ABSTRACT
Objective To investigate the distribution and antibiotic resistance profile of clinical isolates in the First Hospital of Qiqihar during 2015.Methods Antimicrobial susceptibility test was carried out according to a unified protocol using automated system from January 1,2015 to December 31,2015.The results were analyzed with WHONET 5.6 software according to the 2014 breakpoints of Clinical and Laboratory Standards Institute.Results A total of 5 162 clinical isolates were collected,of which 28.1％ (1 450/5 162) were gram-positive cocci and 71.9％ (3 712/5 162) were gram-negative bacilli.About 36.5％ (255/698) ofS.aureus isolates and 81.4％ (180/221) of coagulase negative Staphylococcus isolates were resistant to methicillin.No S.aureus and coagulase negative Staphylococcus isolate were found resistant to vancomycin or linezolid.Enterococcus isolates showed low resistance to vancomycin and linezolid.One strain of E.faecium was found resistant to vancomycin.ESBLs were produced in 39.9％ (298/747) ofE.coli,26.1％ (294/1 127) ofKlebsiella spp.,and 15.6％ (12/77) ofP mirabilis strains.The Enterobacteriaceae strains were less resistant to imipenem,beta-lactam/beta-lactamase inhibitor combination and amikacin.About 36.6％ (163 / 445) of A.baumannii isolates and 1.8％ (13/715) of P.aeruginosa isolates were extensively drug-resistant strains.Conclusions Antibiotic resistance poses a serious threat to clinical practice,to which more attention should be paid.Clinical microbiology lab should make more efforts to provide better support to clinical therapy.
ABSTRACT
Objective To evaluate the early diagnosis value of procalcitonin (PCT) in severe brain damage combined with pul‐monary infection .Methods The brain injury patients in the hospital from January to October 2014 were enrolled in the study and divided into infectious group whose infection had occurred within 5 days after admitting to hospital and non‐infectious group who had not suffered from infection .The blood samples of the patients were collected within 2 h and 3 days after admitting to hospital and detected for PCT concentration .The Early diagnosis value of PCT in brain damage combined with pulmonary infection was e‐valuated and compared with white blood cells (WBC) ,neutrophile granulocyte(N)and hypersensitive C‐reactive protein(hs‐CRP) . Results The incidence of pulmonary infection within 5 days of severe brain injury was 22 .9% (41/179) .There were statistically differences of PCT ,WBC ,N and hs‐CRP between infectious group and non‐infectious group(P< 0 .05) .The areas under curve (AUC) of PCT ,WBC ,N and hs‐CRP were 0 .83 ,0 .80 ,0 .78 and 0 .82 respectively .The combination of PCT+WBC+ hs‐CRP had the highest diagnostic value since its AUC was 0 .87 .PCT had a satisfied diagnostic veracity since it had good sensitivity ,specificity and positive predictive value in the diagnosis of brain damage combined with pulmonary infection .Conclusion PCT could be an ear‐ly diagnosis indicator in severe brain damage combined with pulmonary infection ,and the diagnostic veracity is higher when com‐bined with WBC and hs‐CRP .An antimicrobial treatment is recommended when PCT concentration of brain damage patient rises , especially when combined with WBC and hs‐CRP concentration elevating .