%、75.5%、46.5%;CREC对替加环素的敏感率为100.0%。结论广东省第二中医院临床分离的CR-GNB以CRKP、CRAB、CRPA和CREC为主。CR-GNB呈多重耐药或泛耐药,可选择的治疗药物有限,临床需规范抗生素的使用,同时根据CR-GNB的耐药特点制定有效可行的治疗方案,防范CR-GNB在院内感染和传播。

Treatment of primary nasal tuberculosis with anti-tumor necrosis factor immunotherapy:A case report

BACKGROUND Primary nasal tuberculosis(TB)is a rare form of extrapulmonary TB,particularly in patients receiving anti-tumor necrosis factor(TNF)immunotherapy.As a result,its diagnosis remains challenging.CASE SUMMARY A 58-year-old male patient presented to the ear,nose,and throat department with right-sided nasal obstruction and bloody discharge for 1 month.He was diagnosed with psoriatic arthritis and received anti-TNF immunotherapy for 3 years prior to presentation.Biopsy findings revealed chronic granulomatous inammation and a few acid-fast bacilli,suggestive of primary nasal TB.He was referred to our TB management department for treatment with oral anti-TB agents.After 9 months,the nasal lesions had disappeared.No recurrence was noted during follow-up.CONCLUSION The diagnosis of primary nasal TB should be considered in patients receiving TNF antagonists who exhibit thickening and crusting of the nasal septum mucosa or inferior turbinate,particularly when pathological findings suggest granulomatous inflammation.

2015~2019年重庆某三甲医院革兰阴性杆菌的分布特点和耐药性变迁

目的:对重庆某三甲医院2015~2019年期间临床分离的革兰阴性杆菌的分布和耐药性进行监测。方法:利用抗菌药物耐药性趋势监测(SMART)项目提交的重庆某医院革兰阴性杆菌标本,使用定制药敏板通过Trek系统进行抗菌药物敏感性测试。结果:共收集来自腹腔、呼吸道、尿路和血流感染患者的950株革兰阴性杆菌标本。其中大肠埃希菌、肺炎克雷伯菌、铜绿假单胞菌、鲍曼不动杆菌的检出率分别为43.37%、18.63%、14.11%、10.84%。鲍曼不动杆菌和铜绿假单胞菌对常规抗菌药物的耐药率较高但5年内变化较小。而肺炎克雷伯菌在2017年对第三代头孢菌素类和氟喹诺酮类药物的耐药率较2016年明显上升,对碳青霉烯类药物的耐药率在2019年降至20%以下。此外,不同感染部位的革兰阴性杆菌的耐药率也存在显著差异。其中,尿路感染来源的鲍曼不动杆菌对氟喹诺酮类抗菌药物左氧氟沙星和黏菌素均具有较高的敏感率;然而在腹腔和呼吸道感染中,其耐药率大多数超过50%。对于检出的耐碳青霉烯类鲍曼不动杆菌、对头孢噻肟或头孢曲松耐药的大肠埃希菌、耐氟喹诺酮类大肠埃希菌、多重耐药鲍曼不动杆菌和多重耐药铜绿假单胞菌,目前可选用的常规抗菌药物较少。结论:该院2015~2019年期间革兰阴性耐药菌的问题比较突出,尤其是三代头孢菌素耐药肠杆菌目细菌。而鲍曼不动杆菌无论是否为特殊耐药菌,对大部分抗菌药物的耐药率都很高,有待于持续监测并结合临床实际合理选择有效抗菌药物。

异基因造血干细胞移植后短期内死亡的危险因素分析

背景:异基因造血干细胞移植是治愈各种血液病的有效甚至唯一手段,但患者移植后短期内死亡率较高。目的:探讨影响血液病患者异基因造血干细胞移植后短期(100 d)内总体生存的危险因素,旨在降低异基因造血干细胞移植后短期(100 d)内死亡率及有效预防相关危险因素。方法:回顾性分析于2018-01-01/2021-06-30在郑州大学第一附属医院造血干细胞移植中心行异基因造血干细胞移植的585例血液病患者的临床资料,探究影响血液病患者异基因造血干细胞移植后100 d内总体生存的危险因素。结果与结论:共585例血液病患者行异基因造血干细胞移植,92例死于移植后100 d内,死亡率为15.7%(92/585),死亡时中位年龄为26.5岁(1-56岁),死亡病例的中位生存时间为48 d(0-97 d)。单因素分析显示,年龄≥14岁、发生急性移植物抗宿主病、Ⅳ度急性移植物抗宿主病、细菌血流感染及耐碳青霉烯类革兰阴性杆菌血流感染是影响异基因造血干细胞移植后100 d内总体生存的危险因素(P<0.05);多因素分析显示,年龄≥14岁、发生Ⅲ-Ⅳ度急性移植物抗宿主病、细菌血流感染及耐碳青霉烯类革兰阴性杆菌血流感染是影响异基因造血干细胞移植后100 d内总体生存的独立危险因素,相对危险度分别为1.77(95%CI 1.047-2.991),7.926(95%CI 3.763-16.695),2.039(95%CI 1.117-3.722),3.389(95%CI 1.563-7.347)。结果表明:异基因造血干细胞移植后短期内全因死亡率较高,对于移植后短期内合并细菌血流感染、Ⅲ-Ⅳ度急性移植物抗宿主病的患者需及时发现、给予有效治疗,从而改善异基因造血干细胞移植的疗效。

ZOPOMED-60结核分枝杆菌显微扫描仪检测抗酸杆菌效果

目的 评价ZOPOMED-60结核分枝杆菌显微扫描仪在痰涂片查找抗酸杆菌的阅片效果。方法 收集2023年5月于广西壮族自治区胸科医院就诊患者的合格痰标本203份,分别采用萋-尼染色法和荧光染色法进行染色,通过人工镜检和ZOPOMED-60结核分枝杆菌显微扫描仪进行抗酸杆菌检测,以分枝杆菌液体培养为标准,计算不同方法查找抗酸杆菌的敏感度、特异性、阳性预测值、阴性预测值。结果 荧光染色人工阅片和仪器智能阅片的阳性率分别为12.3%和18.7%,萋-尼染色人工阅片和仪器智能阅片的阳性率分别为13.3%和17.7%,4种阅片检测结果差异无统计学意义(P>0.05)。以分枝杆菌液体培养结果为标准,荧光染色人工阅片和仪器智能阅片、萋-尼染色人工阅片和仪器智能阅片检测抗酸杆菌的敏感度分别为40.0%、45.0%、45.0%和53.3%,特异性分别为99.3%、92.3%、100.0%和97.2%,阳性预测值分别为96.0%、71.0%、100.0%和88.9%,阴性预测值分别为79.8%、80.0%、81.2%和83.2%,一致性均较好。结论 两种染色方法应用ZOPOMED-60结核分枝杆菌显微扫描仪检测抗酸杆菌的性能较好,值得推广应用。

NMR studies of the interaction between Bacillis subtilis neutral proteinase and inorganic metal compounds

The interaction between Bacillis subtilis neutral proteinase (B.S.NP) and inorganic metal compounds (CoCI2, NiCI2) was investigated by 1H NMR spectroscopy. It has been shown that the Zn(Ⅱ) ion in the active center of the native enzyme may directly interact with external CoCI2 and NiCI2, producing Co(Ⅱ)- and Ni(Ⅱ)-substituted derivatives, and their 1H NMR spectra were obtained for the first time. From the 1H NMR spectra, the coordinated structure of the active center in the native enzyme was described.

碳青霉烯耐药革兰阴性杆菌的耐药机制及抗菌药物的研究进展

碳青霉烯类抗生素是一类非典型的β-内酰胺类药物,是目前抗菌谱最广、杀菌活性最强的抗生素,然而随着此类抗生素的广泛使用,碳青霉烯耐药革兰阴性杆菌(Carbapenem-resistant organism,CRO)在全球范围内扩散,导致临床选择抗菌药物越来越艰难,给临床治疗带来了新的挑战。本文从碳青霉烯酶的产生、通道蛋白的缺失、外排泵的过度表达、药物结合位点的改变、生物膜的形成等5个方面介绍了碳青霉烯类抗生素的耐药机制,以及对抗菌药物的选择进行综述,为临床预防和治疗CRO提供科学依据。

Effect of Dampness on the Enteric Bacilli，SlgA and Pathological Studies in Rate

Thirty rats were divided into three groups: Damp group ( relative humidity was over 90% andtemperature 18 ￣25 ) , Cold group ( T : 2 2 , RH : 54 4% ) and normal control group ( T : 18 ￣ 25 , RH :54 4% ) . The results showed that number of Escherichia coli increased greatly while number of bifidobac-terium reduced in high moisture. In Damp group, Ievel of secretory IgA was much higher as compared withthat of the normal controlled and Oold group. Th/i and Ts/c in Cold group and in Damp group were slighttylower than that in the normal group. Light microscopic examinations showed that there were intiltration ot in-flammatory colls and low-grade hyperemla in the phalangeal joints' synovium of rats of the Damp group inpathological section. Meanwhile there were low-grade erosion, degeneration, necrosis and exfoliation in ep-ithelium mucosa of small intestine.

肝硬化合并腹腔感染者腹腔积液病原菌的分布及药敏特点分析

目的探究肝硬化合并腹腔感染者腹腔积液病原菌的分布及药敏特点。方法选择2022年8月—2023年4月本院收治的186例肝硬化合并腹腔感染患者作为研究对象,收集所有患者腹腔积液进行病原菌鉴定及药敏试验,分析肝硬化合并腹腔感染者腹腔积液病原菌的分布及主要病原菌药敏特点。结果186例肝硬化合并腹腔感染患者腹腔积液中,有84例培养出阳性标本,培养阳性率为45.16%(84/186)。84例阳性标本中共分离出病原菌94株,三种病原菌重叠感染者2例,占比2.38%(2/84),两种病原菌重叠感染6例,占比7.14%(6/84),单一病原菌感染76例,占比95.24%(1/84)。94株病原菌中革兰氏阴性菌57株,占比60.64%(57/94),主要为大肠埃希菌、肺炎克雷伯菌、铜绿假单胞菌;革兰氏阳性菌33株,占比35.11%(33/94),主要为表皮葡萄球菌、肺炎链球菌、粪肠球菌;真菌4株,占比4.26%(4/94)。57株革兰氏阴性菌药敏结果显示,大肠埃希菌对亚胺培南、氨苄西林、头孢曲松的耐药率较高,均在70%以上,对莫西沙星、氨曲南、红霉素耐药性低;肺炎克雷伯菌对头孢曲松、氨苄西林、头孢噻肟的耐药率较高,均在80%以上,对美罗培南、红霉素、氨曲南耐药性低;铜绿假单球菌对头孢曲松、亚胺培南、氨苄西林的耐药率较高,均在50%以上,对莫西沙星、头孢呋辛、红霉素耐药性低。33株革兰氏阳性菌药敏结果显示,表皮葡萄球菌对青霉素、庆大霉素、头孢吡肟的耐药率较高,均在60%以上,对替考拉宁、万古霉素、氨苄西林耐药性低;肺炎链球菌对青霉素、庆大霉素、苯唑西林的耐药率较高,均在60%以上,对替考拉宁、氨苄西林、利福平耐药性低;粪肠球菌对青霉素、头孢噻肟、庆大霉素的耐药率较高,均在70%以上,对替考拉宁、氨苄西林、四环素、利福平耐药性低。结论肝硬化合并腹腔感染者腹腔积液中主要病原菌为革兰氏阴性杆菌,其次为革兰氏阳性球菌、真菌,不同病原菌对不同药物的耐药性各不相同,临床医师在治疗时应根据药敏试验及病原菌的鉴定结果选择合适的抗菌药物,以确保临床疗效。

革兰阴性杆菌感染呼吸机相关性肺炎患者病原菌分布及耐药性

目的:分析革兰阴性杆菌感染呼吸机相关性肺炎(VAP)患者病原菌分布及耐药性。方法:选取2020年3月至2022年12月该院收治的134例革兰阴性杆菌感染VAP患者进行前瞻性研究。采集患者下呼吸道分泌物标本,分析革兰阴性杆菌分布及耐药性。结果:134例革兰阴性杆菌感染VAP患者下呼吸道分泌物中检出347株病原菌,其中铜绿假单胞菌检出率最高(101株,29.11%),其次为肺炎克雷伯菌(62株,17.87%)、大肠埃希菌(52株,14.99%)、鲍曼不动杆菌(49株,14.12%);肺炎克雷伯菌对阿米卡星、哌拉西林/他唑巴坦、头孢替坦的耐药性为80%以上;鲍曼不动杆菌对左氧氟沙星、氨苄西林/舒巴坦、氨苄西林的耐药性为70%以上;铜绿假单胞菌对阿米卡星的耐药性为81.19%;大肠埃希菌对亚胺培南、美罗培南的敏感性达100.00%。结论:铜绿假单胞菌、肺炎克雷伯菌、大肠埃希菌、鲍曼不动杆菌为革兰阴性杆菌感染VAP患者常见病原菌,其耐药性均较高。

某三甲医院两年内革兰阴性杆菌耐药性变化的研究

目的回顾性分析某三甲医院2020-2022年期间临床分离菌株的分布和耐药特征,为指导医疗合理应用抗菌药物提供可靠依据。方法分析调查期间医院住院患者培养呈阳性的所有菌株分布特点,针对主要的革兰阴性杆菌的分布和耐药性变化进行相关性分析。结果剔除重复后对共计9287株菌株分析统计,其中革兰阴性菌5627株(60.6%),革兰阳性菌2189株(23.6%),其余为真菌1471株(15.8%)。最多见的多重耐药菌是碳青霉烯耐药鲍曼不动杆菌(CRAB)、碳青霉烯耐药肺炎克雷伯菌(CRKPN)和碳青霉烯耐药铜绿假单胞菌(CRPA)。经对比发现细菌对多数常规抗菌药的耐药率降低,也出现少数对多黏菌素类耐药的细菌。结论该医院多重耐药菌以革兰阴性杆菌为主,各种管控措施下细菌的耐药率降低,多黏菌素类抗菌药物耐药的出现需引起临床科室和管控部门的高度重视。