摘要:目的:了解细菌药物敏感性以指导临床合理选用抗生素。方法:采用VITEK32及GNS120药敏卡、GPS107药敏卡完成细菌的鉴定及药敏实验。结果:葡萄球菌占72.5%。青霉素对葡萄球菌敏感性几乎为0,葡萄球菌的产酶率均在95%以上。结论:临床应了解细菌对抗生素的耐药特点,掌握好适应症,科学合理选用抗生素
Objective To study the influence of brominated furanones on the biofilm (BF) formation of Staphylococcus epidermidis (SE) on polyvinyl chloride(PVC) materials, and provide new ideas for the research of surface modification of materials and clinical treatment of biomaterial centered infection. Methods We chose three kinds of brominated furanone with representative chemical structure for our research which were respectively 3,4dibromo-5-hydroxy2 (5H) -furanone (Mucobromic acid) in the first furanone group, 4-bromo-5(4-methoxyphenyl)3(methylamino)2(5H)furanone in the second furanone group, and 3,4dibromo-5,5-bis(4-methylphenyl)2(5H)-furanone in the third furanone group. The PVC material soaked with 75% ethanol for 5minutes was classified as the control group. The surface coating of the PVC materials in the four groups all underwent modification respectively and then they were cocultivated with staphylococcus epidermidis together. Confocal laser scanning microscope(CLSM) was adopted to detect the thickness of bacterium BF and bacterium community quantity unit area on PVC materials and scanning electron microscope(SEM) was used to observe surface structure of SE, BF formation at 6 h, 12 h, 18 h and 24 h respectively. Results The results of CLSM showed that, compared with the control group, SE bacterium community quantity unit area and the thickness of bacterium BF on the PVC material surface in the second furanone group were obviously smaller (Plt;0.05). SE bacterium community quantity unit area and thickness of bacterium BF on PVC material surface in the first and the third furanone groups had no significant difference (Pgt;0.05). The result of SEM showed that, the quantity of SE bacterium community unit area on PVC material surface in the second furanone group were smaller than that of the control group at 6 hours. The biofilm structure on PVC material surface in the control group was formed at 18 hours, but there were no mature biofilm structure on PVC material surface in the second furanone group at 18 hours. Conclusion The impact of different brominated furanone on SE biofilm formation on the surface of PVC materials is different. The second kind of furanone can inhibit the quantity of SE bacterium community unit area and SE biofilm formation on the surface of PVC materials.
Objective The intercellular adhesion (ica) gene of Staphylococcus epidermidis (SE) is a key factor to bacterial aggregation, to analysis the genotype of iatrogenic SE and to explore the effect of iatrogenic SE ica operon on theformation of bacterial biofilm on the surface of polyvinyl chloride (PVC). Methods Fifty-six cl inical isolates of iatrogenic SEwere selected, and PCR and gene sequencing were used to detect the genes related with bacterial biofilm formation. The genes contained 16S rRNA, autolysin (atlE), fibrinogen binding protein (fbe), and icaADB. The bacteria suspension of 1 × 105 cfu/mL iatrogenic SE was prepared; according to the test results of target genes, the PVC material and the genotype of icaADB+, atlE+, fbe+ strains were co-cultivated as the ica positive group; the PVC material and the genotype of icaADB-, atlE+, fbe+ strains were co-cultivated as the ica negative group. The thickness of biofilm and bacterial community quantity unit area on PVC materials were measured by confocal laser scanning microscope, and the surface structure of biofilm formation was observed by scanning electron microscope (SEM) at 6, 12, 18, 24, and 30 hours. Results The positive rate of 16S rRNA of iatrogenic SE strains was 100% (56/56). The genotype of icaADB+, atlE+, and fbe+ strains accounted for 57.1% (32/56). The genotype of icaADB-, atlE+, and fbe+ strains accounted for 37.5% (21/56). The sequencing results showed that the product sequences of 16S rRNA, atlE, fbe, and icaADB were consistent with those in GenBank. With time, no significant bacterial biofilm formed on the surface of PVC in ica operon negative group. But in ica operon positive group, the number of bacterial community was gradually increased, and the volume of bacterial biofilms was gradually increased on the surface of PVC. At 24 hours, mature bacterial biofilm structure formed, and at 30 hours, the volume of bacterial biofilms was tending towards stabil ity. The thickness of biofilm (F=6 714.395, P=0.000) and the bacterial community quantity unit area on PVC materials (F=435.985, P=0.000) in ica operon positive groupwere significantly higher than those in ica operon negative group. Conclusion Iatrogenic SE can be divided into 2 types ofica operon negative and ica operon positive bacteria. The iatrogenic SE ica operon can strengthen bacterium biofilm formation capabil ity on PVC materials, bacterium community quantity, and thickness of biofilm, it plays an important role in bacterium biofilm formation on PVC materials.
Objective To evaluate the effect of hepatocyte growth factor(HGF) on intestinal permeability and bacterial translocation after small bowel transplantation in rats. Methods Twenty Wistar rats were as recptors and twenty SD rats as donors. After heterotopic intestinal grafting, cyclosporine A was administered at 6mg/kg·day intramuscularly for inhibiting rejection. The SD rats were divided into 2 groups(n=10). HGF was administered at 150 μg/kg·day (HGF group) and normal saline was administered at 150 μg/kg·day (controlgroup). Intestinal permeability and bacterial translocation to the mesenteric lymph nodes and portal vein were assessed at the 8th postoperative day. Results The lactulose and lactulose/ mannitol of control group (0.0931%±0.008 5% and 0.132± 0.021) were higher than those of normal reference value (0.015 0%±0.002 0% and 0.020±0.005)（Plt;0.05）. The lactulose and lactulose/ mannitol of HGF group (0.039 6%±0.009 0% and 0.056±0.013) were also higher than those of normal reference value（Plt;0.05）.The bacterial culture positive proportion of lymphaden in HGF group and control group were 10% and 60%, showing statistically significant difference（Plt;0.05）. The bacterial culture positive proportion of portal vein in HGF group and control group were 10% and 20% respectively（P＞0.05）. Conclusion HGF can decrease intestinal permeability and bacterial translocation from the lumen of the graft to the mesenteric lymph nodes,thus improve gut barrier function, may be of help to reduce the incidence of septic complications after intestinal grafting.
目的:了解本地区小儿败血症的病原菌种类、不同病原菌在各年龄段的分布情况及主要病原菌药物敏感状况,为指导临床诊断及合理使用抗生素提供依据。方法:对本院儿科近3年经血培养分离出的310株阳性菌株的构成比及对抗生素的药物敏感状况进行回顾性分析。结果:310株检出菌中G+菌201株占64.8%;G杆菌106株占34.2%;前5位病原菌依次为凝固酶阴性葡萄球菌(CNS)、沙门菌、大肠埃希菌、金黄色葡萄球菌(简称金葡菌)、链球菌属,分别占40.97%、21.61%、6.45%、4.51%、4.19%;新生儿败血症病原菌以CNS为主 (101株),其次为大肠埃希菌、肠球菌、克雷伯氏菌;6个月内小婴儿败血症致病菌与新生儿近似;婴幼儿各种细菌败血症均有发生;学龄前及学龄期儿童败血症病原菌依次为沙门菌、链球菌、金葡菌;药敏结果显示,大多数G+菌对青霉素、红霉素、苯唑西林、氨苄西林、头孢唑啉、头孢他啶、复方新诺明、庆大霉素耐药率超过60%;对万古霉素、利福平、阿米卡星、头孢西丁、喹诺酮类敏感。G杆菌中沙门菌对亚胺培南、氨曲南、三代头孢菌素、酶抑制剂复方制剂、喹诺酮类、复方新诺明保持高度敏感;大肠埃希菌多重耐药,对氨苄西林、哌拉西林、复方新诺明耐药率超过80%,对氨曲南、环丙沙星、庆大霉素、妥布霉素、头孢吡肟、头孢噻肟耐药率超过50%;其他G杆菌大多数对亚胺培南、呋南妥因、阿米卡星、奎诺酮类、头孢西丁敏感,酶抑制复合制剂的敏感率明显提高。结论:(1)CNS是新生儿及小婴儿败血症的主要病原菌,低毒力条件致病菌在该阶段小儿中感染率高;沙门菌是本地区近三年学龄期儿童败血症的主要病原菌,其感染呈逐年下降趋势。(2)不同病原菌的药敏状况差异很大,应高度重视感染病例的病原学检查,以利于制定临床抗感染方案,合理使用抗生素。(3)万古霉素、利福平、亚胺培南、氨曲南、第3代头孢菌素、阿米卡星及喹诺酮类目前仍为敏感抗生素。
Objective To evaluate the clinical efficacy and safety of domestic sparfloxacin in the treatment of acute bacterial infections. Methods A multicenter randomized controlled clinical trial was conducted. 117 patients were treated with domestic sparfloxacin 200-300 mg qd for 5-14 days and 114 patients were treated with domestic lomefloxacin 300 mg bid for 5-14 days. Results The cure rates and the efficacy rates in each group were 84.62%, 74.56% and 94.87%, 92.98%, respectively. The bacterial clearance rates were 94.28% and 92.02%, respectively. Adverse drug reactions rates were 7.69% and 11.40%, most of them were mild. There were no significant differences of above results between the two groups (Pgt;0.05). Conclusions The results suggest that sparfloxacin with wide antibacterial spectrum, satisfactory activity, is an effective and safe antibacterial agent in treatment of mild to moderate acute bacterial infections.
Objective To design and construct a graphene oxide (GO)/silver nitrate (Ag3PO4)/chitosan (CS) composite coating for rapidly killing bacteria and preventing postoperative infection in implant surgery. Methods GO/Ag3PO4 composites were prepared by ion exchange method, and CS and GO/Ag3PO4 composites were deposited on medical titanium (Ti) sheets successively. The morphology, physical image, photothermal and photocatalytic ability, antibacterial ability, and adhesion to the matrix of the materials were characterized. Results The GO/Ag3PO4 composites were successfully prepared by ion exchange method and the heterogeneous structure of GO/Ag3PO4 was proved by morphology phase test. The heterogeneous structure formed by Ag3PO4 and GO reduced the band gap from 1.79 eV to 1.39 eV which could be excited by 808 nm near-infrared light. The photothermal and photocatalytic experiments proved that the GO/Ag3PO4/CS coating had excellent photothermal and photodynamic properties. In vitro antibacterial experiments showed that the antibacterial rate of the GO/Ag3PO4/CS composite coating against Staphylococcus aureus reached 99.81% after 20 minutes irradiation with 808 nm near-infrared light. At the same time, the composite coating had excellent light stability, which could provide stable and sustained antibacterial effect. ConclusionGO/Ag3PO4/CS coating can be excited by 808 nm near infrared light to produce reactive oxygen species, which has excellent antibacterial activity under light.