ABSTRACT
Objective To evaluate the change of extended spectrum β-lactamase (ESBLs) Producing Klebsiella Pneumoniae (ESBLs-KPN) and Escherichia coli (ESBLs-ECO) causing nosocomial infection after antimicrobial intervention. Methods We regularly monitored the data on the yearly consumption [defined as daily dose (DDD) per 1 000 patient-days] of frequently used antibiotics from Dec. 2004 to Dec. 2007. From Jan. 2005 to Dec. 2007, we monitored the resistance of frequently used antibiotics and the timely integrative antimicrobial intervention was based on the outcome of antimicrobial resistance. We also monitored the isolation rate of ESBLs-KPN and ESBLs-ECO causing nosocomial infection. The departments studied were the experimental group and other comparable medical departments were the control group(ICU was excluded).Results The isolation rate of ESBLs-KPN ((43.90%)) and ESBLs-ECO (45.83%) in the experimental group was higher than that in the control group (28.04% and 24.90%, respectively) before the intervetion (P＜0.05). The isolation rate of ESBLs-KPN decreased (from 26.47% to 17.65%) in the experimental group and that in the control group increased ( ESBLs-KPN: from 34.18% to (52.94%;) ESBLs-ECO: from 47.13% to 63.78%) from 2005 to 2007 (P＜0.05). The isolation rate of ESBLs-KPN and ESBLs-ECO in the experimental group was lower than that in the control group after the antimicrobial intervention (P＜0.05). Usage of ceftazidime and cefoperazone/sulbactam and imipenem was reduced and the consumption of cefepime was increased in the experimental group ((P＜0.05)). Consumption of ceftazidime and cefoperazone/sulbactam and cefepime was increased. Conclusion The prevalence of ESBLs-KPN and ESBLs-ECO may be decreased after the integrative antimicrobial intervention.
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OBJECTIVE To evaluate the relationships between antimicrobial usage and the isolated rate of ESBLs-KPN and ESBLs-ECO.METHODS We monitored the data on the yearly patient-days and the yearly consumption(defined daily dose(DDD) per 1000 patient days) frequent antibiotics and the isolated rate of ESBLs-KPN and ESBLs-ECO causing nosocomial infections from Jan 2004 to Dec 2007 was analyzed.RESULTS The yearly patient-days of our department significantly increased from 64 203 days in 2004 to 74 442 days in 2007(P
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Objective To observe the influence of recombinant human brain natriuretic peptide(rhBNP)treatment on serum C-reactive protein(CRP)level in patients with congestive heart failure.Methods Forty patients with congestive heart failure(NYHA class Ⅳ)were divided into experimental group(n=20)receiving rhBNP and control group(n=20)receiving isosorbide dinitrate.Blood pressure and central venous pressure were observed and hypersensitive CRP was checked before and one week after treatment in both groups.Results No obvious change of blood pressure at each time point was found after BNP treatment(systolic blood pressure:P=0.804;diastolic blood pressure:P=0.492)while significant decrease of CVP was noted(P=0.016).Serum CRP level was significantly decreased one week after BNP treatment(10.1?7.4 mg/L vs 7.7?5.0 mg/L;P=0.013)in experimental group,obviously different from that in the control group(P=0.044).hsCRP change was positively related to CVP change(Pearson correlation:0.469,P=0.043).Conclusion Brain natriuretic peptide effectively decreases serum C-reactive protein level in the patients with congestive heart failure,indicating its possible role in relieving inflammation in heart failure.