ABSTRACT
Objective In order to understand the distribution and drug resistance of the extended-spectrumβ-lactamase-producing (ESBLs) Enterobacteriaceae in female vaginal secretions and to provide the basis for clinical treatment.Methods 939 strains of Enterobacteriaceae isolated from female vaginal secretions were collected from Obstetrics and Gynecology Hospital of Fudan University from January 2014 to December 2017.The strain identification and drug sensitivity test of VITECK 2 Compact-totally automatic bacterial identification analyzer were used to analyze the detection rate and drug resistance of ESBLs Enterobacteriaceae.Results 257 strains of ESBLs-producing strains were detected in 939 strains of Enterobacteriaceae with a detection rate of 27％, including 220 Escherichia coli, 34 Klebsiella pneumoniae, 2 Stink-nose Klebsiella and 1 strain of Acidogenic Klebsiella.ESBLs Escherichia coli and Klebsiella pneumoniae were all resistant to Ampicillin and Cefazolin, and to Ceftazidime, Nitrofurantoin, SMZ, Amikacin, Ciprofloxacin, Gentamicin, tobramycin, Ampicillin/Sulbactam, Ceftriaxone, Ertapenem, Piperacillin/Tazobactam, Aztreonam, Cefepime, Levofloxacin the drug resistance rates of were 36％and 44％, 2％ and 41％, 67％ and 68％, 2％ and 15％, 58％ and 38％, 51％ and65％, 14％and 26％, 65％and 76％, 99％and 97％, 0％and 29％, 0％and 3％, 50％and 65％, 26％and 18％, 57％ and 32％, but they are all sensitive to Imipenem and Cefotetan.Conclusion The inicdence of ESBLs Enterobacteriaceae in female vaginal secretions is high, and Imipenem, Cefotetan, Piperacillin/Tazobactam have high antibacterial activity, which can be used as the experience of initial treatment.
ABSTRACT
Objective To investigate the correlation between the unilateral middle cerebral artery (MCA)stenosis ratio and cerebrovascular reserve(CVR) using computed tomography perfusion (CTP) and CO2 inhalation test in patients with unilateral middle cerebral artery stenosis.Methods CTP were performed in 31 patients who were diagnosed as unilateral middle cerebral stenosis before and after CO2 inhalation.The basal ganglia and radial dimension were selected as interested regions (thickness 8 mm).The value of cerebral blood flow (CBF) was measured and the mean CBF values of all interested regions in each MCA territory were harvested separately.Then the CVR of each MCA territory was calculated according to the following formula:CVR =(CBF after CO2 inhalation test-CBF before CO2 inhalation test)/ CBF before CO2 inhalation test × 100％.Patients were divided into two groups:the severe stenosis group and the moderate stenosis group.The association between the MCA stenosis ratio and the CVR values was investigated.Results In 31 patients,different changes of CBF were found in affected MCA territory after CO2 inhalation.CBF increased in 17 cases,unchanged in 2 cases and decreased in 12 cases.A decreased CVR was detected in 51.6％ of the patients(16/31) and more likely found in the severe stenosis group (13/19) than that in the moderate stenosis group(3/12,P =0.029).The degree of stenosis in MCA was also significantly correlated with the changes of CVR(r =0.423,P =0.018).Conclusions CVR is decreased in some patients with unilateral MCA stenosis and significantly correlates with the severity of stenosis in MCA.