ABSTRACT
Objective To analyze the distribution and antibiotic resistance of the clinical bacterial isolated from the intensive care unit (ICU) of Tongren Hospital during 2013-2017.Methods All the bacterial isolates were identified by Vitek-2 Compact system.Antimicrobial susceptibility testing was carried out using Kirby-Bauer method or automated systems.The susceptibility data were analyzed using WHONET 5.6 software.Results were interpreted according to CLSI M100-S27th breakpoints.Results A total of 1 049 clinical isolates were collected,including 331 (31.6％) strains of gram positive bacteria and 718 (68.4％) strains of gram negative bacteria.The overall prevalence of methicillin-resistant Staphylococcus aureus (MRSA) in Staphylococcus aureus and methicillin resistant coagulase negative staphylococci (MRC-NS) in coagulase-negative Staphylococcus were 84.5％ and 80.2％.No Staphylococcus strains were found resistant to vancomycin or linezolid.The resistance rates of E.faecalis strains to most drugs tested were lower than those of E.faecium.Polymerase chain reaction (PCR) amplification and sequencing analysis indicated that the only one vancomycin-resistant strains isolated from E.faecium was vanM type.The resistance rates to carbapenems of Klebsiella pneumoniae,Pseudomonas aeruginosa,and Acinetobacter baumannii respectively were 50.7％,50.4％,and 82.7％.Conclusions Antibiotic resistance is still very serious in ICU.It is necessary to maintain good practice in surveillance of bacterial resistance,and strengthen management of clinical use of antimicrobial agents and hospital infection control.
ABSTRACT
Objective To compare the safety of dopamine ( DA) and norepinephrine ( NE) in hypovolemic shock , and the impact on the stability of blood pressure and haemodynamics .Methods Eighty two patients with hypovolemic shock were given fluid resuscitation . All the patients were divided into two groups including DA group (n=41) and NE group(n=41).Recovery of blood pressure, hemody-namic parameters were observed at different time point , and the complications and mortality of two groups were recorded .Results Blood pressure of all the patients returned to normal in 15min after the medication, and became stable after 30min.There was no significant difference in the blood pressure in both groups except that of 15min.Compared with T0, There were higher in the numerous of CVP , CI, ELWI, ITBI.The ELWL at T2 in DA group was higher than that of NE group , while there was no significant difference in the other time points between the two groups(P>0.05).After treatment for 24 h, blood oxygen saturation, urine volume in two groups were significantly increased, blood lactic acid markedly reduced , but lactic acid in NE group was obviously lower than that in DA group (P0.05).Conclusion The effect of NE and DA in maintaining the stability of blood pressure and hemodynamic are equivalent , and NE did not increase the risk of acute kidney injury , but can effectively improve tissue perfusion , reduce arrhythmia and case fatality rate , improve clinical outcomes .