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Objective To investigate antimicrobial resistance among nosocomial gram-negative bacilli in 2016 across China.Methods About 1 394 consecutive and non-repetitive gram-negative bacilli were isolated from 14 teaching hospitals from March to August in 2016 across China.All of these isolates were sent to the central laboratory for reidentification and susceptibility testing.The minimal inhibitory concentration(MICs)of meropenem and other antibacterial agents were determined by agar dilution method.The data were analyzed by using WHONET-5.6 software.Results The activity of antimicrobial agents against Enterobacteriaceae was as follows in descending order of susceptible rate: meropenem (95.2%,891/936), amikacin (94.6%,885/936), ertapenem (92.1%,862/936), piperacillin/tazobactam (88.1%,825/936), imipenem (88.0%,823/936), cefoperazone-sulbactam (83.1%,778/936), cefepime (72.2%,676/936), cefiazidime (72.2%,676/936), levofloxacin(68.8%,644/936), ciprofloxacin (63.2%,592/936), minocyline (62.9%,589/936), cefiriaxone (54.9%,514/936), cefotaxime (54.0%,505/936), cefoxitin (44.3%,415/936).The sensitivities of E.coli to carbapenems, amikacin, piperacillin-tazobactam, polymyxin B and cefoperazone-sulbactam were over 80%.The more sensitive antibiotic to Klebsiella pneumoniae was polymyxin B (99.0%), followed by amikacin (84.9%), meropenem (84.4%) and imipenem (82.0%).The prevalence of extended-spectrum β-lactamase was 62.8%(137/218)in Escherichia coli and 28.3%(58/205)in Klebsiella pneumonia.The activity of antimicrobial agents against E.cloacae, E.aerogenes and Citrobacter freundii was as follows in descending order of susceptible rate: meropenem (97.0%-98.5%), amikacin (95.8%-98.3%), imipenem (94.5%-97.5%), polymyxin B (96.4%-100%), cefoperazone-sulbactam (76.5%-90.0%), ertapenem (73.3%-90.1%), piperacillin/tazobactam (82.4%-88.3%).The most active agents against Pseudomonas aeruginosa were polymyxinB (100%), followed by amikacin (89.3%) and ciprofloxacin (82.4%).The most active agents against Acinetobacter baumannii were polymyxinB (100%).The sensitivities of Acinetobacter baumannii to meropenem, imipenem, minocycline and cefoperazone-sulbactam were 20.3%(39/202), 19.3%(41/202), 66.3%(134/202) and 24.8%(50/202), respectively.Conclusions Carbapenems remain high sensitive against Enterobacteriaceae.Controlling carbapenem resistant Klebsiella pneumoniae is urgent.Drug antimicrobial resistance in A.baumanni is a still serious problem.
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Objective To evaluate the efficacy of a two-step infusion therapy with meropenem against noso-comial multi-drug resistant Pseudomonas aeruginosa infections in elderly patients with chronic obstructive pulmonary disease.Methods 112 elderly patients with nosocomial multi-drug resistant Pseudomonas aeruginosa infections and chronic obstructive pulmonary disease were randomized into two groups:two-step infusion therapy group ( rapid first-step infusion in 30 minutes and slow second-step infusion in 2.5 hours) and traditional 30 minutes infusion therapy group.The antibiotic clinical efficacy and bacteriological efficacy were observed between two groups .Results The clinical efficacy of observation group and control group were 82.2%(46/56) vs 57.1%(32/56).The difference was statistically significant(χ2 =10.185,P<0.05);The bacteriological efficacy of observation group and control group were 75.0%(42/56) vs 46.4%(26/56),The difference was statistically significant (χ2 =10.265,P<0.05). Conclusion The clinical efficacy and bacteriological efficacy of two-step infusion therapy with meropenem against nosocomial multi-drug resistant Pseudomonas aeruginosa infections in elderly patients with chronic obstructive pulmo -nary disease were superior to the traditional therapy .
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OBJECTIVE To analyze the superinfection and multidrug resistance of patients in ICU.METHODS(Isolation),cultivation,and identification of ESBLs and drug-sensitivity tests to 17 antibiotics in 219 clinical(specimens) from ICU were conducted.Susceptibility testing was performed by disk diffusion(KB) method,(according) the NCCLs standard to manipulate and judge the results.interim sensitivity was ascribed to resistance.RESULTS Totally 219 cases of patients with bacterial infection in ICU,in which there were 132 cases of patients with superinfection(60.3%),in the same time,100 cases of patients with bacterial infection in general wards,in which there were only 11 cases of patients with superinfection(11%),the superinfection in ICU and general wards had significant deference(P(