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目的探讨青霉素酶免疫血清在治疗产青霉素酶葡萄球菌感染中的作用。方法采用青霉素酶加弗氏完全佐剂、弗氏不完全佐剂充分乳化后,于新西兰兔背部皮下多点注射,制备青霉素酶免疫血清。以肉汤培养管中加入产青霉素酶的金黄色葡萄球菌、青霉素酶免疫血清和青霉素为实验组,同时设立肉汤培养管中加入产青霉素酶的金黄色葡萄球菌和青霉素酶免疫血清的实验对照组、仅有营养肉汤的实验空白组和肉汤培养管中加入青霉素和产青霉素酶的金黄色葡萄球菌的空白组,进行体外实验,观察培养基有无细菌生长,并采用Phoenix100细菌鉴定仪鉴定所生长细菌是否为金黄色葡萄球菌。同时制备新西兰兔产青霉素酶金黄色葡萄球菌感染模型,分为实验组(经耳静脉注射青霉素酶免疫血清和青霉素)、空白对照组(仅经耳静脉注射青霉素)、实验对照组(仅经耳静脉注射青霉素酶免疫血清),连续观察各组新西兰兔体温、血培养变化。结果体外培养72 h后,实验组、实验空白组无细菌生长;空白组和实验对照组有金黄色葡萄球菌生长。体内注射后第2、3、4、5、6天,实验组新西兰兔体温升高者均少于实验对照组(χ2=5.051、5.051、5.051、7.500、7.540,P<0.05)和空白对照组(χ~2=7.200、5.058、7.200、5.495、7.540,P<0.05);第7天,实验组新西兰兔与实验对照组和空白对照组比较,体温增高者差异无统计学意义(χ2=3.058、3.529,P>0.05)。第1、2、3、4、5、6、7天,实验对照组新西兰兔与空白对照组比较体温增高者差异无统计学意义(χ2=0.000、0.267、0.000、0.267、0.220、0.059、0.024,P>0.05)。接种后第2天,实验组新西兰兔血培养阳性者与实验对照组比较差异无统计学意义(χ2=3.333,P>0.05),但显著低于空白对照组(χ~2=5.051,P<0.05);实验对照组新西兰兔血培养阳性者与空白对照组比较差异无统计学意义(χ2=0.220,P>0.05)。接种后第4天,实验组新西兰兔血培养阳性者显著低于实验对照组和空白对照组(χ~2=7.500、7.500,P<0.05),实验对照组新西兰兔血培养阳性者与空白对照组比较差异无统计学意义(χ2=0.000,P>0.05)。接种后第6天,实验组新西兰兔血培养阳性者显著低于实验对照组和空白对照组(χ~2=7.540、5.000,P<0.05);实验对照组与空白对照组比较差异无统计学意义(χ2=0.460,P>0.05)。结论青霉素酶免疫血清可以消除金黄色葡萄球菌因产青霉素酶而产生的对青霉素类抗生素的耐药作用。
Objective To explore the role of penicillinase immune serum in the treatment of penicillinase-producing staphylococcal infection. Methods Penicillinase plus Freund’s complete adjuvant, incomplete Freund’s complete adjuvant emulsion, in New Zealand rabbit back subcutaneous injection, preparation of penicillinase immune serum. To the broth culture tube added penicillinase-producing Staphylococcus aureus, penicillinase immune serum and penicillin as the experimental group, while the establishment of broth culture tube added penicillinase-producing Staphylococcus aureus and penicillinase immune serum experimental control Group, only the blank group of nutrient broth and broth culture medium added penicillin and penicillinase-producing Staphylococcus aureus blank group, in vitro experiments to observe the presence or absence of bacterial growth in the medium, and the use of Phoenix100 bacterial identification instrument Identification of the growth of bacteria is Staphylococcus aureus. At the same time, a model of penicillinase-producing Staphylococcus aureus in New Zealand rabbits was established and divided into experimental group (penicillin-immunized serum and penicillin via ear vein), blank control group (penicillin only via ear vein), experimental control group Intravenous penicillinase immune serum), continuous observation of each group New Zealand rabbit body temperature, blood culture changes. Results After cultured in vitro for 72 h, there was no bacterial growth in experimental group and experimental blank group. Staphylococcus aureus growth was observed in blank group and experimental group. On the 2nd, 3rd, 4th, 5th and 6th day after in vivo injection, the body temperature of New Zealand rabbits in the experimental group were significantly lower than those in the experimental group (χ2 = 5.051,5.051,5.051,7.500,7.540, P <0.05) (χ ~ 2 = 7.200,5.058,7.200,5.495,7.540, P <0.05). On the 7th day, no significant difference was found between the experimental group and the control group , 3.529, P> 0.05). On the 1st, 2nd, 3rd, 4th, 5th, 6th and 7th day, there was no significant difference between the experimental control group and the blank control group (χ2 = 0.000,0.267,0.000,0.267,0.220,0.059,0.024 , P> 0.05). On the second day after inoculation, there was no significant difference between the experimental group and the experimental group (χ2 = 3.333, P> 0.05), but significantly lower than that of the blank control group (χ ~ 2 = 5.051, P < 0.05). There was no significant difference between the positive control group and the blank control group in New Zealand rabbits (χ2 = 0.220, P> 0.05). On the 4th day after inoculation, the blood culture positive rate of New Zealand rabbits in the experimental group was significantly lower than that in the experimental group and the blank control group (χ ~ 2 = 7.500, 7.500, P <0.05). In the experimental control group, There was no significant difference between the two groups (χ2 = 0.000, P> 0.05). On the 6th day after inoculation, the blood culture positive rate of New Zealand rabbits in the experimental group was significantly lower than that in the experimental control group and the blank control group (χ ~ 2 = 7.540, 5.000, P <0.05); there was no significant difference between the experimental control group and the blank control group Significance (χ2 = 0.460, P> 0.05). Conclusion Penicillinase immune serum can eliminate S. aureus penicillinase-producing penicillin-resistant antibiotics.