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Objective To investigate the distribution and antibiotics resistance of the major non-fermenting bacteria in our hospital from 2011 to 2016 ,then provide a reference for clinic practice .Methods Retrospective-ly analyze clinical distribution and antimicrobial susceptibility of 2398 non-fermenting bacteria from 2014 to 2016 .Results Over the past 3 years ,2398 main non fermented bacteria were isolated ,mainly 1019 strains of Acinetobacter Bauman (42 .5％ ) ,followed by Pseudomonas aeruginosa 1016 (42 .4％ ) .The main non fermen-tative bacteria isolated from ICU were 727 strains (30 .3％ ) ,ranking the first in all departments ,and the Acin-etobacter Bauman was the top .The sensitivity rate of Acinetobacter Bauman to antibiotics was decreasing year by year ,as low as 25 .0％ -40 .0％ .Especially in ICU ,the sensitivity rates were less than 10 .0％ .The suscep-tibility rates of Pseudomonas aeruginosa to a variety of antibiotics ,such as ceftazidime ,cefepime ,imipenem , ciprofloxacin ,levofloxacin ,were all increased ,and the sensitivity was >70 .0％ .Conclusion Acinetobacter and Pseudomonas aeruginosa were the main pathogenic bacteria in the clinical distribution of non fermenting bacte-ria .The most sensitive rate of the former to antibiotics was decreasing year by year ,especially the ICU situa-tion was severe ,the sensitivity of the latter was increasing year by year ,which was beneficial to the clinical se-lection of antimicrobial agents .
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Objective To investigate the distribution and drug resistance of common bacteria isolated from geriatric hospital for 2014 -2016 years,and to provide basis for the use of infection in elderly patients. Methods Bacterial identification and drug sensitivity test of isolates from January 2014 to December 2016 were performed by Microscan WalkAway 96 automatic microorganism analyzer.The drug resistance was ana-lyzed by Whonet5.6 software.Results In 2014-2016 a total of 2 133 strains of pathogens were isolated,in-cluding 1 668 strains of gram negative bacteria,accounting for 78.2%;318 strains of gram positive bacteria ac-counted for 14.9%;leather were the top 5 bacteria were Gram-negative bacteria,522 strains of Escherichia co-li,accounting for 24.5%,407 strains of Klebsiella pneumoniae,accounting for 19.1%,244 Pseudomonas aeruginosa,Proteus strains accounted for 11.4%,163 strains of proteus,accouuting for 7.6%;141 strains of Acinetobacter baumannii,accounting for 6.6%.No resistance to vancomycin,linezolid and daptomycin in Staphylococcus and Enterococcus,were not detected in carbapenem resistant Escherichia coli,Klebsiella pneu-moniae,Proteus drug.The detection rates of ESBLs producing Escherichia coli and Klebsiella pneumoniae were 26.7% and 13.6%,respectively.The detection rates of ESBLs producing Escherichia coli and Klebsiella pneu-moniae were 26.7% and 13.6%,respectively.The resistance rates of Pseudomonas aeruginosa and Acineto-bacter Bauman to imipenem w ere 8.6% and 32.6%,respectively.Conclusion T he bacterial resistance rate level is not high,the carbapenem resistant Enterobacteriaceae and non fermentive bacteria should be paid at-tention to,and the monitoring of bacterial multi drug resistant bacteria in the management and prevention of nosocomial spread and the restriction of the use of antibacterial drugs should be strengthened.We should refer to the drug resistance monitoring data of elderly population and select rational antibiotics according to the sen-sitivity test results.
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Objective To study the effect of different drugs on the treatment of severe pneumonia caused by multi drug resistant Acinetobacter Bauman, and to provide reference for clinical application in the future.MethodsA retrospective analysis was conducted on 250 cases of severe pneumonia patients with multiple drug resistant Acinetobacter Bauman admitted to intensive care unit in Yuyao Second People's Hospital from June 2011 to June 2016.The 250 cases were divided into the observation group and the control group, 125 cases in each group.The observation group were given imipenem (imipenem/cilastatin sodium), mepem (meropenem), sulperazone (Chuba Staw Na, cefoperazone) and levofloxacin, while the control group were given polymyxin E.The clinical efficacy, adverse reaction rate, C-reactive protein(CRP) and white blood cell count(WBC) were compared between the two groups.ResultsAfter treatment, the total effective rate in the observation group was 87.20% and 61.60% in the control group, the difference between the two groups was statistically significant, P<0.05.The adverse reaction rate in the observation group was 10.40% and 8.80% in the control group.There was no significant difference between the two groups about adverse reaction rarte.Inflammatory markers, CRP and WBC in the observation group were significantly lower than those in the control group, P<0.05.ConclusionImipenem, mepem, sulperazone and levofloxacin in treatment of severe pneumonia with multi drug resistant Acinetobacter Bauman, the clinical curative effect is good, less adverse reaction, is a drug treatment program that is worth promoting in clinical practice.
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Objective The clinical distribution and drug resistance of isolated Acinetobacter Bauman strains were retrospectively analyzed in Xiangya Hospital Central South University in 2015,and its resistant transitions in ten years were also analyzed,to provide theoretical guidance for clinical rational use of antibiotics and control of infection.Methods 534 Acinetobacter Bauman strains were collected at Xiangya Hospital in 2015,the clinical distribution characteristics and drug resistance of Acinetobacter Bauman strains were analyzed according to specimen type,department,age and drug resistance result.Meanwhile,the drug resistance situation was compared with that in 2006 and 2011.Results The isolation rate of Acinetobacer Bauman from respiratory tract specimen was 76.78％,the tolal isolation rate from ICU,respiratory department of internal medicine,neurology department of internal medicine and neurosurgery department ward was 57.87 ％,and the infection patients over the age of 61 occupied 37.83 ％.Risperidone/Shubatan showed the best antibiotic activity with the resistance rate 3.02 ％ in ten drugs,the Acinetobacter Bauman strains were resist to other nine drugs in different level,with the percent from 50.0％ to 85.0％.The drugs of tobramycin and imipenem showed the greatest growth,with the resistance rate of 1.87％ and 11.70％ in 2006 in Xiangya hospital,increased to 69.85％ and 80.53％ in 2015,respectively.The drug of levofloxacin and cefepime also showed great growth in ten years with the increase of 58.81％ and 55.98％,respectively.Conclusion The clinical isolates of Acinetobacter Bauman strains mainly derived from respiratory tract specimen,and mainly distributed in ICU,the most infection people were from the older.The resistance rate of common drugs showed a significant increase in ten years,especially for cephalosporins and carbapenems.With the increase of multiple drug resistant strains,the monitoring of drug resistance of Acinetobacter Bauman and use of antibiotics rationally should be strengthened.
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Objective To observe the results of broth dilution method and disc diffusion method to test the synergistic effect of Reduning and cefoperazone sodium / sulbactam sodium(SCF) on extensive drug resistant Acinetobacter bauman (XDR-AB) in vitro environment ,and compare their compliance to guide the clinical medication .Methods A total of 12 strains of XDR-AB from infec-tion patients in our hospital in 2015 were collected ,the strain was sub cultured .Firstly ,observe the minimum inhibitory concentra-tion (MIC) of SCF and Reduning on XDR-AB alone and in combination by broth dilution method .And then judge the synergy effects through calculation .Secondly ,the inhibition ring diameter and the synergy effects was detected using the disc diffusion meth-od .Results The MIC of Reduning and SCF in combination on XDR-AB was declined compared with them alone .The Fractional in-hibitory concentration of Reduning and SCF in combination on XDR-AB were equal or less than 0 .5 ,they had synergistic effect on XDR-AB .The inhibition ring diameter of Reduning was 10 mm tested by disk diffusion method .Different strains of XDR-AB on SCF bacteriostatic annulus diameter difference ,5 strains were 15 mm ,3 strains were 16 mm ,and 4 strains were 17 mm .Reduning and SCF appeared synergistic effect according to the inhibition ring diameter expanded when they effected on XDR -AB in combina-tion .Conclusion In vitro ,Reduning combined with SCF on XDR-AB has good synergistic effect .Compared with broth microdilution checkerboard dilution method ,disk diffusion method is more simple and convenient ,but it has a certain subjective on judging re-sults ,which is better to operate by experienced person .