ABSTRACT
Objective To investigate the etiological and antibiotic resistance profile in the old patients with bloodstream infection (BSI).Methods Microbiological and clinical data were collected and reviewed retrospectively for the patients with confirmed bloodstream infection and at least 65 years of age who were treated as inpatients in Tongling People′s Hospital from January to December 2015.Results A total of 107 strains of pathogen were isolated from the blood samples of 107 patients with bloodstream infections, of which community-acquired BSI accounted for 57.9 % (62/107), and hospital-acquired BSI 42.1 % (45/107). Gram negative bacilli accounted for 67.7 % in the pathogens of community-acquired BSI and gram positive cocci accounted for 55.5 % in the pathogens of hospital-acquired BSI. More male BSI patients were secondary to respiratory tract infection than female patients (P<0.001), while more female BSI patients were secondary to urinary tract infection than male patients (P<0.001). Of the 107 isolates, gram negative bacilli, gram positive cocci and fungi accounted for 55.1 % (59/107), 42.1 % (45/107) and 2.8 % (3/107), respectively. The top six pathogens were E. coli (30.9 %), coagulase negativeStaphylococcus (CNS) (20.6 %), S. aureus (10.3 %),K. pneumoniae (6.5 %),Enterococcusspp. (6.5 %) and Acinetobacter spp. (4.7 %). About 51.5 % of the E. coli isolates and 28.6 % of the K. pneumoniae isolates produced extended-spectrum β-lactamases (ESBLs).E. coli isolates showed low resistance rate (< 10 %) to amikacin,cefoxitin and piperacillin-tazobactam. No E. coli isolate was found resistant to carbapenem. About 14.3 % to 28.6 % of K. pneumoniae isolates were resistant to carbapenems. No tigecycline-resistant K. pneumoniae was found. The prevalence of MRSA and MRCNS was 36.4 % and 72.7 %, respectively. No staphylococcal isolates were found resistant to vancomycin, teicoplanin or linezolid. One strain of E. faecium was identified as resistant to vancomycin (VRE).Conclusions This surveillance data indicate that gram negative bacilli play an important role in the BSI of old patients. E. coli and CNS are the most common pathogens. We should pay more attention to the effect of gender and site of infection on the BSI in old patients.
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Objective To investigate the bacterial resistance profile of clinical isolates collected in Tongling area . Methods Antimicrobial susceptibility test was conducted by Kirby‐Bauer method . All the data were analyzed with WHONET 5 .6 software .Results A total of 3 419 clinical isolates were collected during 2013 ,of which gram negative organisms and gram positive organisms accounted for 75 .9% and 24 .1% .MRSA accounted for 41 .3% of S .aureus and MRCNS accounted for 73 .5% of coagulase negative Staphylococcus ,respectively .MRSA showed higher resistance to gentamicin ,ciprofloxacin , erythromycin and rifampicin . No vancomycin‐ or teicoplanin‐resistant strains of Staphylococcus spp . were found . No vancomycin‐or teicoplanin‐resistant strains of E . f aecalis and E . f aecium were found .About 51 .6% of E .coli isolates and 42 .8% of K . pneumoniae isolates produced extended‐spectrum β‐lactamases (ESBLs ) . The prevalence of imipenem‐ or meropenem‐resistant strains of K . pneumoniae increased significantly .The percentage of P . aeruginosa strains resistant to amikacin ,piperacillin‐tazobactam ,ciprofloxacin ,cefepime and cefoperazone‐sulbactam was lower than 20 .0% .The percentage of A .baumannii strains resistant to cefoperazone‐sulbactam , minocycline and amikacin w as 34 .7% ,57 .0% and 58 .3% , respectively . More than 68 .0 % of A . baumannii strains were resistant to any of the other antibiotics tested . Conclusions The antibiotic resistance is growing in clinical bacterial isolates .The spread of carbapenem‐resistant strains of K . pneumoniae in some departments poses a serious threat to clinical practice .We should pay more attention to resistance surveillance and rational use of antibiotics .
ABSTRACT
Objective To investigate the bacterial resistance of clinical isolates collected in Tongling area. Methods Antimicrobial susceptibility test was conducted by Kirby-Bauer method.All the data were analyzed with WHONET 5.5 software.Results A total of 3 092 clinical isolates were collected during 2012,of which gram negative organisms and gram positive organisms accounted for 76.3% (2 359/3 092)and 23.7% (773/3 092),respectively.MRSA and MRCNS accounted for 50.9% of S.aureus and 73.0% of coagulase negative Staphylococcus,respectively.MRSA and MRCNS showed higher resistance to gentamicin,ciprofloxacin and erythromycin.No vancomycin-or teicoplanin-resistant strains of Staphylococcus spp.were found.No vancomycin-or teicoplanin-resistant strains of E.faecalis were found.Some E.faecium strains were resistant to vancomycin and teicoplanin.About 52.1% of E.coli isolates and 42.1% of Klebsiella isolates produced extended-spectrumβ-lactamases (ESBLs).Imipenem-or meropenem-resistant strains of K. pneumoniae were found. The percentage of P.aeruginosa strains resistant to amikacin, cefoperazone-sulbactam and cefepime was 3.4%,14.0% and 17.7%,respectively.More than 70% of Acinetobacter spp. strains were resistant to all the antibiotics tested except minocycline and cefoperazone-sulbactam,to which 42.1%and 4.4% of the strains were resistant.Conclusions The antibiotic resistance of clinical bacterial isolates is growing. The spread of multi-drug or pan-drug resistant strains in a specific region poses a serious threat to clinical practice.We should pay more attention to resistance surveillance and the rational use of antibiotics.
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Objective To investigate the bacterial resistance of clinical isolates collected in Tongling area during 2011.Methods Antimicrobial susceptibility testing was conducted by Kirby-Bauer method.All the data were analyzed by WHONET 5.5 soft-ware.Results A total of 2 690 clinical isolates were collected during 2011,of which gram negative organisms and gram positive organisms accounted for 74.2% and 25.8%,respectively.MRSA and MRCNS accounted for 45.1% of S.aureus and 71.6%of coagulase negative Staphylococcus,respectively.MRSA and MRCNS showed higher resistance to gentamicin,ciprofloxacin and erythromycin than the corresponding methicillin-susceptible strains.No vancomycin- or teicoplanin-resistant strain of Staphylococcus spp.was identified.The resistance rate to penicillin,nitrofurantoin and fosfomycin was low in E.faecalis.No ampicillin-,vancomycin-or teicoplanin-resistant strains were found.For E.faecium,some strains were resistant to vancomy-cin and teicoplanin.About 46.6% of E.coli isolates and 27.7% of Klebsiella isolates produced extended-spectrumβ-lactamas-es (ESBLs).No imipenem-or meropenem-resistant isolate was found.The percentage of P .aeruginosa strains resistant to imipenem,meropenem and amikacin were 29.5%,36.9%and 2.3%, respectively. More than 60.0% of the Acinetobacter strains were resistant to all the antibiotics test-ed except minocycline and cefoperazone-sulbactam,to which 26.4% and 12.5% of the strains were resistant.Conclusions No glycopeptides-resistant isolate was found in gram positive organisms except E.faecium.The resistance rate of Enter-obacteriaceae isolates was lower to imipenem,meropenem, cefoperazone-sulbactam,piperacillin-tazobactam and amika-cin.The prevalence of resistant strains is still increasing,es-pecially carbapenem-resistant P .aeruginosa and carbapenem-resistant A.baumannii.It is mandatory to take effective antibiot-ic policy and infection control measures.