Drug susceptibility

药物敏感性
  • 文章类型: Journal Article
    迫切需要新型抗疟药来对抗对现有药物日益增长的耐药性。咪唑哌嗪加那普利胺是一种有前途的候选药物,但是实验室菌株的易感性降低与恶性疟原虫环胺抗性基因座(PfCARL)的多态性有关,乙酰辅酶A转运蛋白(PfACT),和UDP-半乳糖转运蛋白(PfUGT)。描述非洲寄生虫引起疾病的特征,我们评估了2017年至2023年在乌干达收集的750株恶性疟原虫分离株对加那普拉特的体外药物敏感性。使用72小时SYBRGreen生长抑制测定法评估药物敏感性。ganaplacide的中位IC50为13.8nM,但一些分离株的IC50高达31倍(31/750,IC50>100nM)。为了评估基因型-表型关联,我们使用分子倒置探针和双脱氧测序方法对分离株中可能介导改变的加纳帕胺敏感性的基因进行了测序。PfCARL是高度多态的,在>5%的分离株中存在8个突变。先前没有在具有体外药物压力的实验室菌株中选择过这八个突变中的任何一个,并且没有发现与加纳拉米德敏感性降低显着相关。在≤5%的分离株中发现PfACT和PfUGT突变,除了PfACT中的两个常见(>20%)突变外;PfACT中的一个突变(I140V)与易感性的适度降低相关.总的来说,乌干达恶性疟原虫分离株大多对甘纳帕胺高度敏感。已知的抗性介质是多态的,但是以前选择的体外药物压力突变没有看到,乌干达分离株中鉴定出的突变通常与甘纳帕特胺敏感性降低无关。
    Novel antimalarials are urgently needed to combat rising resistance to available drugs. The imidazolopiperazine ganaplacide is a promising drug candidate, but decreased susceptibility of laboratory strains has been linked to polymorphisms in the Plasmodium falciparum cyclic amine resistance locus (PfCARL), acetyl-CoA transporter (PfACT), and UDP-galactose transporter (PfUGT). To characterize parasites causing disease in Africa, we assessed ex vivo drug susceptibilities to ganaplacide in 750 P. falciparum isolates collected in Uganda from 2017 to 2023. Drug susceptibilities were assessed using a 72-hour SYBR Green growth inhibition assay. The median IC50 for ganaplacide was 13.8 nM, but some isolates had up to 31-fold higher IC50s (31/750 with IC50 > 100 nM). To assess genotype-phenotype associations, we sequenced genes potentially mediating altered ganaplacide susceptibility in the isolates using molecular inversion probe and dideoxy sequencing methods. PfCARL was highly polymorphic, with eight mutations present in >5% of isolates. None of these eight mutations had previously been selected in laboratory strains with in vitro drug pressure and none were found to be significantly associated with decreased ganaplacide susceptibility. Mutations in PfACT and PfUGT were found in ≤5% of isolates, except for two frequent (>20%) mutations in PfACT; one mutation in PfACT (I140V) was associated with a modest decrease in susceptibility. Overall, Ugandan P. falciparum isolates were mostly highly susceptible to ganaplacide. Known resistance mediators were polymorphic, but mutations previously selected with in vitro drug pressure were not seen, and mutations identified in the Ugandan isolates were generally not associated with decreased ganaplacide susceptibility.
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  • 文章类型: Journal Article
    FDA最近批准的cabotegravir已经证明了作为抗逆转录病毒药物治疗和预防艾滋病毒的有效性,成为阻止美国流行的重要工具。然而,cabotegravir的有效性可能会受到特定整合酶天然多态性的影响,包括T97A,L74M,M50I,S119P,和E157Q,特别是与原发性耐药突变G140S和Q148H偶联时。Cabotegravir最近批准作为暴露前预防可能会增加服用Cabotegravir的人数,which,同时,可能会增加流行病学影响的数量。在这种情况下,抗性突变,自然多态性,缺乏药物敏感性研究普遍存在,必须全面调查与使用cabotegravir有关的问题。我们使用基于分子和细胞的测定法来评估T218I和T218S在主要抗性突变G140S/Q148H对感染性的影响。一体化,以及对Cabotegravir的抗药性.我们的研究结果表明,T218I和T218S,单独或与G140S/Q148H组合,没有显著影响传染性,一体化,或对Cabotegravir的抗性。值得注意的是,这些多态性对其他广泛使用的整合酶抑制剂也表现出中性,即Raltegravir,elvitegravir,还有dolutegravir.因此,我们的研究表明,T218I和T218S天然多态性不太可能破坏cabotegravir作为治疗和暴露前预防策略的有效性.
    The recently Food and Drug Administration (FDA)-approved cabotegravir (CAB) has demonstrated efficacy as an antiretroviral agent for HIV treatment and prevention, becoming an important tool to stop the epidemic in the United States of America (USA). However, the effectiveness of CAB can be compromised by the presence of specific integrase natural polymorphisms, including T97A, L74M, M50I, S119P, and E157Q, particularly when coupled with the primary drug-resistance mutations G140S and Q148H. CAB\'s recent approval as a pre-exposure prophylaxis (PrEP) may increase the number of individuals taking CAB, which, at the same time, could increase the number of epidemiological implications. In this context, where resistance mutations, natural polymorphisms, and the lack of drug-susceptibility studies prevail, it becomes imperative to comprehensively investigate concerns related to the use of CAB. We used molecular and cell-based assays to assess the impact of T218I and T218S in the context of major resistance mutations G140S/Q148H on infectivity, integration, and resistance to CAB. Our findings revealed that T218I and T218S, either individually or in combination with G140S/Q148H, did not significantly affect infectivity, integration, or resistance to CAB. Notably, these polymorphisms also exhibited neutrality concerning other widely used integrase inhibitors, namely raltegravir, elvitegravir, and dolutegravir. Thus, our study suggests that the T218I and T218S natural polymorphisms are unlikely to undermine the effectiveness of CAB as a treatment and PrEP strategy.
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  • 文章类型: Journal Article
    OBJECT: To investigate the association of R-loop binding proteins with prognosis and chemotherapy efficacy in lung adenocarcinoma. METHODS: The data related to R-loop regulatory genes were obtained from literature of R-loop proteomics and relevant databases. We used 403 lung adenocarcinoma cases in the Cancer Genome Atlas as training set, and two datasets GSE14814 and GSE31210 in Gene Expression Omnibus as validation sets. The weighted gene co-expression network analysis (WGCNA) was employed to identify R-loop genes with a significant impact on the clinical phenotype of lung adenocarcinoma. Least absolute shrinkage and selection operator (LASSO) regression was utilized to eliminate genes exhibiting multicollinearity. A multivariate Cox proportional hazards model was employed to scrutinize clinical variables and R-loop characteristic genes that exert independent prognostic effects on patient survival. Subsequently, a risk score model was constructed. The predictive capacity of this model for the prognosis of patients was analyzed and validated. Additionally, the performance of risk model on the anti-neoplastic drug sensitivity was assessed. The mutations of R-loop gene were analyzed by maftools. The effect of PLEC expression on anti-tumor drug sensitivity was tested on non-small cell lung adenocarcinoma H1299 and A549 cells in vitro. RESULTS: A collection of 1551 R-loop genes were obtained, and 78 genes exhibited significant effects on the clinical phenotype shown on WGCNA. The LASSO regression analysis retained 14 R-loop genes. A multivariate Cox analysis further identified 3 R-loop genes (HEXIM1, GLI2, PLEC) and a clinical variable (tumor grading) that were associated with patient prognosis. Risk prediction model was established according to the regression coefficients of each parameter. Kaplan-Meier survival analysis showed that the prognosis of high-risk group patients was significantly worse than that of low-risk group (P<0.01). The time-dependent ROC curve showed that the risk model had good predictive ability in both training and validation sets. Predictive analyses of anti-neoplastic drug sensitivity indicated a diminished responsiveness to both chemotherapy and targeted treatment drugs among high-risk patients. The expression of PLEC was strongly correlated with the sensitivity of gefitinib, a classical EGFR inhibitor. CONCLUSIONS: R-loop binding proteins have been identified as significant determinants in the prognosis and therapeutic strategies for lung adenocarcinoma. The results indicates that therapeutic interventions targeting these specific R-loop binding proteins might contribute to a better survival in lung cancer patients.
    目的: 研究R环结合蛋白对肺腺癌预后与抗肿瘤药物敏感性的影响,为R环在肿瘤生物学中的调控机制研究与临床决策提供科学依据。方法: 从R环结合蛋白质组学研究文献与相关数据库中获取R环结合基因,以癌症基因组图谱数据库中的403例肺腺癌病例的数据作为训练集,以基因表达综合数据库中GSE14814与GSE31210两个数据集的数据作为验证集,采用加权基因共表达网络分析(WGCNA)、最小绝对收缩和选择算子(LASSO)、多因素Cox比例风险模型逐步筛选具有独立预后作用的临床变量与R环特征基因,Maftools分析R环特征基因的突变特征,构建基于R环特征基因的风险评分和列线图模型,验证该模型对高低分险亚型患者预后预测的能力及其对抗肿瘤药物治疗敏感性的影响。最后采用实验验证R环特征基因表达对抗肿瘤药物敏感性的影响。结果: 收集整理得到R环基因1551条,WGCNA筛选得到显著影响临床表型的R环基因78条,LASSO回归保留R环基因14条,多因素Cox筛选到三个与患者预后密切相关的R环基因(HEXIM1、GLI2、PLEC)和一个临床变量(肿瘤分级),根据各参数的回归系数构建预后模型与列线图模型。Kaplan-Meier生存分析显示,高风险组患者预后明显差于低风险组(P<0.01)。时间依赖受试者工作特征曲线表明,该模型在训练集和验证集列队中均具有较好的预测能力。抗肿瘤药物敏感性预测结果表明,高风险组患者对肺癌化疗与靶向治疗药物的敏感性更低。PLEC基因沉默实验表明抑制PLEC的表达能增强表皮生长因子受体野生型非小细胞肺腺癌细胞株对吉非替尼的敏感性。结论: R环结合蛋白是肺腺癌预后的风险因素,联合临床信息和R环特征基因可以有效预测肺腺癌预后,靶向上述R环特征基因可能对提高患者存活率具有重要意义。.
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  • 文章类型: Journal Article
    本研究探讨了昼夜节律紊乱(CRD)与肝细胞癌(HCC)风险增加之间关联的分子和生物学机制。
    CRD与HCC风险增加有关,但是这种关联背后的分子和生物学机制是有限的。目的本研究构建并验证CRD相关基因模型作为HCC的独立预后因子,深入了解CRD与HCC风险增加相关的分子机制,并确定免疫治疗和抗癌药物疗效的潜在指标。这有助于为HCC患者的个性化治疗策略提供重要线索。
    从分子特征数据库(MSigDB)获得与来自肝细胞癌细胞数据库(HCCDB)的癌症基因组图谱(TCGA)和HCCDB18中的肿瘤样品和对照样品之间的差异表达基因(DEG)相交的与昼夜节律相关的基因集。通过单变量Cox和逐步多变量分析建立CRD相关基因模型。免疫检查点阻断(ICB)治疗和抗癌药物分析使用肿瘤免疫功能障碍和排除(TIDE)和pRophetic,分别。Seurat通过分析单细胞数据确定HCC的细胞类型,用Copykat鉴定恶性细胞。检测CRD相关基因模型中基因的mRNA水平,进行定量实时聚合酶链反应(qRT-PCR)。
    HCC组织的昼夜节律活性明显低于对照组织。随后,选择EZH2、IMPDH2、TYMS和SERPINE1构建CRD相关基因模型,这是HCC预后的独立因素。值得注意的是,与高风险HCC患者相比,低风险患者的免疫细胞浸润水平较低,TIDE评分较低,表明低风险患者可能从免疫治疗中获得更多益处.IMPDH2,TYMS和SERPINE1在恶性细胞中的表达明显高于良性上皮细胞。
    这项研究提出了一个CRD相关基因模型,以揭示CRD与癌症之间关联的依赖机制的分子观点,这为了解ICB和抗癌药物的临床前疗效提供了一个潜在的指标。
    UNASSIGNED: This study explored the molecular and biologic mechanisms underlying the association between circadian rhythm disorders (CRD) and increased risk for hepatocellular carcinoma (HCC).
    UNASSIGNED: CRD are linked to increased risk for HCC, but the molecular and biologic mechanisms underlying this association are limited.ObjectiveThe study constructed and validated a CRD related gene model as an independent prognostic factor for HCC, providing insight into the molecular mechanisms linking CRD to increased HCC risk and identifying potential indicators for the efficacy of immunotherapy and anticancer drugs. This helps provide important clues for personalized treatment strategies for HCC patients.
    UNASSIGNED: Gene sets correlated with circadian rhythm were obtained from the Molecular Signatures Database (MSigDB) to intersect with differentially expressed genes (DEGs) between tumor samples and control samples in The Cancer Genome Atlas (TCGA) and HCCDB18 from Hepatocellular Carcinoma Cell DataBase (HCCDB). The CRD related gene model was developed by univariate Cox and stepwise multivariate analysis. Immune checkpoint blockade (ICB) therapy and anticancer drugs were analyzed using the tumor immune dysfunction and exclusion (TIDE) and pRRophetic, respectively. Seurat determined the cell type of HCC by analyzing single-cell data, and malignant cells were identified using Copykat. To detect the mRNA levels of genes in the CRD related gene model, quantitative real-time polymerase chain reaction (qRT-PCR) was carried out.
    UNASSIGNED: The activity of circadian rhythm in HCC tissue was significantly lower than that in control tissue. Subsequently, EZH2, IMPDH2, TYMS and SERPINE1 were selected to construct the CRD related gene model, which was an independent factor for HCC prognosis. Notably, low-risk patients had lower levels of immune cell infiltration and lower TIDE scores compared to high-risk patients with HCC, indicating that patients with a low risk may derive more benefit from immunotherapy. IMPDH2, TYMS and SERPINE1 expressed significantly higher in malignant cells than in benign epithelial cells.
    UNASSIGNED: This study presents a CRD related gene model to reveal the molecular perspective of the dependent mechanism of the association between CRD and cancer, which provides a potential indicator for understanding the preclinical efficacy of ICB and anticancer drugs.
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  • 文章类型: Journal Article
    白色念珠菌(Ca),人类中一种突出的机会性真菌病原体,由于其传染性,引起了相当大的关注。在这里,我们已经鉴定和表征了CaCDAP1(Caorf19.1034),在酿酒酵母中发现的ScDAP1的同源物。CaCDAP1编码具有保守的细胞色素b5样血红素结合结构域的183个氨基酸的蛋白质。CaDAP1的缺失使Ca细胞对卡泊芬净和特比萘芬敏感。CaDAP1缺失赋予刚果红和CalcofluorWhite抗性,和对十二烷基硫酸钠的敏感性。CaDAP1的缺失导致细胞壁内几丁质含量减少50%,CaMkc1磷酸化水平下调,CaCek1磷酸化水平上调。值得注意的是,CaDAP1缺失导致Ca细胞的菌丝发育异常,并在小鼠全身感染模型中降低毒力。因此,CaDAP1成为控制细胞对抗真菌药物反应的关键调节因子,细胞壁几丁质的合成,和Ca中的毒力。
    Candida albicans (Ca), a prominent opportunistic fungal pathogen in humans, has garnered considerable attention due to its infectious properties. Herein, we have identified and characterized CaCDAP1 (Ca orf19.1034), a homolog of ScDAP1 found in Saccharomyces cerevisiae. CaCDAP1 encodes a 183-amino acid protein with a conserved cytochrome b5-like heme-binding domain. The deletion of CaDAP1 renders Ca cells susceptible to caspofungin and terbinafine. CaDAP1 deletion confers resistance to Congo Red and Calcofluor White, and sensitivity to sodium dodecyl sulfate. The deletion of CaDAP1 results in a 50% reduction in chitin content within the cell wall, the downregulation of phosphorylation levels in CaMkc1, and the upregulation of phosphorylation levels in CaCek1. Notably, CaDAP1 deletion results in the abnormal hyphal development of Ca cells and diminishes virulence in a mouse systemic infection model. Thus, CaDAP1 emerges as a critical regulator governing cellular responses to antifungal drugs, the synthesis of cell wall chitin, and virulence in Ca.
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  • 文章类型: Letter
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  • 文章类型: Journal Article
    食管鳞状细胞癌(ESCC)是最常见的消化道恶性肿瘤之一,全球第六高的死亡率。ESCC相关数据集,GSE20347,从基因表达综合(GEO)数据库下载,进行加权基因共表达网络分析以鉴定与ESCC高度相关的基因。从癌症基因组图谱数据库获得总共91个转录组表达谱及其相应的临床信息。使用最小绝对收缩和选择算子Cox回归分析构建线粒体相关风险(MAR)模型,并使用GSE161533进行验证。使用MAR模型探索肿瘤微环境和药物敏感性。最后,进行了体外实验以分析hub基因对ESCC细胞增殖和侵袭能力的影响。为了确认MAR模型的预测能力,我们构建了一个预后模型并评估了其预测准确性.MAR模型揭示了高风险人群和低风险人群之间的免疫浸润和肿瘤微环境特征的实质性差异,以及风险评分和一些常见免疫检查点之间的实质性相关性。AZD1332和AZD7762对低危组患者更有效,而Entinostat,尼洛替尼,Ruxolutinib,Wnt。c59对高危组患者更有效。敲除TYMS可显著抑制ESCC细胞的增殖和侵袭能力。总的来说,我们的MAR模型提供了稳定可靠的结果,可用作ESCC患者个性化治疗的预后生物标志物。
    Esophageal squamous cell carcinoma (ESCC) is among the most common malignant tumors of the digestive tract, with the sixth highest fatality rate worldwide. The ESCC-related dataset, GSE20347, was downloaded from the Gene Expression Omnibus (GEO) database, and weighted gene co-expression network analysis was performed to identify genes that are highly correlated with ESCC. A total of 91 transcriptome expression profiles and their corresponding clinical information were obtained from The Cancer Genome Atlas database. A mitochondria-associated risk (MAR) model was constructed using the least absolute shrinkage and selection operator Cox regression analysis and validated using GSE161533. The tumor microenvironment and drug sensitivity were explored using the MAR model. Finally, in vitro experiments were performed to analyze the effects of hub genes on the proliferation and invasion abilities of ESCC cells. To confirm the predictive ability of the MAR model, we constructed a prognostic model and assessed its predictive accuracy. The MAR model revealed substantial differences in immune infiltration and tumor microenvironment characteristics between high- and low-risk populations and a substantial correlation between the risk scores and some common immunological checkpoints. AZD1332 and AZD7762 were more effective for patients in the low-risk group, whereas Entinostat, Nilotinib, Ruxolutinib, and Wnt.c59 were more effective for patients in the high-risk group. Knockdown of TYMS significantly inhibited the proliferation and invasive ability of ESCC cells in vitro. Overall, our MAR model provides stable and reliable results and may be used as a prognostic biomarker for personalized treatment of patients with ESCC.
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  • 文章类型: Journal Article
    背景:脓肿分枝杆菌复合体(MABC)是结构性肺部疾病中最常见的快速生长的分枝杆菌物种,可能危及生命。本研究旨在评估不同脓肿分枝杆菌(MAB)亚种的临床特征和药敏状态。
    方法:DNA测序用于区分临床MABC亚种分离株。临床和实验室标准研究所指南用于确定亚胺培南-瑞巴坦的体外敏感性,omadacycline,和其他常规抗生素。收集并分析患者的临床特征。
    结果:有139个脓肿,39M.massiliense,还有1M.bolletii,占77.7%,21.8%,和0.5%的MABC分离株,分别。脓肿分枝杆菌肺病患者(M.ab-PD)的老年人比例较高,结核病史,慢性肺病,和恶性程度比患有M.massiliense肺病的人(M.MA-PD)。与M.ma-PD患者相比,M.ab-PD患者的双侧中叶和下叶受累率较高。这两个亚种对强力霉素和莫西沙星都表现出很高的耐药率,克拉霉素诱导的耐药性在M.ab中比在M.ma中更常见。在MAB中,与单独的亚胺培南相比,雷巴坦与亚胺培南的最低抑制浓度(MIC)值降低了2倍;此外,M.ab的MIC低于M.ma.Omadacycline和替加环素具有相当的体外敏感性,MIC在M.ab和M.ma之间无统计学差异。
    结论:M.ab是浙江省最普遍的MABC亚种。患有M.ab-PD的患者具有复杂的潜在疾病和更广泛的叶病变。亚胺培南-雷巴坦和奥马环素是治疗MABC感染的有前途的抗生素。
    OBJECTIVE: Mycobacterium abscessus complex (MABC) is the most common rapidly growing Mycobacterium species in structural pulmonary diseases and can be life-threatening. This study aimed to assess the clinical characteristics and drug-susceptibility statuses of different M. abscessus (MAB) subspecies in the Zhejiang Province.
    METHODS: DNA sequencing was used to differentiate clinical MABC subspecies isolates. The Clinical and Laboratory Standards Institute guidelines were used to determine in vitro susceptibility of imipenem-relebactam (IMP-REL), omadacycline, and other conventional antibiotics. Patient clinical characteristics were collected and analysed.
    RESULTS: In total, 139 M. abscessus, 39 Mycobacterium massiliense, and 1 Mycobacterium bolletii isolates were collected, accounting for 77.7%, 21.8%, and 0.5% of the MABC isolates, respectively. Patients with M. abscessus pulmonary disease (M.ab-PD) had higher proportions of older adults, tuberculosis history, chronic pulmonary disease, and malignancy than those with M. massiliense pulmonary disease (M.ma-PD). Patients with M.ab-PD had higher rates of bilateral middle- and lower-lobe involvement than patients with M.ma-PD. Both subspecies showed high resistance rates to doxycycline and moxifloxacin, and clarithromycin-induced resistance was more common in M.ab than in M.ma. IMP-REL resulted in a twofold reduction in the minimum inhibitory concentration (MIC) value compared with imipenem alone among MAB; furthermore, the MIC was lower in M.ab than in M.ma. Omadacycline and tigecycline had comparable in vitro susceptibility, and the MIC showed no statistically significant difference between M.ab and M.ma.
    CONCLUSIONS: M.ab is the most prevalent MABC subspecies in the Zhejiang Province. Patients with M.ab-PD have complex underlying diseases and broader lobar lesions. IMP-REL and omadacycline are promising antibiotics for MABC infection treatment.
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  • 文章类型: Journal Article
    使用基于高含量成像的中和试验评估流感病毒的抗病毒易感性。帽依赖性核酸内切酶抑制剂,baloxavir和AV5116,优于AV5115对A型病毒,AV5116对测试的PA突变体最有效。然而,这三种抑制剂对来自6个谱系的C型病毒显示出相当的活性(EC508-22nM)。香蕉凝集素和单克隆抗体,YA3,靶向血凝素酯酶蛋白有效中和一些,但不是全部,C型病毒。
    Antiviral susceptibility of influenza viruses was assessed using a high-content imaging-based neutralization test. Cap-dependent endonuclease inhibitors, baloxavir and AV5116, were superior to AV5115 against type A viruses, and AV5116 was most effective against PA mutants tested. However, these three inhibitors displayed comparable activity (EC50 8-22 nM) against type C viruses from six lineages. Banana lectin and a monoclonal antibody, YA3, targeting the hemagglutinin-esterase protein effectively neutralized some, but not all, type C viruses.
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  • 文章类型: Journal Article
    本研究的目的是调查流行病学特征,分离株的分布,流行的模式,中国西南地区某三级转诊医院细菌性角膜炎(BK)的抗生素敏感性。
    对2015年1月至2022年12月之间发生的660例细菌性角膜炎进行了回顾性分析。人口统计数据,诱发因素,微生物的发现,和抗生素敏感性谱进行了检查。
    角膜创伤成为最普遍的诱发因素,占病例的37.1%。在这些案例中,318例细菌培养结果为阳性,鉴定出细菌68种。最常见的革兰氏阳性菌是表皮葡萄球菌,最常见的革兰氏阴性菌是铜绿假单胞菌。耐甲氧西林葡萄球菌占所有革兰氏阳性菌的18.1%。铜绿假单胞菌检出率随时间呈增加趋势(Rs=0.738,P=0.037)。随着时间的推移,革兰氏阴性微生物的百分比显着降低(Rs=0.743,P=0.035)。革兰阳性菌对利奈唑胺的敏感性,万古霉素,替加环素,quinupristin/dalfopristin,利福平超过98%。革兰阴性菌对阿米卡星的敏感率,美罗培南,哌拉西林/他唑巴坦,头孢哌酮钠/舒巴坦,头孢他啶,头孢吡肟和头孢吡肟均在85%以上。有植物人创伤史的病人,除了关注真菌性角膜炎外,还应考虑BK的可能性。
    微生物组成主要由革兰氏阳性球菌和革兰氏阴性杆菌组成。在革兰氏阳性菌中,表皮葡萄球菌和肺炎链球菌是最常见的,而铜绿假单胞菌是主要的革兰氏阴性细菌。为了对抗革兰氏阳性菌,万古霉素,利奈唑胺,和利福平被认为是优异的抗微生物剂。当靶向革兰氏阴性病原体时,与第一代和第二代头孢菌素相比,第三代头孢菌素具有更高的敏感性.作为社区环境中细菌性角膜炎和对第四代氟喹诺酮类药物无反应的严重病例的初始经验治疗,万古霉素和妥布霉素的联合治疗是合理的方法。通过了解局部病因和抗菌药物敏感性模式,可以更好地控制细菌性角膜炎。
    UNASSIGNED: The objective of this study was to investigate the epidemiological characteristics, distribution of isolates, prevailing patterns, and antibiotic susceptibility of bacterial keratitis (BK) in a Tertiary Referral Hospital located in Southwest China.
    UNASSIGNED: A retrospective analysis was conducted on 660 cases of bacterial keratitis occurring between January 2015 and December 2022. The demographic data, predisposing factors, microbial findings, and antibiotic sensitivity profiles were examined.
    UNASSIGNED: Corneal trauma emerged as the most prevalent predisposing factor, accounting for 37.1% of cases. Among these cases, bacterial culture results were positive in 318 cases, 68 species of bacteria were identified. The most common Gram-Positive bacteria isolated overall was the staphylococcus epidermis and the most common Gram-Negative bacteria isolated was Pseudomonas aeruginosa. Methicillin-Resistant Staphylococci accounted for 18.1% of all Gram-Positive bacteria. The detection rate of P. aeruginosa showed an increasing trend over time (Rs=0.738, P=0.037). There was a significant decrease in the percentage of Gram-Negative microorganisms over time (Rs=0.743, P=0.035). The sensitivity of Gram-Positive bacteria to linezolid, vancomycin, tigecycline, quinupristin/dalfopristin, and rifampicin was over 98%. The sensitivity rates of Gram-Negative bacteria to amikacin, meropenem, piperacillin/tazobactam, cefoperazone sodium/sulbactam, ceftazidime, and cefepime were all above 85%. In patients with a history of vegetative trauma, the possibility of BK should be taken into account in addition to the focus on fungal keratitis.
    UNASSIGNED: The microbial composition primarily consists of Gram-Positive cocci and Gram-Negative bacilli. Among the Gram-Positive bacteria, S. epidermidis and Streptococcus pneumoniae are the most frequently encountered, while P. aeruginosa is the predominant Gram-Negative bacteria. To combat Gram-Positive bacteria, vancomycin, linezolid, and rifampicin are considered excellent antimicrobial agents. When targeting Gram-Negative pathogens, third-generation cephalosporins exhibit superior sensitivity compared to first and second-generation counterparts. As an initial empirical treatment for severe cases of bacterial keratitis and those unresponsive to fourth-generation fluoroquinolones in community settings, the combination therapy of vancomycin and tobramycin is a justifiable approach. Bacterial keratitis can be better managed by understanding the local etiology and antibacterial drug susceptibility patterns.
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