MDR

摘要： Introduction: The increase in cases of drug-resistant pulmonary tuberculosis, especially in endemic areas, is mainly associated with re-treatment, although resistant tubercle bacilli can be easily transmitted between all susceptible persons. Objective: The study aimed to describe pulmonary tuberculosis, risk factors and MDR in new and re-treated suspected patients attending Wad Madani Tuberculosis Center that provides service in central Sudan. Methods: Cross-sectional laboratory based study among 300 presumptive pulmonary tuberculosis patients during 2018 and 2019 was conducted. Cases were divided into new and re-treated. Mycobacterium tuberculosis DNA and rpoB gene of multi-drug resistance (MDR) were detected in sputum samples by GeneXpert assay as manufacturer instructions. Results: Out of 300 suspected participants, 34% (103/300) were diagnosed as pulmonary tuberculosis using GeneXpert method. The frequency of males, the age group from 21 to 40 and rural housing were the most with percentage reach 68% (70/103), 51% (53/103) and 58.3% (60/103) respectively. All observed symptoms were significantly associated with pulmonary tuberculosis. New cases represented 59.2% (61/103) while re-treated was 40.8% (39/103). The overall frequency of MDR patients was 9.7% (10/103) of which 50% (5/103) had relapse situation. Conclusion: It appeared that the cases of MDR pulmonary tuberculosis are on the increase compared to previous findings, recommended measures must be taken to control the spread of tuberculosis and the causes of re-treatment and relapse must be studied.

摘要： 欧盟发布新版医疗器械法规MDR(EU 2017/745),用于替代旧版医疗器械指令MDD(93/42/EEC)和有源植入医疗器械指令AIMDD(90/385/EEC)。由于受到新冠肺炎疫情影响,原定于2020年5月26日施行MDR法规被延缓到今年5月26日正式施行。欧盟将医疗器械分为医疗器械(MD)和体外诊断器械(IVD)两大类,目前受MDR管辖的仅限于医疗器械,针对体外诊断产品的相应新规为IVDR(EU 2017/746),将于2022年月26日强制执行。

摘要： 欧盟发布新版医疗器械法规MDR(EU 2017/745),用于替代旧版医疗器械指令MDD(93/42/EEC)和有源植入医疗器械指令AIMDD(90/385/EEC)。由于受到新冠肺炎疫情影响,原定于2020年5月26日施行MDR法规被延缓到2021年5月26日正式施行。新版医疗器械法规提高了对医疗器械行业的约束力。MDR施行后,可立即在欧盟成员国家和地区执行,无需经各个国家和地区将法规转化成当地法律法规后再进行实施。

摘要： Objective: Almost all year round occurrence of typhoid fever remains a major public health issue in Bangladesh. In recent years, there has been a significant rise in the prevalence of multi-drug resistance Salmonella typhi in Dhaka city. The major objective of this study was to observe the prevalence of multi-drug and Extended drug-resistant patterns of typhoidal Salmonella typhi among the patients attending a tertiary medical center by conventional culture and serologic test. Materials and Methods: Blood was collected by syringe and equally divided between aerobic & anaerobic BacT Alert bottle, 10 mL for paediatrics. Post isolation Salmonella strains were identified and were tested for antibiotic resistance. Results: A total of 600 blood samples of typhoid suspected patients were tested, where 32.5% came out positive, which were identified as Salmonella typhi. These isolates were susceptible to carbapenem drugs but highly resistant to Fluoroquinolones and Aminoglycosides antibiotics. Discussion: It was seen that 73.23% of isolates among male patients were extensively drug-resistant (XDR) meaning that isolates were sensitive against only one or two antibiotics while in the female it was 58.46%. Isolates from Female patients showed higher multi-drug resistant (MDR) (26.15%) isolates resistance to multiple antibiotics in comparison to isolates from the male (16.54%). 87.19% of the strains showed high drug resistance (XDR and MDR). Conclusion: The emergence of XDR and MDR strains of S. typhi in recent years is becoming a significant threat. Although no PAN-Drug resistance (resistant against all tested drugs) was observed in the current study, a high level of XDR and MDR isolates are indicating that the scenario might take place sooner than later.

摘要： The increasing incidence of multidrug-resistant Klebsiella pneumoniae strains has become a serious global healthcare problem. Additionally, the carriage of both extended-spectrum ß-lactamase and carbapenemase genes on plasmid and genomic DNA in K. pneumoniae clinical isolates has not been documented in Kenya. This study aimed to assess the presence of extended spectrum β-lactamase (ESBL) and carbapenemase genes on genomic and plasmid DNA in K. pneumoniae, and classify these super-bug clinical isolates based on their phylogenetic patterns. The identification of Klebsiella-like clinical isolates (n = 20) collected from Kenyatta National Hospital in Nairobi was performed using API 20E Kit. Screening and confirmation for ESBL and carbapenemase phenotypes were conducted using Kirby-Bauer disk diffusion susceptibility test protocol. Conventional PCR technique was used to characterize ESBL and carbapenemase resistant genes on both genomic and plasmid DNA. Subsequently, 16S rRNA gene amplification and sequencing were performed. The 16S rRNA gene contiguous sequences of the bacterial isolates were analyzed using the ChromasPro. The gene sequence was compared with the sequences in GenBank database, using the BLAST program of NCBI to obtain the nearest phylogenetic neighbours from the databases. Then, the sequences of MDR K. pneumoniae and its relatives were aligned using ClustalW. The evolutionary history was inferred by using the maximum likelihood algorithm in MEGA MX. The phenotypic data of antibiotic susceptibility testing revealed that 2/20 (10%) clinical isolates were resistant both to imipenem and meropenem and producers of carbapenemase. These isolates were carbapenemase producers but not extended β-lactamases. However, 3/20 (15%) isolates that co-harboured blaNDM-1, blaIMP, blaTEM, and bla-OXA were identified during genotypic analysis. The positive control used separately yielded the expected band sizes for blaIMP (275 bp), blaOXA-48 (438 bp), and BlaKPC (798). The phylogenetic analysis showed the dual ESBL and carbapenemase producing Klebsiella pneumoniae could be classified as K. pneumoniae strain DSM 30104 and K. pneumonia subsp. pneumoniae strain GMH1080. This study confirmed the co-existence of ESBL and carbapenemase genes in Klebsiella pneumoniae on both bacterial genomic and Plasmid DNA, and demonstrated that the isolates are evolutionarily distinct. These findings raise a concern about the genotypic diversity of antibiotic resistance genes in bacterial isolates and their location. We, therefore, recommend an alternative management approach to combat these MDR bacterial isolates as well as frequent molecular surveillance programs to support antimicrobial stewardship.

摘要： 目的:研究分析糖尿病足患者发生多重耐药(multidrug resistant,MDR)感染的病原菌、耐药性及其危险因素.方法:选择2015年1月~2016年12月大连市第三人民医院内分泌科、骨科收治的糖尿病足感染患者168例作为研究对象,收集患者一般资料及治疗相关因素,对患者创面分泌物进行病原菌检测及药敏试验,分析导致MDR发生危险因素.结果:入组168例感染患者中多重耐药菌感染92例,多重耐药菌感染率为54.76%,采集患者创面分泌物标本进行实验室病原菌培养及鉴定,共获得病原菌129株,主要包括革兰氏阴性菌63株(48.84%)及革兰氏阳性菌42株(32.56%),主要耐药菌包括3种革兰氏阴性菌:铜绿假单胞菌(13.18%)、大肠埃希菌(11.63%)及肠杆菌属(14.73%),1种革兰氏阳性菌:金黄色葡萄球菌(11.63%).药敏试验检测显示,主要革兰氏阴性菌对氨苄西林、左氧氟沙星及头孢菌素类等药物耐药性高,对美罗培南、阿米卡星等药物较为敏感;主要革兰氏阳性菌对左氧氟沙星、万古霉素等药物敏感性高,对青霉素、氨苄西林、苯唑西林等药物耐药性高.糖尿病病程超过10年、因糖尿病足感染住院≥2次/年、溃疡≥3处、既往抗菌药物使用史、第三代头孢菌素使用史、存在相同部位感染、合并骨髓炎、神经缺血性溃疡是糖尿病足患者出现MDR感染的独立危险因素.结论:糖尿病足患者出现MDR感染与多种因素相关,开始治疗前应注意进行病原菌检测及药敏试验,根据检测结果选择敏感抗生素治疗可提高治疗的有效性和针对性,避免盲目用药.

摘要： 本发明公开了一种Mdr1a/1b双基因敲除的方法，并成功构建了Mdr1a/1b基因敲除大鼠模型，为研究P‑糖蛋白(P‑glycoprotein,P‑gp)的功能例如介导药物的转运提供了新的动物模型。本发明首次利用CRISPR/Cas9技术进行大鼠P‑gp的基因敲除，通过Mdr1a和Mdr1b靶点设计、sgRNA体外合成与转录、假孕鼠的准备、受精卵体外显微注射与胚胎移植等过程得到了F0代嵌合鼠，再经过两代繁殖筛选，最终得到了Mdr1a/1b双基因敲除的纯合子大鼠。经T7EI核酸内切酶验证，在所得到的基因敲除大鼠中没有出现脱靶现象。

摘要： 本发明属于有机化学领域，具体涉及一类具有MDR逆转活性的千金子二萜衍生物及其应用。本发明从大戟植物千金子中提取得到新的千金子二萜衍生物，并对这些化合物进行结构改造，设计并合成了系列化合物，在MCF‑7/ADR细胞内逆转活性优于维拉帕米。其中，化合物17的逆转倍数高达460.32。

摘要： 本发明涉及基于短信和邮件解析的邮件自动发送及MDRS显示系统，属于民航信息服务技术领域，包括客户端和服务端。本发明所述基于短信解析和邮件解析的邮件自动发送及MDRS显示系统是基于推送的短信内容，以及数据推送或自动数据采集与短信解析，邮件解析技术，能够向国际航司、空管用户提供可读性高且方便查询的MDRS数据展示，实施效果好，应用价值高。

摘要： 本发明公开了一种逆转MDR效应的纳米复合载药体系及其制备方法与应用，由油酸包覆的NaY(M)F4:Yb/Ln，与油酸连接的TPGS以及通过疏水作用吸附在油酸与TPGS形成的疏水层中的疏水性治疗药物构成；不仅可满足载药需求，由于含有NaY(M)F4:Yb/Ln，具有很好的生物组织窗口内发光的荧光特性，实现优异的体内标记成像，达到体内示踪的目的；此外，所含有的TPGS为双亲性物质，极大改善了载药体系的生物相容性，更有利于细胞标记成像，同时TPGS可作为耐药癌细胞上过量表达的P‑gp蛋白的抑制剂，有效逆转MDR效应，因此在生物医药领域，特别是抗肿瘤药物制备中具有广大的应用前景。

摘要： 提供了靶向细胞外排泵MDR1的抗体。还提供了包括或编码此类抗体的药物组合物、核酸、重组表达载体、细胞和试剂盒。还公开了使用所述抗体检测细胞例如肿瘤细胞中的MDR1表达的存在或不存在、MDR1表达水平和/或抑制MDR1功能的方法。此外，提供了与MDR1和肿瘤相关抗原结合的多特异性抗体。还提供了用于治疗受试者癌症的方法，所述方法包括向所述受试者施用如本文公开的抗MDR1抗体或靶向MDR1和肿瘤相关抗原二者的多特异性抗体。

摘要： 本发明公开了一种MDRS重要天气发生概率预报评定方法，首先确定评定天气类型，包括关于对雷暴(对流)、低云(云高或垂直能见度＜60米且云量在BKN及以上的云组)、低能见度(＜800米)、降雪和冻降水、中度及以上降水中的一种或多种天气类型进行评定；S1：对预报作“空报、漏报、命中、不参评”定性判定、S2：设定起评阈值、S3：获取被评定日的机场天气报告、雷达回波强度和观测簿纪要栏信息、S4：评定出被评定日天气的偏差量D，并查出命中得分；S5：由命中得分和概率权重得到预报成功率。本方法能够促进MDRS预报产品更好地服务于航空运行,提升航空运行品质,同时客观评定复杂天气条件下的预报质量和预报员能力水平，加强质量控制和人员资质能力建设。

摘要： 本实用新型公开一种基于MDRS系统的无线耦合型室外机，属于无线通信技术领域，包括室外机本体，所述室外机本体的顶部与底部皆设置有散热片，所述室外机本体的一侧设置有提手，所述室外机本体的一端设置有接线头。本实用新型室外机本体端部的上防护壳、下防护壳配合挡板组成的防护机构的设置，能够对接线头处的连接线进行防护，避免外界环境的干扰，确保装置的使用稳定性，且利用下防护壳底部的理线槽能够对线路进行限位，确保连接线的整洁，实用性更高，室外机本体外侧隐藏槽的设置，通过隐藏槽内部铰接的固定板，能够在装置固定时直接利用固定板进行安装固定，使得装置的固定更加方便。

摘要： 本实用新型公开了一种MDR接口伺服专用连接器直接接线分线模块，它涉及连接器技术领域。它包括上部外壳、下部外壳、标准MDR连接器、快插式连接端子、线路板和紧固螺丝，上部外壳与下部外壳之间安装有标准MDR连接器、线路板、快插式连接端子，快插式连接端子固定在线路板上，快插式连接端子与标准MDR连接器通过引线焊接相连，上部外壳与下部外壳通过紧固螺丝固定连接；所述的线路板上设置有对应信号的指示灯灯珠，上部外壳上设置有指示灯外壳显示区，上部外壳上还设置有信号标识。本实用新型操作方便，接线快捷，灵活性高，实用性强，应用前景广阔。

摘要： 本实用新型公开了一种MDR接口连接器直接接线型分线端子模块，它涉及连接器技术领域。它包括上部外壳、快插式连接端子、线路板、标准MDR连接器和下部外壳，上部外壳与下部外壳组成的壳体中安装有快插式连接端子、线路板、标准MDR连接器，线路板上固定有多个快插式连接端子，快插式连接端子嵌入式安装在上部外壳的表面，上部外壳的壳体上配有与快插式连接端子匹配的标识，所述的线路板与标准MDR连接器通过引线焊接，快插式连接端子与标准MDR连接器通过线路板内部电路一对一连接。本实用新型操作方便，可直接根据实际需求连接接线使用，接线更快捷，无需提前制作专用电缆，提高接线效率，应用前景广阔。

摘要： 本实用新型涉及用于带防护的MDR连接器组件，包括连接器主体，所述连接器主体包括插芯和设置在插芯内的端子，所述插芯通过金属连接片与线束的线芯相连接，所述金属连接片与线束的连接处还设置有固定夹，所述固定夹外依次罩设有内模体和外模体，所述插芯上还插设有安装螺栓，所述安装螺栓具有螺纹结构的一端延伸在端子的两侧，所述外模体上还设置有与安装螺栓相匹配的通孔；在线束与连接器主体部分焊接完成后，在将内模体注塑至固定夹和线束外以增加防水性及结构稳定性；然后内模外再包覆外模，进一步加强结构稳定性，保证多次拉拔过程中线束受到影响较小。