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甲氧西林抗药性

甲氧西林抗药性的相关文献在1999年到2019年内共计163篇,主要集中在基础医学、药学、临床医学 等领域,其中期刊论文162篇、会议论文1篇、专利文献12538篇;相关期刊51种,包括国际流行病学传染病学杂志、国际检验医学杂志、医学临床研究等; 相关会议1种,包括中国药学会学术年会等;甲氧西林抗药性的相关文献由561位作者贡献,包括李向阳、俞云松、祁伟等。

甲氧西林抗药性—发文量

期刊论文>

论文:162 占比:1.28%

会议论文>

论文:1 占比:0.01%

专利文献>

论文:12538 占比:98.72%

总计:12701篇

甲氧西林抗药性—发文趋势图

甲氧西林抗药性

-研究学者

  • 李向阳
  • 俞云松
  • 祁伟
  • 卢月梅
  • 吴劲松
  • 吴尚为
  • 周义正
  • 宋诗铎
  • 张伟
  • 朱以军

甲氧西林抗药性

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    • 高振祥; 陶凤蓉; 骈亚亚; 聂晶晶; 胡继红
    • 摘要: 目的 当苯唑西林最小抑菌浓度(MIC)介于0.5~2.0 mg/L,探讨凝固酶阴性非表皮葡萄球菌是否是甲氧西林凝固酶阴性葡萄球菌需做mecA基因检测. 方法 采用头孢西丁纸片扩散法、浓度梯度扩散法(E-test)、最新一代全自动细菌鉴定仪器(Compact VITEK-2)及PCR扩增检测分析mecA基因. 结果 从4 032例患者中筛选到300株凝固酶阴性葡萄球菌(7.4%),CompactVITEK-2鉴定300株凝固酶阴性葡萄球菌中有腐生葡萄球菌45株和溶血葡萄球菌80株,腐生葡萄球菌mecA基因阳性率与溶血葡萄球菌mecA基因阳性率之间差异有统计学意义(P<0.05);头孢西丁(抑菌环直径≥25 mm)、E-test(MIC介于0.5~2.0 mg/L)及Compact VITEK-2(MIC介于0.5~2.0 mg/L)结果显示凝固酶阴性非表皮葡萄球菌共81株;PCR结果发现mecA基因阳性的菌株有10株. 结论 当苯唑西林MIC介于0.5~2.0 mg/L的凝固酶阴性非表皮葡萄球菌,临床微生物实验室应严格执行美国临床实验室标准化研究所(CLSI)指南,一定要做mecA基因检测,若mecA基因检测结果阴性则报告为MSCNS,反之则报告为MRCNS.%Objective To determine whether coagulase-negative non-epidermal staphylococcus is methicillin-resistant coagulase-negative staphylococcus by mecA gene test,when the minimal inhibitory concentration(MIC)of oxacillin is between 0.5-2.0 mg/L.Methods The mecA gene was detected and analyzed by the cefoxitin disk diffusion,E-test,VITEK-2 Compact and polymerase chain reaction (PCR)purification.Results A total of 300 strains of coagulase-negative staphylococci were screened from 4032 patients(7.4%),of which 45 strains of Staphylococcus saprophyticus and 80 strains of Staphylococcus hemolyticus were identified by Compact VITEK-2.There was a statistically significant difference in the positive rate of mecA gene detection between Staphylococcus saprophyticus and Staphylococcus hemolyticus(P <0.05).The results of detection of cefoxitin disk diffusion(inhibitory zone diameter ≥ 25 mm),E-test(MIC of oxacillin between 0.5-2.0 mg/L)and Compact VITEK-2 (MIC of oxacillin between 0.5-2.0 mg/L)showed that there were 81 strains of coagulase-negative non-Staphylococci,of which 10 strains with positive mecA gene were confirmed by PCR.Conclusions When the minimal inhibitory concentration (MIC)of oxacillin against coagulase-negative non-Staphylococci stains is between 0.5-2.0 mg/L,the guidelines of the American clinical laboratory standardization institute(CLSI)should be strictly implemented in clinical microbiology laboratory and the mecA gene must be tested.Based on the wide dissemination of the mecA gene in Staphylococcus aureus population,if the mecA gene test is negative,it is reported as methicillin-susceptible coagulase-negative Staphylococcus(MSCNS),and the reverse result is reported as methicillin-resistant coagulase-negative staphylococcus(MRCNS).
    • 万玉英; 吴红丽; 何耀琴; 刘伟芬; 陈文才; 孙迟; 郝亮
    • 摘要: 目的 探讨三级甲等医院ICU里医务人员频繁接触的诊疗器械及物品表面付着的耐甲氧西林金黄色葡萄球菌(MRSA)的生存周期,为选择最佳材质、最有效方法减少MRSA引起的医院感染提供依据,从而更有效地预防与控制感染的发生.方法 将ICU医务人员频繁接触的物品分成7种不同材质[棉布、聚氯乙烯树脂塑料(PVC)、橡胶、铜、不锈钢、铬合金、银],采用Kirby-Bauer(K-B)纸片法检测MRSA菌,分离MRSA菌调制菌悬液,用无菌滴管吸菌悬液0.5 μ上L分别滴入7种材质物品表面,并分别放入20°C及35°C培养箱里进行MRSA菌培养.调查7种材质表面付着MRSA的生存周期,分别于付着后1~8 h内,干燥后即刻,干燥后第1、2、3、7、15、30天后在2种不同温度下监测MRSA的存活情况.结果 研究发现铜片上付着的MRSA无论20°C或35°C均在干燥后即刻死亡;棉布、银片、铬合金上付着的MRSA无论在20°C或35°C下30 d后均死亡,而PVC、橡胶、不锈钢附着的MRSA在20°C与35°C下生存周期不同.因此MRSA在不同材质上生存周期明显不同,MRSA最不易生存的材质是铜;相同材质不同温度MRSA菌生存期也不同.结论 MRSA在铜具物品表面不易附着,其物表保持干燥后MRSA立即死亡,这为临床选择有效杀菌材质提供依据,从而防止MRSA在医院内传播.
    • 吴许文; 温旺荣; 李沛樟; 倪金良; 简仕铭
    • 摘要: 目的 建立快速检测血液中常见致病菌包括大肠埃希菌(EC)、肺炎克雷伯菌(K P)、金黄色葡萄球菌(SA)及耐甲氧西林SA(M RSA)的多重聚合酶链反应(PCR)方法 ,有利于败血症的及时治疗.方法建立多重PCR方法对EC phoA基因、KP mdh基因、SA femA基因和MRSA mecA基因进行检测,并将16S rDNA作为致病菌感染对照.结果 采用建立的多重PC R方法进行检测的特异性为100%,EC检测限为2.75×102 CFU/mL,KP为2.43×103 CFU/mL,SA为3.13×102 CFU/mL,M RSA为3.03×102 CFU/mL;用多重PCR方法和传统血培养方法对300个血标本进行检测,传统血培养方法检测出187个血标本内阳性,多重PCR方法有4个血标本为假阴性,未能被检出.结论 建立的多重PC R方法可简便、及时地检测血流感染中的EC、KP、SA和M RSA.
    • 陈胜兰; 祝春亚; 周华; 杨青; 沈毅弘; 周建英
    • 摘要: Objective To study the efficacy and safety of linezolid for the treatment of patients with bacteremia caused by methicillin-resistant Staphylococcus aureus (MRSA).Methods Totally 52 cases of MRSA bacteremia patients, from January 2010 to April 2014 in the First Affiliated Hospital, School of Medicine, Zhejiang University, were retrospectively analyzed. They were classified into two groups based on linezolid therapeutic regimen: primary treatment with linezolid (19 cases) and alternated to linezolid (33 cases). The following data were collected and compared: clinical characteristics, lasting time of fever, bacterial clearance rate, clinical efficacy, fatality rate, and adverse events.Results Forty three of the 52 patients (82.7%) suffered complicated MRSA bacteremia. The most common clinical feature was fever[86.5%(45/52)]. Linezolid was initiatively used mostly because of renal insufficiency[68.4%(13/19)].In the other 33 patient, glycopeptides were initiatively used, then alternated to linezolid because of persistent fever[69.7%(23/33)];damage of kidney function during treatment period of glycopeptides[12.1%(4/33)];occurrence of new infectious site related to MRSA[18.2%(6/33)]. The clinical efficacy were 78.9%(15/19) in the group of primary treatment with linezolid and 81.8% (27/33) in the group of alternated to linezolid, persistent time of fever were 4(3, 15) d and 12(5, 24) d, mortality during 28 d period were 15.8% (3/19) and 9.1% (3/33), adverse rate were 15.8% (3/19) and 12.1% (4/33) in these two groups, respectively (all P>0.05).Conclusion Linezolid is an option with high clinical efficacy and good safety for MRSA bacteremia patients.%目的 探讨利奈唑胺治疗耐甲氧西林金黄色葡萄球菌(MRSA)血流感染的效果及安全性.方法 回顾性分析2010年1月至2014年4月浙江大学医学院附属第一医院确诊的52例MRSA血流感染患者的临床资料.按照利奈唑胺治疗方案分为初始治疗组(19例)和替换治疗组(33例).比较分析两组患者临床特征、发热持续时间、临床有效率、细菌清除率、28 d病死率、药物不良反应等.结果 52例MRSA血流感染患者中复杂性血流感染比例高达82.7%(43/52);发热为最常见临床表现,占86.5%(45/52).初始治疗组治疗前肾功能不全占68.4%(13/19);替换治疗组替换原因:持续发热或反复发热占69.7%(23/33)、糖肽类使用后肾功能损害占12.1%(4/33)、治疗期间出现新发MRSA感染病灶占18.2%(6/33).初始治疗组与替换治疗组的治疗有效率[78.9%(15/19)比81.8%(27/33)]、发热持续时间[4(3,15)比12(5,24)d]、28 d病死率[15.8%(3/19)比9.1%(3/33)]、不良反应发生率[15.8%(3/19)比12.1%(4/33)]差异均无统计学意义(均P>0.05).结论 利奈唑胺治疗MRSA血流感染临床效果好且较安全.
    • 杨琳; 陈辉
    • 摘要: 目的:探讨我国医院获得性耐甲氧西林金黄色葡萄球菌(MRSA)感染的危险因素,为预防决策提供依据。方法检索PubMed、Medline、CNKI、CBM、万方等数据库中发表的关于中国人群MRSA感染危险因素的文献,对MRSA感染的危险因素进行Meta分析,计算合并后危险因素的OR值及95%CI。结果共22篇文献入选本研究,累计病例2312例,对照1931例。 Meta分析结果显示,年龄>60岁(OR=1.45,95%CI:1.02~2.08)、存在基础疾病(OR=2.10,95%CI:1.48~2.96)、低蛋白血症(OR=3.17,95%CI:1.57~6.38)、激素治疗(OR=3.94,95%CI:1.70~9.13)、抗菌药物联合应用(OR=4.77,95%CI:2.74~8.29)、深静脉植入(OR=3.44,95%CI:1.59~7.42)、气管切开(OR=3.22,95%CI:1.43~7.25)、机械通气(OR=1.88,95%CI:1.44~2.44)、留置导尿(OR=2.28,95%CI:1.06~4.90)和鼻胃插管(OR=1.75,95%CI:1.10~2.78)是医院获得性MRSA感染的危险因素。结论目前影响我国人群医院获得性MRSA感染的危险因素包括抗菌药物联合应用、侵入性操作、基础疾病、年龄>60岁、低蛋白血症和激素治疗等。%Objective To discuss the risk factors of hospital-acquired methicillin-resistant Staphylococcus aureus (MRSA) infection, and to provide evidence for prevention decision. Methods The relative researches of MRSA infection in China were retrieved by the internet technology in the Pubmed, Medline, CNKI, CBM and Wanfang databases. Meta-analysis was applied to calculate the pooled odds ratio (OR) and 95%CI. Results A total of 22 publications were included. The cumulative cases and controls were 2 312 and 1 931, respectively. The OR values of different risk factors were as follows:age>60 years (OR=1.45, 95%CI:1.02-2.08) , underlying disease(OR=2.10, 95%CI:1.48-2.96), hypoproteinemia (OR=3.17, 95%CI: 1.57-6.38), hormone therapy (OR=3.94, 95%CI: 1.70-9.13), combined antibiotics (OR=4.77, 95%CI: 2.74-8.29), venous catheter insertion (OR=3.44, 95%CI: 1.59-7.42), tracheotomy(OR=3.22, 95%CI:1.43-7.25), mechanical ventilation(OR=1.88, 95%CI:1.44-2.44), indwelling catheter (OR=2.28, 95%CI: 1.06-4.90) and nasogastric intubation (OR=1.75, 95%CI: 1.10-2.78) . Conclusions The risk factors influencing hospital acquired MRSA infection in China are antibiotic combinations, invasive procedures, underlying disease, age>60 years, hypoproteinemia, hormone therapy and so on.
    • 马伽; 朱卫民
    • 摘要: Methicillin-resistant Staphylococcus aureus ( MRSA ) infection has become a challenge of the infection control in hospital. Due to the high toxicity and dispense of traditional drugs like vancomycin, teicoplanin, it becomes a trend to develop new agents such as daptomycin, tedizolid and dalbavancin. These novel drugs for the treatment of MRSA are reviewed in this article, so as to provide reference for clinical treatment.%耐甲氧西林金黄色葡萄球菌(MRSA)感染是现今医院感染控制的一大难题,目前临床常用治疗药物如万古霉素、替考拉宁存在毒性大、费用高等缺点,因此开发新型抗菌药物及治疗手段成为新的趋势,目前已有研究证实达托霉素、特地唑胺和达巴万星等药物可能具有一定的效果。本文对MRSA治疗的新型药物进行综述,以期为临床治疗提供参考。
    • 李影; 周敏娟; 陈良安
    • 摘要: 金黄色葡萄球菌尤其是耐甲氧西林金黄色葡萄球菌的感染日益增多,对人类健康造成巨大威胁.传统检测方法存在局限性,本文从分子生物学和免疫学方法两方面对目前金黄色葡萄球菌检测方法的进展进行综述,分析比较了各类方法的优缺点.%Staphylococcus aureus,especially methicillin-resistant Staphylococcus aureus infection is increasing,which becomes a great threat to human health.There are some limitations of the traditional detection methods.We used the methods of molecular biology and immunology for detection of Staphylococcus aureus,and analyzed the advantages and disadvantages of these two new methods.
    • 史华英; 李青栋; 万献尧
    • 摘要: 目的:探究红霉素对生物膜的破坏作用及红霉素对密度感知信号(QS)系统相关因子的影响。方法检测红霉素对 MRSA 菌株的最低杀菌浓度(MBC)。构建生物膜模型,24 h 予红霉素干预后6、12、24、48、72 h 及7 d 时检测生物膜,并取菌液上清液及大鼠血清检测自分泌诱导肽(AIP)。结果红霉素对 MRSA 的 MBC 为256 g/L。予红霉素或胰蛋白胨大豆肉汤培养基(TSB)后生物膜先减少后增加,干预后12、24、48 h 实验组生物膜量(1.348、1.236、1.667)明显少于对照组(1.789、1.712、2.349),P <0.05。红霉素直接作用于成熟生物膜,使后者逐渐减少乃至完全消散。细菌接种后不同时间予红霉素干预,只有3 h 之内干预可有效杀菌,且无生物膜形成。自分泌诱导肽(AIP)的发展趋势相似于并且早于生物膜的发展趋势。予红霉素或 TSB 干预后6、24、48 h 实验组 AIP (0.8915、0.8539、0.7924)明显少于对照组(1.0237、1.0616、1.0347),P <0.05。结论未形成生物膜时予红霉素干预可有效杀菌;生物膜形成后,红霉素可破坏已形成的生物膜。 AIP 是促进生物膜形成的重要因素。红霉素对 AIP 的合成分泌有一定的抑制作用。%Objective To investigate the destructive effects of erythromycin on biofilm of MRSA and find the effect of erythromycin on QS related factors.Methods Tested the MBC of erythromycin on MRSA.Established the model of biofilm.Erythromycin was added into the medium when bacteria were inoculated for 24 h.Tested the biofilm and collected the supernatant or serum of rat at 6, 12, 24, 48, 72 h and 7 d after adding erythromycin to detect the concentration of autoinducing peptides (AIP).Results The MBC of the erythromycin on standard strains of MRSA was 256 g/L.There is a decreasing tendency of biofilm in a short time after adding erythromycin or TSB and then gradually increase until to a steady state.Biofilm of experimental group(1.348, 1.236, 1.667)were significantly less than the control group(1.789, 1.712, 2.349,P <0.05) at 12, 24, 48 h.Adding erythromycin to the mature biofilm, there was a significant decrease of biofilm.Adding erythromycin within 3 hours after inoculating bacteria, there was no bacterial growth or biofilm formation.The development trend of AIP was similar with biofilm and AIP happened earlier than biofilm.With the intervention of erythromycin, AIP of experimental group ( 0.891 5, 0.853 9, 0.792 4)were significantly less than the control group(1.023 7, 1.061 6, 1.034 7,P <0.05)at 6, 24, 48 h. Conclusion Adding erythromycin timely before biofilm formation, then bacteria were killed effectively.Erythromycin was able to destroy biofilm.Biofilm was inhibited by AIP obviously.To some extent, erythromycin can inhibit the synthesis or secretion of AIP.
    • 袁莉莉; 李光辉
    • 摘要: Methicillin-resistant Staphylococcus aureus ( MRSA) is a common clinic pathogen for nosocomial infections, such as pneumonia, bloodstream infection, endocarditis, skin soft-tissue infection, and osteoarticular infection, which brings giant challenge for clinic treatment.Vancomycin remains an acceptable treatment option, but it needs to be adjusted by pharmacokinetic/pharmacodynamic ( PK/PD ) parameters.Lipoglycopeptides show excellent antimicrobial activity in vitro, but their long half-lives and complex PKs may preclude these agents being used in critically ill patients.Anti-MRSA cephalosporins were reported to be associated with the emergence of its antimicrobial resistance, so clinicians should be cautious when employing these kinds of antibiotics in clinical practice.So far, only linezolid has been proved with better performance than vancomycin for the treatment of hospital acquired pneumonia due to MRSA. Tedizolid, which is also categorized as Oxazolidinone, has higher bioavailability with lower rate of adverse events, but more investigation and validation are still needed for clinic application.Daptomycin displays similar performance with vancomycin on bloodstream infection due to MRSA, so it is recommended as the main drug for the treatment of MRSA associated bloodstream infection.Others such as quinupristin/dalfopristin and tigecycline are all lack of clinical evidence on the treatment of MRSA associated severe infections, so they are only considered when other anti-MRSA drugs showing inferior clinical effects. Rifampicin, Gentamicin, Fosfomycin, Sulfamethoxazole-Trimethoprim and other drugs may be administered for combination therapy, but clinical evidence is still lacking.%甲氧西林耐药金黄色葡萄球菌( MRSA)是医院感染常见的致病菌,可导致肺炎、血流感染、感染性心内膜炎、皮肤软组织感染、骨关节感染等感染性疾病,给临床治疗带来巨大的挑战。万古霉素依然是抗MRSA感染的经典用药,但临床使用时需要通过药代动力学/药效动力学( PK/PD )调整治疗方案。在体外试验中,脂糖肽类抗生素表现出良好的抗菌活性,但其长半衰期和复杂的PK/PD参数限制了在重症患者中的应用。抗MRSA的头孢菌素类药物的耐药和使用情况存在相关性,临床应慎用。目前,除利奈唑胺在治疗MRSA感染所致医院获得性肺炎时的疗效优于万古霉素外,其他抗菌药物在治疗MRSA感染时均未显示出优于万古霉素的疗效。同属恶唑烷酮类的泰地唑胺生物利用度更高,不良反应发生率更低,但其临床应用仍有待更多研究验证。在MRSA所致的血流感染中,达托霉素的疗效与万古霉素相近,因此推荐为抗MRSA血流感染的一线用药之一。其他如奎奴普丁/达福普汀和替加环素等药物在用于治疗MRSA所致的重症感染方面缺乏研究依据,仅在其他抗MRSA药物无法取得临床疗效时被考虑。利福平、庆大霉素、磷霉素、磺胺甲噁唑-甲氧苄啶等药物可能存在联合治疗的价值,但仍缺乏循证学依据。
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