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Objective:To investigate the epidemiological characteristics of community acquired pyogenic liver abscess (CA-PLA) as a reference for its early identification, early diagnosis and rational antibacterial treatment.Methods:A single center retrospective study was carried out in patients with CA-PLA hospitalized in First Hospital of China Medical University from January 2011 to December 2017.The symptoms, signs and treatment results were concluded. The underlying diseases and onset symptoms of the cases were grouped by year, and the change trend of the disease characteristics was analyzed. The etiology results were grouped according to whether the patients had underlying diseases of biliary tract, and the etiology characteristics were analyzed. Statistical analysis was performed by using chi-square test.Results:A total of 1 063 CA-PLA cases were included in this study. The analysis on underlying diseases grouped by year showed that the number of patients admitted to the hospital increased annually, and the percentage of patients with underlying hepatobiliary diseases decreased from 17.3% (19/110) in 2011 to 7.3% (14/191) in 2017, the difference was statistically significant ( χ2=13.648, P=0.034), while that of patients with diabetes mellitus kept high at 31.6% to 46.5% in the past seven years without increasing trend. There were 274 patients (25.8%) with extrahepatic manifestations. Totally 445 cases were microbiologically diagnosed, among which single Klebsiella pneumoniae infection was found in 371 cases (83.4%). Klebsiella pneumoniae was the leading pathogen in patients without underlying hepatobiliary diseases (91.6%, 362/395), in contrast to 18.0%(9/50) in patients with underlying hepatobiliary diseases. The other pathogens were Escherichia Coli (32.0%, 16/50) and mixed infection (18.0%, 9/50). The susceptibility rate to second generation and above cephalosporins of clinically defined hypervirulent Klebsiella pneumoniae was ≥97.5%, and that to carbapenems was 100.0%. Most patients had good prognosis, and 1 049 cases were cure or improvement discharged, six cases left hospital voluntarily, and eight cases died. Conclusions:Most of the CA-PLA patients have no underlying hepatobiliary diseases, and more than half of patients have no history of diabetes mellitus. Most of the pathogens are Klebsiella pneumoniae, which are relatively sensitive to antimicrobial agents.
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Objective To describe the clinical characteristics of hypervirulent Klebsiella pneumoniae (hvKP) infection.To analyze the antibiotic susceptibility of hvKP to provide the empiric antibiotic options.To investigate capsule serotype and sequence type (ST) of hvKP and their correlation with clinical profiles.Methods hvKP was defined as bacteria isolated from patients with community-acquired pyogenic liver abscess (CA-PLA) with co-infection sites outside liver or a bloodstream infection in a host without underlying biliary tract diseases.Patients with CA-PLA hospitalized in the First Hospital of China Medical University were retrospectively analyzed from January 2011 to December 2017.Antibiotic susceptibility was detected by automatic bacterial identification and antibiotic susceptibility analysis system in vitro.Polymerase chain reaction method and gene sequencing were used to detect the main capsule serotype and ST.Results A total of 140 cases with hvKP infection were enrolled.The co-infections outside liver abscess included 98 bloodstream infections,53 pneumonia,11 perianal abscess,10 urinary system infections,3 subphrenic abscess,3 endophthalmitis,2 spleen abscess,and other miscellaneous infections including 1 peritonitis,1 skin and soft tissue infection,1 myelitis,1 colitis,1 psoas major abscess and 1 myocardial abscess.Among the 140 cases,106 presented with single co-infection site,32 with 2 sites,and 2 with 3 sites.HvKP manifested high antibiotic susceptibility up to 80％ for most commonly used antibiotics.Capsule serotyping of 4,3 revived isolates indicated that K1 serotype accounted for 53.49％ (23/43),K2 34.88 (15/43),K54 2.33％ (1/43),K57 2.33％ (1/43),and other serotypes 6.98％(3/43).There was no significant distribution among K1,K2,K54,and K57 of hvKP capsule serotypes in patients with or without diabetes mellitus (P＞0.05).Multilocus sequence typing (MLST) suggested that ST23 and ST65 were predominant accounting for 39.53％ (17/4.3) and 25.58％ (11/4.3) respectively.No serotype or ST predominance was seen in any of the clinical infections.Conclusion HvKP is related to a wide spectrum of infectious diseases,including multiple extrahepatic sites and bloodstream infections besides CA-PLA with high antibiotic susceptibility.K1 and K2 are the predominant capsule serotypes,and ST 23 and ST65 are the predominant sequence types.
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Objective To study the difference between piperacillin-tazobactam and other anti-infective agents in the treatment of blood stream infection caused by extended spectrum beta-lactamase (ESBL )-producing Enterobacteriaceae by systematic review and meta-analysis . Methods PubMed , Cochrane library ,Web of Science , CNKI , Weipu DATA , and CPVIP were systematically searched . Literatures were reviewed and data regarding mortality of mono -drug treatment with different antibiotics were collected . All data were pooled using the technique of meta-analysis by Revman 5 .3 , and heterogeneity tests were performed .Results Eleven articles containing 1620 patients were included . Escherichia coli and K lebsiella pneumonia were the main pathogens ,and there were 31 cases caused by Enterobacter cloacae .There was no statistically significant difference in mortality between carbapenems and piperacillin-tazobactam mono-therapy for the empirical treatment (RR = 0 .86 ;95％ CI :0 .62 - 1 .20 , P> 0 .05) or for definitive treatment (RR = 0 .63 ;95％ CI :0 .20 - 1 .97 ,P > 0 .05) .Carbapenems were used as the main antibiotics for definitive treatment as well as empirical treatment . Conclusion Piperacillin-tazobactam treatment is not associated with increased mortality of the patients with ESBL -positive enterobacteria bloodstream infection ,which can be used as an alternative antibiotics .
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Objective To investigate the risk factors of bloodstream infections caused by multiple drug resistant Acinetobacter baumannii (MDRAB) and those associated with 30-day clinical outcomes of MDRAB patients. Methods A case-control study was designed to retrospectively analyze 49 cases of MDRAB-related bloodstream infections treated in our hospital during the period from January 2013 to December 2014. Additional 29 cases of non-MDRAB bloodstream infections were included as control group. Univariate and multivariate logistic analysis were used to identify the risk factors of MDRAB bloodstream infections. The prognostic factors were analyzed similarly for all the 78 cases of bloodstream infections by comparing the relevant factors between survival group (38 cases) and non-survival group (40 cases) based on the survival status 30 days after collecting blood samples. Results Univariate analysis revealed that the risk factors for MDRAB bloodstream infection included use of carbapenems, quinolones, or at least 2 antibiotics, mechanical ventilation, nasogastric tube, indwelled central venous catheter, and ICU stay prior to infection. Subsequent multivariate logistic analysis showed that ICU stay (OR=7.118) and prior use of at least 2 antibiotics (OR=8.073) were independent risk factors for MDRAB bloodstream infection. Univariate analysis revealed that ICU stay, mechanical ventilation,and MDRAB in blood sample were the prognostic factors of 30-day survival. Multiple logistic regression analysis showed that MDRAB infection (OR=5.837) and mechanical ventilation (OR=4.926) were the independent risk factors predicting of 30-day patient death. Conclusions ICU stay and prior use of at least 2 antibiotics were independent risk factors for MDRAB bloodstream infection. MDRAB infection and mechanical ventilation were the independent risk factors predicting 30-day patient death in MDRAB bloodstream infections.
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Objective To identify the clinical features of patients with brucellosis in Liaoning Province in recent 5 years, and to improve the diagnostic level of the disease.Methods The clinical data including epidemiology, clinical features, laboratory data and diagnosis of 82 hospitalized patients who were diagnosed with brucellosis in the First Affiliated Hospital of China Medical University from 2011 to 2015 were collected and reviewed retrospectively.Results The majority of the 82 patients were middle-aged (45-59 years old) (47.6%) and male gender (63.4%).Fever (90.2%), muscle and joint pain (61.0%), hepatosplenomegaly (36.6%), lymphadenopathy (24.4%) and weight lose (32.9%) were the main complaints.The peripheral leucocyte counts were usually normal (70.7%).C-reactive protein (81.3%), procalcitonin (81.8%) and erythrocyte sedimentation rate (64.2%) increased in most cases.The results of the serum agglutination test in 67 patients were all positive (100.0%).The pathogen isolation was conducted in 60 patients and 49 patients were positive for Brucella species.Among them, 35(71.3%) isolates were identified as Brucella melitensis.A total of 90.2%(74/82) cases were firstly diagnosed with fever of unknown origin and were hospitalized.Misdiagnosis accounted for 52.4(43/82)%.Conclusions Contact history with cow and sheep should be inquired thoroughly in patients with clinical manifestations of fever, muscle and joint pain and hepatosplenomegaly.Pathogen isolation, agglutination test and other specific tests should be performed as soon as possible to diagnose the disease early.
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Objective To investigate the antibiotic resistance and resistance genes of carbapenem-resistant Enterobacteriaceaes (CRE) isolated from 5 hospitals in Northeast China.Methods This study collected 85 CRE isolates during January 2013 to June 2015 from five hospitals in Northeast China.Drug sensitivities of 14 antimicrobial agents were determined by the broth microdilution method.The phenotypes of carbapenemases were screened by modified Hodge test and EDTA test respectively.The genotypes of carbapenemases and other extended spectrum β-lactamases (ESBL) were detected by PCR gene amplification and DNA sequencing method.Using the PCR result as gold standard, the performances of other two carbapenemase detection methods were evaluated.Results Among the 85 CRE strains collected in this study, Klebsiella pneumoniae was the most frequently isolated species (61/85,71.8%).The results of antimicrobial agent sensitivity showed that the 85 CRE strains had resistance rate of cephalosporin and β-lactams/enzyme inhibitor (piperacillin-tazobactam) over 80.0%.The resistance rate of carbapenem was high, with ertapenem 100.0% (85/85), meropenem 65.9% (56/85), imipenem 71.8% (61/85).There were 36 isolates resistant to both meropenem and imipenem.For fluoroquinolones, the resistance rates of levofloxacin and ciprofloxacin were 72.9% (62/85) and 65.9% (56/85), respectively.The resistance rate to fosfomycin and amikacin were 65.0% (55/85) and 54.1% (46/85), respectively.The resistance rate of colistin (21.2%, 18/85) and tigecycline (20.5%, 17/85) were low.Forty-nine strains were modified Hodge test positive and 12 strains were EDTA test positive.By PCR gene amplification and DNA sequencing method, 64 strains carried carbapenemase-encoding genes, of which KPC-2 was the main type (53/85, 62.4%), followed by IMP-4 (10/85, 11.8%), NDM-5 (7/85, 8.2%) and NDM-6 (1/85, 1.2%).At the same time, 85 CRE isolates had the ESBL gene detection and 47 isolates were CTX-M type ESBLs (47/85, 55.3%), with no TEM or SHV type.Conclusions Klebsiella pneumoniae is the majority of CRE strains from 5 large hospitals in Northeastern China.The CRE strains are resistant to most of antimicrobials.Most carbapenemases-producing isolates have the KPC-2 type.Nearly half of the carbapenemase-producing strains also carry ESBL genes, which makes the resistance mechanisms more complicated.
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Objective To understand the adverse reaction profile of linezolid during clinical treatment,especially lactic acidosis and pancytopenia.Methods One case of linezolid-induced lactic acidosis and pancytopenia was described in a patient receiving long-term treatment in our hospital.Similar cases were searched and identified from literatures reports both in China and abroad from 2000 to 2015 for further review.The data were analyzed in terms of patient age,sex,underlying conditions,as well as onset time,clinical characteristics,and outcomes of the adverse reaction.Results A total of 50 similar cases (male/female ratio:1.78∶1) were analyzed,42.0％ of which were old patients (at least 65 years old).Liver and/or renal insufficiency was found in 20 cases (40.0％).The onset of lactic acidosis was at 5.5 weeks after initiation of linezolid on average,and the onset of pancytopenia was at 3.5 weeks after initiation of linezolid.Conclusions Linezolid-induced lactic acidosis or pancytopenia is more frequently found in the elderly patients with hepatic dysfunction and long-term treatment.
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Objective To investigate the homology of carbapenem-resistant Klebsiella pneumoniae (CR-KPN) isolates by multilocus sequence typing (MLST) method,and profile CR-KPN infections in terms of MLST sequence types (STs).Methods A total of 61 CR-KPN isolates were collected in five hospitals from Liaoning Province from January 2013 to June 2015.The MICs of 14 antimicrobial agents against these isolates were determined by broth microdilution method.The genotypes of carbapenemases were analyzed by PCR and DNA sequencing techniques.The homology of CR-KPN isolates were analyzed by MLST method.The clinical data of patients with CR-KPN infection were reviewed to characterize CR-KPN infections.Results A total of 18 STs were identified among the 61 CR-KPN strains according to MLST data.More than 50 ％ of the isolates belonged to ST11 (53.3 ％).ST11 strains showed higher resistance rate to carbapenems and higher prevalence of KPC-2 type carbapenemase.Univariate analysis indicated that more ST 11-infected patients were treated in ICU and with mechanical ventilation than non-ST11 CR-KPN-infected patients (P＜0.05).ST2033,ST2135,ST2193,ST2194,ST2195 and ST2196 were the STs firstly registered in the world.The eBURST analysis showed that ST2193,ST2194,ST2195 and ST 11 were closely related.Clinical data indicated that the prevalent CR-KPN strains during the same period in the same hospital usually belonged to the same ST clone.Conclusions MLST of CR-KPN showed 18 sequence types,of which ST11 was the predominant type.Clinical data indicated that the prevalent CR-KPN strains during the same period in the same hospital usually belonged to the same ST clone.This suggests the potential of local CR-KPN outbreak.The ICU patients and those receiving mechanical ventilation may be prone to CRKPN (especially ST11) infection.Such patients should be managed appropriately.
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Objective To investigate the inoculum effect of fosfomycin on enterococci,in comparison with penicillin,rifampin,vancomycin and teicoplanin.Methods A total of 91 strains of enterococci were obtained from the patients hospitalized in The First Affiliated Hospital of China Medical University from January 2010 to January 2012.There was no repeated strain.The 91 strains consisted of 44 Enterococcus faecalis and 47 Enterococcus faecium strains.Agar dilution method was used to measure the minimum inhibitory concentrations (MIC) of the five antibiotics against the 91 enterococci strains under standard low inoculation concentration (1 × 105 colony-forming units [cfu]/mL) and high inoculation concentration (1 × 107 cfu/mL).Results For all tested strains,MIC of fosfomycin fluctuated between 16-64 tμg/mL in high and low inoculated concentrations.Among the tested strains,both Enterococcus faecalis and Enterococcus faecium had the highest drug-sensitive rate (100.0％) and the lowest drugresistance rate (0) to fosfomycin.With the increase of the inoculation concentration,MIC of the five antibiotics increased less than 8 times,which indicated that there was no inoculation effect.Conclusion Fosfomycin shows high drug-sensitivity against enterococci without inoculum effect in vitro,and it is recommended for the treatment of enterococci-infected patients.
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Objective To evaluate the anti-bacteria effects of polymyxin B combined with meropenem against 30 strains pan-drug resistant pseudomonas aeruginosa that separated in clinic. Methods The minimal inhibitory concentration (MICs) of 30 strains pan-drug resistant pseudomonas aeruginosa after treated with polymyxin B and meropenem as single-use or combination use were determined by both microdilution method and checkerboard method. The FIC index was calculated, then the type of combination effect was determined according to FIC index, which was used to determine whether there was synergistic or antagonistic effects. Results The MICs of pan-drug resistant pseudomonas aeruginosa were reduced significantly after polymyxin B combined with meropenem when compared with single-use. The percentages of the FIC index that less than 0.5 and the index between 0.5 and 1 were 60%and 30%respectively. Conclusion The results indicate that the combinations of polymyxin B with meropenem have good synergistic and additive effects against pan-drug resistant pseudomonas aeruginosa, there is no antagonism.
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Objective To analyze the clinical features of subacute thyroiditis (SAT ) manifested as fever of unknown origin (FUO) for early diagnosis .Methods The clinical and laboratory data were retrospectively reviewed for 20 SAT patients manifected as fever of unknown origin from October 2009 to February 2013 .Results A total of 20 patients were finally diagnosed as subacute thyroiditis ,about 3% of the 661 FUO patients .Only 5 SAT patients had complained of angina or pain in the anterior region of neck .Thyroid enlargement and tenderness were observed in 14 SAT cases .Elevated serum thyroid hormone and a very low serum level of thyroid stimulating hormone were seen in 17 patients with SAT .Ultrasound scan of thyroid showed inhomogenous hypoechongenic texture in 14 patients .99m Tc pertechnetate scan of thyroid showed extremely low radiopharmaceutical uptake in all the 20 cases .All patients had received antibiotic treatment prior to admission .Conclusions Subacute thyroiditis is an uncommon but important cause of FUO .Detailed history ,physical examination and laboratory evaluation can help minimize the chance of misdiagnosis and unnecessary antibiotic therapy .
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Objective To investigate the distribution and susceptibility of carbapenem-resistant Enterobacteriaceae (CRE) isolates in 2012 from CHINET surveillance .Methods Antimicrobial susceptibility testing was carried out according to a unified protocol using Kirby-Bauer method or automated Systems .Results were analyzed according to the breakpoints of CLSI 2012 M100-S22 .Results A total of 1 499 CRE isolates were collected from January to December 2012 ,of which K lebsiella spp .,Enterobacter spp .and E .coli accounted for 63 .5% ,15 .1% and 13 .7% ,respectively .Of the 1 499 isolates , 48 .2% and 29 .3% were from respiratory tract and ICU , respectively . The results of antimicrobial susceptibility testing showed that the resistance rate of CRE isolates to most antimicrobial agents was 70 .0%-100% except amikacin (46 .9% ) and trimethoprim-sulfamethoxazole (49 .8% ) .CRE isolates from adults were more resistant to ciprofloxacin ,aminoglycosides and trimethoprim-sulfamethoxazole than those from children .Conclusions The antibiotic resistance of CRE isolates is very high . The spread of CRE strains in a specific region such as ICU and neurosurgery ward poses a serious threat to clinical practice and implies the importance of strengthening infection control .
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Objective To determine the possible genetic background and the source of our hospital's 43 clinical isolates of multidrug-resistant Acinetobacter baumannii, and the category of gene cassettes in type 1 integrons of all strains.Methods Restriction enzyme Apa I was chosed for all strains in pulsed-field gel electrophoresis (PFGE) methods.Multilocus sequence typing ( MLST) was used to compare the allelic profiles of all the strains. PCR method was used for amplify the integrons of all strains. Results PFGE results showed that 43 strains were divided into four types. A-type and B-type were divided into 4 and 2 subtypes, respectively. The MLST results showed the existing of three allelic profiles; 1-3-3-2-2-7-3, 1-3-3-2-2-11-3, and 1-3-3-2-2-14-3.B-type and D-type of PFGE have the same allelic profile(1-3-3-2-2-11-3).A-type strains were detected mainly in ICU, and in burn unit only found B- and D-type.The same integron was detected in 62.8% of the strains.The constituent ratio of A1,A2,A3,A4,B1,B2,C and D-type was 40.7% , 18.5% , 7.4% , 3.7% , 14.8% , 3.7% , 3.7% and 7.4% , respectively.Conclusions The coexistence of multiple cloning system in this region was proved by the PFGE and MLST, and the same clone can evolve to different subtypes when stimulated by different environmental conditions; and the different carrying-situationt of the same integron in strains prove the possibility of the change during the evolution of resistance mechanisms.
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Objective To detect the encoding gene of efflux pump and two-component system, and investigate the effect of efflux inhibition on the multiresistance of Acinetobacter baumarmii. Methods PCR was used to detect the adeB, adeR and aries gene. Agar dilution was used to determine the minimum inhibitory concentrations(MIC) of ciprofloxacin, cefotaxime, amikacin and imipenem of 50 multiresistance Acinetobacter baumannii, with or without 25 μg/ml reserpine. Results 94%, 96% and 92% of 50 muhiresistance of Acinetobacter baumannii were detected for adeB, adeR and aries gene,respectively. At least four fold decrease of MIC was observed in 49, 50, 50 and 46 isolates for ciprofioxacin, cefotaxime, amikacin and imipenem, respectively. Conclusion The multiresistance of Acinetobacter baumannii is related to the effect of the efflux system.
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Objective To investigate the alternations in gene/amino acid sequence of penicillin-binding protein (PBP)2x from clinical isolates of Streptococcus pneumoniae, and to find the reasons for the rapid surge of penicillin and cefotaxime nonsusceptibility among pneumococcal isolates from Shenyang. Methods Thirty-four strains of Streptococcus pneumoniae were collected from January 2006 to February 2007. The antibiotics susceptibility of these strains was detected. PCR amplification and direct sequencing of pbp2x genes were performed. The sequence variations of PBP genes of the penicillin nonsusceptible Streptococcus pneumoniae(PNSP) in this region were studied by BLAST analysis. Results Two prominent substitutions were common to 12 PNSP isolates for which the MIC of penicillin resistance and cefotaxime were at least 0.5 mg/L, which included the replacement of Thr338→Ala in the first conservative motif STMK and Leu546→Val adjacent to third conservative motif KSG. The importance of the exchange of His394→Leu was identified in one PNSP isolate 15. The remarkable finding in this study was Met342→Ile following the first conservative motif STMK. pbp2x sequences of eight PRSP isolates shared Lys501-Glu505-Thr507 substitutions which might be served as a unique marker for PRSP in this region. Novel gene and amino acid sequence variants in 17 isolate were identified in this study, and these sequences have been deposited in the GenBank database and assigned accession No. EU044831, EU089706-EU089709, EU106881-EU106884 and EU124672. Conclusion It is likely that the emergence of penicillin and cefotaxime nonsusceptible Streptococcus pneumoniae in Shenyang might be associated with novel gene sequence variants.
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Objective To investigate the alternations in gene/amino acid sequence of penicillin-binding protein (PBP) 2b from clinical isolates of penicillin-nonsusceptible Streptococcus pneumonia(PNSP) in this region.Methods 24 strains of Streptococcus pneumonia were collected from January to December 2006.The antibiotics susceptibility of these strains was detected.PCR amplification and direct sequencing of pbp2b genes were performed.The sequence variations of PBP genes of the PNSP in this region were studied with sequence BLAST analysis.Results Three prominent substitutions were common tO 13 PNSP isolates with minimal inhibitory concentration(MIC) at least 0.1 mg/L.These included the replacement of Thr445→Ala following the conservative motif SSN,Glu475→Gly and Thr488→Ala/Ser.The exchange of Glu332→Gly was identified in 12 PNSP isolates of which the MIC was at least 0.25 mg/L.Seven penicillin resistant Streptococcus pneumonia (PRSP) isolates (MIC≥3 mg/L)shared the amino acid substitution Ala618→Gly adiacent to third conserved (KTG) motif and the PBP2b sequences of seven PRSP isolates were classified within Back's group Ⅱ and were very similar to those of the Korean J77 isolate.Novel gene and amino acid sequence variants in isolate 14,15,8,11 and 24 was identified in this study and these gene sequences have been deposited in the GenBank database and assigned accession no.EU035970,EU056919,EU056920,EU056921 and EU106886.Conclusion Analysis of pbp2b genes revealed highly similar patterns of nucleotide and amino acid sequence variation among most resistant isolates.while penicillin intermediate Streptococcus pneumonia might be associated with novel gene sequence variants.
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OBJECTIVE To compare the changing trends of antibiotic resistance of Proteus mirabilis isolates.METHODS A total of 288 P.mirabilis isolates obtained from clinical patients in the First Affiliated Hospital of China Medical University between 2001-2006 were included in the study.K-B test was used to determine the susceptibility and the results were read based on National Committee for Clinical Laboratory Standards(NCCLS)of the USA.RESULTS The sensitivity of P.mirabilis isolates to imipenem,ceftazidime,cefotaxime,aztreonam,cefoperazone-tazobactam,cefepime,amikacin and piperacillin was from 74.5% to 95.2%,meanwhile there was a low sensitivity to ampicillin,cefazolin,ciprofloxacin,sulfamethoxazole co.and tetracycline,from 2.3% to 58.8%.CONCLUSIONS The result of antimicrobial susceptiveity test may instruct the applications of clinical antibiotics.
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OBJECTIVE To study the changing trends of drug-resistance of Acinetobacter baumannii isolates.METHODS All 668 isolates of A.baumannii were obtained from clinical patients in the First Affiliated Hospital of China University of Sciences Medical between 2001-2006.K-B test was used to determine the susceptibility and the results were read based on National Committee for Clinical Laboratory Standards(NCCLS)of the USA.RESULTS The number of A.baumannii isolates was increasing from 61 in the year of 2001 to 247 in the year of 2006.And during the six years,the resistant rate to ciprofloxacin,gentamicin and imipenem was increasing from 28.8%,25.4%,5.4% to 64.9%,72.7% and 48.5%,respectively.The resistant rate of the 50 multidrug-resistant A.baumannii isolates to polymyxin B was 18.6%.CONCLUSIONS During the six years,the isolating rate is increasing,the result showed that there is not a large scale outbreak.The resistant rate is so high that we must strengthen the monitoring and indentify the drug-resistance mechanisms.
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OBJECTIVE To evaluate the efficacy,the eradication rates of pathogens and safety of levofloxacin in patients with community-acquired pneumonia(CAP) in comparison with therapy using a combination of cefuroxime plus azithromycin.METHODS Fifty five patients with CAP were randomly divided into two groups: levofloxacin alone and cefuroxime plus azithromycin,and the efficacy,the eradication rates of pathogens and the rates of side effects were observed.RESULTS From 30 patients in the levofloxacin group,25 patients(83.3%) were clinically cured and 3 patients(10.0%) were improved.And from 25 patients in the cefuroxime plus azithromycin group, 20 patients(80.0%) were clinically cured and 3 patients(12.0%) were improved. The eradication rates of pathogens were 85.7% and 88.9%,respectively.And the rates of side effects were 3.3% and 4.0%,respectively.CONCLUSIONS There are no significant differences in the efficacy,the eradication rates of pathogens and safety between 2 groups in treating community-acquired pneumonia.
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OBJECTIVE To study the information of drug resistance of 1292 coagulase-negative staphylococci(CNS) isolates. METHODS There were 1292 isolates of CNS obtained from clinical patients in between 2001-2006.K-B test was used to determine the susceptibility and the results were read based on Clinical and Laboratory Standards Institute(CLSI) of the USA. RESULTS The isolating rate of CNS isolates was decreasing from 11.0% in the year of 2001 to 6.4% in the year of 2006.During the six years,the resistant rate to erythromycin,oxacillin and benzylpenicillin was high(90.0%,78.9% and 95.0%,respectively) and the resistant rate to cefepime,ciprofloxacin and levofloxacin increased from 17.3%,42.4%,and 28.7% in the year of 2001 to 39.1%,56.0% and 42.6% in the year of 2006.But the resistant rate to tetracycline,trimethoprim/sulfamethoxazole decreased from 71.2% and 72.0% in the year of 2001 to 52.7% and 33.3% in the year of 2006.The resistant rate to quinupristin /dalfopristin was 5.6%. CONCLUSIONS The steady resiatence rate of CNS over the past six years provides powerful evidence for the choice of clinical medication and practice of infection control.