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0.05).In all 57 strains of germ cultured,50.9% were Gram-negative bacilli,40.3% were Gram-positive cocci,and the other 8.8% were fungi.Causes of infection included impaired immunity defense,mistake in aseptic procedure or unstrictness of skin sterilizing,inadequate drainage,etc.CONCLUSIONS Reasonable in choice of antibiotics,strictness in aseptic procedure,adequate drainage and good nursing help are the main preventive measures to prevnt drainage fluid infection after thoracic operation.
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OBJECTIVE To analyze the drug-resistance of Enterobacter cloacae isolated from clinic in the past two years.METHODS The drug-resistance by K-B method,and to perform 3-D test to detect AmpC ?-lactamase and ESBLs were detected.RESULTS One hundred and six strains of E.cloacae was detected.Burn department were the wards which had the highest detection rate.Sputum,wound,bile and drainage fluid had the highest positive rate.Sensitivity test results showed that the resistance rate to penicilins,Ⅰ,Ⅱ-generation cephalosporins and cefoxitin of E.cloacae was the highest,and the resistance rate to the third,and fourth-generation cephalosporins was 24.5-50.9%.The detection rate of ESBLs and AmpC was 27.4% and 40.6%,respectively.Twenty three strains produced both of them.CONCLUSIONS The detection rate and drug resistance of E.cloacae are increasing severely.Laboratory should pay more attention to their detections and surveillance so as to control hospital infection of E.cloacae.
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OBJECTIVE To analyze the distribution and drug-resistance of Klebsiella pneumoniae isolated from clinic in the past two years to help doctors to use antibiotic reasonably.METHODS To detect the drug-resistance of 470 strains of K.pneumoniae to 15 kinds of antimicrobial agents were detected by K-B method,and the AmpC ?-lactamase and ESBLs were detected through the way of 3-D test.RESULTS ICU and burn department were found where had the highest isolation rate,and sputum and wound that had the highest detection rate.Sensitivity test results showed that the resistance rate of K.pneumoniae to penicillins,first and second-generation cepholosporins,fluoroquinolones and sulfamethoxazole compound was high(51.1-88.3%),and resistance rate to the third and fourth-generation cephalosporins was high,too(32.6-40.4%).All strains were sensitive to imipenem,but two of them were resistant to meropenem.ESBLs were found in 152 strains,the detection rate was 32.3%,AmpC was found in 29 strains,the detection rate was 6.2%.Both of them were found out in 21 strains.CONCLUSIONS The lower respiratory tract infection is the most common one.The ICU and wound ward are the high-risk places ward of infection.Detection rate and drug resistance are increasingly severe,clinic and laboratory should make concerted efforts to reduce nosocomial infection and strengthen information feedback.
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OBJECTIVE To investigate the drug-resistance and aminoglycoside modifying enzymes (AME) in Acinetobacter baumannii (ABA) isolated from ICU. METHODS K-B method was conducted to detect the sensitivity to 14 common antibiotics of 291 strains of ABA isolated from 2005 to 2007;PCR was used to detect AME genes of partial bacteria isolated in 2005. RESULTS The drug-resistance rates of 13 kinds of antibiotics were 33.0-91.8%,but cefoperazone/sulbactam was low (12.7%). The rate of amikacin,gentamicin and tobramycin was 41.2%,61.2% and 61.5%. Twenty-three ABA strains were AME gene positive from total 27 ABA strains and the total positive rate was 74.4%.We found 21 strains with aac(3)-Ⅰ (77.8%),23 strains with aac(6′)-Ⅰ (85.2%) and 23 strains with ant(3″)-Ⅰ (85.2%). Two strains were found to have 2 kinds of AME genes,21 strains had 3 kinds of AME genes. The rest of ABA strains had not AME genes. CONCLUSIONS ABA isolated from ICU has strong drug-resistance rate and a high carrier rate,it is a critical area of preventing and controlling hospital infection.
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OBJECTIVE To study the antibiotic resistance of Staphylococcus isolated from the burn patient wounds. METHODS The sensitivity to 14 common antimicrobial agents was deteded by K-B method. MRSA and MRCNS were detected by cefoxitin disk;the inducible resistance to clindamycin was detected by D-test. RESULTS There were 378 strains of Staphylococcus isolated from the burn patient wounds. The isolation rates of Staphylococcus epidermidis,S. aureus and S. haemolyticus were 43.1%,41.6% and 11.1%. Antibiotic resistance rate to vancomycin,teicoplanin,minocycline,rifapin and nitrofurantoin was 0.0-19.0%,the resistance rate to other antibiotics was 54.1-100.0%. The detection rate of MRSA was 81.5%,the detection rate of MRCNS among S. epidermidis and S. haemolyticus was 55.6% and 66.7%. The total positive rate of D-test was 48.2% in Staphylococcus which were sensitive to clindamycin but resistant to erythromycin. The positive rate of S. aureus,S. epidermidis and S. haemolyticus were 49.1%,44.2% and 57.1%. CONCLUSIONS Staphylococcus are ones of the important pathogens which make burn wound infection happen and the antimicrobial resistance is increasingly severe. The high positive results of MRSA and D-test make great trouble to therapy,and that should have taken more attention of clinic.
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OBJECTIVE To investigate the drug-resistant genes in Acinetobacter baumannii(ABA) isolated from Shaoxing and the relationship among them to supply evidences for tracing the source of epidemiology.METHODS Nineteen drug-resistant genes were detected by PCR in 39 strains of ABA.RESULTS TEM-gene was found positive in 13 strains of ABA(33.3%),OXA-23 group-gene was in 20 strains(51.3%),aac(3)-Ⅰ gene was in 23 strains(64.1%),aac(6′)-Ⅰ gene was in 25 strains(64.1%),ant(3″)-Ⅰ gene was in 29 strains(74.4%) and qacE△1-sul1 gene was in 32 strains(81.2%).The others were not found in all 39 isolates detected.Clonial transmitted phenomenon was existed.CONCLUSIONS The carrier rate of TEM,OXA-23group,aac(3)-Ⅰ,aac(6′)-Ⅰ,ant(3″)-Ⅰ and qacE△1-sul1 genes is high in ABA.ABA can induce clonial transmitted hospital infection.
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OBJECTIVE To investigate the pollution of venous indwelling needle and to discuss the preventive measures.METHODS A retrospective investigation was conducted on the results of germ culture of venous indwelling needle and the problems in nursing manipulation.RESULTS The total positive rate of venous indwelling needle cultures isolated from 2006 to 2007 was 20.2%,the positive rate in 2007 was lower than that in 2006(?2=7.66,P
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OBJECTIVE To discuss the effect of preventive medication for preventing incision infection before cesarean.METHODS Patients with cesarean section accepted parturients were divided in 2 groups randomly: group A(medicine before operation) and group B(no medicine before operation),and infection rate were observed after operation.RESULTS The incision infection rate of group A was 3.8%,and that of group B was 9.3%(?2=6.00,P
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OBJECTIVE To study the situation of central supply department and discuss the management of it.METHODS The hygienic monitoring results of sterile room in central supply department from 2007 to 2008 were invectigated.RESULTS The hygienic eligible rate of air,environment and objects was 91.1-97.2%.The qualified rate of sterilized packet was 99.2-100%.The eligible rate of humidity and temperature in disinfection chamber was 92.3% and 88.8%,respectively.CONCLUSIONS To consummate management measures and manage strictly sterilization procedure,assigning special person for the duty and attention to every details which easy tobe contaminated.all these measures mentioned above are the important countermeasures to quarantee environmental quality.
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OBJECTIVE To investigate current status of ventilator-associated pneumonia(VAP) and to provide prevention measures associated with nursing.METHODS Clinical data,such as incidence,categories of pathogenic bacteria and prevention measures associated with nursing,were retrospectively analyzed in 106 patients who received ventilator treatment in our hospital during 2004-2006.RESULTS The positive rate of microorganism culture in these patients was 95.3%.Totally 178 strains of microorganisms were cultured,including 63 strains of fungi,48 strains of nonfermanters,34 strains of Staphylococcus,33 strains of Enterobacteriaceae.There were many risk factors contributed to pathogenesis of VAP.Among these factors,underlying disease was one of the important internal causes and invasive medical procedure was one of the important external causes.The incidence of VAP was reducing yearly as improving of prevention measures associated with nursing.CONCLUSIONS Nurse acts an important role in prevention of VAP.Enhancing nursing management,improving nursing procedure and adopting appropriate intensive care measurement will reduce incidence of VAP.
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OBJECTIVE To investigate the resistance and the genes of quaternary ammonium compounds-resistance(qacE△1) and classⅠintegrase genes(intⅠ1)in continuously isolated Acinetobacter baumannii(ABA).METHODS K-B tests were performed to detect the susceptibility of 85 strains of ABA to 13 kinds of antimicrobial agents.The qacE△1 and intⅠ1 genes were analyzed by PCR.RESULTS The resistant rates to antimicrobial agents were between 8.2% and 81.2%.qacE△1 And intⅠ1 genes were 77.6%.CONCLUSIONS The 85 ABA strains are multiple-drug-resistant.There are very high positive percentages of qacE△1 and intⅠ1 genes in ABA isolated from Shaoxing,Zhejiang Province.
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OBJECTIVE To investigate the genetic background and antibiotic resistance of continuously isolated P.aeruginosa strains in Shaoxing.METHODS Eighty six strains of P.aeruginosa were isolated from hospitalized patients,and drug-resistant genes,integrons and transposons were detected by PCR.RESULTS The positive rates of blaCARB,blaVIM,blaDHA,blaTEM,ant(2″)-Ⅰ,aac(6')-Ⅱ,aac(6')-Ⅰb and ant(3″)-Ⅰ were 30.2%,14.0%,3.5%,1.1%,27.9%,24.4%,15.1% and 4.7%.There were clone transmitted phenomenon.CONCLUSIONS There are very high positive percentages of blaCARB,blaVIM,ant(2″)-Ⅰ,aac(6')-Ⅱ,and aac(6')-Ⅰb genes in continuously isolated P.aeruginosa strains.P.aeruginosa can induce clone transmitted hospital infection and it has fulminant prevalence.
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OBJECTIVE To determine risk factors of crossing infection of Pseudomonas aeruginosa in ICU and to evaluate efficiency of related control measures.METHODS Clinical data of all patients hospitalized in ICU during Feb to Nov 2005 were retrospectively analyzed.These clinical data included medical records,course of diseases,types of antibiotics used and their duration,invasive medical procedures,bacteria culture results and so on.Spot circumstance of ward,measures of isolation and sterilization,asepsis conception of staffs,fulfillment of laws to prevent intra-hospital infection were examined.RESULTS Forty six patients were hospitalized in ICU during 10 months.Bacterial culture was performed in all of them.Totally 108 strains of P.aeruginosa were cultured in specimens of 24 patients,among which 83 strains(76.9%) were cultured during May to Aug 2005(21 strains cultured monthly in average).As source of specimens,52 strains were from phlegm,26 strains from suction in trachea,17 strains from wound discharge, and 13 strains from other sources.Medicine sensitivity analysis revealed that most of the P.aeruginosa cultured strains were resistant to common antibiotics,including imipenem-cilastatin and meropenem.Major causes of this epidemic might include invasive medical procedure,abuse of antibiotics,deficiency of ward circumstance,imperfect in fulfillment of measures for infection prevention.CONCLUSIONS Control measures including improving clinical circumstance,insisting asepsis conception of staffs,appropriate use of antibiotics,and stressing microbiological inspection are vital in preventing and controlling epidemic of P.aeruginosa in ICU.
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OBJECTIVE To investigate the distribution of multiresistant genes produced by Pseudomonas aeruginosa(PAE) isolated from different areas.METHODS Antimicrobial sensitivities of 104 strains of PAE to 13 kinds of antibiotics were determined by K-B method,of which 16 kinds of drug resistant genes were tested by polymerase chain reaction(PCR) and analyzed by clustering method of multi-molecular markers.RESULTS The resistant detective rates to imipenam in three areas were respectively 51.3%,80%,and 100% and that to the third generation cephalosporin were moving from 48.2% to 100%.The detective rate of oprD2 absent was 90-100%.There were similar phenomena of prevalence between some strains in these areas.oprD2 Absent was the main mechanism of prevailing strains in Shaoxing,however,clone strains in Huzhou were caused by TEM,oprD2 absent,aac(3)-Ⅱ,ant(3″)-Ⅰ and qacE△1.CONCLUSIONS There is a multiresistance to antibiotics in PAE isolated from different areas and the phenomena of prevalence are occurred in these areas,but the mechanisms of drug resistant are different.
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OBJECTIVE To know the antibacterial activity of cefotaxime/sulbactam against 4 kinds of Gram- negative bacilli in vitro in general clinics. METHODS By double-disk test to detect the ESBLs of Escherichia coli and Klebsiella pneumoniae and the metallo-?-lactamase of Pseudomonas aeruginosa and Acinetobacter baumannii. And all the tested bacilli were tested by 14 kinds of general antibacterial drugs through K-B experiment. RESULTS Fifty one of 164 Enterobacteriaceae strains were ESBLs positive, including 23 E. coli strains with positive rate of 26.3% and 28 K. pneumoniae strains with positive rate of 35.9%. The metallo-?-lactamase was produced in 33 of 85 P. aeruginosa strains and the positive rate was 38.8%, and none in A. baumannii. The result showed cefotaxime /sulbactam was very sensitive to Enterobacteriaceae, no matter it had enzyme or not. These drugs had a special high sensitivity to ESBLs producing E. coli and K. pneumoniae, and their sensitivity rate was 87.0% and 89.3%. The sensitivity rate to P. aeruginosa, produced enzyme or not was 56.7% and 92.3%. CONCLUSIONS Cefotaxime/sulbactam has a powerful antibacterial activity against 4 kinds of Gram-negative bacilli in vitro in general clinics, especially to the infection caused by ESBLs-producing or metallo-?-lactamase-producing bacteria, and can be taken as the preferred drugs.
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OBJECTIVE To investigate the genotyping of ?-lactamases and aminoglycoside modifying enzymes on Acinetobacter baumannii isolated in Shaoxing. METHODS Thirty nine strains of A.baumannii were isolated from hospitalized patients,and drug-resistant genes were detected by PCR. RESULTS The detection rates of ?-lactamases coding genes of TEM and OXA-23 groups were 33.3% and 51.3%,The detection rates of aminoglycoside modifying enzymes coding genes of aac(3)-Ⅰ,aac(6′)-Ⅰ and ant(3″)-Ⅰ were 64.1%,64.1% and 74.4%,respectively.The others were not found in all 39 isolates tested. CONCLUSIONS The study showed that it is more serious for A.baumannii carrying ?-lactamases and aminoglycoside modifying enzymes coding genes in Shaoxing.
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OBJECTIVE To investigate the drug-resistant genes associated ?-lactams in Pseudomonas aeruginosa(isolated) in Shaoxing,Zhejiang Province.METHODS Thirty nine strains of P.aeruginosa were isolated from(hospitalized) patients,and drug-resistant genes were detected by PCR.RESULTS The positive rates of genes of TEM, CARB,VIM and DHA were 2.6%,30.8%,23%,and 7.7%,respectively,oprD2 gene was all lack.Genes of SHV,OXA-1 groups,OXA-10 groups,PER,VEB,GES,IMP,SPM and GIM were not found in all 39 isolates tested.CONCLUSIONS There are very high positive percentages of CARB and VIM genes in P.aeruginosa(isolated) clinically.The oprD2 gene lack is the important mechanism of P.aeruginosa resistant to(imipenem.) The CARB genes in P.aeruginosa are firsted report domestically.
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Objective By analyzing the dgug-resistance of Acinetobacter baumannii got from clinic in recent 3 years to study the therapy method of pan resistant bacteria.Method Bacteria was got from sputum or trachea pipe of patients normally,identified with ATB and test 14 common antibiotic drugs by K-B method.Result All the drug-sensitive test results of 248 bacteria in 3 years show that drug-resistance rate is high(40.3%~89.5%)except for IPM,IMI and sulbactam(11.7%~15.3%),and pan resistant bacteria(resist 4 or more kinds of antibiotic drugs)is 37.1%.Conclusion Acinetobacter baumannii is the main pathogen of lower respiratory tract infection.The high picks out rate and high drug resistance get great trouble to therapy.We need to make a strict standards of asepsis operation,strengthen monitoring the drug resistance and advocate to use antibiotic drugs reasonably,so that we can prevent and control the prevalence of Acinetobacter baumannii.
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Objective To investigate the genotyping of aminoglycoside modifying enzymes on Pan-drug resistant A..baumannii(PDRA)isolated.Methods The antibiotic susceptibility of 16 different antibiotics of A.baumannii were tested by K-B method,aminoglycoside modifying enzymes coding genes of A.baumannii were detected by PCR.Results The detection rates of OXA-23group were 41.8%and aminoglycoside modifying enzymes coding genes of aac(3)-Ⅰ,aac(6')-Ⅰand ant(3″)-Ⅰ were 64.1%,64.1% and 74.4%.Conclusions The study showed that it is more serious for PDRA carrying aminoglycoside modifying enzymes coding genes.
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OBJECTIVE To study the clinical characteristics and current status of the drug resistance of Burkholderia cepacia(BCE).METHODS Drug sensitivity test was performed on BCE with K-B method isolated from clinic specimen from 2006 to 2007 and the patients′ data were analyzed.RESULTS The pathogens were mainly isolated from sputum(18 strains,39.1%) and blood(9 strains,19.6%).ICU was the common department(28 strains,60.9%);all strains of BCE were resistant to ampicillin/sulbactam.The resistance rate to 3 kinds of aminoglycosides(amikacin etc),ciprofloxacin,piperacillin and imipenem were 63.0-84.8%.The resistance to sulfamethoxazole compound,ceftazidime,cefepime piperacillin/tazobactam,cefoperazone/sulbactam and meropenem were less than 40.0%.CONCLUSIONS Serious underlying diseases,frequent invasive operation and drug abusement were the main causes of BCE infection.Meropenem,sulfamethoxazole compound,ceftazidime,piperacillin/tazobactam and cefoperazone/sulbactam could be selected to treat BCE infection.