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汶川地震遇难者临床分离株的抗菌药敏性

Antimicrobial susceptibility of clinical isolates from earthquake victims in Wenchuan.

作者信息

Kang M, Xie Y, Mintao C, Chen Z, Chen H, Fan H, Chen W, Guo X

机构信息

Division of Clinical Microbiology, Department of Laboratory Medicine, Sichuan University, Chengdu, China.

出版信息

Clin Microbiol Infect. 2009 Jan;15(1):87-92. doi: 10.1111/j.1469-0691.2008.02129.x.

Abstract

On 12 May 2008, an earthquake measuring 8.0 on the Richter scale struck Wenchuan County, Sichuan, China. Between 12 May and 11 June, 1823 victims were hospitalized in West China Hospital. These patients were severely injured, and most of their wounds were contaminated. Here, the results of bacteriological identification and antibiotic susceptibility testing of 725 non-duplicate isolates from earthquake victims are presented. Gram-negative bacilli were most frequently isolated (71.3%). Only 18.9% of isolates were Gram-positive bacteria; Candida spp. accounted for 9.7%, and Gram-negative cocci for 0.1%. After anaerobic culture, four Clostridium sordellii strains and one Clostridium bifermentans strain were isolated from deep wounds. Specimen culture from earthquake victims revealed a spectrum of pathogens and antibiotic susceptibilities that was different from that usually encountered in West China Hospital, especially concerning methicillin-resistant Staphylococcus aureus, extended-spectrum beta-lactamase producers, and multidrug-resistant (MDR) non-fermenting Gram-negative bacilli. The pathophysiology of the injuries in earthquake victims was different from that in the patients who were not earthquake victims. A combination of environmental bacteria with a high proportion of Gram-negative bacteria was often observed in the earthquake victims. Approximately 26% of all earthquake victims were shown to be carriers of MDR microorganisms. Therefore, appropriate microbiological assessment upon admission, and identification of patients to be put in quarantine, is of paramount importance.

摘要

2008年5月12日,中国四川省汶川县发生里氏8.0级地震。5月12日至6月11日期间,1823名受害者被送往华西医院住院治疗。这些患者伤势严重,且多数伤口受到污染。本文呈现了对725株来自地震受害者的非重复分离株进行细菌学鉴定及抗生素敏感性测试的结果。革兰氏阴性杆菌分离率最高(71.3%)。仅18.9%的分离株为革兰氏阳性菌;念珠菌属占9.7%,革兰氏阴性球菌占0.1%。厌氧培养后,从深部伤口分离出4株索氏梭菌和1株双发酵梭菌。地震受害者的标本培养显示出一系列病原体及其抗生素敏感性,与华西医院通常遇到的情况不同,尤其是耐甲氧西林金黄色葡萄球菌、产超广谱β-内酰胺酶菌以及多重耐药(MDR)非发酵革兰氏阴性杆菌。地震受害者损伤的病理生理学与非地震受害者不同。在地震受害者中经常观察到环境细菌与高比例革兰氏阴性细菌的组合。所有地震受害者中约26%被证明是MDR微生物携带者。因此,入院时进行适当的微生物学评估以及识别需要隔离的患者至关重要。

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