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Objectives This study was conducted to detect and analyze the presence of plasmidmediated quinolone resistance (PMQR) determinants [qnr,aac-(6′)-Ib-cr and qepA] among clinical isolates of Citrobacter freundii strains isolated from patients in Anhui,China,and to understand the susceptibility of PMQR positive strains to commonly used antimicrobial agents.Methods During the year 2009,31 Citrobacter strains were collected from the First Affiliated Hospital of Anhui Medical University.Polymerase chain reaction (PCR) was used to detect PMQR genes.Amplicons were purified,sequenced and compared with data from the GenBank.Conjugation experiments were conducted to determine whether the qnr-carrying plasmids were self-transferable.The susceptibility of the positive isolates and transconjugants were tested by agar dilution method according to Clinical and Laboratory Standards Institute (CLSI) guidelines.The minimum inhibitory concentrations (MIC) of ciprofloxacin and levofloxacin were determined by E-test strips.Results Among the 31 Citrobacter strains,the qnr genes were detected in 8 isolates (25.8％),among which,6 carried qnrB.Aac-(6′)-Ib-cr and qepA were not identified in these isolates.The qnr genes were transferred from four clinical isolates to their transconjugants.Sequence analysis identified one novel qnrB variant (qnrB24).The resistant rate of qnr-positive clinical isolates to quinolone was 87.5 ％.Most of them were also resistant to various other antibiotics,including cefotaxime (75.0 ％),amikacin (7.5 ％),ceftazidime (62.5 ％),cefapime (37.5 ％),and gentamycin (87.5 ％).All qnr positive strains were susceptible to imipenem.MIC of all transconjugants showed reduced susceptibility to fluoroquinolones,with MIC increased by 10-23 folds.Conclusions Our study shows that qnr gene has occurred in Citrobacter freundii isolates from Anhui Province,China.QnrB is most prevalent in these isolates.Most qnr positive isolates are resistant to commonly used antimicrobial agents.
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0.05);the main infection site was lower respiratory tract(61.97%),followed by surgical site infection(SSI)(23.94%).CONCLUSIONS In order to reduce postoperation nosocomial infection rate,we should take following measures:Improve pulmonary function,remove tracheal intubation as early as possible,shorten lasting time of surgery and days before operation,keep aseptic technique,strengthen nursing,enhance immunity,and use antimicrobial agents reasonably.
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OBJECTIVE To investigate the surgical site infection(SSI)in clean surgical sites and the perioperative antibiotic usage.METHODS The incidence of SSI and the antibiotics usages in 842 cases during perioperative were analyzed retrospectively in 32 hospitals.RESULTS One case with nosocomial infection was found(0.12%).The use rate of antibiotics was 98.57%.Among 802 cases using prophylactic antibiotics,the antibiotics were given in 181 cases thirty minutes to two hours before operation.136 cases were given 24 h before operation.And 485 cases were given after operation;195 cases stopped using antibiotics after 24 h,472 cases stopped using antibiotics after 4-6 days and 135 cases stopped to use antibiotics after 7 days.CONCLUSIONS The major problem is excessive use of antibiotic in clean surgical site during perioperation,long duration of antibiotics prophylaxis,more expensive antibiotics and unnecessary combination of antibiotics,suggesting that it be important to strengthen the management of antibiotics.
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OBJECTIVE To explore the precaution against nosocomial fungal infections of lower respiratory tract(NFILRT).METHODS A retrospective analysis on eighty-seven cases who catched NFILRT during the years 2002 to 2004 was done.RESULTS 80.46% Cases were over 60 and the average age was 67.95 and the average in-hospital days were 46.95;most of the NFILRT patients had serious underlying diseases.Before the NFILRT,immunosuppressive agents had been injected to 47.13% cases and 42.53% patients had taken anti-acid medicine;94.25% cases had received antimicrobial agents and the average days of using antimicrobial agents were 11.01 days,and among these patients 62.20% had received more than two kinds of antimicrobial agents.About 32.18% of the NFILRT cases were associated with tracheal intubation,incision of trachea and mechanical ventilation;some patients had no clinical symptoms referred to the respiratory tract;the mortality rate was 26.44% and it couldn′t be obviously cut down by using antifungal agents.CONCLUSIONS It is very important to prevent NFILRT by using antimicrobial agents reasonably and enhancing immunity in these patients.
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Objective To study the changes of the bone density and metabolic makers in patients with lupus nephritis (LN) after long time prednisone treatment.Methods All patients were women.The healthy controls (group A, n =20),the patients with normal renal function (group B, n =25) were studied before and after 2 and 4 month prednisone treatment.Dual energy X ray absorptiometry was used to measure bone mineral density (BMD) in the lumbar spine at L2～L4,femoral neck,Ward′s triangle,great trochanter (GT) and ultradis (ULT).Simultaneously,the serum calcium,phosphate,alkaline phosphate enzyme,PTH M,BGP,24 hour urine calcium,creatinine and other biochemical indices were examined in all of them.Results ① There were no significant differences in BMD between both groups ( P
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OBJECTIVE To understand the sites of nosocomial infection and its pathogenic bacteria. METHODS Infection sites and pathogens of 2134 patients with nosocomial infection were analyzed. RESULTS Totally 2235 infections were occurred. The main site was lower respiratory tract(30.47%),followed by upper respiratory tract(18.20%) and operated wound(12.17%). Among 815 strains,149 were Gram-positive bacteria,456 Gram-negative bacteria and 210 fungi. The rates of main Gram-positive cocci in lower respiratory tract,burned and operated wounds were 42.14%,20.00% and 12.86%,respectively; the rates of main Gram-negative rods in lower respiratory tract,burned wound and urinary tract was 44.14%,29.70% and 10.90%,respectively; the rates of fungi in lower respiratory tract,oral cavity and gastrointestinal tract was 41.90%,18.56% and 18.10%,respectively. CONCLUSIONS According to the main sites and pathogenic bacteria of nosocomial infection,countermeasure should be taken to prevent and control nosocomial infection.
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OBJECTIVE To analyze the occurring characteristic and curing measures of hospital infection for inpatients in the departments of neurology.METHODS The data of hospital infection for the medical records of 22 936 inpatients with disease in the departments of neurology of 40 hospitals in Anhui from Jan 2005 to Mar 2006 were analyzed.RESULTS Among all inpatients 1 011 were infected.The rate of infection was 4.41%.The infection distribution is described as follows:640 patients were infected in respiratory tract(63.30%);181 patients in urinary tract(17.90%),84 patients in gastrointestinal tract(8.31%);and 16 patients were in cutis tissue(1.58%).CONCLUSIONS Through performing aseptic manipulation strictly,curing underlying diseases,paying attention to aseptic manipulation and making the rational use of antimicrobial agents,the infection rate could be lowered.