ABSTRACT
Objective To investigate the distribution and antibiotic resistance of pathogens isolated from inpatients with urinary tract infections.Methods A retrospective analysis was carried out on 1033 strains of pathogens isolated from urine culture in patients with urinary tract infections in Zhejiang Xiaoshan Hospital during January 2009 and December 2011.Urine specimens were cultured with Uricult,and K-B method was used for drug susceptibility test,WHONET 5.6 software was used to analyse drug susceptibility test.Results Among 1033 strains of pathogens,681 (65.9％) were gram-negative bacteria,197 (19.1％) were gram-positive bacteria,and 155 (15.0％) were fungi.The three most prevalent bacteria were Escherichia coli (402 strains,38.9％),Klebsiella pneumoniae (74 strains,7.2％) and Candida albicans (64 strains,6.2％).60.7％ (244/402) of Escherichia coli and 45.9％ (34/74) of Klebsiella pneumoniae were extended-spectrum β-lactamases (ESBLs) positive.Escherichia coli and Klebsiella pneumoniae were susceptible to imipenem,meropenem,cefoperazone/sulbactam,piperacillin/tazobactam and amikacin.Enterococcus and staphylococcus were susceptible to vancomycin,linezolid and furadantin.Candida was sensitive to flucytosine,voriconazole and amphotericin B.Conclusion Gram-negative bacteria mainly E.coli is the predominant pathogen to urinary tract infections in this group of patients.Regular analysis and monitoring of pathogen species and drug resistance is important for rational use of antibiotics.
ABSTRACT
Objective To investigate the genotypes of β-lactamases produced by Klebsiella pneumoniae.Methods Plasmid conjugation,PCR amplification,gene cloning and DNA sequencing,isoelectric focusing electrophoresis and extended-spectrum β-lactamase(ESBLs)confirmatory test were carried out for analyzing the encoding gene of β-lactamases in clinical strains of Klebsiella pneumoniae collected from hospital wards.Results Totally 75 clinical strains of Klebsiella pneumoniae were collected,in which 48 strains were confirmed to produce genotype of β-laetamases(64.0%),including 39 ESBLs-producing Btraim(52.0%).Among 48 strains,17 isolates(35.4%)carried 2 types of ESBLs genes,7(14.6%)carried 3 types of ESBL8 genes,and 5(10.4%)carried 4 types of ESBLs genes.CTX-M was the most comon type(30/48,62.5%),followed by TEM(26/48,54.2%)and SHV(25/48,52.1%).Among 9 isolates with DHA-1 AmpC β-laetamase,8 produced AmpC β-lactamases and ESBLs.Class A carbapenemase KPC-2 was produced in 3 isolates.False negative rate of ESBLs confirmatory test was 23.1%(9/39).Condusion Genotypes of β-lactamases produced by Klebsiella pneumoniae are complicated,which results in multi-drug resistance in clinic.