ABSTRACT
Objective To analyze the distribution characteristics and drug resistance of nontuberculous mycobacteria(NTM),and to provide guidance for the selection of targeted agents in clinical treatment. Methods The clinical data of inpatients in our hospital from April 2019 to February 2021 were collected,the culture and strain identification of non tuberculosis mycobacteria were carried out,the drug sensitivity test of anti tuberculosis drugs was carried out,and the drug resistance of non tuberculosis mycobacteria to first-line anti tuberculosis drugs was analyzed. Results A total of 1 326 strains of mycobacterium were isolated,including 1 154(87.03%)strains of mycobacterium tuberculosis and 172(12.97%)strains of non-mycobacterium tuberculosis.Nine species of nontuberculous mycobacteria were detected,including slow-growing mycobacteria such as Mycobacterium kansasii and Mycobacterium avium-intracellulare complex,belonging to Groups I-III,and fast-growing mycobacteria such as Mycobacterium chelonae and Mycobacterium smegmatis,belonging to Group IV. Among them , Mycobacterium avium-intracellulare complex and Mycobacterium chelonae were dominant,accounting for 26.16%and 36.63%,respectively.Drug susceptibility tests showed that the resistance rate of Mycobacterium avium-intracellulare complex to streptomycin was 100.00%,the drug resistance rate of Mycobacterium chelonae to isoniazid,rifampicin and streptomycin was 100.00%,and the drug resistance rate of Mycobacterium smegmatis and Mycobacterium abscessus to most antibacterial drugs was 100.00%.The resistance rate of major NTM bacteria to clarithromycin was relatively low.There was no statistically significant difference in the susceptibility rates of slow and fast-growing mycobacteria to isoniazid and clarithromycin(P>0.05) ; The susceptibility rates of slow-growing mycobacteria to amikacin,clarithromycin and rifambutin were 62.86%,92.86%and 72.86%,all above 50.00%.The susceptibility rate of the fast-growing mycobacteria to clarithromycin was also more than 50.00%,being 87.25%.The susceptibility rate of slow-growing mycobacteria to other antibiotics was higher than that of fast-growing mycobacteria(P<0.05).The drug resistance of Mycobacterium tuberculosis to first-line anti tuberculosis drugs was significantly lower than that of non Mycobacterium tuberculosis(P<0.05). Conclusion Non-tuberculous mycobacteria have high drug resistance,especially fast-growing mycobacteria,so drug susceptibility tests are of great value in clinical treatment.
ABSTRACT
Objective:To explore the precision treatment effect of multidrug-resistant pulmonary tuberculosis (MDR-PTB) based on the proportion method for drug susceptibility test, and to provide a scientific basis for formulating MDR-PTB treatment plan.Methods:One hundred and eighty patients with MDR-PTB treated in Shenzhen Center for Chronic Disease Control from January 5, 2016 to April 30, 2018 were enrolled. The initial treatment plan after diagnosis was six months of amikacin (AM), pyrazinamide (Z), levofloxacin (LFX), ethambutol (E), prothionamide (PTO) and 18 months of Z, LFX, E, PTO. According to whether proportion method for drug susceptibility test for 10 commonly used drugs was implemented, patients were divided into precision treatment group and empirical treatment group. In the precision treatment group, the treatment plans were adjusted according to the results of the drug susceptibility test. The treatment plans and disease outcomes of the two groups of patients were retrospectively analyzed. Chi-square test was used for statistical analysis.Results:Among the 180 patients, there were 113 patients in the precision treatment group and 67 patients in the empirical treatment group. The drug resistance rates of the precision treatment group from low to high were: capromycin (CM) (0, 0/113), AM (2.65%, 3/113) and kanamycin (KM) (2.65%, 3/113), para-aminosalicylic acid (PAS) (7.96%, 9/113), PTO (11.50%, 13/113), ofloxacin (OFX)(38.05%, 43/113), E (39.82%, 45/113), and streptomycin(S) (76.99%, 87/113). In the precision treatment group, the drugs were adjusted for 104 person-times according to the proportion method for drug susceptibility test during the treatment, from low to high: AM (3 person-times), PTO (13 person-times), LFX (43 person-times) and E (45 person-times). The treatment success rate of the precision treatment group was 78.8%(89/113), which was higher than that of the experience treatment group (52.2%(35/67)), the difference was statistically significant ( χ2=13.805, P=0.000 2). In the precision treatment group and empirical treatment group, there were no statistically significant differences of alanine aminotransferase elevated (32.3%(31/96) vs 34.0%(18/53)), serum creatinine elevated (4.2%(4/96) vs 5.7%(3/53)), and white blood cell count decreased (24.0%(23/96) vs 22.6%(12/53)) (all P>0.05). Conclusion:The traditional treatment plan based on the proportion method for drug susceptibility test has a high success rate in the treatment of MDR-PTB, which is still a worthy choice.
ABSTRACT
Objective@#To investigate the etiologic and epidemiologic features of an infectious diarrhea outbreak in a boarding school in Fuyang city, Anhui province.@*Methods@#Traceability hypothesis of this study was tested according to the epidemiological characteristics of the cases. Feces, anal swabs, water samples and food residues related to the patients and chefs were collected for pathogen isolation and detection. Biochemical identification, virulence gene detection, drug susceptibility test, PFGE and multilocus sequence typing were performed.@*Results@#The incidence rate (3.41%) of different dormitory buildings within the water supply area by shallow wells was higher than that (0.98%) of the deep wells, with statistical significance (χ2=17.215, P<0.001). Sixteen strains belonged to the Shigella Sonneri family were isolated from the patient’s samples, and all carrying the ipaH gene. Seven strains belonged to sen and ial genes. Set1 gene that did not appear in all the 16 strains were highly resistant to ampicillin, tetracycline, compound xinnomine, cefazoline, cefotaxime, gentamicin, naphthidinic acid and streptomycin, including 9 strains to doxycycline. The pulse field pattern of the 16 strains of Shigella sonneri appeared the same, with the ST type as ST152.@*Conclusion@#When combined data from the etiological and epidemiological investigation, it was confirmed that Shigella sonneri was the pathogen of this outbreak, and water from the shallow wells might be responsible for the source of infection.
ABSTRACT
Objective To screen the most suitable medium for Brucella drug susceptibility test, and observe the resistance of human derived Brucella to different antibiotics. Methods Totally 180 strains of Brucella isolated from 25 provinces (municipalities, autonomous regions) in recent years were taken as observation objects. Mueller-Hinton ( MH ) agar , MH blood agar and Brinell agar were used to carried out the drug susceptibility test in vitro, and to compare the results of drug susceptibility test of different medium; the most suitable Brucella drug susceptibility test medium was used to detect the resistance of human derived Brucella to Doxycycline, Rifampicin, Streptomycin, Levofloxacin, Moxifloxacin, Ceftriaxone sodium, Co-trimoxazole and Amoxicillin/Clavulanic acid by K-B drug sensitive paper, and to observe the formation of antibacterial ring around the drug sensitive paper. Results The growth of Brucella on the MH agar and MH blood agar were slower than that on the Brinell agar, and the antibacterial rings were not obvious. All the 180 strains of Brucella were sensitive to seven antibiotics such as Doxycycline, Rifampicin, Streptomycin, Levofloxacin, Moxifloxacin, Ceftriaxone sodium, and Amoxicillin/Clavulanic acid; and 70 strains of Brucella were resistant to Co-trimoxazole, accounting for 39％ (70/180); Brucella strains resistant to Co-trimoxazole were found in 21 provinces. Conclusions Brinell agar is the most suitable medium for Brucella susceptibility test. The human derived Brucella is resistant to Co-trimoxazole; the resistant strains are distributed in 21 provinces ( municipalities , autonomous regions ) . It is recommended that relevant departm ents of the province ( municipalities , autonomous regions ) carry out epidemiological investigations on the resistance of Brucella, and strengthen the monitoring of drug resistance in clinical drugs of brucellosis patients.
ABSTRACT
Objective: To analyze the results of bacteria distribution of wound secretion and the drug susceptibility test of the infected patients from Department of Hand Surgery, and to provide the evidence for antibiotic selection in the infected patients in early stage of treatment. Methods: The clincal data of hospitalized patients from Department of Hand Surgery were collected. The patients were divided into three groups according to the wound conditions. The patients in Group 1 who had no wound while being in hospital were infected after operation; the patients in Group 2 had the contaminated wound but no infection while being in hospital; the patients in Group 3 had definite infection while being in hospital. The results of bacterium culture of wound secretion and drug susceptibility test of the patients in three groups were analyzed. Results: The clinical data of 297 patients were obtained, including 17 patients from Group 1, 201 patients from Group 2, and 79 patients from Group 3. A total of 406 strains of 54 species of bacteria were isolated from 297 patients, including 178 strains (43. 84%, 178/406) gram-positive bacteria and 228 strains (56. 2%, 228/406) gram-negative bacteria. The four most common strains were Staphylococcus aureus (15.8%, 64/406), Staphylococcus epidermidis (14.0%, 57/406), Enterobacter cloacae (10.3%, 42/406), and Serratia marcescens (9.9%, 40/406). The results of drug susceptibility test showed that the detection rates of methicillin-resistant staphylococcus aureus (MRSA) and staphylococcus epidermidis were 9. 4% (6/64) and 72. 0% (46/64), respectively. There were no vancomycin-resistant, linezolidresistant, and tigecycline-resistant positive strains among Staphylococcus susceptibility; and there were no the carbapenem-resistant positive strains among Enterobacter cloacae and Serratia marcescens. The susceptibility rate of Enterobacter cloacae to ceftriaxone was 83. 3% (35/42), and its susceptibility to ceftazidime was 90. 5% (38/42). The susceptibility rate of Serratia marcescens to ceftriaxone was 100.0% (40/40), and its susceptibility to ceftazidime was 97.5% (39/40). Conclusion: The first generation of cephalosporin and penicillinase-stabilized penicillin can be used as the preferred empirical antibiotics for the infected patients from Deparment of Hand Surgery in our hospital. The third and fourth generation cephalosporins and quinolones antibiotics can be used as the preferred antibiotics for the infected patients with open trauma as well as the possibility of G- bacillus infection.
ABSTRACT
Objective To understand the distribution characteristics of clinical multi-drug resistant bacteri-a,provide a scientific evidence for control of infection and rational use of antibiotics.Methods The distribu-tion of multi-drug resistant bacteria in the hospital for three years was analyzed retrospectively.Results There were 19 354 non-repeating strains from 2014 to 2016,and 21.9%(4 234)of the total strains were multi-ple resistant strains.Among them,ESBLs-producing Escherichia coli was the most,followed by carbapene-re-sistant Acinetobacter baumannii(MDR-AB),ESBLs-producing Klebsiella pneumoniae,multidrug-resistant Pseudomonas aeruginosa(MDR-AB),Production of carbapene-enzyme Enterobacteriaceae bacteria(CRE), vancomycin-resistant enterococci(VRE),concentrate mainly on the ICU for high-risk areas of infection.The most were from the respiratory system specimens,followed by the urinary system specimens.Conclusion Multiple resistant bacteria are growing critical.There should be more attention to be paid in bacteriological ex-amination for clinic,the clinical isolation of pathogenic microorganisms in the hospital should be grasped.The antimicrobial agents should be rationally applied according to the results of bacterial susceptibility,in addition the management of antimicrobial agents and multi-drug monitoring should be strengthened.
ABSTRACT
Objective To analyze the virulence genes and drug resistance in Vibrio parahaemolyti-cus strains isolated in Nantong City from 2015 to 2016 in order to provide reference for the prevention and treatment of Vibrio parahaemolyticus infection and for rational use of medicines. Methods Virulence genes of tlh,tdh and trh in Vibrio parahaemolyticus strains were detected by fluorescence quantitative PCR. Micro-broth dilution method was used to analyze antimicrobial resistance in these strains to 15 kinds of antibiotics. Results Eighty-two Vibrio parahaemolyticus strains were all positive for tlh gene and negative for trh gene and among them,72 carried tdh gene (87.8%). Antimicrobial resistance rates of these strains to ampicil-lin,cefazolin,tetracycline and chloramphenicol were all 1.2% (1/82). Two strains (2.4%) were resist-ant to trimethoprim/sulfamethoxazole. All strains were sensitive or intermediate to another 10 kinds of antibi-otics. Conclusion From 2015 to 2016,Vibrio parahaemolyticus strains carrying virulence genes of tlh and tdh were prevalent in Nantong and no trh gene-positive strains were reported. Except ampicillin, cefazolin, tetracycline,chloramphenicol and trimethoprim/sulfamethoxazole these five kinds of antibiotics, the remai-ning 10 kinds of antibiotics were effective against Vibrio parahaemolyticus and could be used as the treatment of choice.
ABSTRACT
BACKGROUND: A simple and cost-effective method is needed for the detection of rifampicin resistance in Mycobacterium tuberculosis in resource-limited settings. We suggest a broth medium-based method using 2,3-diphenyl-5-thienyl-(2)-tetrazolium chloride (STC) for detection of rifampin resistance of tubercle bacilli within a reasonable time frame. METHODS: The type strain (M. tuberculosis H37Rv) and 45 cultured clinical strains of M. tuberculosis (35 rifampin-susceptible and 10 rifampin-resistant) were used. Phenotypes of rifampicin resistance were tested by the Korea Institute of Tuberculosis, and confirmed by GenoType MTBDRplus (Hain Lifescience, Germany). Susceptibility tests were performed using STC-containing OADC-enriched Middlebrook 7H9 broth (BD, USA). RESULTS: All tests were finished in 3 to 6 days. The same results were obtained with the standard and current methods for all 45 clinical isolates (100% sensitivity and specificity for resistance detection). CONCLUSION: The current method using STC is a good alternative for detecting M. tuberculosis rifampin resistance in a cost-effective and timely fashion, which is particularly important in resource-limited settings.
Subject(s)
Genotype , Korea , Methods , Mycobacterium tuberculosis , Mycobacterium , Phenotype , Rifampin , Sensitivity and Specificity , TuberculosisABSTRACT
Objective To investigate the bacterial spectrum and drug resistance of bone infection after multiple hospitalizations.Methods A retrospective case series study was conducted on 95 patients with bone infection due to injuries admitted in the General Hospital of Shenyang Military Area from January 2009 to December 2016.There were 76 males and 34 females,with an average age of 47 years (range,17-94 years).Bacterial culture and drug sensitivity tests were performed in 246 specimens of the infection secretions and infected tissues.The bacterial species and drug resistance data of all the specimens were statistically analyzed.The numbers and ratios of Gram-positive bacteria and Gram negative bacteria were counted according to the changes of hospitalization frequency,and the changes of drug resistance of Staphylococcus aureus after repeated hospitalizations were also recorded.Results A total of 110 pathogenic bacteria were isolated,and mixed infection was found in 19％ of the bacteria.There were 61 Gram-positive bacteria (55.5％),including 35 Staphylococcus aureus [seven methicillin-resistant staphylococcus (MRSA) strains],accounting for 57％ of Gram-positive strains.Other Gram positive bacteria were mainly Enterococcus faecalis and Staphylococcus epidermidis.There were 48 Gram-negative bacteria (43.6％),including 12 Pseudomonas aeruginosa strains,accounting for 25％ of Gram-negative strains,nine Klebsiella pneumoniae strains,accounting for 19％ of the Gramnegative strains.Staphylococcus aureus had a resistance rate to penicillin of 82％,and the major Gram positive bacteria (Staphylococcus aureus,Enterococcus faecalis,Staphylococcus epidermidis) were all highly sensitive to vancomycin and linezolid.The major Gram-negative bacteria (Pseudomonas aeruginosa,Klebsiella pneumoniae,Escherichia coli,Acinetobacter baumannii) were highly resistant to the second generation of cephalosporins and were sensitive to carbapenem antibiotics.In 95 bone infection patients,the ratio of Gram positive bacteria to Gram negative bacteria increased from 0.98 at the first admission to 3 after repeated hospitalizations,and the ratio change was statistically significant (P ＜0.05).After multiple hospitalizations,the drug resistance of Staphylococcus aureus to gentamicin,ciprofloxacin,levofloxacin,and tetracycline increased gradually.The resistance rate to penicillin was even up to 100％.Conclusions The mixed infection of bone infection is common,among which Staphylococcus aureus and Staphylococcus epidermidis are the main Gram-positive pathogenic bacteria,Pseudomonas aeruginosa and Klebsiella pneumoniae are the main Gram negative pathogenic bacteria.The proportion of Gram-positive bacteria infection increased after multiple hospitalizations and became the major pathogenic bacteria.Penicillin should be avoided in the treatment of Staphylococcus aureus infection in multiple hospitalizations,and gentamicin and ciprofloxacin should be used with caution.Vancomycin or linezolid which is more sensitive is a better option.
ABSTRACT
Objective..To analyze the bacterial distribution and drug resistance of fetal membrane sample from women suffered premature rupture of membranes(PROM),so as to provide evidence for rational use of antibiotics.Methods:A total of 1041 fetal membrane samples in women with premature rupture of membranes were cultured and drug susceptibility tests were done.Among those samples,258 of them came from women who had used antibiotics during prenatal period,while the others came from women who unused.Results:Among the 1041 fetal membrane samples,369 (35.4％) were infected.The infection of Gram-negative bacteria accounted for 66.7％,whereas gram positive bacteria accounted for 33.1％.The expectant time prolonged,and the positive rate of infection from women with PROM did not increase(P ＞0.05),whereas the positive rate of infection among PPROM increased(P＜0.05).There were 35 strains of bacteria identified in non-antibiotics group during prenatal period,while 17 strains of bacteria were identified in the antibiotics group.The main strain was Escherichia coli which accounted for 59.7％.Escherichia coli were resistant to piperacillin,ampicillin and tetracycline.For the mentioned drugs,the resistance rates were all above 45.0％.The resistance rate of Escherichia coli in antibiotics group was higher than that in the non-antibiotics group(P ＜0.05).The resistance rate of Gram positive bacteria to Nitrofurantoin,Teicoplanin,Vancomycin and Linezolid was 0.Conclusions:Escherichia coli is the main pathogenic bacteria isolated from fetal membrane samples of women with premature rupture of membranes.It is important to use antibiotics rationally according to the feature of pathogenic bacteria.
ABSTRACT
Objective To retrospectively analyze the pathogenic bacterial distribution and drug resistance in the patients with u-rinary tract infection in our hospital to provide a basis for clinically rational use of antibacterial drugs .Methods The midstream u-rine of the patients with urinary tract infection in our hospital during 2013-2015 was performed the bacterial culture .The bacterial identification and drug susceptibility test were performed by using the Vitek-2 Compact automatic microorganism identification in-strumen .The data were statistically analyzed by adopting the WHONET 5 .6 software .Results Among 11130 urine culture sam-ples ,1676 strains of pathogenic bacteria were cultured with the detection rate of 15 .1% ;among them ,1332 strains were Gram-negative bacteria and accounted for 79 .5% ,275 strains were Gram-positive bacteria and accounted for 16 .4% and 69 strains were fungi and accounted for 4 .1% .The top 3 pathogenic bacteria of detection rate were in turn Escherichia coli ,Klebsiella pneumoniae and Enterococcus faecalis .Six hundreds and eleven strains of ESBLs bacteria were detected ,in which Escherichia coli ,Klebsiella pneumoniae accounted for 88 .5% and 10 .2% respectively .Escherichia coli had higher sensitivity to carbapenems ,fosfomycin ,ami-kacin ,etc .(>95 .0% ) .Klebsiella pneumoniae had higher sensitivity to carbapenems (>90 .0% ) .No vancomycin ,teicoplanin and linezolid resistant Enterococcus faecalis was detected .One strain of vancomycin resistant enterococcus faecium was detected .These pathogens mainly derived from the urology surgery department ,the constituent ratio of female was higher than that of male .Conclu-sion The pathogens of urinary tract infection in this hospital is dominated by Gram-negative bacteria ,Escherichia coli is mainly pathogenic bacterium .Multidrug resistant species and number are continuously increased .Clinicians should rationally and correctly use the antibacterial drugs based on the drug sensitivity test results for improving the effect of clinical anti-infection treatment .
ABSTRACT
Objective To compare the efficacy and the risk of adverse effect of drug susceptibility test guided therapy and novel empirical quadruple therapy for Helicobacter (H.) pylori infection.Methods Literature retrieval was conducted by using major databases.Related papers published up to June 2015 were considered eligible if they were randomized control trials comparing different pharmacological formulations for H.pylori infection and used in a network Meta-analysis and a single rate Meta-analysis to evaluate the relative and absolute rates of H.pylori eradication and the risk of adverse effect.The Jadad score was used to evaluate the methodological quality.Funnel plot was constructed to evaluate the risk of publication bias.Begg's rank correlation test or Egger's regression intercept test was done for the asymmetry of funnel plot.Results Twenty randomized control trials for the treatment of 6 753 initial treated patients with H.pylori infection were included.Drug susceptibility test guided therapy was significantly superior to concomitant therapy,hybrid therapy,sequential therapy and bismuth quadruple therapy.The culture-based therapy had the highest likelihood of improving clinical efficacy,with lowest risk of adverse effect.Concomitant therapy had the highest probability of causing adverse effect despite its effectiveness.Hybrid therapy and bismuth quadruple therapy were associated with lower risk of adverse effect and higher effectiveness.Conclusion Drug susceptibility test guided therapy showed superiority to other 4 interventions for H.pylori eradication mentioned above.Hybrid therapy and bismuth quadruple therapy might be applied in the settings where the culture-based strategy is not available.
ABSTRACT
Objective To compare the efficacy and the risk of adverse effect of drug susceptibility test guided therapy and novel empirical quadruple therapy for Helicobacter (H.) pylori infection.Methods Literature retrieval was conducted by using major databases.Related papers published up to June 2015 were considered eligible if they were randomized control trials comparing different pharmacological formulations for H.pylori infection and used in a network Meta-analysis and a single rate Meta-analysis to evaluate the relative and absolute rates of H.pylori eradication and the risk of adverse effect.The Jadad score was used to evaluate the methodological quality.Funnel plot was constructed to evaluate the risk of publication bias.Begg's rank correlation test or Egger's regression intercept test was done for the asymmetry of funnel plot.Results Twenty randomized control trials for the treatment of 6 753 initial treated patients with H.pylori infection were included.Drug susceptibility test guided therapy was significantly superior to concomitant therapy,hybrid therapy,sequential therapy and bismuth quadruple therapy.The culture-based therapy had the highest likelihood of improving clinical efficacy,with lowest risk of adverse effect.Concomitant therapy had the highest probability of causing adverse effect despite its effectiveness.Hybrid therapy and bismuth quadruple therapy were associated with lower risk of adverse effect and higher effectiveness.Conclusion Drug susceptibility test guided therapy showed superiority to other 4 interventions for H.pylori eradication mentioned above.Hybrid therapy and bismuth quadruple therapy might be applied in the settings where the culture-based strategy is not available.
ABSTRACT
We compared the MGIT 960 method,the reference,and the broth microdilution method for detecting the susceptibility of Mycobacterium tuberculosis isolates to protionamide (PTO).We performed drug susceptibility testing for 248 M.tuberculosis clinical isolates to PTO using MGIT 960 and broth microdilution method.In addition,a total of 117 isolates were randomly selected for further evaluation of the consistency of the minimal inhibitory concentrations determined by these two methods,and eleven concentrations of PTO had been involved accordingly (0.062 5,0.125,0.25,0.5,1,2,4,8,16,32,64 μg/mL).The MGIT method showed an average detection time of 10.1 days,while the detection period of broth microdilution method was 8 days,and the difference was statistically significant (P＜0.001).In addition,the rate of the sensitivity,specificity and concordance between these two methods was 96.5％ (55/57),93.2％ (178/191),and 94.0％ (233/248),respectively.The Kappa value was 0.84.Comparison of the MIC values detected by different methods revealed that the overall concordance rate was 81.2％ (95/117).For the isolates harboring low MIC values (MIC＜8.0 μg/mL),the concordance rate was 86.3％ (82/95),while that of the isolates with high MIC values was only 59.1％ (13/22).In conclusion,our data demonstrate that the broth microdilution method showed excellent concordance with MGIT method for detecting the resistance rate of M.tuberculosis isolates to PTO,indicating that the broth microdilution method with available performance,short turn-around time and convenient manual operation was suitable for rapid detection of M.tuberculosis to PTO.
ABSTRACT
Objective To understand the clinical distribution situation of streptococcus penumoniae (SP) and drug susceptibility test results to provide a basis for the clinical diagnosis,treatment and prevention of SP infection.Methods Totally 416 nonrepeat strains of SP were isolated during 2010 to 2015.Their identification and drug susceptibility test were performed by using the ATB Express bacterial identification system.The results were interpreted according to the standard of CLSI 2014 edition.Results In these 6 years,SP showed the isolation peak in spring and winter;the detection rate of respiratory tract specimens reached more than 90 ％;the young children and elderly people were predominant;SP maintained high sensitivity to penicillin,amoxicillin,etc.,the difference in the sensitivity rate and non-sensitivity rate had statistical significance(P＜0.05);but SP showed high level non-sensitivity to clindamycin,erythromycin,etc.,the difference in the sensitivity rate and non-sensitivity rate had no statistical significance (P＞0.05).Conclusion Although β-lactam antibiotics such as penicillin can still be used as the first choice of therapy,but PISP and PRSP show the increasing trend year by year;therefore the antibacterial drugs should be selected according to the drug susceptibility test results.
ABSTRACT
Objective To study the pathogens and their drug susceptibility of septic arthritis of hip in children. Methods Prior to the antibiotic treatment, pus was extracted for bacterial culture under aseptic operation. The pathogenic bacterium was identified and drug susceptibility was analyzed using a fully automated bacterial identification/drug susceptibility system. Results A total of 68 pathogens were isolated, in which 42 were Gram-positive bacteria, 23 were Gram-negative bacteria and 3 were fungi. The results showed differences in the bacterial types of hip septic arthritis in children with different ages (5 days to 13 years). For newborns (less than 1 month), the most common pathogen was Klebsiella pneumoniae; for the ages of 1 month to 13 years old, the most common pathogen was Staphylococcus aureus. The results of drug susceptibility tests showed that Gram-positive bacteria were highly susceptible to vancomycin, teicoplanin and linezolid;the resistance of Staphylococcus aureus to penicillin was up to 96％; and Klebsiella pneumoniae, Escherichia coli, Haemophilus influenzae, Enterobacter cloacae and Salmonella were highly sensitive to meropenem and imipenem. Conclusion In the antimicrobial drug treatment of children with hip septic arthritis, the etiology sample should be collected for drug susceptibility analysis. Empirical drug therapy strategy should be applied in the absence of the analysis results. Sensitive antibiotic drug therapy should be used after obtaining reliable etiological diagnosis and drug susceptibility results, and simultaneously taking the age into consideration.
ABSTRACT
Objective To monitor the distribution of pathogens and the drug resistance of inpatients in Southwest Hospital in ChongQing ,and to analyze the prevalence of pathogens in various departments .Methods A total of 15249 pathogens cultured from clinical specimens in our hospital in 2016 and the antimicrobial susceptibility testing results were retrospectively analyzed .The anti-microbial susceptibility testing was carried out by using the paper diffusion method (K-B) or the automated instrument method (MIC) .The data were analyzed by WHONET5 .5 software according to the standard of CLSI2017-M100 .Results Compared with 2015 ,a total of 15249 pathogenic microorganisms were isolated from the hospital in 2016 ,among which 9742 were Gram-negative bacteria ,down 11 .45% and 4188 were Gram-positive bacteria ,up 15 .34% and 1319 were fungi ,down 11 .48% .Top five depart-ments which collected most microbiological culture specimen were Burn ,Pediatric ,ICU ,Hepatobiliary surgery ,Neurosurgery .The main specimen type of culture was sputum ,accounting for 27 .28% ,followed by blood ,wound secretion ,urine ,abdominal fluid .The first five pathogens were Klebsiella pneumoniae ,Acinetobacter baumannii ,Escherichia coli ,Staphylococcus aureus ,Pseudomonas aeruginosa .Conclusion Gram-negative bacteria are mainly infected organisms in our hospital .However ,Gram-positive bacteria are also important pathogens .Antibiotics should be selected according to the results of antimicrobial susceptibility testing .The distribu-tion of pathogens and the changes of drug sensitivity should be emphasized ,which can provide an effective theoretical basis for treat-ment .
ABSTRACT
The cause of death in patients with tuberculosis (TB) may differ according to the phase of anti-tuberculosis treatment. However, there are limited data regarding this issue in Korea. We compared the cause of death of TB patients who died during the early intensive and late continuation phase of treatment. Twenty (56%) of the 36 early deaths were due to TB-related causes, whereas 34 (89%) of the 38 late deaths were due to TB-unrelated causes. This finding suggests that TB-related early deaths mainly attributable to delayed diagnosis should be improved to further reduce the overall TB deaths.
ABSTRACT
Objective To investigate the drug tolerance and PFGE patterns of Salrnonella (S.) paratyphi A strains isolated from sentinel hospitals in Dengfeng,Henan province,during 2009-2015.Methods Venous blood samples were collected from paratyphoid patients and cultured in double phase blood culture bottle.Suspicious strains were identified and used for Salomonella.O antigen and H1/2 phase flagellum-induced serum agglutination test with API20E biochemical systems and SSI Salmonella typing sera.According to Salmonella molecular typing and K-B drug susceptibility testing method published by PulseNet China bacterial infectious disease monitoring network and USA Clinical and Laboratory Standards Institute,we analyzed the drug susceptibility and PFGE molecule characteristics of S.paratyphiA strains isolated from the patients.Results A total of126 strains of S.paratyphi A were isolated from 248 blood samples,the antigen modes of them were 1,2,12:a:-.The resistance rate of 126 strains of S.paratyphi A was 83.3％ to ampicillin;29.4％ to ceftazidime,31.2％ to cefotaxime,17.5％ to cefepime;62.6％ to nalidixic acid;19.3％ to ciprofloxacin,26.4％ to norfloxacin;22.8％ to gentamicin,47.9％ to streptomycin;19.2％ to chloramphenicol,24.2％ to methicillin benzyl ammonium,58.6％ to compound sulfamethoxazole and 46.7％ to tetracycline.The 126 strains of S.paratyphi A had different levels of resistance to 8 kinds of antibiotics,109 strains were multidrug resistant (86.5％),9 strains were resistant to 2-3 kinds of antibiotics (7.1％),76 strains were resistant to 5-8 kinds of antibiotics (60.3％),17 strains were resistant to 9-10 kinds of antibiotics (13.5％),7 strains were resistant to 11-12 kinds of antibiotics (5.6％).The 126 strains of S.paratyphi A were divided into 14 molecular patterns by digestion with Xba I and pulsed field gel electrophoresis.The antibiotics resistance to third generation cephalosporin (CAZ,CTX),one generation and three generation of quinolones (NAL,CIP,NOR) and aminoglycosides antibiotics (STR) showed an upward trend.Each pattem contained 1-98 strains with similarity ranged from 64.10％ to 100.00％.PTYA 1,6,9 and 10 were the main PFGE belt types.Conclusion The drug resistance of clinical isolates ofS.paratyphi A was serious in Dengfeng,Henan province,PFGE pattems showed a diversity,but predominant patterns could also be found.The PFGE patterns of some strains had clustering and were related with their antidrug spectrums.
ABSTRACT
Objective To investigate the drug tolerance and PFGE patterns of Salrnonella (S.) paratyphi A strains isolated from sentinel hospitals in Dengfeng,Henan province,during 2009-2015.Methods Venous blood samples were collected from paratyphoid patients and cultured in double phase blood culture bottle.Suspicious strains were identified and used for Salomonella.O antigen and H1/2 phase flagellum-induced serum agglutination test with API20E biochemical systems and SSI Salmonella typing sera.According to Salmonella molecular typing and K-B drug susceptibility testing method published by PulseNet China bacterial infectious disease monitoring network and USA Clinical and Laboratory Standards Institute,we analyzed the drug susceptibility and PFGE molecule characteristics of S.paratyphiA strains isolated from the patients.Results A total of126 strains of S.paratyphi A were isolated from 248 blood samples,the antigen modes of them were 1,2,12:a:-.The resistance rate of 126 strains of S.paratyphi A was 83.3％ to ampicillin;29.4％ to ceftazidime,31.2％ to cefotaxime,17.5％ to cefepime;62.6％ to nalidixic acid;19.3％ to ciprofloxacin,26.4％ to norfloxacin;22.8％ to gentamicin,47.9％ to streptomycin;19.2％ to chloramphenicol,24.2％ to methicillin benzyl ammonium,58.6％ to compound sulfamethoxazole and 46.7％ to tetracycline.The 126 strains of S.paratyphi A had different levels of resistance to 8 kinds of antibiotics,109 strains were multidrug resistant (86.5％),9 strains were resistant to 2-3 kinds of antibiotics (7.1％),76 strains were resistant to 5-8 kinds of antibiotics (60.3％),17 strains were resistant to 9-10 kinds of antibiotics (13.5％),7 strains were resistant to 11-12 kinds of antibiotics (5.6％).The 126 strains of S.paratyphi A were divided into 14 molecular patterns by digestion with Xba I and pulsed field gel electrophoresis.The antibiotics resistance to third generation cephalosporin (CAZ,CTX),one generation and three generation of quinolones (NAL,CIP,NOR) and aminoglycosides antibiotics (STR) showed an upward trend.Each pattem contained 1-98 strains with similarity ranged from 64.10％ to 100.00％.PTYA 1,6,9 and 10 were the main PFGE belt types.Conclusion The drug resistance of clinical isolates ofS.paratyphi A was serious in Dengfeng,Henan province,PFGE pattems showed a diversity,but predominant patterns could also be found.The PFGE patterns of some strains had clustering and were related with their antidrug spectrums.