ABSTRACT
Objective To evaluate the clinical,microbiological and epidemiological characteristics of enterococcal bloodstream infections (BSIs).Methods Microbiological and clinical data were retrospectively collected and reviewed for the adult patients with enterococcal BSI who were treated in Sichuan Provincial People′s Hospital from January 1,2011 to November 30,2013. Results Of the 92 cases of enterococcal BSIs,21 were due to E.faecalis and 71 were caused by E.faecium,respectively.The BSI was hospital acquired in 67 cases.The other were community acquired BSI.E.faecalis BSIs were complicated with uremia (42.9%),heart disease (23.8%),pulmonary infection (19.0%)and central neurological disorder (19.0%),while E. faecium BSIs were complicated with hepatobiliary and pancreatic diseases (40.8%),neoplastic disease(40.8%)and pulmonary infection (40.8%).Risk factors for E.faecium acquisition were mainly central venous catheter (73.2%),recent surgey within 30 days (62.0%),elderly patients (52.1%),ICU admission (32.4%)and invasive mechanical ventilation (26.8%).Strains of E.faecalis were 100% susceptible to ampicillin and vancomycin,90.4% to linezolid.Strains of E.faecium were 100%susceptible to linezolid,96.9% to vancomycin, and approximately 90% resistant to ampicillin and penicillin. Logistic with hepatobiliary and pancreatic diseases had lower mortality rate than other patients.Conclusions E .faecium is responsible for majority of the enterococcal BSIs.E .faecium strains have higher resistance rate to most antimicrobial agents tested than E . fecalis .Elderly patients,ICU admission,invasive mechanical ventilation and neoplastic diseases are the independent risk factors of 15-day mortality.Adequate antimicrobial therapy within 48 hours can decrease the mortality rate effectively.
ABSTRACT
Objective To investigate the bacterial distribution and drug resistance in urinary tract infection from Sichuan Provin‐cial Antimicrobial Resistant Investigation Net during 2011-2012 .Methods The distribution and drug resistance data of pathogens isolated from urine specimens of urinary tract infection cases were collected from the members of Sichuan Provincial Antimicrobial Resistant Investigation Net ,and the results were counted and analyzed .Results There were 54 hospitals enrolling in the investiga‐tion .A total of 12 420 pathogenic strains were isolated from urinary tract infection in the survey .The top 5 predominant bacteria were Escherichia coli(46 .5% ) ,Excrement enterococcus (7 .0% ) ,K lebsiella pneumoniae (5 .8% ) ,Dung enterococcus (5 .7% ) and Pseudomonas aeruginosa(3 .7% ) .The resistant rates of Escherichia coli ,K lebsiella pneumoniae and Pseudomonas aeruginosa to imipenem were 16 .0% ,16 .7% and 16 .0% ,and to levofloxacin were 55 .2% ,28 .2% and 27 .7% ,respectively .The resistant rates of Excrement enterococcus and Dung enterococcus to vancomycin were 4 .1% and 1 .4% respectively .Conclusion Escherichiacoli and Enterococcus are still the predominant organism in urinary tract infection cases .Clinical treatment should refer to the results of drug sensitive test .