ABSTRACT
Objective To investigate the risk factors for nosocomial bacteremia and decrease the prevalence of nosocomial bacteremia.Methods We collected the data of bacteremia patients in our hospital from January,2006 to December,2009.According to the criterion of nosocomial infection,the patients were divided into nosocomial bacteremia group (83) and community-onset bacteremia group (119).The influence of a series of variables on the development on both types of bacteremia was analyzed by Student＇s t test and x2 test.The risk factors were performed using multivariate logistic regression.Results Compared to that of community-onset bacteremia group,the proportion of malignancy (21/83 vs 12/119,x2 =8.2846,P ＜ 0.01 ),venous catheter ( 28/83 vs 3/119,x2 =36.67,P ＜ 0.01 ),diabetes ( 37/83 vs 0/119,x2 =68.226,P ＜0.05),surgical operation(37/83 vs 0/119,x2 =68.226,P ＜0.01),previous antibiotics(78/83 vs 10/119,x2 =173.5657,P ＜ 0.01 ) in nosocomial bacteremia group were higher.Multivariable logistic regression analysis showed that only 4 factors were significantly and independently responsible for nosocomial bacteremia,They were malignancy ( P ＜ 0.05,OR =3.186),diabetes ( P ＜0.001,OR =4.821 ),venous catheter( P ＜ 0.05,OR =2.135),previous antibiotics ( P ＜ 0.05,OR =2.135 ).The bacteria in nosocomial bacteremia group showed more ability to resist to antibiotics.Conclusions We should pay more attention to the patients with diabetes or malignancy or venous catheter or previous treated with antibiotics.These patients have more chances to develop to nosocomial bacteremia and infect by the drug-resistant bacteria.
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Clinical data of 116 patients with implanted permanent dual catheters for hemodialysis,including 18 with infection and 98 non-infection, during January 2006 and July 2009 were retrospectively analyzed to study risk factors for catheter-related bacteremia (CRB). Duration of catheter implantation,primary disease, routine blood examinations and blood biochemical examination of the patients were analyzed between the two groups. COX proportional hazard regression analysis was performed for all predictor variables. Results showed that overall incidence of bacteremic episodes was 0. 314 per 1000 catheter-day.Compared to that in infection group, levels of hemoglobin, plasma albumin, peripheral lymphocyte count and ratio of CD4/CD8 in non-infection group were significantly higher ( all P ＜ 0. 05 ), and OR of CRB were 4. 011 (P =0. 0213) for diabetes mellitus and 7. 181 for hemoglobin level less than 80g/L (P = 0. 0020),respectively. It is suggested that improving nutrition status and correcting anemia for patients with hemodialysis are necessary to reduce CRB.
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OBJECTIVE Through detecting to drug susceptibility results of 12 commonly used antibiotics in Pseudomonas aeruginosa (PAE),we provide the scientific basis for the prevention of infection and reasonable choice of antibiotics. METHODS Twelve antibiotics′ susceptibility tests in vitro were carried out in PAE isolated from lower respiratory tract in Renming Hospital,Wuhan University from Jan 2007 to Dec 2008. RESULTS In the anti-infective drugs,the resistance rate to ceftazidime was the lowest (36.8%),followed by amikacin (39.6%),piperacillin/tazobactam (43.8%),cefepime (47.8%) and cefoperazone/sulbactam (48.5%).The resistant status of PAE was serious and multi-drug resistance existed. CONCLUSIONS The lower respiratory tract infection caused by PAE which possesses single and multiple drug-resistance. We should more think of it and strengthen preventive measures to reduce the rate of infection. Reasonably prudent use of antibiotics is still the best way of delaying its rapid increase of drug-resistance strains.
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OBJECTIVE To study the distribution and drug resistance of nosocomial infection pathogens isolated from of lower respiratory tract in senile patients and preventive control measures.METHODS The sputum and lower respiratory tract secretion of 594 senile patients were cultured to detect pathogens which were confirmed by routine methods.Disk diffusion test was used to analyze drug resistance.RESULTS Pseudomonas aeruginosa was the top one(21.2%).The drug resistance of Gram-negative organisms were the highest.Extensive-spectrum beta-lactamase(ESBLs) were tested out with 38.2% occurrence.CONCLUSIONS Strictly control in every step of procedures could reduce nosocomial infection.
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Objective To study the infection condition of AmpC ? lactamases producing strains for reasonable use of antibiotics in clinic. Methods Adopting modified three dimensional extract test was adopted to detect enterobacteriaceae strains, and 12 antibiotics were determined by the antimicrobial disk diffusion susceptibility tests in specimen collected from 233 senile infectious patients. Results The total isolating rate of AmpC ? lactamases producing enterobacteriaceae strains in senile patients was 8 6%. The incidence of AmpC ? lactamases producing strains was found most often in E.cloacae. The AmpC ? lactamases producing strains were susceptive to imipenem and there the resistance rates to imipenem were 100 0%. The resistance rates to cefepime were 85%～100% to the third generation cephalosporins and aztreonam Conclusions The drug resistance of AmpC ? lactamases producing enterobacteriaceae is very serious. It is important to surveillance and control drug resistance of AmpC producing strains.