ABSTRACT
Objective To study the drug resistance and disinfection -resistant gene in Staphylococcus aureus isolates. Methods The sensitivity to 17 antibacterial agents was detected in 36 strains of Staphylococcus aureus by E -test.The disinfection -resistant genes qac (A /B ) were detected by PCR.Results The resistance rates of clindamycin, ciprofloxacin,erythromycin,levofloxacin,oxacillin and penicillin G were 94.44%,75.00%,94.44%,72.22%, 97.22% and 100.00%,respectively.There were no significantly difference of drug resistance rates between isolates from ICU setting and non -ICU setting (P >0.05 ),and 14 (38.89%)isolates were qac (A /B)positive.Conclusion Clinically isolated staphylococcus aureus is multi -drug -resistant and the qac (A /B)positive rate is high.
ABSTRACT
BACKGROUND AND PURPOSE: Cerebral venous flow obstruction (CVFO) is a fatal complication of traumatic brain injury. To compare the outcomes of patients with CVFO secondary to traumatic-brain-injury-induced transsinus fracture who were diagnosed early versus those diagnosed late in the therapeutic course. METHODS: In total, 403 patients with transsinus fracture were reviewed retrospectively. The patients were divided into an early-diagnosis group (n=338) and a delayed-diagnosis group (n=65). The patients submitted to 2D time-of-flight magnetic resonance venography (2D-TOF MRV) and/or CT venography (CTV), depending upon the findings of intracranial pressure monitoring, in order to identify potentially complicated CVFO. These examinations took place within 3 days of the onset of malignant intracranial hypertension symptoms in the early-diagnosis group, and after an average of 7 days in the delayed-diagnosis group. Once diagnosed, patients received intravenous thrombolytic therapy with low-dose urokinase. Patients with massive transsinus epidural hematoma, depressed fracture, or cerebral hernia were treated surgically to relieve the compression and repair any damage to the venous sinuses. RESULTS: Cerebral venous flow obstruction was much more severe in the delayed-diagnosis group than in the early-diagnosis group (p<0.001), and hence patients in the former group were given a higher dose of urokinase (p<0.001) for thrombolytic therapy. They were also significantly more likely to need surgery (48.1% vs. 20.6%, p=0.003) and had a higher mortality rate (37.0% vs. 4.1%, p<0.001). However, patients in both groups experienced a similarly favorable prognosis, not only with regard to functional outcome but also with respect to neuroradiological improvement, as evaluated by 2D-TOF MRV/CTV at the final follow-up (p=0.218). CONCLUSIONS: Delayed diagnosis can result in increased risk of surgery and death in the acute phase. Thrombolytic therapy with low-dose urokinase resulted in promising improvements in both functional and neuroradiological outcomes in all of the patients in this study, regardless of the time to diagnosis.