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Objective To investigate the etiological and antibiotic resistance profile in the old patients with bloodstream infection (BSI).Methods Microbiological and clinical data were collected and reviewed retrospectively for the patients with confirmed bloodstream infection and at least 65 years of age who were treated as inpatients in Tongling People′s Hospital from January to December 2015.Results A total of 107 strains of pathogen were isolated from the blood samples of 107 patients with bloodstream infections, of which community-acquired BSI accounted for 57.9 % (62/107), and hospital-acquired BSI 42.1 % (45/107). Gram negative bacilli accounted for 67.7 % in the pathogens of community-acquired BSI and gram positive cocci accounted for 55.5 % in the pathogens of hospital-acquired BSI. More male BSI patients were secondary to respiratory tract infection than female patients (P<0.001), while more female BSI patients were secondary to urinary tract infection than male patients (P<0.001). Of the 107 isolates, gram negative bacilli, gram positive cocci and fungi accounted for 55.1 % (59/107), 42.1 % (45/107) and 2.8 % (3/107), respectively. The top six pathogens were E. coli (30.9 %), coagulase negativeStaphylococcus (CNS) (20.6 %), S. aureus (10.3 %),K. pneumoniae (6.5 %),Enterococcusspp. (6.5 %) and Acinetobacter spp. (4.7 %). About 51.5 % of the E. coli isolates and 28.6 % of the K. pneumoniae isolates produced extended-spectrum β-lactamases (ESBLs).E. coli isolates showed low resistance rate (< 10 %) to amikacin,cefoxitin and piperacillin-tazobactam. No E. coli isolate was found resistant to carbapenem. About 14.3 % to 28.6 % of K. pneumoniae isolates were resistant to carbapenems. No tigecycline-resistant K. pneumoniae was found. The prevalence of MRSA and MRCNS was 36.4 % and 72.7 %, respectively. No staphylococcal isolates were found resistant to vancomycin, teicoplanin or linezolid. One strain of E. faecium was identified as resistant to vancomycin (VRE).Conclusions This surveillance data indicate that gram negative bacilli play an important role in the BSI of old patients. E. coli and CNS are the most common pathogens. We should pay more attention to the effect of gender and site of infection on the BSI in old patients.
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Objective To compare the effect of different body position and length of bed time after lumbar puncture on the postoperative headache.Methods Literatures were searched at home and abroad through the database,and provided comprehensive quantitative analysis to compare the effect of different body position and length of bed time after lumbar puncture on the postoperative headache by the Cochrane collaboration Meta-analysis.Results A total of 20 studies (3 514 patients) were included for Meta-analysis.Mter lumbar puncture for the low supine pillow and the pillow recumbent position,headache incidence rate had no significant difference between the two positions,combined odds ratio (OR) and 95％ confidence intervals were 0.87 (0.41-1.87)(P＞ 0.05);After lumbar puncture to stay in bed for a long time to rest (≥ 4 h) and short time in bed rest (＜1 h),headache incidence rate had no significant difference between the two different time,the combined odds ratio (OR) and 95％ confidence intervals were 0.77 (0.58-1.02)(P ＞ 0.05).Conclusions After lumbar puncture,the occurrence rate of headache is not increased after taking a low pillow lying position or a short time in bed rest (＜1 h).
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Objective To compare the effect of laminar flow bed in the prevention of hospital infections in patients with leukemia after chemotherapy. Method The Meta-analyses were done on Meta RevMan5.0 by retrieving the domestic databases from January 1999 to January 2014 to look into and compare the hospital infections in leukemic patients using laminar flow beds and common beds, including of the rate of hospital infection, duration of fever, days for antibiotic use, hospital stay. Results A total of 16 papers were included. The Meta analyses showed that the rate of hospital infection in the wards with laminar flow beds was significantly lower than that in the wards with common beds (RR=0.54,95%CI (0.47, 0.62), P<0.01). The fever duration, time for antibiotics use and hospital stay in patients in the wards with laminar flow beds were all significantly shorter than those in the patients in the wards with common beds [WMD=-3.64, 95%CI (-4.83,-2.46);WMD=-4.13, 95%CI (-5.95,-2.32)];WMD=-5.36, 95%CI (-7.52,-3.20);P<0.01,respectively)]. Conclusion Laminar flow beds are effective in preventing hospital infections among acute leukemic patients having undergone chemotherapy.
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Objective To investigate the bacterial resistance profile of clinical isolates collected in Tongling area . Methods Antimicrobial susceptibility test was conducted by Kirby‐Bauer method . All the data were analyzed with WHONET 5 .6 software .Results A total of 3 419 clinical isolates were collected during 2013 ,of which gram negative organisms and gram positive organisms accounted for 75 .9% and 24 .1% .MRSA accounted for 41 .3% of S .aureus and MRCNS accounted for 73 .5% of coagulase negative Staphylococcus ,respectively .MRSA showed higher resistance to gentamicin ,ciprofloxacin , erythromycin and rifampicin . No vancomycin‐ or teicoplanin‐resistant strains of Staphylococcus spp . were found . No vancomycin‐or teicoplanin‐resistant strains of E . f aecalis and E . f aecium were found .About 51 .6% of E .coli isolates and 42 .8% of K . pneumoniae isolates produced extended‐spectrum β‐lactamases (ESBLs ) . The prevalence of imipenem‐ or meropenem‐resistant strains of K . pneumoniae increased significantly .The percentage of P . aeruginosa strains resistant to amikacin ,piperacillin‐tazobactam ,ciprofloxacin ,cefepime and cefoperazone‐sulbactam was lower than 20 .0% .The percentage of A .baumannii strains resistant to cefoperazone‐sulbactam , minocycline and amikacin w as 34 .7% ,57 .0% and 58 .3% , respectively . More than 68 .0 % of A . baumannii strains were resistant to any of the other antibiotics tested . Conclusions The antibiotic resistance is growing in clinical bacterial isolates .The spread of carbapenem‐resistant strains of K . pneumoniae in some departments poses a serious threat to clinical practice .We should pay more attention to resistance surveillance and rational use of antibiotics .
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Objective To discuss the role of matrix metalloproteinase-8(MMP-8) mRNA in apical granuloma and periapical cyst by detecting the its expressions in the periapical granuloma and periapical cyst.Methods Reverse transcription polymerase chain reaction(RT-PCR) technique was used to measure the expressions of MMP-8 mRNA in 22 cases of periapical granuloma,11 cases of periapical cyst and 10 cases of normal periapical tissues.Results The positive rates and the levels of MMP-8 mRNA expression in apical granulomas and periapical cysts were significantly higher than those in normal tissues(P0.05).Conclusion The expression of MMP-8 may play an important role in the pathogenesy of apical granuloma and periapical cyst,and it may be involved in the process of bone destruction.
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OBJECTIVE To investigate drug-resistance status and changing tendency of Escherichia coli in traditional Chinese medicine hospital to provide the evidence for reasonable use of antibiotics.METHODS Pathogenic bacteria were isolated and identified according to the National Clinical Laboratory Operation Rules.Drug resistance profile was analyzed by K-B methods.RESULTS In the four years,the resistance to seventeen commonly used antibiotics in E.coli was on the rise.The resistance rate to ampicillin was the most highest(90.8-94.2%).No strain was resistant to imipenem and meropenem.the detection rate of extended spectrum ?-lactamases(ESBLs) producing E.coli was increasing from 13.2% to 32.0%.CONCLUSIONS Drug-resistance status of E.coli in traditional Chinese medicine hospital is very serious.We should strengthen the management of antibiotic use and control the spread and prevalence of the drug-resistant bacteria.