Drug resistance analysis and Staphylococcal cassette chromosome SCCmec genotypes of methicillin resistant Staphylococcus aureus / 国际检验医学杂志

Objective To investigate the drug resistance situation and Staphylococcal cassette chromosome mec(SCCmec) genotypes of methicillin resistant Staphylococcus aureus (M RSA ) strains isolated from Shang-hai Putuo District People′s Hospital in order to provide a theoretical basis for predicting the trend of drug re-sistant bacterial strains and clinical treatment and prevention of MRSA .Methods Three hundreds and eighty clinically isolated MRSA strains in this hospital were collected from January 2012 to December 2016 .The in vitro drug susceptibility test was performed by adopting the broth microdilution method .The SCCmec geno-types were examined by adopting the multiplex polymerase chain reaction .Results All strains were sensitive to linezolid and vancomycin ,the sensitivity rate was 100 .0％ ;the resistance rates to rifampicin and cotrimox-azole were lower ,which were 5 .0％ and 7 .6％ respectively ;but the strains were highly resistant to erythromy-cin ,levofloxacin and tetracycline ,with the resistance rate of 100 .0％ ,94 .2％ ,93 .4％ and 90 .0％ .The resist-ance rate to penicillin was 100 .0％ .Among 380 strains of MRSA ,there were 281 strains(73 .9％ ) of SCCmecⅡ ,59 strains (15 .5％ ) of SCCmecⅢand 5 strains (1 .3％ ) of SCCmecⅣa ,other 35 strains(9 .2％ ) of MRSA could not be classified .Conclusion M RSA strains isolated in the Shanghai Putuo District People′s Hospital are mainly the type SCCmecⅡ ,w hich has the multi-drug resistant characteristics ,and the drug resistance spec-trum of different SCCmec genotypes is different .

Antimicrobial resistances and clinical distributions of Acinetobacter junii and Acinetobacter lwoffii / 上海交通大学学报（医学版）

Objective · To analyze the clinical distribution and drug resistance of Acinetobacter junii (A. junii) and Acinetobacter lwoffii (A. lwoffii) from a grade 3A hospital in Shanghai, China, and provide the foundation for prevention and control of infections caused by them. Methods · A. junii and A. lwoffii were collected from the hospital between Aug, 2011 and Aug, 2016. VITEK2 Compact of bioMérieux (French) was used for bacterial identification and antibiotic susceptibility tests, clinical information of each strain was also analyzed. Results · 28 strains of A. junii and 58 strains of A. lwoffii were enrolled. A. junii was mainly from the departments of urology, thoracic surgery and geriatrics, and the samples were mainly sputum and urine. The resistant rates of A. junii to gentamicin, ampicillin sulbactam, piperacillin, piperacillin/tazobactam, ceftazidime, cefepime, imipenem, meropenem, levofloxacin, ciprofloxacin and cotrimoxazole were 35.71%, 3.57%, 10.71%, 3.57%, 3.57%, 3.57%, 3.57%, 3.57%, 0, 3.57% and 35.71%, respectively. A. lwoffii was mainly isolated from the departments of urology, geriatrics, respiratory and renal medicine, and the samples mainly included urine, blood and sputum. The rates of antibiotics (mentioned above) resistance were 29.31%, 13.79%, 13.79%, 6.90%, 20.69%, 18.97%, 12.07%, 15.52%, 18.97%, 31.03% and 31.03%, respectively. The levels of antibiotic resistance of these two strains were constant during the five years. Conclusion · A. junii and A. lwoffii antibiotic resistant rates were much lower than those of reported A. baumannii, the over-all antibiotic resistances of A. junii were lower than those of A. lwoffii. This study provided fundamental data for prevention or control of these two strains by empirical use of antibiotics.

Prevalence and molecular proifle of theStaphylococcus aureus strains harboring tstand/or pvl genes / 中国感染与化疗杂志

Objective To investigate the prevalence, accessory gene regulator (agr) and staphylococcal cassette chromosome mec (SCCmec, only for methicillin resistantS. aureus, MRSA) types of theS. aureus strains carrying toxic shock syndrome toxin-1 (tst) and/or panton-valentine leukocidin (pvl) genes.Methods Nine hundred and sixteen isolates ofS. aureus were collected from seven hospitals in Shanghai and Zhejiang Province and subjected to detection oftst,pvl,mecA andmecC genes by polymerase chain reaction (PCR). Theagr and SCCmec (only for MRSA) types were determined in thetst orpvl gene positive isolates.Results Of the 916 isolates, 208 carriedtst gene (22.7%), 35 harboredpvl gene (3.8%), and 665 weremecA positive (MRSA). No isolate was mecC positive. Out of the 665 MRSA isolates, 198 hosted thetst gene (29.8%). The most commonagr and SCCmec types were agr 2 (97.0%) and SCCmec II (94.4%), respectively. For thepvl gene, only 14 isolates were positive (2.1%). Theagr 1 (85.7%), SCCmecIII (42.9%) and SCCmec IVa (28.6%) were the most commonagr type and SCCmec type. In the 251 methicillin-sensitiveS. aureus (MSSA) isolates, 10 carriedtst gene (4.0%) and 21 carriedpvl gene (8.4%). The prevalence oftst gene in MRSA was higher than that in MSSA, while the prevalence ofpvlgene was just the opposite. However, the prevalence ofpvlgene in MRSA isolates from Zhejiang Province was higher than that in the MRSA isolates from Shanghai (P severeS. aureus infections.

Co-production of carbapenem-hydrolyzing enzyme KPC-2 and ArmA 16S rRNA methylase in pandrugs resistant Enterobacter cloacae / 中华微生物学和免疫学杂志

Objective To investigate the production of carbapenemase and 16S rRNA methylase in five isolates of pan-drugs resistant E.cloacae recovered in Ruijin hospital.Methods MICs of the five isolates to 10 antibiotics were determined by E test.Six kinds of 16S rRNA methylase genes and a series of β- lactamase genes were amplified by PCR.Shotgun cloning was performed to detect carbapenem resistance determinant.The conjugal transfer of carbapenemase gene and 16S rRNA methylase gene was performed in broth culture with E.coli J53 as the recipient.Pulsed-field gel electrophoresis (PFGE) was carried out to analyse the genotyping.IEF was performed to detect β-1actamases.Southern blot was performed to determine the location of carbapenem resistance determinant.Results The MICs of 10 antibiotics were ＞32 mg/L.Four β-1actamases with pIs of 5.4 ( TEM-1 ),6.7 ( KPC-2 ),8.2 ( SHV-12 ),8.4 (CTX-M-14) were determined.The insertion sequence in the recombinant plasmid was blaKPC-2 flanked by a transposon.blaKPC-2 was located on a large non-conjugative plasmid whereas armA was located on an other conjugative plasmid.PFGE patterns of 5 isolates were identical.Conclusion KPC-2 was responsible for carbapenem resistance in pandrugs resistant Enterobacter cloacae.There was no relationship between blaKPC-2 and armA.Although pandrug resistant Enterobacteriaceae remain rare,the emergence of this group of organism merits monitoring.

Detection of Metallo-?-lactamase in Multi-resistant Pseudomonas aeruginosa / 中华医院感染学杂志

OBJECTIVE To investigate the production of metallo-beta-lactamase in clinical isolates of multi-resistant Pseudomonas aeruginosa and evaluate the validity of the detection methods.METHODS The multi-resistant strains were selected by K-B method according to the standard Aloush et al recommended.The metallo-beta-lactamase phenotypes were detected by multi-disk-multi-inhibitors synergy test(MDMIST),and the genotypes of IMP and VIM gene were analyzed by PCR amplification.RESULTS A total of 192 strains of multi-resistant P.aeruginosa were selected from 1081 clinical strains.The antimicrobial agents test in these multi-resistance strains demonstrated that ciprofloxacin and piperacillin had the highest resistant rate(92.5%),and the next were aztreonam and trimethoprim-sulfamethoxazole(91.5%),the polymyxin showed sensitive in all of these strains.Sixty-seven strains of metallo-beta-lactamase phenotypes were positive and the amplification PCRs showed that 65 strains were IMP or VIM in these 192 multi-resistant strains.CONCLUSIONS The resistance mechanisms in multi-resistant P.aerugionsa present multiple and changeable.The clinical laboratory should enhance the detection of metallo-beta-lactamase in these multi-resistant strains.

Mupirocin resistance in Staphylococcus aureus / 中华临床感染病杂志

Objective To investigate mupiroein resistance in Staphylococcus aureus (SAU) and the resistance to commonly used antibiotics in mupirocin-resistant strains. Methods Four hundred and ninety clinically isolated SAU strains froin January 2005 to May 2007 in the First Affiliated Hospital,Wenzhou Medical College were screened by mupirocin(5μg)disc diffusion method.Minimum inhibition concentration(MIC)and the amplification of mupA gene were performed to determine the resistance to mupirocin.Resistance to cefoxitin,gentamycin, levofloxacin, trimethoprim/sulfamethoxazole, rifampin, erythromycin, clindamycin, tetracycline and vancomycin in mupirocin-resistant strains was detected by disc diffusion method, and the amplification of mecA gene was performed to confirm the methieillin resistance among mupiroein-resistant strains.Results Twenty-seven mupirocin-resistant strains were obtained,in which 22(81.5%)were hish-level mupirocin resistant(MuH)and the rest were low-level mupirocin resistant(MuL).Among 27 mupirocin-resistant strains,24 were methicillin-resistant Staphylococcus aureus (MRSA)in which 21 were MuH and 3 were MuL strains.Drug sensitivity tests showed that the resistance to gentamycin,levofloxacin,trimethoprim/sulfamethoxazole,rifampin,erythromycin,elindamycin and tetracycline were hish among MuH and MuL strains,and most of these strains were multi-drug resistant.All strains were susceptible to vaneomycin.Conclusions Most of the clinical emerged mupirocin-resistant SAU strains are MuH and show hish resistance to commonly used antibiotics.Therefore,detection and drug sensitivity test of mupirocin-resistant strains should be strengthened in clinic practice in order to prevent it from dissemination.

Pathogenic Bacteria and Drug Resistance in Nosocomial Septicemia:An 8-year Analysis of Their Changes / 中华医院感染学杂志

OBJECTIVE To investigate the changes in pathogenic bacteria and drug resistance in nosocomial(septicemia).METHODS The blood samples of inpatients were cultured with blood culture apparatus,VITEK-AMS were used to identify the pathogenic bacteria and conduct drug resistance test.RESULTS The proportion of(Gram-positive) cocci had been increasing,coagulase negative staphylococcus increased significantly,but the(proportion) of Staphylococcus aureus decreased significantly.The proportion of Gram-negative bacteria and fungi decreased too.Vancomycin and imipenem were the highest susceptible to Gram-positive and Gram-negative(bacteria),respectively.CONCLUSIONS Gram-negative bacteria are the major pathogens in nosocomial septicemia.But Gram-positive cocci had been increasing in the past years.Coagulase negative staphylococcus is the main pathogen in nosocomial septicemia.pathogenic bacteria are higher resistant to the commonly used antibiotics.

Genotyping of Meticillin-resistant Staphylococcus aureus Outbreak Isolates / 中华医院感染学杂志

OBJECTIVE To investigate characters of molecular epidemiology of meticillin-resistant Staphylococcus aureus(MRSA) outbreak strains in an emergency intensive care unit(EICU),to follow-up the possible sources,understand transmission for infection,and determine preventive strategies.METHODS Pulsed-field gel electrophoresis(PFGE) was used to analyze the homology of MRSA strains,isolated from clinical patients′ infection sites and environment,and carried by patients and healthcare workers in EICU of our hospital in December,2004.RESULTS Six of 17 patients were infected by MRSA,and 7 strains were isolated((including) 2 strains from different sites of the same patient).Surveillance cultures of ward′s environments,(patients)′ nares and healthcare workers′ nares and hands were performed in the outbreak period.Five MRSA strains were isolated,including a strain from nares of a patient,a strain from a table-board of a procedure room,a strain from hand of a nurse,a strain from a bed bar,and a strain from ward′s air.PFGE typing of the 12 MRSA strains showed that all 7 strains isolated from patients′ infection sites and two strains from nares of a patient and hand of a nurse were of type A.Strains from a procedure room,bed bar and air were of types B,C and D,respectively.CONCLUSIONS MRSA′s source and its transmission route are elucidated by genotyping.MRSA appears to come from a patient′s nares and has been transferred in ward by hand of healthcare workers.

Immunolocalization of the Signaling Protein l4-3-3 of Schistosoma japonicum / 中国寄生虫学与寄生虫病杂志

Objective To study the localization of the signaling protein 14-3-3 of Schistosoma japonicum (Sj14-3-3)in the parasite. Methods Cercariae were collected from the infected Oncomelania hupensis for the infection of rabbits. Fifteen-day-old schistosomula and adult worms obtained from infected rabbits 15 and 42 days post-infection were used for frozen sections and indirect immunofluorescence staining with monoclonal antibody to rSj14-3-3. Results The results showed that the Sj14-3-3 distributed mainly in the tegument, subtegument, muscle, and parenchyma of both adult worms and 15-day-old schistosomula. Conclusion The wide distribution and large sites of Sj14-3-3 in the parasite were clearly demonstrated, which established a significant clue for further studies of biologic actions and application of 14-3-3 protein.

Protective Immunity Induced by Recombinant Signaling Protein 14-3-3 Vaccine of Schistosoma japonicum / 中国寄生虫学与寄生虫病杂志

Objective To evaluate the immunoprotective effect of Schistosoma japonicum (Chinese strain) recombinant signaling protein 14-3-3(rSj14-3-3), and to observe the synergism of rSj14-3-3 and rSjGST proteins as candidate vaccine and the effect of ??-T cells activated by Mtb against Schistosoma japonicum. Methods BALB/c mice immunized with rSj14-3-3 and rSjGST purified through SDS-PAGE, electroelution and dialysis were challenged by cercaria infection. Six weeks after challenging infection, the mice were killed and the worm and egg reduction rates were calculated. Results Worm reduction rate was found to be 32.20% in rSj14-3-3+Freund adjuvant group, 31.10% in rSj14-3-3+rSjGST+Freund adjuvant group, 27.96% in rSj14-3-3+Mtb group, 26.00% in rSj14-3-3+rSjGST+Mtb group, and 27.10 % in rSjGST+Mtb group, respectively, number of eggs in liver tissue was reduced by 50.40%, 53.30%, 51.10%, 58.60% and 51.30%, respectively. Conclusion rSj14-3-3 could induce partial immunity against Schistosoma japonicum in BALB/c mice, and might serve as a candidate vaccine; ??-T cell activated by Mtb played a role in anti-Schistosoma japonicum similar to the immune reactions induced by Freund adjuvant, but no synergistic effect combined with rSjGST was observed.

Experimental Study of Effect of Acupuncture on Behaviors of Mice Model of Rapid Senilized Dementia / 中医杂志

By adopting scoring method on the degree of senilization and methods of high cross frame labyrinthine experiment and shuttle box on the basis of systematic observation on behavior characteristics of rapid senilized dementia in SAM - P/8 model, the effect of acupuncture method for wakening the consciousness and opening of orifices was observed. Results showed SAM -P/8 revealed apparent senilized characteristics of brain, being in a low intelligent condition, which is a rather ideal model for the study of natural damentia in the elderly. The acupuncture methods revealed an action of delaying senility process, improving the condition of frightening and increasing the ability of learning and memory.