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OBJECTIVE To study the characteristics of clinical distribution and drug resistance in patients with vancomycin-resistant Enterococci（VRE），and to provide reference for clinical prevention and control of infection. METHODS From May 1，2017 to May 1，2020，a total of 290 patients with Enterococci cultured from the samples submitted by inpatient department of our hospital were included. They were divided into VRE group （24 cases）and vancomycin-sensitive Enterococci （VSE）group（266 cases）according to the results of sensitivity tests. The basic information of patients （gender，age，submitting department，etc.）， basic diseases （hypertension，diabetes，chronic obstructive pulmonary disease ，etc.）， clinical events （catheterization，endotracheal intubation ，deep venous catheterization ，etc.），use of antibiotics （utilization and utilization time of antibiotics before and after detection ），clinical manifestations （abnormal inflammatory indicators ，clinical symptoms ，etc.）， clinical outcomes （length of stay ，improvement，etc.），drug sensitivity spectrum were all collected. Clinical distribution and drug resistance were compared and analyzed between 2 groups. RESULTS There were significant differences in the type of Enterococci， mixed infection strains and clinical manifestations between 2 groups（P＜0.05）. In VRE group ，two natural drug-resistant bacteria were detected in 66.7％ and 20.8％ of the patients ，i.e. Enterococcus gallinarum and E. casseliflavus . E. faecium was only sensitive to linezolid ，teicoplanin and tegacyclin （the drug resistance rate was 0），and was resistant to other antibiotics （the drug resistance rate was 100％）；E. faecalis was not detected. E. faecium and E. faecalis were detected in 51.9％ and 44.7％ of patients in VSE group. The resistance rates of E. faecium to other antibiotics were more than 55％ except linezolid ，teicoplanin and tegacyclin （resistance rate ≤0.72％）；the resistance rates of E. faecalis to clindamycin and erythromycin were all more than 60％，and the sensitivity to other antibiotics was more than 60％. CONCLUSIONS The VRE infection strains in our hospital are mainly natural drug-resistant bacteria such as E. gallinarum and E. casseliflavus ，and vancomycin-resistant E. faecium is found. The resistance rates of different strains to antibiotics are quite different.
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Objective To investigate the epidemiological characteristics and drug resistance of Escherichia coli infection in Chengdu Second People's Hospital from 2014 to 2019. Methods The specimen types, department sources, infection sites and population characteristics of 1 999 strains of Escherichia coli isolated from the hospital from 2014 to 2019 were analyzed. The trend χ2 was used to analyze the annual isolation rate of Escherichia coli and the change of the rate of Escherichia coli resistance to common antibacterial drugs. Results The isolation rate of Escherichia coli showed a downward trend year by year from 2014 to 2019 (P2trend=16.345, χ2trend=10.697, χ2trend=7.324, P<0.05). Conclusion From 2014 to 2019, the isolation rate of Escherichia coli had a downward trend year by year, but the drug resistance rate of Escherichia coli to ampicillin, piperacillin and ceftriaxone showed an upward trend year by year. In addition to strengthening the monitoring of high-risk sites, departments and population, drug sensitivity tests should also be done to guide rational clinical use.
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OBJECTIVE：To provide reference for clinical treatment of Acinetobacter baumannii infection and rational use of antibiotics. METHODS ：By retrospective analysis ，64 500 strains of bacteria were isolated from the inpatients of our hospital during Jan. 2015 to Dec. 2018. WHONET 5.6 software was used to analyze the detection rate ，specimen type ，departments of A. baumannii. The resistance of A. baumannii to 18 commonly used antibiotics in 4 years was analyzed by RxC table χ 2 test. RESULTS：A total of 2 072，2 040，2 017 and 2 143 strains of A. baumannii were isolated during 2015-2018，accounting for 12.85％，13.38％，13.60％，11.71％ of positive specimens. The main specimen types of 8 272 strains of A. baumannii were sputum（4 368 strains，52.81％），pus（1 106 strains，13.37％），ascites（804 strains，9.72％）. The main departments were burn department（1 605 strains，19.40％），hepatobiliary department （1 200 strains，14.51％），brain surgery department （977 strains， 11.81％）. The drug resistance rate to 18 kinds of antibiotics showed a wave-like decreasing trend （P＜0.001）. In 2018，drug resistance rate to ampicillin and aztreonam was more than 80％，and that to ampicillin/sulbactam ，ceftazidime，levofloxacin， Compound sulfamethoxazole ，gentamicin，amikacin，tobramycin and tegacyclin was less than 50％ ，among which the drug resistance rate to amikacin and tegacyclin were 14.7％ and 0，respectively. CONCLUSIONS ：There is no significant change in the number of isolates and detection rate of A. baumannii in our hospital between 2015 and 2018. The bacteria mainly cause respiratory tract infection. Amikacin or tegacyclin are recommended for treatment.
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Objective: To analyze the distribution and drug resistance of clinical isolated pathogens to provide reference for rational use of antimicrobial agents. Methods: We retrospectively analyzed the distribution and drug resistance data of clinical bacterial isolates from the Second Affiliated Hospital of Hainan Medical University from Jan 2018 to Dec 2018 and their clinical distribution and drug resistance were analyzed. Results: The results of comprehensive analysis of 7 897 non-repetitive bacteria showed that 5 044 strains (63.87%) were Gram-negative bacteria, 1 818 strains (23.02%) were Gram-positive bacteria, and 1 035 strains (13.11%) were fungi. Gram-negative bacteria mainly were Pseudomonas aeruginosa (15.44%), Escherichia coli (12.79%) and Acinetobacter baumannii (8.66%). Gram-positive bacteria mainly were Staphylococcus aureus (6.43%), Enterococcus faecium (4.89%) and Enterococcus faecalis (4.65%). The main fungi were Candida albicans (6.34%). Most of the collected and tested samples were urine (32.87%), followed by sputum (30.10%) and wound secretion (13.54%). In emergency department, intensive care unit and urology department, the detection rate of pathogens was most frequently found among three departments. Escherichia coli had higher resistance to ampicillin, tetracyclin and piperacillin, but were sensitive to imipenem and meropenem. Pseudomonas aeruginosa were sensitive to amikacin, tobramycin and gentamycin. Acinetobacter baumannii had higher resistance to cefotaxime, cefepime, and they were sensitive to minocycline. Among Staphylococcus aureus, a total of 123 strains of MRSA (24.21%) were more resistant to penicillin, azithromycin and erythromycin, but sensitive to vancomycin, linezolid and taicoplanin. Conclusions: The problem of drug resistance of clinical isolated pathogens was serious. The hospital should strengthen the dynamic monitoring of drug resistant bacteria. Antibiotics should be used rationally to reduce the spread of drug resistant strains and effective measures must be taken to prevent infections.
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OBJECTIVE:To provide reference for hospital infection treatment and control. METHODS:The etiological data of Enterococcus isolated from clinical specimens were collected from our hospital during Jan. 2009-Jun. 2017. The drug resistance of commonly used antibiotics and infection related risk factors were analyzed retrospectively. RESULTS:A total of 6252 isolates of Enterococcus were isolated,of which there were 1994 strains of E. faecalis and 3575 strains of E. faecium. The bacteria were mainly isolated from urine(2009 strains),drainage liquids(1538 strains),bile(1168 strains),wound secretions(561 strains), blood (493 strains). The detection rate increased 9.4％ in 2009 to 13.4％ in 2017. Resistance rate of E. faecalis to ampicillin, penicillin and vancomycin showed a wavelike decrease,and E. faecalis showed low resistance rate to vancomycin,teicoplanin, linezolid and tigecycline. Resistance rate of E. faecalis to ciprofloxacin,moxifloxacin and levofloxacin decreased wavily to 2014 but showed a fluctuating upward trend since 2015. Resistance rate of E. faecium to linezolid decreased from 1.9％ in 2009 to 0.2％ in Jun. 2017;resistance rate of E. faecium to vancomycin and teicoplanin continues to fluctuate,but it is still at a low level;resistance rate of E. faecium to tetracycline decreased, but that to high concentration gentamicin increased. There were 43 strains of vancomycin-resistant E. faecium and 8 trains of vancomycin-resistant E. faecalis detected in 51 patients. Resistant rates of vancomycin-resistant E. faecium to linezolid,tigecycline and teicoplanin were 23.3％,0,35.3％,respectively. Resistant rates of vancomycin-resistant E. faecalis to linezolid,tigecycline and teicoplanin were 0. Pearson relationship analysis showed that days in ICU (r=0.225,P<0.01),tracheotomy or intubation (r=0.314,P<0.01),days of antibiotic use (r=0.347,P<0.01),types of antibacterial drugs (r=0.226,P<0.01),use of glucocorticoids (r=0.190,P<0.01),and days of carbapenems use (r=0.173,P<0.05)were positively correlated with vancomycin-resistant E. faecium infection rate and vancomycin-resistant E. faecalis infection rate. CONCLUSIONS:The detection rate of Enterococcus in our hospital is fluctuating upward. E. faecalis and E. faecium were the main types,mainly from urine and drainage fluids. The resistance rate of Enterococcus most of antibiotics shows a downward trend. The resistance rate of E. faecium to high concentration gentamycin is on the rise,while that of E. faecium to linezolid and tetracycline is decreased. The appropriate antibiotics should be selected according to the patient's condition and drug susceptibility results.
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OBJECTIVE:To provide reference for rational drug use and hospital infection control. METHODS:AmpC enzyme-producing Enterobacter cloacae were isolated from non-sputum specimen of a hospital during Jan. 2011-Oct. 2017. Drug sensitivity test was conducted by using MIC. The situation of AmpC enzyme production was confirmed by three dimensional test, and that of ESBLs-producing stain was detected with double-disk synergy test. RESULTS:There were 546 strains of AmpC enzyme-producing E. cloacae isolated from non-sputum specimen of the hospital,accounting for 4.80% of non-sputum specimen (546/11 375)and 38.97% of E. cloacae(546/1 401). Top 3 non-sputum samples in the list of detection rate were wound secretion (27.29%),midstream urine(25.82%)and blood(21.79%),and the departments with high detection rate were ICU(22.89%), neurosurgery department(18.68%)and general surgery department(16.67%). Resistance rate of AmpC enzyme-producing E. cloacae to most commonly used antibiotics was higher than 40%. There was statistical significance in resistant rate of the bacteria to ceftriaxone, cefotaxime, gentamicin, nitrofurantoin, levofloxacin, piperacillin/tazobactam, cefoperazone, ceftazidime,cefepime,tobramycin and minocycline among different years (P<0.05). The resistant rate to imipenem and meropenem was lower than 2%. Among 546 strains of AmpC enzyme-producing E. cloacae,68 strains of ESBLs were detected,and detection rates were 5.77%,6.06%,8.70%,10.26%,13.79%,17.35%,18.75% during 2011-2017. CONCLUSIONS:AmpC enzyme-producing E. cloacae are mainly isolated from samples as wound secretion and midstream urine,and mainly come from ICU and neurosurgery department. The drug resistance of the bacteria is severe,and drug resistance of the bacteria to antibiotics as β-lactams and quinolones is increased significantly. The detection rate of ESBLs-producing strain increases year by year. The bacteria are sensitive to carbapenems antibiotics,which can be regarded as first choice. It is necessary to strengthen drug resistance and enzyme production monitoring of AmpC enzyme-producing E. cloacae,select antibiotics combined with results of drug sensitivity test so as to prevent or delay the rapid increase of its resistance rate.
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OBJECTIVE:To provide reference for rational drug use in clinic and nosocomial infection control. METHODS:Acinetobacter baumannii(AB)were collected from our hospital during Jan. 2014-Jun. 2017. Drug sensitivity tests were conducted by using K-B method and MIC method. Drug-resistance genes of multidrug-resistant Acinetobacter baumannii(MDR-AB)were amplified by PCR,and compared with GenBank database by using Blast comparison. RESULTS:A total of 1 758 strains of AB were detected,and mainly came from sputum and throat swab(65.24%),followed by urine(18.49%). These infected patients were mainly distributed in the departments of ICU(38.51%)and respiratory medicine(24.00%),respectively. Drug resistance of clinical isolated AB to most commonly used antibiotics were more than 40%,such as compound sulfamethoxazole,piperacillin sodium and tazobactam sodium,gentamicin,cefepime,levofloxacin,minocycline,imipenem,etc.;it had increased year after year. Drug resistance to colistin was lower than 5% and decreased year by year.A total of 673 strains of MDR-AB were detected, and detection rates were 22.77%,29.82%,52.09%,54.33%,respectively.Among 110 strains of MDR-AB,detection rates of TEM, AmpC,IMP,VIM,OXA-23,OXA-24,OXA-51,aac(6′)-Ⅰ,aac(3)-Ⅰ,ant(3″)-Ⅰ,anmA,gyrA,parC gene were 97.27%, 91.82%,49.09%,12.73%、90.91%,12.73%,98.18%,34.55%,60.91%,89.09%,87.27%,77.27%,82.73%,respectively. Results of Blast comparison showed that point mutation occurred in 83rd and 121st base of gyrA gene,144th base of parC gene. CONCLUSIONS:AB mainly come from sputum and throat swab specimens in our hospital,and infected patients are mainly distributed in the departments of ICU and respiratory medicine. Drug resistance is serious,and the detection rate of MDR-AB is increased year by year. Main genes of multidrug-resistant strains mainly include TEM,AmpC,OXA-23,OXA-51,ant(3″)-Ⅰ, anmA,etc.,and mutation of gyrA and parC gene are found. It is necessary to strengthen the management of classification use of antibiotics and strengthen the monitoring of AB drug resistance. According to the results of drug sensitivity test,antibiotics are selected rationally to prevent or delay planting and cross transmission of AB-resistant strain.
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Objective The distribution of pathogenic bacteria and antibiotic resistance was studied in the People's Hospital of Inner Mongolia Autonomous Region from January 2012 to December 2017 for rational antimicrobial therapy and control of bloodstream infections. Methods A retrospective analysis was conducted on the pathogenic strains of bloodstream infection. A total of 2 095 strains were collected and subjected to identification by Bact/ALERT 3D automatic blood culture instrument and VITEK 32 automatic microbiological analysis and susceptibility testing. The data were analyzed by using WHONET 5.6 software and SPSS 22.0 software. Results Of the 2 095 strains of pathogens, gram negative bacteria accounted for 50.1％ and gram-positive bacteriaaccounted for 49.9％. Specifically, the top species included coagulase negative Staphylococcus (34.8％), Escherichia coli (27.8％), Klebsiella pneumoniae (9.1％), Staphylococcus aureus (6.9％), and Enterococcus (6.6％). These strains were mainly identified from ICU (22.5％) and general surgery department (9.3％). The prevalence of methicillin-resistant coagulase negative Staphylococcus (MRCNS) and methicillin-resistant Staphylococcus aureus (MRSA) was 82.3％ and 44.8％, respectively. No gram-positive bacteria were resistant to vancomycin and linezolid. The E. faecium strains showed higher resistance rates to common antimicrobial agents than E. faecalis strains. Enterobacteriaceae species including E. coli, K. pneumoniae, and E. cloacae were highly resistant to ampicillin (＞80％). The resistance rate of Enterobacteriaceae species to imipenem, meropenem, amikacin, and piperacillin-tazobactam was lower than 9.4％. In the non-fermentative bacteria, Acinetobacter baumannii strains were highly resistant to multiple antimicrobial agents except amikacin (22.2％). Conclusions The pathogenic bacteria of bloodstream infection are complex, consisting of similar proportion of gram-positive bacteria and gram-negative bacteria. The pathogens were mainly found in ICU. Antibiotic-resistant strains identified are highly resistant to multiple antimicrobial agents. Efforts should be made to strengthen antimicrobial resistance surveillance for rational antimicrobial therapy.
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Objective To analyze the antimicrobial resistance profile and homology of the Acinetobacter baumannii strains isolated from Rushan People's Hospital in a three-year period for better control of hospital infections.Methods A.baumannii strains were isolated from clinical specimens during the period from 2013 to 2015.Homology analysis were conducted by pulsed field gel electrophoresis (PFGE) for 60 randomly selected isolates.Results A total of 567 A.baumannii isolates were isolated,85 isolates in 2013,156 in 2014,and 326 in 2015.These isolates were mainly from Department of Respiratory Diseases (47.4％) and ICU (23.8 ％).Overall,62.1％ of the isolates were from sputum specimens followed by secretions (15.2％).All isolates were sensitive to polymyxin B,but all resistant to sulfamethoxazole and ampicillin.The A.baumannii isolates showed increasing resistance rate to imipenem,meropenem,ceftriaxone,and trimethoprim-sulfamethoxazole over the 3-year period,but decreasing resistance rate to gentamicin.The 60 selected isolates were grouped into 4 types by PFGE.A-type was the main pattern.Conclusions A.baumannii strains were mainly isolated from inpatients with respiratory tract infections.The A.baumannii strains showed serious antimicrobial resistance associated with possible clonal spread in this hospital.
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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 investigate the clinical distribution and antimicrobial resistance of Streptococcus agalactiae(S.agalactiae) in neonatal intensive care unit(NICU), and provide reference for antimicrobial use and intervention measures.Methods Specimens from neonates in the NICU of a hospital in 2010-2014 were collected, the department sources and antimicrobial susceptibility testing results of 62 strains of S.agalactiae isolated from children were analyzed.Results 62 strains of S.agalactiae were mainly distributed at full-term NICU, accounting for 64.52％;the main source of specimens was blood, accounting for 90.33％, followed, by cerebrospinal fluid (6.45％), sputum, and secretion(both were 1.61％).S.agalactiae had the highest resistance rate to tetracycline(79.03％);resistance rates to erythromycin and clindamycin were both 74.19％, resistance rate to levofloxacin was 40.32％, susceptibility rates to penicillin and ampicillin were both 100％.Conclusion S.agalactiae infection mainly occurred in neonates in full-term NICU, and has high resistance rate to multiple antimicrobial agents, penicillin and ampicillin can be used as the preferred antimicrobial agents for the treatment of S.agalactiae infection.
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Objective · To analyze the clinical distribution and drug resistance of Acinetobacter junii (A. junii) and Acinetobacter lwoffii (A. lwoffii) from a grade 3A hospital in Shanghai, China, and provide the foundation for prevention and control of infections caused by them. Methods · A. junii and A. lwoffii were collected from the hospital between Aug, 2011 and Aug, 2016. VITEK2 Compact of bioMérieux (French) was used for bacterial identification and antibiotic susceptibility tests, clinical information of each strain was also analyzed. Results · 28 strains of A. junii and 58 strains of A. lwoffii were enrolled. A. junii was mainly from the departments of urology, thoracic surgery and geriatrics, and the samples were mainly sputum and urine. The resistant rates of A. junii to gentamicin, ampicillin sulbactam, piperacillin, piperacillin/tazobactam, ceftazidime, cefepime, imipenem, meropenem, levofloxacin, ciprofloxacin and cotrimoxazole were 35.71%, 3.57%, 10.71%, 3.57%, 3.57%, 3.57%, 3.57%, 3.57%, 0, 3.57% and 35.71%, respectively. A. lwoffii was mainly isolated from the departments of urology, geriatrics, respiratory and renal medicine, and the samples mainly included urine, blood and sputum. The rates of antibiotics (mentioned above) resistance were 29.31%, 13.79%, 13.79%, 6.90%, 20.69%, 18.97%, 12.07%, 15.52%, 18.97%, 31.03% and 31.03%, respectively. The levels of antibiotic resistance of these two strains were constant during the five years. Conclusion · A. junii and A. lwoffii antibiotic resistant rates were much lower than those of reported A. baumannii, the over-all antibiotic resistances of A. junii were lower than those of A. lwoffii. This study provided fundamental data for prevention or control of these two strains by empirical use of antibiotics.
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OBJECTIVE:To provide reference for rational use of antibiotics in the clinic. METHODS:In retrospective study, the distribution,composition and drug resistance of pathogens in our hospital during Jan.-Dec. in 2015 were analyzed statistically. RESULTS:In 2015,a total of 9401 specimens were collected in microbiology laboratory of our hospital;pathogens were detect-ed in 1743 specimens with positive rate of 18.54%;1591 strains of pathogens were isolated,mainly from sputum (59.77%), urine (14.775) and blood sample (8.93%). Totally 347 strains of Gram-positive bacteria(21.81%),991 strains of Gram-negative bacteria (62.29%),253 strains of fungus (15.90%)were detected. Top 4 pathogens in the list of amount were Escherichia coli, Klebsiella pneumoniae,Pseudomonas aeruginosa and Staphylococcus aureus. S. aureus,Streptococcus pneumoniae and Staphylo-coccus haemolyticus were sensitive to vancomycin,linezolid and sodium fusidate,with resistance rate of 0;resistance rates of them to erythromycin were more than 65%. The resistance rate of S. aureus to penicillin was more than 95%,and S. haemolyticus showed high resistance rate to common antibiotics. Drug resistances of E. coli,K. pneumoniae and P. aeruginosa to carbapenems were all lower than 15%,and they were sensitive to polymyxin with resistance rate of 0. Resistance rate of E. coli to quinolones was more than 50%. CONCLUSIONS:The main pathogens are Gram-negative bacteria in our hospital,drug resistance of them are not satisfactory. Drugs most sensitive to main pathogens include vancomycin,linezolid,carbapenems,etc. The inspection of patho-gen drug resistance characteristics should be strengthened,and antibiotics should be selected rationally and normatively according to the results of drug sensitivity test.
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Objective To study the clinical characteristics of multi-drug resistance bacterias(MDROs) isolated from hospitalized patients in the Second People′s Hospital of Longgang District,to provide strategies for the prevention of MDROs infection.Methods The MDROs data of hospitalized patients from January 2015 to December 2016 were analyzed retrospectively.The multi-drug resistance incidence of each bacterias,each types of specimens and each clinical departments were analyzed and compared by SPSS16.0.Results A total of 104 strains of MDROs were isolated,and the top five bacteria were E.coli(32 strains,30.77%),coagulase negative staphylococcus(24 strains,23.08%),pseudomonas aeruginosa(16 strains,15.38%),staphylococcus aureus(10 strains,9.62%),kiebsiella pneumonia(10 strains,9.62%) respectively.There was significant difference in the multi-drug resistance incidence of each bacterias(χ2=20.62,P<0.05),the average incidence was 25.12%,and the top three incidence were E.coli(36.78%),pseudomonas aeruginosa(33.33%),coagulase negative staphylococcus(28.24%) respectively.There was significant difference in the multi-drug resistance positive rate of each types of specimens(χ2=43.68,P<0.05),the average positive rate was 5.84%,and the highest positive rate were wound secretion and pus(11.00%),followed by urine(8.25%).There was significant difference in the multi-drug resistance positive rate of each clinical departments(χ2=40.36,P<0.05),and the highest positive rate were in department of urinary surgery(12.63%),followed by department of gynaecology and obstetrics(11.16%).Conclusion E.coli coagulase negative staphylococcus and pseudomonas aeruginosa were mainly epidemic MDROs,and the MDROs are mainly distributed in urological surgery,obstetrics and gynecolog in this hospital.The occurrence of MDROs should be for the prevention and control strongly in the hospitalized patients with all kinds of trauma or diseases of urinary system and in the clinical department of urinary surgery,gynaecology and obstetrics.
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Objective To investigate the clinical distribution and resistance change of pseudomonas aeruginosa (PAE) in the four hospitals of Henan province during 2012-2015,so as to provide guidance for reasonable clinical use of antibiotics.Methods By means of disk diffusion method (K-B method) or automatic instrument,the drug susceptibility testing was performed for the clinical isolated strain which collected from the 371st Central Hospital of PLA,the Third Affiliated Hospital of Xinxiang Medical University,the 150th Central Hospital of PLA and the 153rd Central Hospital of PLA during 2012-2015,then the result were interpreted according to the criteria of Clinical and Laboratory Standards Institute 2010,and the date were analyzed by using WHONET 5.6 software.Results A total of 1 796 strains of PAE had been isolated,and mainly distributed in department of critical care medicine (32.6％) and department of gastroenterology (28.7％).The specimens mainly collected from sputum (74.6％) and wound secretion (9.6％).The drug susceptibility results showed that the antibiotic sensitive rate of PAE to polymyxin B(93.5％) was the highest,followed by the piperacillin/tazobactam(78.2％) and amikacin(76.2％).Resistance rate of PAE to piperacillin(34.4％) was the highest,followed by the ticarcillin/calvulanic acid(34.1％) and aztreonam (30.7 ％).Drug-resistance of PAE to the ceftazidime,cefepime,aztreonam,amikacin,gentamicin and polymyxin B had a downward trend,respectively.Conclusion Drug-resistance of the PAE to the most commonly used antimicrobial has a downward trend.However,the drug-resistance situation of PAE is very serious and the resistance rates still keep the high level during 2012-2015.It is necessary to investigate the clinical distribution and resistance of PAE,so as to provide guidance for reasonable clinical use of antibiotics.
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Objective To investigate the clinical distribution and epidemiological feature of nine respiratory pathogens of acute respiratory tract infection patients in the northern area of Henan Province,in order to provide reference for clinical effective prevention and treatment of acute respiratory tract infection.Methods The clinical distribution and epidemiological feature of nine respiratory pathogens were analyzed by a retrospective review of 11 135 serum samples which were detected by indirect immunofluorescence method from December 2014 to November 2016.Results There were 2 630 cases with nine respiratory pathogens infection,the infection rate was 23.62％.The main four respiratory pathogens were mycoplasma pneumonia (16.63 ％),influenza B virus (2.41％),parainfluenza virus (2.29 ％),adenovirus (0.79％).The nine respiratory pathogens infection rate of male and female was 21.60％ (1 516/7 020) and 27.07 ％ (1 114/4 115),respectively.The nine respiratory pathogens infection rate of ＜ 1 year group,1-5 years group,6-14 years group,15-30 years group,31-50 years group and ＞ 50 years group was 8.91％ (330/3 702),31.12％ (1 424/4 576),37.36％ (634/1 697),27.10％ (90/332),24.64％ (69/280),15.13 ％ (83/548),respectively.The nine respiratory pathogens infection rate of ＜ 1 year group was lower than that of the other five groups (P ＜ 0.05).The nine respiratory pathogens infection rate of spring group,summer group,autumn group and winter group was 24.66％ (591/2 396) 、23.86％ (631/2 645) 、31.09％ (748/2 406)、17.90％ (660/3 688),respectively.The nine respiratory pathogens infection rate of autumn group was higher than that of the other three groups (P ＜ 0.05).There were 253 patients with polyinfection which all were amphimorphic polyinfection in the 2 630 patients with respiratory pathogens infection,the polyinfection rate was 2.27％.Conclusions Respiratory pathogen infection rate was different because of different gender,different age and different season.The virus was the main pathogen of acute respiratory tract infection.Because of multiplicity of infection and seasonal distribution of pathogens,the prevention of the epidemic should be strengthened in spring and autumn season especially.
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Objective To analyze the clinical distribution and drug resistance of Burkholderia gldioli,so as to provide epidemiological evidence for prevention and treatment of related diseases.Methods A total of 86 412 hospitalized patients in the First Affiliated Hospital of Xinxiang Medical University front January 2013 to November 2016 were selected as the subjects,including 81 807 patients who met the diagnostic criteria of bacteremia,and 4 605 patients who met the diagnostic criteria of meningitis.The blood,bone marrow and cerebrospinal fluid samples were collected for bacterial culture,strain identification and drug sensitivity test.The data were analyzed by WHONET 5.5 software.The carrying viral infection and the related inflammation markers including white blood cell count (WBC),C-reactive protein (CRP),erythrocyte sedimentation rate (ESR) and fibrinogen (FIB) were analyzed and summarized by Reimei software.Results There were 145 strains of Burkholderia gldioli were isolated from 86 412 patients,the isolating rate was 0.17％,and 122 cases were accompanied by basic diseases (84.14％).The isolating rate of blood specimens was the highest (0.17％).The isolating rate in mail was higher than that in female(0.22％ vs 0.10％),the isolating rate in the patients with more than 18 years old was higher than that in the patients with less than 18 years old (0.23％ vs 0.05％),the proportion was the highest in the department of infectious diseases (28.97％).In vitro drug sensitivity test showed that the resistance rate of Burkholderia gladioli to gentamicin,cefazolin,ampicillin,piperacillin,cotrimoxazole,aztreonam,amoxicillin clavulanic acid was more than 50％;the resistance rate of Burkholderia gladioli to aztreonam and amoxicillin clavulanic acid was 87.58％ and 80.00％ respectively;the proportion of multi drug resistant strains was 48.97％.The coincidence rate of Burkholderia gldioli and inflammatory markers was high (91.03％),and the carrying viral infection rate was 7.59％.Conclusion Attention should be paid to the bloodstream infections caused by Burkholderia gldioli,and the protection of patients with basic diseases should be strengthened.Because of the severe drug resistance situation,clinical diagnosis should be combined with inflammatory markers,and attention should be paid to patients with viral infection.Rational drug and drug combination should be selected according to drug sensitivity report.
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Objective To analyze the distribution and antimicrobial resistance of Escherichia coli (E.coli)causing infection in a county hospital,and provide basis for clinical treatment of E.coli infection.Methods From 2012 to 2014,all kinds of clinical specimens in a hospital were performed bacterial culture,identification,and antimicrobial susceptibility testing;extended-spectrum β-lactamases (ESBLs )were initially screened by broth microdilution method,and confirmed by disc diffusion method;data were statistically analyzed by WHONET 5.6 and SPSS 19.0 software.Results 271 isolates of E.coli were detected,and mainly isolated from midstream urine (26.94%).The detection rate of ESBLs-producing E.coli was 49.82%,most were isolated from sputum specimens (56.52%), but there was no significant difference in detection rates of ESBLs-producing E.coli isolated from different speci-mens (P >0.05).Antimicrobial susceptibility testing results showed that the resistance rate of E.coli to penicillins was the highest (> 90%),to cefalotin and cefuroxime were both > 75%,susceptibility rates to amikacin and piperacillin/ tazobactam were both high (resistance rates < 10%),carbapenem-resistant strain was not found, resistance rates of ESBLs-producing strains to most antimicrobial agents were significantly higher than non-ESBLs-producing strains.Conclusion E.coli is mainly isolated from midstream urine specimens,antimicrobial resistance of ESBL-producing strains is more serious.
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Objective To study the distribution ,specimen types and characteristics of antibiotic resistance of Escherichia coli producing extended‐spectrum βlactamases(ESBLs) of the hospital in 2013 and to guide clinical drug use .Methods Analyzed the distribution and antibiotic resistance for the 375 strains of ESBLs‐producing E .coli ,and ESBLs was detected by disk diffusion phe‐notypic confirmatory test .Results The major distribution department was gynecology department which accounted for 42 .67% , followed by uropoiesis surgical department which accounted for 14 .67% ;the major specimen type was urine(55 .2% ) ,followed by puncture fluid(15 .47% )and excretion(14 .67% ) .For the 375 isolates of ESBLs‐producing E .coli ,the resistance rates to cefazolin , cefuroxime ,cefoperazone and cefotaxime were 100 .00% ,to SMZco was 78 .10% ,while the resistance rate to imipenem was 0 .00% , and to amikacin and fosfomycin were 4 .30% and 10 .10% respectvely ,the resistance rates to piperacillin/tazobactam and aztreonam were 17 .10% and 66 .70% respectvely .Conclusion ESBLs producing Escherichia coli have severe multidrug resistance .Antibiotics should be chosen and used rationally in accordance with results of drug susceptibility testing ,meanwhile the monitoring of ESBLs′infection rate and drug resistance should be strengthened .
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Objective To understand the clinical distribution of Acinetobacter baumannii and its resistance to commonly used an‐tibiotics so as to provide the theoretical basis for rational clinical use of antibacterial medicines .Methods The clinical distribution and drug resistance situation of 206 strains of clinically isolated Acinetobacter baumannii in the Anhua County People′s during 2012-2014 were analyzed .The bacterial identification was completed by the department of clinical laboratory ,the drug susceptibili‐ty test was performed by adopting the disk diffusion method ,and the detection results were judged according to CLSI 2012 criteria . Results A total of 2 803 strains of bacteria were isolated during 2012-2014 ,including 206 strains of Acinetobacter baumannii .Its constituent ratios during this period were 6 .71% ,6 .82% and 8 .19% ,showing the increasing trend year by year .The samples were mainly isolated from sputum (78 .16% ) ,followed by urine (7 .28% ) ,bronchoaleolar lavage fluid (6 .80% ) ,wound secretion (3 .40% ) and blood(2 .91% ) .The infected patients were mainly distributed in the respiratory department (40 .29% ) and neurosur‐gery department(22 .82% ) .The detection results of Acinetobacter baumannii showed the higher resistance to 20 kinds of commonly used antibacterial drugs ,in which the drugs with most significantly increase in 3‐year drug resistance rate were in turn ceftazidime , cotrimoxazole ,levofloxacin ,piperacillin and ciprofloxacin ,the 3‐year resistance rate to meropenem ,imipenem ,cefoperazone/sulbac‐tam and cefepime was less than 35% .Conclusion Acinetobacter baumannii is the major opportunistic pathogenic bacterium in noso‐comial infection with higher drug resistance rate .It is necessary to strengthen the monitoring of Acinetobacter baumannii drug re‐sistance and rationally use antibacterial medicines in order to stop the drug‐resistant strains colonization and cross expansion in hos‐pital .