不同酚类成分及其组合对P.aeruginosa PAO1的抑制效果研究

为研究茶叶酚类成分及其复方对P.aeruginosa PAO1的体外抑制作用,筛选出用药量最低的最佳抑菌组方,采用倍比稀释法结合刃天青显色测定5种酚类成分对P.aeruginosa PAO1的最小抑菌浓度(MIC),并采用响应面法研究对P.aeruginosa PAO1具有较强抑制作用的最佳配伍。结果表明5种酚类成分对P.aeruginosa PAO1均有不同程度的抑制作用,5种茶叶活性成分对P.aeruginosa PAO1的抑菌性大小为:EGCG>TF60=ECG>EGC>EC。响应面分析结果表明,EGCG、EGC、ECG、TF60这4种酚类成分以1.0∶4.0∶4.81∶4.0的比例配伍时对P.aeruginosa PAO1具有最佳抑菌效果。

Detoxification strategy of Microcystis aeruginosa to the toxicity of Cd(Ⅱ):role of EPS in alleviating toxicity

Although many studies have found that cadmium(Cd)can be toxic to microalgae,only a few reports focused on the role of extracellular polymeric substances(EPS)in Cd(Ⅱ)detoxification.The biochemical and physiological endpoints of Microcystis aeruginosa,including the composition and functional groups of soluble EPS(SL-EPS),loosely bound EPS(LB-EPS),and tightly bound EPS(TB-EPS),were detected to elucidate the toxicity and detoxification mechanisms of Cd(Ⅱ)for cyanobacteria.Toxicological and physiological assays on M.aeruginosa showed that the 0.25-mg/L Cd(Ⅱ)resulted in a larger inhibition on growth and F_(v)/F_(m).Nevertheless,Cd(Ⅱ)significantly induced much higher contents of superoxide dismutase(SOD),intracellular microcystin LR(MC-LR),extracellular MC-LR,and EPS.Scanning electron microscopy with energy dispersive X-ray spectroscopy confirmed that Cd(Ⅱ)was absorbed into the EPS layer.Fourier transform infrared spectrum analysis revealed that the functional groups bound with Cd(Ⅱ)of algae biomass,SL-EPS,LB-EPS,and TB-EPS were somewhat different.The C=O/C=N groups ofδ-lactam or protein were their prominent functional groups,suggesting that amide or proteins in the EPS played a key role in the adsorption in Cd(Ⅱ).The concentration of 0.25 mg/L of Cd(Ⅱ)may change the chemical structure of EPS by altering the production of protein-like substances containing tryptophan.This study indicated that M.aeruginosa could detoxify Cd(Ⅱ)stress via induction of antioxidant capacity(higher SOD activity and MC synthesis),EPS production,and modification in chemical structure of EPS.

Molecular investigation of exoU and exoY virulence genes in Pseudomonas aeruginosa collected from hospitalized patients in North of Iran:A descriptive-analytical study

Objective:To investigate the frequency of exoU and exoY genes in patients with Pseudomonas aeruginosa infection.Methods:In this study,100 clinical isolates of Pseudomonas aeruginosa were collected from patients hospitalized in educational-therapeutic hospitals and were identified using standard microbiological tests.Then,the antibiotic resistance pattern of the isolates was determined by the disk agar diffusion method.The bacterial DNAs were extracted by the alkaline lysis method.Finally,the presence of exoU and exoY genes was evaluated by the PCR test.Results:In this study,47%,72%,29%,39%,40%,and 44%of the isolates were non-susceptible to piperacillin,aztreonam,ceftazidime,imipenem,tobramycin,and ciprofloxacin,respectively.In addition,95%and 93%of the clinical isolates carried the exoU and exoY genes.Blood and fecal isolates had both virulence genes,while only one wound isolate had neither genes.Meanwhile,all urinary isolates contained the exoY gene and only one isolate lacked the exoU gene.Also,88 isolates simultaneously had both exoU and exoY genes.Conclusions:High prevalence of exoU and exoY genes in this region indicates a significant role of typeⅢsecretion system in pathogenesis of Pseudomonas aeruginosa.The typeⅢsecretion system may be a suitable target to reduce the pathogenicity of this bacterium.

Efficacy of Pudilan Xiaoyan Oral Liquid in the treatment of pneumonia induced by drug-resistant Pseudomonas aeruginosa

Background:Pudilan Xiaoyan Oral Liquid(PDL)is a Chinese patent medicine with notable pharmacological properties,including anti-inflammatory and antibacterial effects.Drug-resistant Pseudomonas aeruginosa infection is a common and refractory bacterial infection in clinical practice.Due to its high drug resistance,it brings great challenges to treatment.This study aimed to assess the therapeutic efficacy of PDL in a murine model of pneumonia induced by drug-resistant Pseudomonas aeruginosa.Methods:Three different doses of PDL(11 mL/kg/d,5.5 mL/kg/d,2.75 mL/kg/d)were used to observe lung tissue pathology and inflammatory cytokine levels in pneumonia mouse models induced by multidrug-resistant Pseudomonas aeruginosa(MDR-PA).Additionally,the protective efficacy of PDL against mortality in infected mice was evaluated using a death model caused by MDR-PA.Finally sub-MIC concentration of levofloxacin was used to induce drug-resistant mice pneumonia model to evaluate the role of PDL in reversing drug resistance.Experimental data are expressed as mean±standard deviation.Statistical significance was determined by one-way analysis of variance followed by Tukey’s multiple-comparisons test.Results:Treatment effect of PDL on MDR-PA pneumonia:the medium and small doses of PDL can significantly reduce the lung index of multi-drug resistant bacteria infected pneumonia model mice(P<0.05),the lung index inhibition rates for these groups were 55.09%and 58.43%,and improve the degree of lung tissue lesions of mice;The expression of serum cytokines keratinocyte chemoattractant,tumor necrosis factor-αand monocyte chemoattractant protein-1 could be decreased in the three dosage groups of PDL(P<0.01).PDL treatment not only lowered the mortality but also extended the survival duration in mice infected with MDR-PA.It was found after sub-MIC concentration of levofloxacin induced resistance of Pseudomonas aeruginosa to pneumonia in mice.Compared with the model group,the lung index of mice in high and medium PDL doses was significantly reduced(P<0.05),with inhibition rates of 32.16%and 37.73%,respectively.Conclusion:PDL demonstrates protective effects against MDR-PA infection pneumonia,notably decreasing serum inflammatory factor levels.It shows promise in mitigating antibiotic resistance and offers potential for treating pneumonia resulting from Pseudomonas aeruginosa resistance.

Association ofβ-lactam antimicrobial's exposure with carbapenem-resistant Pseudomonas aeruginosa infection:a cumulative meta-analysis

Background:Carbapenems are effective against severe Pseudomonas aeruginosa nosocomial infections.Therefore,carbapenem-resistant Pseudomonas aeruginosa is a serious public health threat.An understanding of the risk of inappropriate exposure to different antimicrobials in resistant Pseudomonas aeruginosa infection could help in elucidating the effective approach towards using antimicrobials in vulnerable patients with CRPA infection.Object:To investigate the association between exposure ofβ-lactam antimicrobials and CRPA infection relative to control patients.Methods:The MEDLINE/PubMed and OVID/Embase databases were used to search case-control and cohort studies in English language which reported antimicrobial exposure as risk factors for CRPA infection.The pooled odds ratios(OR)were calculated using a random-effect and fixed-effect model,and forest plots from a cumulative meta-analysis method were used to better show how pooled OR changed as updated evidence accumulated.Results:A total of 24 studies comprising 7039 participants were included for cumulative meta-analysis.A positive correlation was found between development of CRPA infection and exposure of beta-lactam antimicrobials:carbapenems(OR=7.60,95%CI:3.95 to 14.62,P<0.0001),imipenem(OR=9.81,95%CI:5.56 to 17.33),ampicillin(OR=1.86,95%CI:1.14 to 2.41),piperacillin(OR=2.82,95%CI:1.46 to 2.43),penicillins(OR=1.42,95%CI:0.90 to 2.24),cephalosporins(OR=1.88,95%CI:1.46 to 2.43)andβlactamase inhibitors(OR=1.96,95%CI:1.44 to 2.67).Further,exposure of other antimicrobial agents like quinolone(OR=2.35,95%CI:1.78 to 3.10),ciprofloxacin(OR=2.35,95%CI:1.66 to 3.95),aminoglycoside(OR=2.17,95%CI:1.60 to 2.95),amikacin(OR=3.11,95%CI:2.10 to 4.61),glycopeptides(OR=3.02,95%CI:1.92 to 4.75)and vancomycin(OR=3.26,95%CI:1.48 to 7.18),were also found to be positively associated with development of CRPA infection.Conclusions:Exposure of all kinds ofβ-lactams is significantly associated with development of carbapenemresistant Pseudomonas aeruginosa infection.These findings provide an impetus to take a more active approach while usingβ-lactam antimicrobials in patients with resistant Pseudomonas aeruginosa infections.

β-cyclopiazonic acid binds iron demonstrating siderophorelike activity and promotes growth in Pseudomonas aeruginosa

This chemical study reports a novel siderophore-like compound,β-cyclopiazonic acid(1,β-CPA)extracted from marine fungus Aspergillus flavus.The chemical structure ofβ-CPA was elucidated by a combination of extensive spectroscopic analyses and TDDFT-ECD calculations.The iron-binding ability and CAS assays demonstrate thatβ-CPA is a novel siderophore that features a different chemical structure from those of traditional siderophores.Theβ-CPA has no obvious influence on the growth of bacterium Pseudomonas aeruginosa PAO1.However,its iron chelator could promote the growth of P.aeruginosa PAO1,suggesting that P.aeruginosa employed siderophores to sequester iron,which is vital for their survival.The study provides the physiochemical evaluation ofβ-CPA,an unusual skeletonstructure siderophore,which for the first time,was proven to have the ability to bind iron and affect P.aeruginosa growth.This new discovery of siderophore provides an opportunity for developing novel anti-P.aeruginosa drugs.

Anti-bacterial mechanism of baicalin-tobramycin combination on carbapenem-resistant Pseudomonas aeruginosa

BACKGROUND Pseudomonas aeruginosa(P.aeruginosa)is an important cause of nosocomial infections,and contributes to high morbidity and mortality,especially in intensive care units.P.aeruginosa is considered a'critical'category bacterial pathogen by the World Health Organization to encourage an urgent need for research and development of new antibiotics against its infections.AIM To investigate the effectiveness of baicalin combined with tobramycin therapy as a potential treatment method for carbapenem-resistant P.aeruginosa(CRPA)infections.METHODS Polymerase chain reaction(PCR)and RT-PCR were used to detect the expression levels of drug-resistant genes(including VIM,IMP and OprD2)and biofilmrelated genes(including algD,pslA and lasR)in CRPA that confer resistance to tobramycin,baicalin and tobramycin combined with baicalin(0,1/8,1/4,1/2 and 1MIC).RESULTS There was a correlation between biofilm formation and the expression of biofilmrelated genes.In addition,VIM,IMP,OprD2,algD,pslA and lasR that confer biofilm production under different concentrations in CRPA were significantly correlated.The synergistic effect of baicalin combined with tobramycin was a significant down-regulation of VIM,IMP,algD,pslA and lasR.CONCLUSION Baicalin combined with tobramycin therapy can be an effective treatment method for patients with CRPA infection.

Study on the Effect of Shuanghuanglian Powder Needle Combined with Cefoperazone and Sulbactam Sodium on Pseudomonas aeruginosa in Vitro

Objective: To explore the antibacterial activity of combined use of Shuanghuanglian and cefoperazone sulbactam sodium on resistant strains of Pseudomonas aeruginosa. Methods: The Pseudomonas aeruginosa strains which were sensitive and resistant to cefoperazone sulbactam sodium were selected to prepare different test bacterial solutions respectively;The experimental liquid of Shuanghuanglian and Cefoperazone Sulbactam Sodium were prepared separately and set as different test groups and control groups;The Drug Sensitivity Tests of Shuanghuanglian and cefoperazone sulbactam sodium at different concentration gradients which were used alone or used in combination were carried out for different strains with sensitivity and resistance, And use standard entry as a reference control. Result: The results of drug sensitivity test of Shuanghuanglian combined with Cefoperazone-Sulbactam sodium against the resistant strains of Pseudomonas aeruginosa were compared with the results of drug sensitivity test of the two separately used, and the difference was statistically significant (P 〈 0.05) [The drug sensitivity test results of Shuanghuanglian and cefoperazone sulbactam sodium to Pseudomonas aeruginosa resistant strains were statistically significant compared with the drug sensitivity test results of Shuanghuanglian and Cefoperazone Sulbactam Sodium used separately (P 〈 0.05)];There was a dependence between strains and concentration in the effect of the combination of the two drugs. Conclusion: The combination of Shuanghuanglian and cefoperazone sulbactam sodium has synergistic antibacterial or bactericidal effect on Pseudomonas aeruginosa resistant strains. .

Establishment of extensively drug-resistant Pseudomonas aeruginosa pneumonia model in rat

Objective:To establish extensively drug-resistant Pseudomonas aeruginosa(XDR-PA)infection-induced pneumonia model in rats.Methods:Twenty-four male SD rats were randomly divided into blank group,low bacterial group,medium bacterial group,and high bacterial group.The low,medium and high bacterial groups were given intratracheal instillation of 0.1 mL of bacterial suspension(bacterial concentration in turn is 7.5×10^(9),3×10^(10),6×10^(10)CFU/mL),while the blank group were given the same volume of sterile normal saline.After modeling,the general conditions of rats in each group were observed,including mental state,hair,respiration,activity,eating,weight,and the survival curve was drawn.The pathological characteristics of lung tissue and the infiltration of inflammatory cells were observed.Pathogenic identification of each group was carried out by bacterial culture of lung tissue homogenate.Results:The general state of the blank group was normal,and the rats in other groups showed signs of mental depression,bristling,shortness of breath,even oral and nasal bleeding,decreased food intake and activity,and significant weight loss,and different degrees of death within 48 hours,the difference was statistically significant(P<0.05).Pathological results showed that the alveolar structure of rats in the blank group was complete,and the alveolar space was clear without exudation.The lung tissue of the low and medium bacterial groups showed obvious inflammatory cell infiltration,alveolar structure destruction,alveolar septum thickening,interstitial edema,but the pathological damage of the medium group was more severe,with a mortality rate of up to 50%,and the mortality rate of the low bacterial group was 17%.In the high bacterial group,red blood cells,inflammatory cells and a large amount of fibrin-like exudation can be seen in the alveolar space,which has the pathological characteristics of acute respiratory failure,and the mortality rate is as high as 67%.The results of bacterial culture of lung tissue homogenate showed that the blank group had no bacterial colonies,while PA colony growth can be seen in low,medium and high bacterial groups.Conclusion:9 Intratracheal instillation of low bacterial count(0.1 mL of 7.5×10^(9) CFU/mL)XDR-PA bacterial suspension can successfully construct a rat pneumonia model of XDR-PA infection.

溶藻细菌胶囊与植物共生系统的建立及其对Microcystis aeruginosa的控制

当前,蓝藻水华时常爆发,其中铜緑微囊藻(Microcystis aeruginosa)是我国蓝藻水华的典型代表.微生物控藻技术具有高效、生态安全性好、原位修复等特点,近年来已经成为治理蓝藻水华的主要手段.本文通过搭建芦苇湿地试验装置,模拟太湖近岸水域原生环境,以水生植物控藻与溶藻细菌胶囊强化相结合的方式对Microcystis aeruginosa进行生态学-微生物操控试验.从藻胆蛋白、抗氧化系统、膜脂值活性等方面的研究来探究控藻系统的溶藻机制,并通过高通量技术与主成分分析来探索溶藻细菌与藻之间的群落动态关系.试验结果表明,原位藻类控制系统效率高,14 d溶藻率为(88.74%±1.10%),其中溶藻细菌胶囊占主导地位,植物修复为辅.通过对藻胆蛋白的破坏和藻类抗氧化系统的摧毁来导致藻类膜结构的受损,胞内物质流出而死亡.利用高通量技术发现,溶藻细菌胶囊所包埋的菌株Bacillus sp.HL在微生物体系中成为优势菌种.主成分分析结果表明高效原位控藻体系促进了藻体内ROS水平,增强了藻的Zeta电位和抗氧化酶活性,从而抑制了Microcystis aeruginosa的生长.

Antimicrobial Resistance of Pseudomonas aeruginosa Isolated from Human Infections in N’Djamena, Chad

Background: Urinary Tract infections and pus are major public health problems. The evolution of bacterial resistance to antibiotics makes the treatment of these infections problematic. This is why this study is undertaken to identify and evaluate the resistance of Pseudomonas aeruginosa to antibiotics. Methods: This is a prospective study carried out from December 2020 to November 2021. The germs were isolated on the agar supplemented with cetrimide and identified by the API 20 NE gallery method according to the manufacturer’s protocol. The strains’ resistance profiles were determined by the diffusion method on Mueller-Hinton according to the criteria EUCAST- 2021. Results: A total of 46/1467 (3.13%) Pseudomonas aeruginosa were identified, of which 29/1008 (2.87%) were urinary tract infections and 17/459 (3.70%) were pus. The high resistances were: 97.8% to ceftazidim, 91.3% to aztreonam, 93.5% to cefepim, 82.6% to piperacillin, 58.7% to levofloxacin, 52.2% to amikacin, 47.8% to tazobactam-piperacillin, 47.8% to tobramycin and 43.5% to ciprofloxacin. Low resistance was only 2.2% to fosfomycin, 2.2% to colistin and 15.2% to imipenem. Conclusion: This study reveals the considerable resistance of Pseudomonas aeruginosa to commonly used antibiotics, and thus compromises the empirical treatment practiced in hospitals. This result motivates the need to carry out susceptibility testing of isolates before any prescription of antimicrobials.

Kinetics of Bioremediation of Oil Contaminated Water Dispersed by Environment-Friendly Bacteria (Pseudomonas aeruginosa) and Fungi (Aspergillus niger)

The comparative effectiveness of remediating water polluted with crude oil, using environment-friendly bacteria (Pseudomonas aeruginosa) and fungi (Aspergillus niger) were investigated. The samples were separately treated with Aspergillus niger and Pseudomonas aeruginosa. The bioremediation kinetic efficiency for these systems was studied. At the end of the bioremediation periods, the oil and grease content of the samples decreased from 47.0 mg/L in the untreated sample to 7.0 mg/L after 20 days when inoculated with bacteria while the sample inoculated with fungi decreased to 10.0 mg/L. Post analysis when inoculated with bacteria showed a fall in the value of the biological oxygen demand (BOD) from 73.84 mg/L to 33.28 mg/L after 20 days, while, the fungi inoculated sample showed a reduction from 73.84 mg/L to 38.48 mg/L. The biodegradation process with the bacteria was consistent with the pseudo-first-order model with a rate constant of 0.0891 day-1, while the biodegradation process with the fungi was consistent with the first order reaction model with a rate constant of 0.422 day-1. The degree of degradation after the 20th day of inoculation with Pseudomonas aeruginosa was 85.11%, while with Aspergillus niger was 78.72%. Thus, the results obtained showed that, Pseudomonas aeruginosa performed better than Aspergillus niger. The bioremediation data with fungi fitted the first-order model, while that of the bacteria fitted the pseudo-first-order model. Therefore, the data obtained in this study could be applied in the design of a bioremediation system for potential application to remediation of crude oil polluted water.

Enhancing Accumulation and Penetration Efficiency of Next-Generation Antibiotics to Mitigate Antibiotic Resistance in Pseudomonas aeruginosa PAO1

This study explores the efficacy of advanced antibiotic compounds against P. aeruginosa, focusing on Antibiotic B, an enhanced derivative of Ceftriaxone. The study measured the intracellular uptake of Antibiotic B and introduced a novel adjuvant, Influximax, which augmented its antibacterial activity. Results showed a diminished potential for resistance emergence with Antibiotic B, particularly when used in combination with Influximax. The study suggests that optimizing antibiotic delivery into bacterial cells and leveraging syner-gistic adjuvant combinations can enhance drug resistance combat. .

Analysis of Clinical Characteristics and Risk Factors of Pseudomonas aeruginosa Bloodstream Infection in 55 Cases

Objective: Pseudomonas aeruginosa bloodstream infection presents a severe challenge to hospitalized patients. To investigate the clinical characteristics, risk factors and drug resistance of Pseudomonas aeruginosa bloodstream infection. Methods: Clinical data and laboratory results of patients with Pseudomonas aeruginosa bloodstream infection in the First Affiliated Hospital of Yangtze University from January 2019 to December 2022 were retrospectively analyzed. The factors associated with infection and death were analyzed by univariate analysis. Results: A total of 55 patients were enrolled in this study, The 28-day mortality rate was 14.5%. Univariate analysis showed that high procalcitonin, low albumin, ICU admission, central venous catheterization, indwelling catheter, and mechanical ventilation were associated with death. Multivariate Logistic regression analysis showed that hypoproteinemia and central venous catheters were independent risk factors for death in patients with Pseudomonas aeruginosa bloodstream infection. Conclusions: The drug resistance of P. aeruginosa bloodstream infection is not high, but the fatality rate is high. The combination of hypoalbuminemia after the onset of the disease and the use of central vein catheters can lead to increased mortality, suggesting that clinical identification of high-risk patients as early as possible, reducing the use of catheters, preventing the occurrence of P. aeruginosa bloodstream infection and improving the prognosis.

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。

典型有机磷阻燃剂对蓝藻的Hormesis效应及机制探究

为探究有机磷阻燃剂(Organophosphate Flame Retardants,OPFRs)对蓝藻的毒性效应,以铜绿微囊藻为蓝藻受试模型,测定典型OPFRs{烷基OPFRs磷酸三乙酯(Triethyl Phosphate,TEP)和氯代OPFRs磷酸三(2-氯乙基)酯[Tris(2-Chloroethyl)Phosphate,TCEP]}对蓝藻生长及光合色素、氧化应激、细胞膜疏水性等相关生理指标的影响。结果显示,TEP与TCEP均对铜绿微囊藻的生长产生了低质量浓度促进、高质量浓度抑制的Hormesis效应,促进生长的质量浓度分别为6.80×10^(-4)~1.53×10^(-1)mg/L和5.87×10^(-5)~1.54×10^(-1)mg/L。相关生理指标变化显示,低质量浓度OPFRs通过提高光合色素的合成及调控活性氧的适当增加可刺激蓝藻增殖;相反,高质量浓度OPFRs则阻碍光合作用,对藻细胞产生氧化胁迫,进而改变细胞膜疏水性致使细胞膜受损,最终导致蓝藻大量死亡。研究结果表明,OPFRs能引发蓝藻生长的Hormesis效应,且氯代OPFRs比烷基OPFRs具有更明显的生物效应,在一定暴露质量浓度内具有促进蓝藻水华形成的潜在环境风险。研究可为OPFRs水生毒性和相应的环境风险评价提供数据基础和理论依据。

头孢他啶阿维巴坦与多黏菌素B治疗耐碳青霉烯类铜绿假单胞菌感染疗效比较

目的比较头孢他啶阿维巴坦(CAZ/AVI)与多黏菌素B(PMB)治疗耐碳青霉烯类铜绿假单胞菌(CRPA)感染的临床疗效。方法回顾性分析医院2019年1月至2022年12月收治的CRPA感染患者75例,按治疗方案的不同分为CAZ/AVI组(48例)和PMB组(27例),分别静脉滴注CAZ/AVI和PMB。结果CAZ/AVI组患者的临床治愈率、细菌清除率均显著高于PMB组(54.17%比29.63%,66.67%比37.04%,P<0.05),但皮肤色素沉着发生率显著低于PMB组(0比48.15%,P<0.001)。两组患者疗程、联合治疗及30 d死亡率均无显著差异(P>0.05)。结论CAZ/AVI治疗CRPA感染的临床疗效和细菌清除率均较PMB更高,且不良反应更少。

铜绿假单胞菌脓毒症患者程序性细胞死亡受体1/程序性细胞死亡配体1信号通路相关蛋白与短期临床预后的相关性分析

目的探讨程序性细胞死亡受体1/程序性细胞死亡配体1(PD-1/PD-L1)信号通路相关蛋白对铜绿假单胞菌(PA)脓毒症患者短期临床预后的影响。方法选择2021年1月—2023年6月宁夏医科大学总医院收治的122例PA脓毒症患者为研究对象,均根据脓毒症治疗指南和实际病情开展治疗。收集患者临床资料、治疗前慢性健康状况评分系统Ⅱ(APACHEⅡ)评分;治疗前抽取外周静脉血测定T淋巴细胞水平(CD3^(+)、CD4^(+)、CD8^(+))以及血清PD-1和PD-L1水平。结果122例PA脓毒症患者入住急诊重症监护室及其他科室后28 d存活101例(82.79%,存活组),死亡21例(17.21%,死亡组)。存活组与死亡组患者高血压比率、慢性阻塞性肺病比率、慢性肝病比率、APACHEⅡ评分、CD4^(+)、CD4^(+)/CD8^(+)、PD-1和PDL-1比较,差异有统计学意义(P<0.05)。单因素Logistic回归分析结果显示,基础疾病(高血压、慢性阻塞性肺病、慢性肝病)、APACHEⅡ评分、CD4^(+)/CD8^(+)、PD-1和PD-L1均是PA脓毒症患者短期生存的影响因素(P<0.01)。多因素Logistic回归分析结果显示,基础疾病(高血压、慢性阻塞性肺病、慢性肝病)、APACHEⅡ评分、PD-1和PD-L1均是PA脓毒症患者短期生存的影响因素(P<0.01)。结论PD-1/PD-L1信号通路对PA脓毒症患者的临床预后有影响,该通路相关蛋白表达上调可增加PA脓毒症患者短期临床预后不良的风险。

2020—2022年某医院主要细菌耐药情况分析

目的通过分析福建中医药大学附属第二人民医院2020年1月—2022年12月常见细菌的耐药性,了解医院的细菌耐药情况,为临床提供合理使用抗菌药物的参考依据。方法通过回顾性分析方法对2020年1月—2022年12月福建中医药大学附属第二人民医院患者标本分离的病原菌株进行统计,从病原菌标本分布、病原菌种类及耐药等方面进行分析。结果2020—2022年分离的菌株共计12009株,呼吸道标本(包括痰、肺泡灌洗液)最多。前5位为大肠埃希菌2139株(17.81%)、肺炎克雷伯菌1342株(11.17%)、铜绿假单胞菌1094株(9.11%)、金黄色葡萄球菌为主793株(6.60%)、鲍曼不动杆菌541株(4.50%)。耐碳青霉烯类肺炎克雷伯菌(Carbapenemresistant K.pneumoniae,CR-KP)和耐碳青霉烯类铜绿假单胞菌(Carbapenemresistant Pseudomonas aeruginosa,CR-PA)2022年比2020年明显升高,差异有统计学意义(P<0.01)。其余3种耐甲氧西林金黄色葡萄球菌(Methicillin-resistant S.aureus,MRSA)、耐碳青霉烯类大肠埃希菌(Carbapenemresistant Escherichia coli,CR-EC)、耐碳青霉烯类鲍曼不动杆菌(Carbapenemresistant Acinetobacter baumannii,CRAB)3年间检出率差异无统计学意义(P>0.05)。鲍曼不动杆菌对大多数常用抗菌药物耐药率>50%。结论福建中医药大学附属第二人民医院主要以革兰阴性杆菌为主,鲍曼不动杆菌对大多数常用抗菌药物耐药率>50%,CR-KP(耐碳青霉烯类肺炎克雷伯菌)和CR-PA(耐碳青霉烯类铜绿假单胞菌)的耐药率呈增高趋势,建议临床密切关注病原菌耐药情况的变化,减少多重耐药菌的产生。

铜绿假单胞菌的耐药性和耐药机制

铜绿假单胞菌是一种多重耐药性病原体,其感染在临床上构成了重大挑战。本文归纳综述了铜绿假单胞菌的固有性耐药、获得性耐药和适应性耐药机制,旨在为临床预防和治疗提供新的视角和方法。铜绿假单胞菌之所以能够抵御多数抗生素攻击,主要是依赖其高水平的固有性和获得性耐药性。固有耐药性涉及多种药物外排泵系统、低渗透性的外膜以及天然存在的抗生素降解酶等。获得性耐药性则是通过基因突变、接合转移以及水平基因转移等途径实现。适应性耐药性则与生物膜的形成和群体感应系统的调控紧密相关。文章通过分析这些不同耐药性的特点和发展趋势,探讨目前的治疗方法,指出铜绿假单胞菌耐药现象是多机制共同作用的结果,而非单一因素所致。鉴于此,未来治疗铜绿假单胞菌感染的有效策略可能需要结合传统治疗方法与新治疗方法相结合的联合治疗手段,研究为开发针对铜绿假单胞菌的新型治疗方法提供了理论基础,并为临床治疗提供了新的思路。