Objective:To evaluate the incubation time and antibacterial adsorption properties of culture bottles of Meriere activated carbon and resin with different adsorption media.Methods:The incubation time of bacterial strains simulated bacteremia samples in vitro was used to detect the positive detection time. On the basis of the simulated bacteremia samples, antibiotics such as genamicin, levofloxacin, vancomycin and meropenem were added. The antibacterial adsorption capacity of two different adsorption media culture jars was evaluated by the incubation time.Results:Time to detection of culture bottle: (1) In the aerobic bottle group, the positive detection time of resin bottle was shorter than that of activated carbon bottle, especially the growth rate of Enterococcus faecium and Escherichia coli was faster in resin bottle, and the difference between them was statistically significant (P=0.040). (2) In the anaerobic bottle group, the positive detection time of resin bottle was not significantly better than that of activated carbon bottle, and there was no statistical difference between them (P=0.638). (3) In the children's bottle group, the positive detection time of resin bottle was more obvious. The positive detection time of Staphylococcus aureus cultured in two bottles was significantly different, and there was a statistical difference between them (P=0.040). The adsorption performance of antibiotics: (1) The positive detection time of resin aerobic bottle in Gentamicin group, levofloxacin group and vancomycin group was shorter than that of activated carbon aerobic bottle, and there was statistical difference between them (P＜0.001). (2) In gentamicin group, the positive detection time of resin anaerobic bottle was not significantly different from that of activated carbon anaerobic bottle, and there was no statistical difference between them (P=0.822). The positive detection time of resin anaerobic bottle in levofloxacin group was longer than that of activated carbon anaerobic bottle, and there was statistical difference between them (P＜0.001). (3) In vancomycin group and meropenem group, resin anaerobic bottles reported positive within the specified time, while activated carbon anaerobic bottles reported negative, and there was a statistical difference between the two groups (P＜0.001). (4) The positive detection time of resin bottles in gentamicin group, levofloxacin group and vancomycin group was shorter than that in activated carbon bottles, and there was statistical difference between the two groups (P＜0.001).Conclusions:The positive detection time of Meriere resin aerobic bottle and resin children's bottle is shorter than that of activated carbon aerobic bottle and activated carbon children's bottle, indicating that their adsorption capacity of antibacterial drugs is stronger. The advantage of resin anaerobic bottle in the positive detection time is not obvious compared with activated carbon anaerobic bottle, and resin anaerobic bottle has better adsorption effect on meropenem and vancomycin. The adsorption of gentamicin was not significant compared with that of activated carbon anaerobic bottle, and the adsorption of levofloxacin on resin anaerobic bottle was not as good as that of activated carbon anaerobic bottle.

目的 探讨GeneXpert MTB/RIF检测技术在肺结核诊断及利福平耐药中的应用价值.方法 以2020年7月-2021年6月在天门市第一人民医院治疗的疑似肺结核患者120例作为研究对象,所有患者均留取痰标本,进行痰涂片、痰培养、GeneXpert MTB/RIF检测、比例法药物敏感(药敏)试验.以培养法和比例法药敏试验结果为金标准,计算GeneXpert MTB/RIF检测结核分枝杆菌(Mycobacterium tuberculosis,MTB)及其对于利福平耐药性检测的灵敏度、特异度、与金标准的一致率.结果 120例疑似肺结核患者中,痰涂片阳性42例(35.00％),痰涂片阴性78例(65.00％).以痰培养结果为金标准,GeneXpert MTB/RIF检测MTB的灵敏度为85.42％(41/48),特异度为88.14％(52/59).GeneXpert MTB/RIF与痰培养诊断一致率为86.92％(93/107);进一步分析,GeneXpert MTB/RIF检测痰涂片阳性患者MTB的灵敏度为97.22％(35/36),特异度为33.33％(1/3),检测痰涂片阴性患者MTB的灵敏度为50.00％(6/12),特异度为91.07％(51/56).以比例法药敏试验结果为金标准,确认痰培养阳性36例患者中利福平耐药有4例(11.11％),敏感的有32例(88.89％);GeneXpert MTB/RIF检测痰培养阳性患者利福平耐药的灵敏度为75.00％(3/4),特异度为93.75％(30/32).GeneXpert MTB/RIF与比例法药敏试验一致率为91.67％.结论 GeneXpert MTB/RIF检测技术对于肺结核诊断以及利福平的耐药分析具有重要实用价值.

Objective:To investigate the clinical and pathogenic characteristics of Bordetella parapertussis infection.Methods:Clinical data of the patient who was admitted to the First People’s Hospital of Tianmen City was collected, the disease course records of this patient and the laboratory isolation and identification process of the pathogenic bacteria were analyzed and the relevant literatures were reviewed.Results:This child, female, 1 year and 3 months old, with clinical manifestations such as cough and shortness of breath, mild inspiratory trigeminal sign, coarse breath sounds in both lungs, moderate croup and a few wet rales could be heard; laboratory examination results showed that white blood cells: 12.49 × 109/L, red blood cells: 4.36 × 1012/L, neutrophil percentage: 58.4%, platelets: 260 × 109/L, serum iron: 7.5 μmol/L, creatinine: 26.5 μmol/L, total carbon dioxide: 19.6 mmol/L, total calcium: 2.76 mmol/L, hydroxybutyate dehydrogenase: 291 U/L, lactate dehydrogenase: 310 U/L, creatine kinase isoenzyme: 25.20 U/L, creatine kinase: 308 U/L; Mycoplasma pneumoniae IgM antibody: weakly positive. The patient’s chest CT imaging showed a sheet of high-density film of the right upper lung. The sputum culture isolates were identified as Bordetella parapertussis by protein time-of-flight mass spectrometry (MALDI-TOF MS). The child was discharged from hospital after anti-infection treatment.Conclusion: Bordetella parapertussis infection is relatively rare, and early pathogen diagnosis is important for effective treatment.

Objective:To investigate the diagnostic characteristics of facial abscess caused by Streptococcus constellatus.Methods:The clinical data of a case of facial abscess caused by Streptococcus constellatus admitted to the Oncology Department of Tianmen First People′s Hospital on June 27, 2020 were retrospectively analyzed, and the relevant literatures were reviewed.Results:The patient presented with a mass in the right maxillofacial region, with partial skin ulceration and purulent discharge. The patient had an anamnesis of nasopharyngeal carcinoma. Imaging indicated right middle ear mastoiditis and sinusitis. Laboratory examination found that IgA antibody of human herpesvirus was weakly positive, C-reactive protein level was 11.07 mg/L, procalcitonin level was 1.26 μg/L, blood culture was negative, and Streptococcus constellatus was detected in wound secretion. The pathogen was resistant to erythromycin and clindamycin.Conclusions:As a kind of opportunistic pathogen, Streptococcus constellatus can cause suppurative infection in various tissues and organs of human body, which should arouse clinical attention. We should improve the detection rate of pathogenic bacteria, so as to achieve early diagnosis and treatment.

诺卡菌病常见的为肺诺卡菌病和播散型诺卡菌病,半数以上肺诺卡菌病患者合并肺外疾病 [1].病原菌多由外伤进入皮肤或经呼吸道吸入引起感染 [2],常见于各种原因所致的机体免疫功能低下患者 [3],20％播散型诺卡菌病患者无明显肺部受累表现,脑是最常见的播散部位.多数诺卡菌病患者存在免疫缺陷.我院从1例脑脓肿患者穿刺液中分离到1株皮疽诺卡菌,现报道如下.

啮蚀艾肯菌是一种条件致病菌，在临床感染中比较少见，国内也只有零星报道。该菌可存在于人呼吸道、消化道、口腔、泌尿道等黏膜表面，当人体免疫力低下或黏膜表面破损时，常引起软组织脓肿、脑膜炎、脑脓肿、颈部脓肿及腹部感染等。该菌营养要求高，生长缓慢，培养困难，容易漏检、漏诊，应引起微生物实验室检验人员的注意。本文报道1例由啮蚀艾肯菌引起的颈部脓肿，最终行手术并抗感染治疗后痊愈的病例。

目的 分析耐甲氧西林金黄色葡萄球菌(MRSA)的临床分布及药敏试验,为临床合理使用抗生素及控制医院感染提供依据.方法 回顾性分析本院2013年1月至2015年12月分离的MRSA菌株,用WHO-NET 5.6软件分别按照科室分布、标本来源、年龄段及药物敏感性进行统计分析,用SPSS 17.0软件进行组间比较.结果 3年间共分离出金黄色葡萄球菌797株,其中MRSA 105株,分离率为13.2%.MRSA的标本来源以痰液、伤口分泌物、血液为主,分别占47.6%、27.6%、8.6%.临床科室分布以普外科、ICU、骨外科为主,分别占20.00%、14.30%、13.30%.MRSA对多种抗菌药物均呈不同程度的耐药性,对万古霉素、利奈唑胺全敏感.对苯唑西林、氨苄西林/舒巴坦、头孢唑啉、头孢呋辛、头孢西丁、庆大霉素、妥布霉素、左旋氧氟沙星、克林霉素、红霉素的耐药率均高于MSSA,差异有统计学意义(P<0.05).结论 MRSA的耐药形势十分严峻,应定期监测MRSA的临床分布及耐药性,并采取有效措施预防和控制医院感染的发生.

患者男，64岁，2015年12月21日就诊，主诉“头痛2个月余”。患者于2个月前无明显诱因出现头痛，为双侧颞部搏动样痛，较剧烈，伴恶心呕吐，为胃内容物。头疼时好时坏，严重时疼痛难忍，2015年12月21日以“头痛待查”收入湖北省天门市第一人民医院神经内科。

Objective To analyze the annual reporting to China Antimicroblal Resistance Survellance System data of our hospital in 2014, and to understand the distribution of hospital clinical isolates, specimen source, the distribution of drug resistance and multi-drug resistant pathogens.Methods Clinical isolates of pathogens distribution, specimen source, the distribution of multi-drug resistant and drug sensitivity test from software for January 2014 to December 2014 in our hospital were analyzed by WHONET 5.6 software, retrospectively.Results Among all the 4 779 isolated, Gram-negative bacteria accounted for 79.92% (3 819/4 779), and Gram-positive bacteria accounted for 20.08% (960/4 779). The top ifve bacteria wereEscherichia coli (1 477 strains, accounting for 30.91%),Klebsiella pneumoniae (677 strains, accounting for 14.17%),Pseudomonas aeruginosa (430 strains, accounting for 9% ),Acinetobacter (290 strains, accounting for 6.07%) andEnterococcus faecalis (270 strains, accounting for 5.65%). The top five clinical isolates of the department were pediatric (801 strains, accounting for 16.76%), general surgery (447 strains, accounting for 9.35%), urology (424 strains, accounting for 8.87%), respiratory medicine (341 strains, accounting for 7.14%) and critical care medicine (335 strains, accounting for 7.01%). The top ifve types specimens were respiratory specimens (1 824 strains, accounting for 38.17%), urine&nbsp;(1 050 strains, accounting for 21.97%), secretions (523 strains, accounting for 10.94%), drainage (513 strains, accounting for 10.73%) and blood (361 strains, accounting for 7.55%). Methicillin-resistant coagulase-negativeStaphylococci (53/148, 35.81%), producing extended spectrum β-lactamases (788/2 221, 35.48%), resistance to carbapenems BowmanAcinetobacter (9/52, 17.31%), methicillin-resistantStaphylococcus aureus (29/205, 14.15%),Enterobacteriaceae resistant to carbapenem 15 (15/2 712, 0.55%) were isolated, while penicillin-resistantStreptococcus pneumoniae unseparated to vancomycin-resistantEnterococci(VRE) and penicillin resistantStreptococcus pneumonia (PRSP) were not found.Conclusions The 2014 annual drug monitoring data analysis, on the distribution of hospital clinical isolates, specimen source, multi-drug-resistant and drug-resistant bacteria could guide clinical rational use of antibiotics in clinical to improve the security.