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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 To analyze the predominant genotypes of outer membrane porin I (PI)and to determine the correlation between G120 as well as A121 mutations in PI proteins and drug resistance in Neisseria gonorrhoeae isolates in the local area.Methods A double PCR to simultaneously detect both pIA and pIB genes,was established in this study.The target amplification products were T-A cloned and then sequenced to determine the mutations at G120,A121 and the specificity of double PCR.By using acidity slip method and double agar dilution method,the β-lactamase production and resistance to six antibiotics of pIA~+ and pIB~+ gonoeoeeal isolates were detected.Results Double PCR could be used to accurately genotyping pI genes in all the tested gonococcal isolates with the sensitivity of 1 ng DNA template.In the 116 N.gonorrhoeae isolates,30.2%(35/116) were pIA~+ strains and 69.8%(81/136) were pIB~+ strains.All the pIA~+ strains presented G120D/A121G double mutations (88.6%) or A121G single mutation (11.4%).98.8% of the pIB +strains presented G120K/A121D (65.0%),G120K/A121G or G120N/A121D ( 13.8% ) double mutations,and G120D/N/K single mutation (21.3% ).34.5% (40/116) of the isolates produced β-lactamase,and the enzyme-produced rate (20%) in pIA~+ strains was significantly lower than that in pIB~+ strains (40.7%) with P＜0.05.No spectinomycin-resistant swains were identified but three ceftriaxoneresistant strains were presented.However,the resistance ratios to penicilin,terramycin,ciprofloxacin and azithromycin of all the isolates were as high as 75.0%-90.5%.100% and 71.4% of the pIA~+strains without β-lactamase production and with G120 and/or A121 mutations were sensitive topenicillin and terramycin,respectively.On the contrast,100% of the pIB~+ strains without β-1actamase production and with G120 and/or A121 mutations were resistant to both the two antibiotics.Conclusion The established double PCR method could be used for fast and accurate genotyping of N.gonorrhoeae pI genes.The N.gonorrhoeae strains prevalent in the local areas mainly possessed pIB gene.Both spectinomycin and ceftriaxone could still be chosen to treat gonorrhea.The resistance enhancement caused by G120 and/or A121 mutations to penicillin and tetramycin was only presented in pIB~+ gonococci.
ABSTRACT
OBJECTIVE To study the clinical distribution and the drug resistance of extended-spectrum ?-lactamases (ESBLs) producing Klebsiella pneumoniae and Escherichia coli. METHODS The clinical isolates were identified by VITEK-60 of Bio-Merieux of France. K-B agar diffusion method and confirmed test were used to detect the drug resistance of ESBLs-producing K. pneumoniae and E. coli. RESULTS The incidence of ESBLs was 52.8% in E. coli and 63.5% in K. pneumoniae. E. coli was mostly isolated from urine (22.1%). The second was isolated from pus/wound (11.7%). Majority strains were isolated from surgical and pediatric wards. K. pneumoniae was mostly isolated from sputum and throat swab (37.8%), 21.8% from neonate ward and 16% from child ICU. CONCLUSIONS To cure infections caused by ESBLs-producing K. pneumoniae and E. coli, imipenem is the best choice and piperacillin/tazobactam is the second choice.