ABSTRACT
OBJECTIVE:To provide reference for standardizing the clinical use of carbapenem antibiotics and controlling drug-resistant bacteria infection. METHODS:The detection of 3 kinds of carbapenems-resistant Gram-negative bacillus in our hospi-tal during 2011-2016 were analyzed retrospectively. The consumption,target cure rate and treatment course of carbapenem antibiot-ics were analyzed statistically. The correlation between detection rate of drug-resistant bacteria with the consumption of carbapenem antibiotics was investigated by Pearson test. RESULTS:During 2011-2016,1222 strains of carbapenems-resistant Acinetobacter bauman (CRAB),655 strains of carbapenems-resistant Pseudomonas aeruginosa (CRPA) and 53 strains of carbapenem-resistant Escherichia coli (CRE) were detected in our hospital. The detection rates increased from 23.88%,8.92%,0.09% in 2011 to 80.34%,35.74%,0.97% in 2016. The types of carbapenem antibiotics in our hospital were mainly imipenem and meropenem. The consumption of them increased from 4222,145 g in 2011 to 7218,4387 g in 2016. The both target cure rates were all lower than 60%,and the proportion of the patients with treatment course >14 d was more than 65%. The detection rates of CRAB,CR-PA and CRE were positively correlated with the consumption of carbapenem antibiotics (r>0.9,P<0.05). CONCLUSIONS:The detection rate of carbapenems-resistant Gram-negative bacillus and drug consumption increase year by year in our hospital,and they have certain correlation. The target cure rate of carbapenem antibiotics in our hospital is in low level,and there is a long treatment course. They are should be standardized in the clinic. The selection of carbapenem antibiotics should be strictly followed clinical in-dications so as to reduce the generation of drug-resistant strains.
ABSTRACT
Objective To establish a desirable quantitative assay system to evaluate the correlation between surgical manipulation and micrometastasis in primary esophageal cancer patients.Methods 118 pe- ripheral blood samples from 40 esophageal cancer patients undergoing radical resection were collected before surgery(B-1),immediately after surgery(B0)and at the third day postoperatively(B+3).Based on real-time quantitative reverse transcription-PCR,carcinoembryonic antigen(CEA)mRNA gene was used in the detec- tion.12 patients with benign tumor and 13 healthy volunteers were collected as negative control groups.Re- sults The median of CEA mRNA copies at B-1,B0 and B+3 were 1592,13 314 and 6221 copies/ml blood, respectively.CEA mRNA expression levels were found to be significantly higher at both B0 and B+3 than that of B-1(P=0.0001 and 0.0209,respectively).No significant difference was found between B0 and B+3(P= 0.4396).Conclusion Surgical manipulation on esophageal cancer patients increases the probability of mi- crometastasis.Therefore,adjuvant therapy is needed during perioperative stage.