ABSTRACT
Objective To analyze the correlation between antimicrobial use density (AUD) and change in antimicrobial resistance rate of Stenotrophomonas maltophilia (SM), and explore the influencing factors of antimicrobial resistance of SM. Methods Antimicrobial resistance rate of SM and AUD of commonly used antimicrobial agents in patients in a hospital from 2012 to 2017 were summarized, correlation was analyzed with Pearson correlation method. Results A total of 23 994 strains of gram-negative bacteria were isolated, of which 1 331 strains (5.55％) were SM, mainly from sputum (54.02％) and distributed in intensive care unit (21.49％). Resistance rates of SM to ceftazidime, levofloxacin, and compound sulfamethoxazole were 21.79％, 7.66％, and 13.37％ respectively, resistance rates to levofloxacin showed an increasing trend year by year (P＜0.05). Resistance rate of SM to levofloxacin was positively correlated with the use intensity of β-lactamase inhibitors, carbapenems, fluoroquinolones, and oxazolidinones (all P＜0.05); resistance rate to compound sulfamethoxazole was positively correlated with the use intensity of macrolides (P＜0.05).Conclusion Change in resistance rates of SM to levofloxacin and compound sulfamethoxazole are positively correlated with the use intensity of some commonly used antimicrobial agents, reducing AUD is beneficial to the control and reducing of the resistance of SM.
ABSTRACT
<p><b>OBJECTIVE</b>To investigate influence of electroacupuncture at "Zusanli" (ST 36) on pharmacokinetics after oral administration of Paracetamol in rats and explore the effect and mechanism of acupuncture combined with medicinal drugs.</p><p><b>METHODS</b>Forty-eight SD rats, in half respectively male and female, were randomly divided into 6 groups: Paracetamol groups of low, moderate, and high doses (oral dose of Paracetamol 300, 600 or 1200 mg/kg, respectively), and electroacupuncture plus Paracetamol groups of low, moderate, and high doses (electroacupuncture at "Zusanli" (ST 36) acupoint for 20 min after oral dose of Paracetamol 300, 600 or 1 200 mg/kg, respectively). Serum specimens of rats in each group were obtained at different time points to determine the concentrations of Paracetamol by RP-HPLC after oral administration of Paracetamol at different dosage, and the pharmacokinetic parameters were calculated by software 3P87, so as to observe the influence of electroacupuncture on absorption and metabolism of Paracetamol.</p><p><b>RESULTS</b>Except in electroacupuncture plus Paracetamol groups of high doses group showing a non-linear dynamics model, the pharmacokinetics parameters of Paracetamol in the other fives groups were all fitted to first order grade absorption of two-compartment open model. Compared with the Paracetamol groups of low and moderate doses, the time to peak concentration (T(max)) was advanced (P < 0.01), the peak values of plasma concentration (C(max)) were significantly higher (P < 0.01), and the absorption half-life (T1/2ka) speeded up apparently (P < 0.01), but the elimination half-life (T1/2ke) remained basically unchanged (P > 0.05), and the area under the curve (AUC) increased significantly (P < 0.01), and plasma clearance (Cl(s)) was lower (P < 0.01) in the electroacupuncture plus Paracetamol groups of low and moderate doses. Compared with the Paracetamol group of high doses, the AUC also increased significantly (P < 0.01) and the mean residence time (MRT) postponed relatively (P < 0.05) in the electroacupuncture plus Paracetamol group of high doses.</p><p><b>CONCLUSION</b>It indicates that clinical consideration must be given to the drug dosage and the possible influence of electroacupuncture on the metabolism of some drugs in order to avoid and reduce adverse reactions.</p>