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类白喉杆菌——重要的医院病原体。

Diphtheroids-Important Nosocomial Pathogens.

作者信息

Chandran Reshmi, Puthukkichal Dinju Raj, Suman Ethel, Mangalore Shashidhar Kotian

机构信息

Ex Postgraduate Student, Department of Microbiology, Kasturba Medical College, Manipal University , Mangalore, Karnataka, India .

Associate Professor, Department of Microbiology, Kasturba Medical College, Manipal University , Mangalore, Karnataka, India .

出版信息

J Clin Diagn Res. 2016 Dec;10(12):DC28-DC31. doi: 10.7860/JCDR/2016/19098.9043. Epub 2016 Dec 1.

Abstract

INTRODUCTION

Diphtheroids are defined as aerobic, non-sporulating, pleomorphic Gram-positive bacilli which are more uniformly stained than , lack the metachromatic granules and are arranged in a palisade manner. They are usually commensals of the skin and mucous membranes. They differ from in biochemical rea-ctions as well as in toxin production. Since, they are usually found as commensals on the skin, they are often considered as mere contaminants when isolated from clinical samples. However, there are increasing reports of these organisms being associated with various infections. Hence, we felt the need to study the common species associated with infections and know the properties of these organisms which are otherwise considered as mere laboratory contaminants.

AIM

To identify the various species of diphtheroids isolated as pure growth from clinical specimens whose Gram's smear revealed numerous inflammatory cells with Gram positive bacilli and had clinical evidence.

MATERIALS AND METHODS

A total of 100 isolates of Gram-positive bacilli from 16,242 clinical samples received in the Microbiology Department of Kasturba Medical College were considered for this study from Dec 2013-Dec 2014. Gram-positive bacilli which were seen in the smear along with pus cells, isolated as pure growth and reported as " spp having clinical significance" were taken for this study while those which were reported as 'Probable skin contaminants' were excluded from this study. Species identification of Gram-positive bacilli was done by biochemical reactions. Antibiotic susceptibility test was done by Kirby-Bauer disk diffusion method. Biofilm production was done by the microtitre plate method of O'Toole and Kolter and statistical analysis was done by using proportion test and Chi-square test.

RESULTS

Various species of diphtheroids were isolated from different clinical specimens. isolated from catheter tips, sputum, tracheostomy secretions and wound infections were highly resistant to many antibiotics while isolates from blood namely and were nearly sensitive to most of them. It was also interesting to note that there was an increased rate of biofilm production in these isolates.

CONCLUSION

may survive in the form of biofilms in hospitals and cause multidrug resistant infections. Hence, we need to judiciously identify these organisms, find their antimicrobial susceptibility, treat them and thus prevent infections in hospitals.

摘要

引言

类白喉杆菌被定义为需氧、无芽孢、多形性的革兰氏阳性杆菌,其染色比[此处原文缺失相关对比对象]更均匀,缺乏异染颗粒,呈栅栏状排列。它们通常是皮肤和黏膜的共生菌。它们在生化反应以及毒素产生方面与[此处原文缺失相关对比对象]不同。由于它们通常在皮肤上作为共生菌被发现,所以从临床样本中分离出来时,它们常常仅被视为污染物。然而,越来越多的报道表明这些微生物与各种感染有关。因此,我们觉得有必要研究与感染相关的常见菌种,并了解这些通常被视为仅仅是实验室污染物的微生物的特性。

目的

从革兰氏涂片显示有大量炎性细胞和革兰氏阳性杆菌且有临床证据的临床标本中,鉴定分离为纯培养物的类白喉杆菌的各种菌种。

材料与方法

2013年12月至2014年12月,从卡斯图尔巴医学院微生物学系接收的16242份临床样本中,共选取了100株革兰氏阳性杆菌进行本研究。涂片上与脓细胞一起可见的革兰氏阳性杆菌,若分离为纯培养物并报告为“具有临床意义的[此处原文缺失相关菌种名称]菌种”则纳入本研究,而那些报告为“可能的皮肤污染物”的则被排除在本研究之外。革兰氏阳性杆菌的菌种鉴定通过生化反应进行。抗生素敏感性试验采用 Kirby-Bauer 纸片扩散法。生物膜形成通过 O'Toole 和 Kolter 的微量滴定板法进行,统计分析采用比例检验和卡方检验。

结果

从不同临床标本中分离出了各种类白喉杆菌菌种。从导管尖端、痰液、气管切开术分泌物和伤口感染中分离出的[此处原文缺失相关菌种名称]对多种抗生素具有高度耐药性,而从血液中分离出的[此处原文缺失相关菌种名称]和[此处原文缺失相关菌种名称]对大多数抗生素几乎敏感。同样有趣的是,这些分离株中生物膜形成率有所增加。

结论

[此处原文缺失相关菌种名称]可能在医院以生物膜的形式存活并引起多重耐药感染。因此,我们需要明智地鉴定这些微生物,了解它们的抗菌药敏情况,对其进行治疗,从而预防医院感染。

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