目的：对住院患者不同部位分离纹带棒状杆菌的分子流行病学特征及耐药性进行分析，为临床进一步认识纹带棒状杆菌临床意义提供新的实验数据和思路。方法收集内蒙古医科大学附属医院2013年11月至2014年3月间45例住院患者不同部位分离纹带棒状杆菌45株，采用微量肉汤稀释法进行体外药敏试验；采用盐水棉拭子法对纹带棒状杆菌阳性患者周边环境进行采样、分离纹带棒状杆菌，并对分离的纹带棒状杆菌进行体外药敏试验；进一步采用脉冲场凝胶电泳（ PFGE）方法对45株纹带棒状杆菌进行分子分型。结果45株纹带棒状杆菌主要分离自神经外科病房（21株）、呼吸内科病房（8株）和重症监护病房（8株），其中39株分离自下呼吸道标本。2013年12月、2014年1月和2014年2月3个月内纹带棒状杆菌呈聚集分布。药敏试验结果显示，青霉素、红霉素、四环素、环丙沙星、克林霉素5种抗菌药物的最小抑菌浓度（ MIC90）值≥64μg/ml；庆大霉素、万古霉素和利福平的MIC90值均为0.5μg/ml；仅1株分离株对除克林霉素之外的所有抗菌药物全部敏感。 PFGE分型结果显示，41株纹带棒状杆菌共分为7个不同基因型，其中以0002型和0006型为优势型，分别占63％（26/41）和22％（9/41）。同一病房同期住院患者分离株高度同源。环境采样结果显示，纹带棒状杆菌分离阳性率达40％（8/20）。结论住院患者分离纹带棒状杆菌呈多重耐药特征，不同患者分离株高度同源。特定病房如神经外科、重症监护病房、呼吸内科等科室应重新评估其临床分离意义及与临床治疗之间的相关性。

Objective To explore the molecular epidemiological features and in vitro susceptibility profile of Corynebacterium striatum strains isolated from different sites of inpatients , and further provide new data and idea for clinicians to better get knowledge of the clinical significance of Corynebacterium striatum. Methods Fourty-five strains of Corynebacterium striatum isolated from different sites of inpatients from November, 2013 to March, 2014 in Affiliated hospital of Inner Mongolian medical university , and microdilution method was employed to do in vitro antibiotics susceptibility test.Saline-cotton swab method was used to sample the surrounding environmental surfaces for Corynebacterium striatum carrying patients , and suspected colonies were further identified and in vitro drug susceptibility test were performed.Pulsed Field Gel Electrophoresis ( PFGE) method was used to do molecular typing for 41 isolates of Corynebacterium striatum.Results Fourty-five isolates of Corynebacterium

目的：评估 VITEK-2 compact微生物鉴定系统、法国生物梅里埃公司及德国 Bruker公司的 MALDI TOF MS对棒状杆菌的鉴定能力。方法方法学评价研究选择来自法国生物梅里埃公司的棒状杆菌40株，以16S rDNA测序为金标准，分别使用 VITEK-2 compact，VITEK MS及 Bruker MS进行鉴定，对其鉴定率、检测时间及耗材成本作描述性分析。结果 VITEK-2 compact，VITEK MS及Bruker MS正确鉴定至种水平的鉴定率分别为95.0％，88.9％和97.5％，平均检测时间分别为5～6 h，2～3 min和2～3 min，检测耗材成本约为50～70元、15～25元和10～20元。结论三种方法均具有较高的正确鉴定率，能够满足临床的鉴定需要，但 VITEK MS对无植酸棒状杆菌鉴定能力需要进一步提高。

Objective To evaluate the performance of VITEK-2 compact,VITEK MS and Bruker MS on the identification of Corynebacterium.Methods This was a methodological evaluation study.The 40 Corynebacterium from bioMerieux were i-dentified with the three methods respectively.16S rDNA gene sequencing was conducted as reference method.Made a de-scriptive analysis of the identification ability,time and cost.Resulets The accuracy of species level of the three methods was 95.0%,88.9% and 97.5%.The mean time was 5~6 h,2~3 min and 2~3 min.The cost of consumable was 50~70 yuan, 15~25 yuan and 10~20 yuan.Conclution Three methods with high accuracy can meet the requirement of clinical diagno-sis,and the identification ability of VITEK MS on Corynebacterium amycolatum need to be further improved.

目的 预防性管理措施改进对人工关节转换术术后感染的影响.方法 收集山东省烟台市烟台山医院收治的309例施行人工关节置换术的患者,按改进前后时间将患者分为改进前组(94例)和改进后组(215例).对2组患者术中空气、主刀人员的手、手术护士的手进行细菌采集,观察改进前与改进后的细菌生长情况.结果 改进后组空气培养有细菌生长率与改进前组比较,差异有统计学意义[59.5％(128/215)比73.4％ (69/94)](P＜0.05).空气培养中的细菌有微球菌、棒状杆菌、溶血葡萄球菌、奈瑟菌、柘草芽孢杆菌、黏质沙雷菌.改进后组主刀人员、护士手培养的有细菌菌生长率与改进前组比较,差异有统计学意义[1.9％ (4/215)比6.4％ (6/94)] (P＜0.05).空气、主刀人员、护士手细菌培养中的细菌有微球菌、棒状杆菌、溶血葡萄球菌、奈瑟菌、枯草芽胞杆菌、黏质沙雷菌、表皮葡萄球菌、鲍曼不动杆菌.结论 加强手术室感染管理,层流设备定期检测消毒,对人工关节置换术后感染的预防起重要作用.

Objective To analyze the causes of reducing postoperative infection after joint replacement and to observe the prophylactic mangement measures.Methods Totally 309 patients with total joint replacements of Yantaishan hospital of Yantai city were selected and divided into improving before group (94 cases) and improving group (215 cases).The speciments for bacterial culture were taken from the hands of the operation surgeon,the scrub nurse and the air flow in the operation room for all cases.The growth of bacteria after improvement was observed.Results There were significant differences on bacteria growth rate of air aulture in improving group compared with improve before group [59.5 ％ (128/215) vs 73.4％ (69/94)] (P ＜ 0.05).There were significant differences on bacteria growth rate of hand of surgeon and nurse in improving group compared with improving before group [1.9％ (4/215) vs 6.4％ (6/94)] (P ＜ 0.05).There were Micrococcus,Corynebacterium,Staphylococcus haemolyticus,N

以谷氨酸棒状杆菌(Corynebacterium glutamicum)为出发菌株,利用低能氮离子束注入对其进行多次诱变,结合异亮氨酸氧肟酸盐(Ile Hx)等氨基酸结构类似物定向筛选,得到一株稳定的高产L-异亮氨酸菌株:摇瓶培养72 h,产酸可达21~22 g/L,在50 L发酵罐上发酵51 h,产酸可达32 g/L。

U sing C orynebacterium glutam icum as originalstrain,through low energy N + im planting into C .glutam icum ,com bining w ith isoleucine hydroxam ic (IleH x)and otheram ino acid structure analogues to conductdirected screening,one high L-isoleucine yield m utantstrain w as obtained. A fter72 h ferm entation in shaking flask,the concentration ofL-Ile w as 21-22 g/L,and after51 h ferm entation in 50-liters ferm entor,the concentra-tion ofL-Ile w as32 g/L.

目的对董志塬地区眼部细菌性炎症包括细菌性角膜炎、细菌性结膜炎的病原菌进行流行病学调查,监测病原菌的药物敏感性及耐药性。方法对2011年1月至11月的69例细菌性角膜炎和287例细菌性结膜炎患者的分泌物进行细菌培养和药物敏感试验,并对细菌培养的阳性率、细菌菌属分布及其变化进行分析。结果细菌培养阳性率为26.7%,革兰氏阳性球菌占54.7%,革兰氏阴性杆菌占22.1%,革兰氏阳性杆菌占11.7%,革兰氏阴性球菌占7.5%;表皮葡萄球菌占48.0%,金黄色葡萄球菌占42.3%,荧光假单胞菌占22.1%,棒状杆菌占11.7%。药敏试验结果显示,表皮葡萄球菌对氟喹诺酮类敏感,对氨基糖甙类次之;金黄色葡萄球菌对左氧氟沙星敏感,对妥布霉素次之。结论董志塬地区眼部细菌性炎症主要为革兰氏阳性球菌感染,表皮葡萄球菌是首要致病菌。从药敏结果看,左氧氟沙星强于妥布霉素,是治疗感染性眼病的首选药物。

Objective Epidemiological investigation on pathogen of Dongzhi yuan area about ocular bacterial inflammation including bacterial keratitis ,bacterial conjunctivitis ,drug sensitivity and drug resistance of pathogenic bacteria .Methods From January to November 2011 ,69 cases of bacterial keratitis and 287 cases of bacterial con-junctivitis patients secretions for bacterial culture and drug sensitivity test ,and the positive rate of bacterial culture , bacterial genus distribution and variation analysis .Results The positive rate of bacterial culture was 26 .7% ,gram positive cocci accounted for 54 .7% ,gram negative bacilli accounted for 22 .1% ,Gram positive bacillus accounted for 11.7% ,Gram negative cocci accounted for 7.5% ,staphylococcus epidermidis accounting for 48% ;Staphylococ-cus aureus accounted for 42.3% ,Pseudomonas fluorescens accounted for 22.1% ,corynebacterium accounting for 11.7% .Drug sensitivity test showed ,Staphylococcus epidermidis sensitive to fluoroquinolones ,a