Study on the anti-Candida krusei in vitro combined with tacrolimus and itraconazole / 安徽医科大学学报

Objective The use of the antifungal agent itraconazole and the calcineurin inhibitor tacrolimus alone, together with the above two drugs, was evaluated in vitro for growth of Candida krusei. Whether or not the combina-tion is more effective than the antifungal alone can inhibit the growth of Candida krusei. Methods According to the guidelines of the American Institute of Clinical and Laboratory Standards, 12 Candida krusei strains were divided into blank control group, itraconazole group, tacrolimus group, and combination group by microdilution method, and then 12 the Candida krusei strain was incubated for 24 h and its growth was observed. Results In comparison with the alone use of isotriconazole in Candida krusei, the combined use of itraconazole,its minimal inhibitory con-centration was much less than that of alone, with a maximum multiple of 32 fold, a minimum multiple up to 4 times; the same, In comparison with the alone use of tacrolimus in Candida krusei, the combined use of tacroli-mus, its maximum multiple of 32 times, the lowest multiple of 2 times. Conclusion The combined use of itracon-azole and tacrolimus in 12 strains of Candida krusei displayed a powerful synergistic effect in vitro.

Surveillance of antibiotic resistance in clinical isolates from the First Affiliated Hospital of Anhui Medical University during 2017 / 中国感染与化疗杂志

Objective To investigate the antibiotic resistance of clinical isolates in the First Affiliated Hospital of Anhui Medical University during 2017. Methods Antimicrobial susceptibility testing was carried out according to a unified protocol using automated system or Kirby-Bauer method. Results were interpreted according to the breakpoints of CLSI 2017. The data were analyzed by WHONET 5.6 software. Results A total of 6 495 non-duplicate clinical isolates were collected in 2017. There were 1 727 strains (26.6％) of gram-positive bacteria and 4 768 strains (73.4％) of gram-negative bacteria. The most frequently isolated microorganisms were E. coli (19.8％), followed by Klebsiella pneumoniae and Acinetobacter baumannii. The strains were mainly isolated from respiratory tract (37.0％) and urine (23.1％). The prevalence of MRSA and MRCNS in Staphylococcus aureus and coagulase-negative Staphylococcus was 50.1％ and 82.1％, respectively. No Staphylococcus strains were found resistant to vancomycin or linezolid. E. faecalis and E. faecium accounted for 49.9％ and 40.4％ of total Enterococcus isolates. The prevalence of ESBLs-producing strains was 57.6％ in E. coli, 27.1％ in Klebsiella spp. and 33.0％ in Proteus mirabilis. Enterobacteriaceae strains were still highly susceptible to carbapenems antibiotics. The Klebsiella pneumoniae isolates in 2017 showed significantly higher resistance rate to imipenem and meropenem than the strains in 2016. However, Pseudomonas aeruginosa and Acinetobacterbaumannii strains showed lower resistance rates to carbapenems than the strains in 2016. Conclusions The bacterial isolates in 2017 pose serious threat to clinical antibiotic therapy. More attention should be paid to rational use of antimicrobial agents and infection control measures.

Surveillance report of antimicrobial resistance in the clinical isolates from the First Affiliated Hospital of Anhui Medical University during 2016 / 中国感染与化疗杂志

Objective To report the distribution and antibiotic resistance of bacterial strains isolated in the First Affiliated Hospital of Anhui Medical University during 2016 for improving clinical treatment of bacterial infections. Methods Antimicrobial susceptibility testing was carried out according to a unified protocol using Kirby-Bauer method or automated systems. The results were interpreted according to the clinical and laboratory standards institute (CLSI) 2015 breakpoints, and analyzed using WHONWT 5.6. Results A total of 5 406 clinical isolates were collected during 2016, of which gram positive organisms accounted for 25.6％ (1 386/5 406) and gram negative organisms 74.4％ (4 020/5 406). The strains were mainly isolated from respiratory tract (35.4％, 1 913/5 406) and urine (26.7％, 1 441/5 406). The most frequently isolated microorganisms were E. coli (23.1％, 1 247/5 406), followed by K. pneumoniae (12.1％,654/5 406). The prevalence of MRSA was 52.2％ (166/318). The prevalence of MRCNS was 80.3％ (462/575). Of the ESBLs producers, E. coli accounted for 59.7％ (745/1 247), and K. pneumoniae accounted for 30.6％(200/654). ESBLs-producing strains showed significantly higher resistance rates to most antibiotics than non-ESBLs-producing strains. All the E. faecalis strains were susceptible to vancomycin. A few (0.2％) of the E. faecium strains were resistant to vancomycin, which were all from urine specimens. A total of 1 046 (19.3％, 1 046/5 406) carbapenemresistant strains were isolated. Most Enterobacteriaceae isolates were still highly sensitive to carbapenems. Carbapenem-resistant isolates were mainly A. baumannii (41.1％, 430/1 046), P. aeruginosa (17.4％, 182/1 046)) and K. pneumoniae (12.0％, 126/1 046). Most Acinetobacter strains were resistant to most of the antibiotics tested. Conclusions Antimicrobial resistance is increasing in the clinical isolates in this hospital. We should continue to strengthen antimicrobial stewardship, prescribe antibiotics for strict indications, and improve rational antibiotic use.

Surveillance of antibiotic resistance in the bacterial strains from the First Affiliated Hospital of Anhui Medical University during 2015 / 中国感染与化疗杂志

Objective To investigate the distribution and the antibiotic resistance profile of clinical isolates in the First Affiliate Hospital of Anhui Medical University during 2015.Methods Antimicrobial susceptibility testing was carried out according to a unified protocol using Kirby-Bauer method and automated systems.Results A total of 5 524 nonduplicate clinical isolates were collected during 2015,including gram-negative bacteria (3 882,70.3 ％),gram-positive bacteria (1 642,29.7 ％).The prevalence of methicillin-resistant isolates in Staphylococcus aureus (MRSA) and coagulase-negative Staphylococcus (MRCNS) was 57.6％ and 83.0 ％,respectively.All staphylococcal isolates were susceptible to vancomycin and linezolid.E.faecalis and E.faecium accounted for 46.1％ and 46.8 ％ of enterococcal isolates.Some E.faecalis and E.faecium strains were nonsusceptible to vancomycin or linezolid.The prevalence of extended-spectrum lactamases (ESBLs) positive strains was 62.0 ％ in E.coli,32.2 ％ in Klebsiella and 18.8 ％ in Proteus mirabilis.Enterobacteriaceae strains were still highly susceptible to carbapenem antibiotics,evidenced by lower resistance rate of Enterobacteriaceae strains to ertapenem,imipenetn and meropenem (a11＜22 ％).Conclusions It seems that antibiotic resistance still poses a serious threat to clinical antimicrobial therapy.More attention should be paid to resistance surveillance and rational use of antibiotics.

Expression of serum anti-endothelial cell antibody in emphysema rats induced by smoking and intervention effect of methylprednisolone / 重庆医学

Objective To investigate the expression of anti-endothelial cell antibody AECA in the emphysema rats induced by smoking and to analyze the intervention effect of methylprednisolone on it.Methods Thirty-nine rats were randomly divided into the control group,smoking rat emphysema model group (model group) and methylprednisolone intervention group (intervention group).The model group and intervention group conducted the 1-month passive smoking by smog exposure.The intervention group was intraperitoneally injected by methylprednisolone(once daily,6 d per week).After exposing to smog for 90 d,the differences of serum AECA level,IL-8,MMP-9 and TNF-α level in bronchoalveolar lavage fluid(BALF),lung MLI and mean alveolar number (MAN) were compared among groups.Results Compared with the control group and theintervention group,the level of serum AECA in the model group was significantly increased (P＜0.05);Compared with the control group and intervention group,the IL-8,TNF-α and MMP-9 levels of BALF in the model group were also increased(P＜0.05).Conclusion ACEA participates in the smoking induced emphysema formation;methylprednisolone may decrease the level of AECA and cell inflammatory factors and affects the emphysema formation.

Evaluation of matrix-assisted laser desorption/ionisation time-of-flight mass spectrometryfor identification of clinical yeasts / 安徽医科大学学报

Objective To evaluate the ability of MALDI-TOF MS in identification of the yeast isolated from clinical specimens.Methods 387 strains of yeasts were tested.All the strains were from clinical specimen and identified by VITEK MS and API ID 32C system at the same time.Sequencing of the internal transcribed spacer (ITS) regions of ribosomal DNA was used as the reference method in the analysis of a total of 387 yeast isolates.The accuracy of detected results was analyzed by the X2 test.Results The identification accuracy rates of VITEK MS, API ID 32C were respectively 97.7% and 93.0%.The difference was statistically significant (X2=9.439, P=0.002).There was no statistical significance between MALDI-TOF and ITS sequencing.Conclusion MALDI-TOF is a rapid simple and accurate method which is identified to species level in identification of yeasts.

Analysis of clinical characteristics and risk factors for 92 cases of nosocomially acquired candidemia / 中华传染病杂志

Objective To investigate the clinical features and prognostic factors of nosocomially acquired candidemia.Methods A retrospective analysis was conducted for hospitalized patients with nosocomial candidemia between January 2012 and December 2014 at the First Affiliated Hospital of Anhui Medical University.The univariate and multivariate Logistic regression analyses were used to determine the prognostic factors of candidemia.Results A total of 92 patients were diagnosed with nosocomially acquired candidemia.The most common pathogen was Candida glabrata (C.glabrata,39/92,42.4％),followed by Candida albicans (C.albicans,30/92,32.6％),then Candida krusei (C.krusei,7/92,7.6％),Candida tropicalis (C.tropicalis,5/92,5.4％),Candida parapsilosis (C.parapsilosis,4/92,4.4％) and other Candida spp.(7/92,7.6％).The sensitivity rates of Candida spp.strains against flucytosine,amphotericin B,voriconazole,fluconazole and itraconazol were 100.0％,98.9％,92.4％,82.6％oo and 77.2％,respectively.The 30-day attributable case fatality rate was 13.0％(12/92).Multivariate Logistic regression analyses indicated that presence of central venous catheter (OR=4.833,95％CI:1.010-23.125,P=0.049),invasive mechanical ventilation (OR=6.075,95％CI:1.144-32.257,P=0.034),and receiving hemodialysis (OR =8.367,95 ％ CI:1.390-50.364,P =0.020)were factors independently correlated with increased mortality.Conclusions The pathogens causing nosocomially acquired candidemia are mainly C.glabrata,C.albicans and C.krusei.The drug susceptibility of Candida spp.varies among fluconazole,itraconazol voriconazole.The resistant rates of Candida spp.against voriconazole,fluconazole and itraconazol are different.The presence of central venous catheter,invasive mechanical ventilation and receiving hemodialysis are factors independently correlated with increased mortality.

New biodegradable paclitaxel-eluting stents for repair of traumatic urethral stricture / 中华创伤杂志

Objective To evaluate the feasibility and effect of the new biodegradable paclitaxel-eluting stents in treatment of traumatic urethral stricture.Methods Twenty-five adult New Zealand rabbits were divided into study group (n =20) and control group (n =5) according to the random number table.In study group,rabbit models of traumatic urethral stricture were developed by self-designed explosive devices.All the stents were inserted under direct vision.Reparative results were evaluated by urethroscopy,retrograde urethrogram and histological examinations at postoperative 4,8,and 12 weeks.Results In study group all the stents were smoothly inserted into the strictured urethra without the occurrence of stent migration and lithogenesis.Urethroscopy showed that the stents in study group were partially degraded at 8 weeks,mostly degraded at 12 weeks and discharged with the urine.And from the naked eye,there was no distinct difference between the repaired and normal urinary mucosa.Retro~ade urethrogram demonstrated the stents restored urethral patency.Histological examinations showed the stents minimized stent-related inflammatory reactions,uroepithelial hyperplasia and scar formation.Conclusion New biodegradable paclitaxel-eluting stents exhibiting good biocompatibility are more effective to repair urethral stricture in rabbits.

The experimental study of the microbial contamination after the puncture needle downward and ex-posed in the air of infusion bottle stopper / 中国实用护理杂志

Objective To study the relationship between the exposure time of puncture needle of infusion bottle stopper and microbial contamination during clinical intravenous transfusion. Methods A total of 600 cases from November 1, 2014 to January 31, 2015 who have received the clinical intravenous transfusion for investigation were selected.When replacing the infusion bottle (bag), inserting the puncture needle slowly across the bottle stopper and making the needle tip be canted to the transfusion bottle mouth (bag) of the rubber plug, gently squeezing the Murphy's tube until solution was not dripping, recording down the exposure time in the air of the needle tip from medicine droplet to the end. To dip the lower part with sterile swabs and culture the swabs in nutrient broth medium. Meanwhile, to replace the next bottle of medicine and get the remaining 2 ml of liquids into the culture broth medium, after 48 h, both of which medium were switched to blood plate culture cultivation for observing the general situation of the bacteria growth. Results Among the 600 cases of clinical transfusion, 24 cases were positive for sterile swabs microorganisms culture, positive rate was 4.0%, among which microorganisms, 15 cases were gram-positive coccus, 3 cases were gram-negative bacillus, 3 cases were gram-positive bacillus and 3 cases were fungi. Correspondingly, 3 cases were positive for liquid broth culture, positive rate was 0.5%as the gram-positive coccus. The exposure time and broth microbial culture result was statistically significant, while the exposure time and medicinal broth microorganisms culture result possesses had no statistical significance. Conclusions Inserting the puncture needle across the bottle stopper could successfully reduce the liquid drug residues in the infusion bottle (bag), however, which might also cause time-dependent microbial contamination during the exposure process in the air.

Relationship between benign prostatic hyperplasia and urine albumin excretion / 中华老年医学杂志

Objective To investigate the relationship between benign prostatic hyperplasia (BPH) and urine albumin excretion.Methods A total of 258 male inpatients aged 60 to 70 years were enrolled in this study.According to prostate volume (PV) measured by transrectal ultrasonography,patients were divided into BPH group(PV≥20 ml) and NBPH(non benign prostatic hyperplasia) group(PV＜20 ml).Urine albumin and urine creatinine concentrations were measured and urine albumin/creatinine ratio(UACR) was calculated.Fasting blood glucose(FBG) and fasting insulin(FINS) also were measured,insulin resistance index(HOMA-IR) was calculated based on the formula HOMA-IR=ln(FBG × FINS/22.5).The correlation between PV and other indicators were analyzed by Pearson correlation analysis.The risk factors for BPH were analyzed by logistic regression analysis.Results UACR was significantly higher in BPH group than in NBPH group[(163.6± 69.8) mg/g vs.(73.3 ± 55.6) mg/g,t =4.81,P＜ 0.01],and hypertension duration was longer in BPH group than in NBPH group [(9.2±6.6)years vs.(6.0±3.6)years,t=2.27,P＜0.05].The prevalence rate of BPH and PV were increased along with increasing of urine albumin excretion(x2=4.58,F=4.85,respectively,P＜0.05 or 0.01).Prostate volume was positively correlated with UACR,HOMA-IR,hypertension duration,body mass index(r=0.248,0.229,0.183,0.157,respectively,all P ＜ 0.05).Logistic regression analysis indicated that UACR,HOMA-IR and hypertension duration were the risk factors for BPH(OR=16.348,1.040,0.166,respectively,all P ＜0.05).Conclusions BPH is correlated with UACR,which indicates that there is a close relationship between atherosclerosis and BPH.Insulin resistance probably plays an important role in the progression of arteriosclerosis and BPH.

Distribution and antibiotic resistance of the pathogens isolated f rom bloodstream infections / 中国感染与化疗杂志

Objective To investigate the distribution and antibiotic resistance of the pathogens isolated from blood culture . Methods Identification and antimicrobial susceptibility testing were performed with MicroScan WalkAway 96 PLUS or VITEK 2 compact .WHONET 5 .6 software was used for analysis of the susceptibility data according to CLSI 2013 breakpoints .IBM SPSS 20 .0 was employed to compare the resistance rates between groups . Results Gram-positive bacteria , gram-negative bacteria and fungi accounted for 57 .8% ,36 .0% and 6 .2% of the 503 nonduplicate isolates ,respectively .The most common isolates included coagulase-negative Staphylococcus , Escherichia coli , Enterococcus spp ., Staphylococcus aureus and K lebsiella pneumoniae . The prevalence of methicillin-resistant S . aureus (MRSA ) and coagulase-negative Staphylococcus (MRSCN) was 32 .3% and 71 .7% respectively .The coagulase-negative Staphylococcus isolates from ICU patients showed higher resistance rates to many antibiotics than those non-ICU strains (P<0 .05) .E .coli and K .pneumoniae strains showed high percentage of resistance to cephalosporins , but relatively low resistance to piperacillin-tazobactam , imipenem and amikacin .A .baumannii isolates were highly resistant to most antimicrobial agents . Candida species were less resistant to antifungal agents .Conclusions The pathogens isolated from blood culture are diverse .The resistance profile is quite different among various pathogens .The distribution and antibiotic resistance should be actively monitored for the pathogens isolated from blood culture in order to facilitate the rational use of antimicrobial agents .

Distribution and drug resistance of pathogens isolated from urinary tract infections / 中华临床感染病杂志

Objective To investigate the distribution and drug resistance of pathogens isolated from urinary tract infections.Methods A total of 6 262 midstream urine samples were collected from patients in the First Alfiliated Hospital of Anhui Medical University during April 2012 and March 2013.MicroScan WalkAway 96 Plus or Vitek 2 Compact system was applied in bacteria identification and drug sensitivity test.WHONET 5.6 was adopted to analyze drug resistance,and IBM SPSS 20.0 was applied to compare resistance rates between isolates from outpatients and hospitalized patients.Results A total of 1 426 strains were isolated,in which 370 strains were gram-positive coccus (25.9％),942 strains were gram-negative bacilli (66.1％) and 114 strains were fungi (8.0％).Escherichia coli and Klebsiella pneumoniae,Enterococcus faecium and Enterococcus faecalis were the top two among gram-negative bacilli and grampositive coccus,respectively.The prevalence of extended-spectrum β-lactamases (ESBLs)-producing Escherichia coli,Klebsiella pneumoniae and Proteus mirabilis were 60.5％,51.0％ and 30.3％,respectively; About 73.3％ of Staphylococcus aureus strains and 86.7％ of coagulase-negative Staphylococcus strains were methicillin-resistant.Candida albicans and Candida glabrata were the two most prevalent fungi in urinary tract infections,and they were sensitive to most antifungal agents.Conclusion Gram-negative bacilli,especially Escherichia coli are the most prevalent pathogen in urinary tract infections,and strains are highly resistant to most antibacterial agents,suggesting that antimicrobial resistance monitoring system is needed.

Construction of a capsular tissue-engineered ureteral stent seeded with autologous urothelial cells / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the feasibility of constructing a capsular poly L-lactic acid (PLLA) ureteral stent seeded with autologous urothelial cells using tissue engineering methods.</p><p><b>METHODS</b>The capsular ureteral stent was constructed by subcutaneously embedding PLLA ureteral stent in the back of beagles for 3 weeks to induce the formation of connective tissue on the surfaces. After decellularization of the stent, the expanded autologous urothelial cells were seeded on the stent. The surface structure and cell adhesion of the stent were observed using HE staining, scanning electron microscope (SEM) and immunocytochemical staining. MTT assay was used to evaluate urothelial cell proliferation on the capsular PLLA ureteral stent and on circumferential small intestinal submucosa graft.</p><p><b>RESULTS</b>HE staining and VIII factor immunohistochemistry revealed numerous capillaries in the connective tissue encapsulating the stent without obvious local inflammatory response. The results of SEM and immunocytochemical staining showed that the capsule contained rich collagenic fibers forming three-dimensional structures, and the seeded autologous urothelial cells could adhere and well aligned on the surface. MTT assay showed normal growth of the cells on the stent as compared with the cells grown on circumferential small intestinal submucosa graft.</p><p><b>CONCLUSION</b>The capsular PLLA ureteral stent allows adhesion and proliferation of autologous urothelial cells and shows a potential in applications of constructing tissue-engineered ureter.</p>

Risk factors of nosocomial enterococcal infections / 中华传染病杂志

Objective To determine the risk factors of nosocomial infections caused by Enterococcus,and to develop effective protective measures.Methods A retrospective study was conducted among 193 patients who had been infected by Enterococcus from Jan.2011 to Dec.2011 in the First Affiliated Hospital of Anhui Medical University.Clinical data were collected and related risk factors for enterococcal infection were screened.Results The risk factors for enterococcal infection included biliary tract surgery (OR=1.264,95％CI:1.141-1.401,P =0.000),drainage tube intubation (OR=1.619,95％CI:0.301-4.190,P=0.010),urinary tract intubation (OR=2.001,95％CI:1.739-3.803,P 0.000),uses of third generation cephalosporin (OR=2.085,95％CI:1.181-3.682,P=0.011) andcarbapenems (OR=1.473,95％CI:1.060-2.023,P =0.024).Furthermore,biliary tract surgery (OR=4.861,95％CI:3.029-7.802,P=0.000) and urinary tract intubation (OR=2.737,95％CI:1.764-4.246,P=0.002) were risk factors for both Enterococcus faecalis and Enterococcus faecium infection,while drainage tube intubation (CR =1.861,95％CI:1.702 1.911,P=0.038),uses of the third generation cephalosporin (OR=1.122,95％CI:1.022-1.224,P=0.016) and carbapenems (OR=3.051,95％CI:1.185-7.855,P=0.021) were independent risk factors for Enterococcus faecium infection.Conclusions Surveillance

Analysis of the diagnostic and therapeutic status of elderly benign prostatic hyperplasia / 中华老年医学杂志

Objective To evaluate the diagnostic and therapeutic status of elderly benign prostatic hyperplasia (BPH).Methods Totally 188 male elderly in outpatient department from January 2010 to March 2012 were enrolled in this study.Medical history was inquired in detail,and prostatic volumes (PV)were measured by abdominal ultrasound,PV≥ 20ml was diagnosed as BPH.Lower urinary tract symptoms (LUTS) was evaluated by international prostate symptom score (IPSS),prostate specific antigen (PSA) was measured.Age≥62 years,PSA≥1.6 μg/L and PV≥31 ml were considered as higher risk of clinical progression of BPH.We investigated the rate of prevalence,awareness and treatment of BPH.PV,IPSS and PSA were compared among different age groups by ANOVA.Logistic regression analysis was made to show the risk factors of BPH.Results Among 188 male elderly,the prevalence rate of BPH was 48.4％,and the total rate of awareness was 41.5％.The rate of awareness resulting from seeing doctor due to LUTS was 10.6％.PV,IPSS and PSA were increased with ageing.Risk factors contributing to BPH were age,hypertension and diabetes.The treatment rate with drugs of 5a-reductase inhibitor was 47.3 ％,however 10 subjects had not been given drugs treatment among 46 patients with higher risk of clinical progression of BPH.Conclusions The prevalence rate of BPH is increased with ageing,the proportion of seeing a doctor with passion is lower because the male elderly have not paid enough attention to LUTS.And doctors have not given drugs intervention to patients with clinical progression BPH in time.We should launch propaganda and education among the elderly patients with hypertension and diabetes and take comprehensive treatment.

Meticillin-resistant Staphylococcus haemolyticus and Resistance in 103 Isolates of S.haemolyticus / 中华医院感染学杂志

OBJECTIVE To investigate the prevalence of meticillin-resistant Staphylococcus haemolyticus(MRSH)and resistance in S.haemolyticus isolates. METHODS MRSH was detected by cefoxitin disc test and susceptibilities were tested by agar dilution method. RESULTS There were 86.4% of MRSH isolates.MRSH was highly resistant to penicillin,cefazolin,cefuroxime,ceftriaxone,tetracycline,ciprofloxacin,and clindamycin.The resistance rate to amikacin,rifampicine and chloramphenicol was 16.9%,11.2% and 28.1%,respectively.All isolates were susceptible to vancomycin and teicoplanin.Except for tetracycline,amikacin,rifampicin,and chloramphenicol,the resistant rate to other antimicrobial agents was significantly higher in MRSH than in MSSH. CONCLUSIONS MRSH is mostly occupied in S.haemolyticus isolates and resistant to most of antimicrobial agents.More attention should be paid to survey and detect these strains.

Clinical distribution and antibiotics resistance of 576 strains isolated from blood specimens / 中华临床感染病杂志

Objective To investigate the distribution and antibiotics resistance in blood culture isolates.Methods The clinical isolates of blood specimens from patients in the First Affiliated Hospital of Anhui Medical University during 2004 to 2006 were identified anti the drug resistance to antimierobial agents was tested.The results were analyzed and compared with those during 1986 to 1998.Results A total of 576 strains were isolated from 6203 blood specimens,among which gram positive cocci and gram negative bacilli account for 57.8%(333/576)and 31.4%(181/576),respectively.The frequent isolates were coagulase negative Staphylococcus,Escherichia coli,Staphylococcus aureus,hemolytic Streptococcus viridans,Klebsiella pneumoniae and fungi.The methicillin-resistant coagulase negative Staphylococci(MRCNS)accounted for 78.3%(155/198).Gram negative bacilli were highly susceptible to imipenem,piperacillin/tazobactam and amikacin.Conclusions The incidence of bloodstream infections caused by MRCNS,gram negative bacilli producing ESBLs and fungi are increasing.The clinical isolates from blood have hish resistance to the first line antibiotics.

Application of preoperative three dimensional helical CT assessment in retroperitoneal laparoscopic nephron-sparing surgery / 中华泌尿外科杂志

pful in decision making of retroperitoneal laparoscopic NSS.

Multislice spiral CT and digital subtraction angiography in interventional therapy of hepatocellular carcinoma / 中国基层医药

Objective To investigate the value of multislice spiral CT(MSCT,)in interventional therapy of the hepatocellular carcinoma(HCC)emphasising on transcatheter hepanc arterial chemoembolization(TACE).Methods MSCT were performed in 60 cases of HCC before interventional procedure,CT findings of hepatic artery phase,portal venous phase and hepatic venous phase were observed respectively,among which CTA were done in 15 cases,and the anatomy of celiacartery and its branches were observed in 45 cases.The schemes of interventional therapy were worked out according to the findings of MSCT.Results MSCT showed 250 lesions,10 cases of tumor thrombosis in portal vein and 19 cases of hepatic arterioportal shunt.There was no significant difference between MSCT and digital subtraction angiography(DSA)in positive rate of in showing number of tumor or tumor thrombosis in portal vein(P＞0.05),but the 3D construction of celiac artery branches in CTA was better than that in DSA,while angles between celiac artery and abdominal aorta in MSCT were more convenient than that in DSA.MSCT showed 5 eases of hepatic artery original abnormality,according to that in DSA.Conclusion MSCT is of importance for guidance of interventional therapy of hepatocellular carcinoma.

Detection of metallo-β-lactamase produced by clinical Chryseobacterium spp.and their genotypes / 中华检验医学杂志

Objective To investigate the antibiotic resistance and the phenotype and genotype of metallo-β-lactamase in clinical isolates Chryseobacterium spp.Methods The MIC of 18 antibiotics in 50 Chryseobacterium spp.isolates was detected by agar dilution method.Phenotype of metallo-β-laetamase was detected by three-disc synergy test and modified three dimension test.Polymerase chain reaction(PCR)detection for metallo-β-lactamase gene was conducted for all isolates,and then the DNA sequence analysis was conducted for the PCR products which are positive for metallo-β-lactamase and identify genotype.conjugation experiment was used to study the transmission of metallo-β-lactamase encoding gene.pIs of β-lactamase was measured by isoelectric focusing assay. Results The antibiotic resistance of 50 clinical isolates of Chryseobacterium spp.against imipenem,Meropenem was 82.0%and 82.0%respectively.However,these isolated had high resistance to gatifloxacin.levofloxacin and rifampin compared with other antibiotics.Phenotype detection showed 33 isolated produced metallo-β-lactamase using three-disc synergy test and modified three dimension test,and the incidence of producing metallo-β-lactamase was 66.0%.Twenty isolateds producing Chryseobacterium indologenes were detected to have metallo-β-laetamase genotype by PCR amplification,among them 9 isolates containing blaIND-1 genotype and 10 isolateds containing blaIND-2 genotype.Strain CI-25 was identified to represent blaIND-LIKE genotype.Fourteen Chryseobacterium meningosepticum were detected to have metallo-β-lactamase genotype by PCR amplification,including 15 blaB and 2 blaGOB. The number of strain producing blaB1,blaB2,blaB3 and blaB11 in Chryseobacterium meningosepticum was 2,5,4 and 4,respectively. Conjugation experiments showed that metallo-β-lactamase encoding gene cannot be transfered. The extracted plasmid of 4 strains did not harbor metallo-β-lactamase gene.Strain C-5 was proved to have blaIND-1 gene,but its phenotype and IEF of metallo-β-lactamase was negative.Conclusions Chryseobacterium spp.had high frequency of multidrug resistance and high incidence for producing metallo-β-lactamase,and thus it was difficult to be treated.The gene of metallo-β-lactamase located on chromosome of Chryseobacterium spp.and cannot be transfered.There was negative or low lever of expression of blaIND-1.