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OBJECTIVE To investigate the produce of extended-spectrum ?-lactamases(ESBLs) and the presence of genotype of the ?-lactamases-encoding genes in Klebsiella pneumoniae isolated from the 98th Hospital of PLA,Huzhou,Zhejiang Province,China.METHODS Twenty-five strains of K.pneumoniae were isolated from the inpatients between Sep 2005 and Apr 2006.ESBLs were tested by phenotypic confirmatory tests recommended by CLSI.Twenty-one kinds of ?-lactamases genes of blaTEM,blaSHV,blaLEN,blaOKP,blaCTX-M-1 group,blaCTX-M-2 group,blaCTX-M-9 group,blaOXA-1 group,blaOXA-2 group,blaOXA-10 group,blCARB,blaPER,blaVEB,blaGES,blaLAP,blaDHA,blaACT/MIR,blaCMY/MOX,blaFOX,blaCMY/LAT,and blaACC were analyzed by PCR and verified by DNA sequencing.RESULTS In 25 strains of K.pneumoniae,the positive,negative,and "uncertainty" rates of ESBLs were 56.0%,20.0%,and 24.0%,respectively.The positive rate of genes of blaTEM,blaSHV,blaCTX-M-1 group,blaOXA-10 group,blaLAP,and blaDHA were 80.0%,4.0%,4.0%,80.0%,4.0% and 32.0%,respectively.The 15 kinds of rest genes were all tested negative.The total positive rate of 21 kinds of ?-lactamases gene was 92.0%.Among them,the blaLAP-2 gene sequence of the HZ12593 strain has been registered in GenBank(GenBank Accession Number: EU529981).CONCLUSIONS There are higher rate of ESBLs-producing strains in K.pneumoniae isolated from the inpatients,and at least 6 kinds of ?-lactamases gene existed.Both genes of blaTEM and blaOXA-10 group are the most common genotypes.Carring blaDHA Gene may influence the result of phenotypic confirmatory test for ESBLs in K.pneumoniae.
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OBJECTIVE To investigate drug-resistance status of Klebsiella pneumoniae(KPN) among oil field staff-workers and provide the evidence for clinical application of antibiotics.METHODS Referring to the National Clinical Laboratory Operation Rules,KPN strains were isolated and identified.The drug-sensitivity testing was performed by K-B methods.The extended-spectrum-?-lactamases(ESBLs) producers were detected by double-disc synergy test and disc confirming test.RESULTS The 276 strains of KPN were mainly isolated from respiratory tract and urinary tract.The isolating rate of ESBLs-producing KPN was 37.0%.The results of susceptibility testing showed the drug-resistance to common antibiotics in ESBLs producers was generally higher than that in ESBLs nonproducer.There was no KPN resistant to imipenem and meropenem.CONCLUSIONS Drug-resistance status of KPN in a oil field hospital is very serious.We should strengthen monitoring and controlling of it.
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OBJECTIVE To investigate the drug-resistance status of Klebsiella pneumoniae(KPN) in mountain hospitals and provide the reference for rational application of antibiotics.METHODS Referring to Rules of Operation in Clincal Laboratory of Nationwide,146 KPN isolates were cultured and identified and the drug-sensitivity test was performed in our hospital.RESULTS 100% of KPN isolates were sensitive to imipenem and meropenem.The resistant rates to amikacin,piperacillin/tazobactam,cefoperazone/sulbactam and cefoxitin were all below 22.0%.And that to the other 11 antibiotics were higher and all above 30%.The detection rate of the extended-spectrum-?-lactamases(ESBLs) producing KPN was 28.8%.CONCLUSIONS The drug-resistance of KPN in mountain hospitals is obviously lower than that in general hospitals of developed cities.We should strengthen reasonable management of antibiotics to prevent and control the occurrence and dissemination of drug resistant strains.
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OBJECTIVE To investigate the drug-resistance status of Escherichia coli(ECO)from various kinds of specimens to provide the scientific evidence for reasonable use of antibiotics.METHODS ECO strains were isolated and identified according to the National Clinical Laboratory Operation Rules.Drug resistance profile was analyzed by K-B method recommended by CLSI.RESULTS Among 275 ECO strains,50.2%(the most highest isolating rate)were isolated from urine.Detection rate of extended spectrum ?-lactamases(ESBLs)producing ECO was 32.4%(89/275).Except for 100% susceptibility to carbopenems,the drug-resistance to 14 antibiotics in ESBLs producers was higher than in the nonproducers.CONCLUSIONS Laboratory department should think highly of the monitoring of ECO to prevent and control the occurrence and prevalence of the nosocomial infection with ECO.
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Objective:To investigate the distribution of common pathogens of senile lower respiratory tract infection and drug resistance.to improve clinical therapeutic efficacy.Methods: The susceptibility to antimicrobial agents was tested with diffusion method on mueller-Hinton medium.The double-dish test for ESBLs Confirmed all putative ESBLs-producing strains.Results:A total of 263 strains were obtained from lower respiratory tract in senile patients.108 of 263 strains were Gram-negative bacilli(38.7%).There were 30 strains of Klebsiellae pneumonia,26 strains of Escherichia coli,21 strains of E.cloacae and 17 strains of Acinetobacter;64 strains of gram-positive bacteria(24.3%) and 91 strains of fungi(34.6%).Nineteen strains(33.9%) produced ESBLs in Escherichia coli and Klebsiella pneumoniae.Most gram-negative bacilli kept high susceptibility to the imipenem.Conclusions:Grau-negative bacilli were predominant in aged patients with lower respiratory tract infection.Attention should be paid to multi-drug resistance of pathogenic bacteria and fungus infection.
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OBJECTIVE To investigate drug-resistance status and changing tendency of Escherichia coli inducing hospital infection to provide the evidence for reasonable use of antibiotics. METHODS Pathogenic bacteria were isolated and identified according to the National Clinical Laboratory Manipulation Rules. Drug resistance profile was analyzed by K-B methods. RESULTS In the four years, the resistance to seventeen common antibiotics in E. coli was on the rise. The resistance rate to ampicillin was the most highest, 90.8-94.2%. There was no strain that was resistant to imipenem and meropenem. Detection rate of extended spectrum ?-lactamases (ESBLs) producing E. coli increased from 13.2% to 32.0%. CONCLUSIONS Drug-resistance status of E. coli inducing hospital infection is very serious. We should strengthen the management of antibiotic use and control the spread and prevalence of the drug-resistant bacteria.
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OBJECTIVE To investigate drug-resistance status of Klebsiella pneumoniae(KPN) in nosocomial infections and provide the reference for rational application of antibiotics.METHODS According to Nationwide Rules of Clincal Laboratory Manipulation,the strains were identified and drug-sensitivity test was performed by K-B methods.The extended-spectrum-?-lactamases(ESBLs) producing strains were detected by double-disc synergy test and disc confirmed test.RESULTS Totally 356 strains of KPN were mainly isolated from respiratory department,gerontology department,neurosurgery department and chest surgery department.The specimens were mostly sputum,pharynx swab,urine and secretion.The detection rate of ESBLs-producing KPN was 36.0%.The drug-resistance rate to common antibiotics in ESBLs producers was generally higher than that in ESBLs nonproducers.No KPN was resistant to imipenem and meropenem.CONCLUSIONS Drug-resistance status of K.pneumoniae in nosocomial infections is very serious.We should strengthen monitoring and controlling of it.
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OBJECTIVE To investigate the distribution and resistance characteristic of Escherichia coli in order to provide reference for the clinical application of drugs.METHODS The strains of E.coli were detected and their sensitivity to antibiotics was determined by VITEK automatic bacterium identifying and drug sensitivity analyzing systems,then the specimens in which E.coli was detected and the result of sensitivity to antibiotics were analyzed.RESULTS Among 210 specimens in which E.coli was detected,the urine was the most frequent.There were 46 strains which produced extended-spectrum ?-lactamases(ESBLs),the ESBLs-producing rate of E.coli was 21.9%,the drug resistance of ESBLs producers was more serious than that of nonproducers.The resistant rate of ESBLs producers against penicillins was 100%,but the susceptibility rate was 19.6-84.8% while combined with the ?-lactamases inhibitors.The susceptibility rates of ESBLs producers to the antibiotics from the first generation cephalosporins to the third generation ones were 0.0-45.6%.The susceptibility rates of ESBLs producers to cefepime,cefoxitin,ciprofloxacin and Cotrimoxazole were 60.9%,34.8%,10.9% and 13.0%,respectively,whereas amikacin,imipenem,and meropenem were more effective against the bacteria,the susceptibility rates of ESBLs producers were 89.1%,97.8% and 97.8%,respectively.while all the nonproducers were susceptible to them.The ESBLs producers had high sensitivity to imipenem,meropenem,amikacin and piperacillin/tazobactam,and had high resistance to the other antimicrobial drugs,they showed multi-drug resistance.CONCLUSIONS It is rather serious the resistance of E.coli to usual antibiotics,and that of ESBLs producers is more serious.It should be cautious to use cephalosporins to treat infections caused by E.coli,carbapenem,amikacin and some of complex antibiotics containing ?-lactamases inhibitor are very effective to treat infections caused by ESBLs producers.It is very important to select rational drugs correctly for clinical treatment of the infections according to the results of antibiotics susceptibility tests.
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OBJECTIVE To investigate drug-resistance status and changing tendency of Escherichia coli in traditional Chinese medicine hospital to provide the evidence for reasonable use of antibiotics.METHODS Pathogenic bacteria were isolated and identified according to the National Clinical Laboratory Operation Rules.Drug resistance profile was analyzed by K-B methods.RESULTS In the four years,the resistance to seventeen commonly used antibiotics in E.coli was on the rise.The resistance rate to ampicillin was the most highest(90.8-94.2%).No strain was resistant to imipenem and meropenem.the detection rate of extended spectrum ?-lactamases(ESBLs) producing E.coli was increasing from 13.2% to 32.0%.CONCLUSIONS Drug-resistance status of E.coli in traditional Chinese medicine hospital is very serious.We should strengthen the management of antibiotic use and control the spread and prevalence of the drug-resistant bacteria.
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OBJECTIVE To study and analyze the yearly increasing trend of extended spectrum ?-lactamases(ESBLs) producing Klebsiella pneumoniae and its drug resistance.METHODS To identify the bacteria by French bitmerieux ATB Microbiological System,and use K-B disk diffusion procedure for drug senstive test.RESULTS A total of 103 cases with(ESBLs) producing K.pneumoniae strains had been found from 293 cases with K.pneumoniae,the detectable rate was 35.2%,at the same time,its drug resistance was very complicated.CONCLUSIONS The ESBLs producing K.pneumoniae is more emerged in clinical research,which is showing a tendency of rising year by year.Multi-drug resistance is obvious,which must be paid enough attention on clinic.
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OBJECTIVE To investigate ESBLs-producing Escherichia coli and Klebsiella pneumoniae and their antibiotic resistance changing at the same area in different period.METHODS Using Bio-Merieux ATB susceptibility test panels microdilution broth method to detect the antibiotic resistance of E.coli and K.pneumoniae,in addition to the use of phenotypic confirmatory test to detect the ESBLs.RESULTS The ESBLs-producing rate of E.coli and K.pneumoniae during 1999-2001 compared with 2003-2005,was elevated more than double.To imipenem,cefoxitin,piperacillin/tazobactam,and amikacin,the resistant rate was relatively lower,but to other ?-lactams,aminoglycosides,quinolones and sulfonamides,the resistant rate increased significantly in both periods compared,the differences were significant(P
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OBJECTIVE To investigate the distribution and drug-resistance of extended-spectrum ?-lactamases((ESBLs)) producing Gram-negative bacteria in the hospital,in order to control and treat them.METHODS The bacteria were detected and isolated with VITEK TWO system,the suspected ESBLs producing bacteria were(detected) with K-B method.RESULTS There were 1 889 isolated strains of Enterobacteriaceae and the ESBLs(producing) bacteria were 302 strains including E.coli(551),K.pneumoniae(583),and others bacteria(755).Their(positive) rates bacteria were 18.5%,24.7%,and 7.4%,respectively;the wards isolated rate was in the following order: 38.2% were in surgical ICU,29.9% in medical ICU,20.5% in surgery wards,20.6% in oncology wards,12.7% in respiratory wards.12.4% in hematology wards,10.3% in cadre wards,6.4% in endocrinology wards,and 1.6% were in(others) wards.ESBLs producing bacteria were better sensitive to imipenem and meropenem,then to piperacillin(/tazobactam) and cefoperazone/sulbactam.CONCLUSIONS(Enterobacteriaceae) could be(detected) accurately with VITEK TWO system.The main sources of ESBLs producing bacteria are patients in ICU and chronic(patients).To kill these bacteria,imipenem and meropenem can be used first,then(piperacillin)/tazobactam and(cefoperazone)/sulbactain.
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OBJECTIVE To comprehend antimicrobial susceptibility distribution of the ?-lactamases products from Feb 2002 to Feb 2003 in our hospital.METHODS The Microscan-USA was used to identify pathogens and drug sensitivity tests,the results of examination were judged according to NCCLS 1999 standard.(RESULTS) Among the isolated 67 strains of ESBLs-producing bacteria(35.64%),31 strains of(Klebsiella) pneumoniae(36.05%),29 strains of Escherichia coli(43.28%), 6 strains of Enterobacter cloacae((22.22)%)and 1 of K.oxytoca(12.5%) were detected.The multi-resistance of ESBLs~+ bacteria was very usual,besides to the ?-lactam antibiotics.The pattern of being resistant to both of tobramycin and ciprofloxacin was relatively common,and amikacin was relatively less,even the complex antibiotics containing ?-lactamases inhibitor would lose their effect.(CONCLUSIONS)The ESBLs bacteria exist in our area at a high level and also be the main antimicrobial-resistant ones and have got the resistance to many kinds of antibiotics.To control the(ESBLs)~+(bacteria) infection,expanding and supervision management of antibiotics is a urged task and important for us.
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OBJECTIVE To explore the phenotype and genotype of Klebsiella and Escherichia coli producing extended-spectrum ?-lactamases(ESBLs).METHODS The producing ESBLs strains in 110 E.coli and 94 Klebsiella isolates were determined according to disk diffusion test,recommended by NCCLS and the drug-resistant genes such as TEM,SHV,CTX-M-1,CTX-M-2 and CTX-M-9 were detected by PCR and sequencing.RESULTS The producing ESBLs rates were 36.2%,42.7% and 39.7% in Klebsiella,E.coli,and in both two strains,respectively.The positive rate in detecting ESBLs by CTX and CTX/CLAV was higher(66.7%);the negative rates were 68.1% in E.coli,64.7% in Klebsiella when using CAZ alone and CAZ/CLAV.The rates of TEM,SHV,CTX-M-1,CTX-M-2 and CTX-M-9 were 54.3%,38.3%,21.0%,24.7% and 70.4%,respectively,in producing ESBLs isolations.The CTX-M genotype was predominant,(91.4%);the isolations(71.6%) contained more than two resistance genes.CONCLUSIONS More attention should be payed on ESBLs producing E.coli and K.pneumoniae strains.
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Objective To compare the application of three automated microbiology identification and rapid susceptibility assessment systems,Vitek1,Viket2 and BD Phoenix,in detection of extended-spectrum beta-lactamases(ESBLs).Methods The genotypes of 67 clinical isolates of ESBLs-producing E.coli and K.phneumoniae,which were collected from the 1st and 2nd Affiliated Hospital of Zhejiang University,were determined by PCR amplification and sequencing.Meanwhile,these isolates were analyzed by the three automatic microbiology identification system,and the minimum inhibitory concentration(MIC)s for antibiotics were determined.Results Majority of the 67 isolates produced CTXM type of ESBL.Among them,CTX-M-14,CTX-M-22,CTX-M24 and CTX-M-3 were the most frequently detectable types.By using Vitek-AMS,60 isolates(89.6%)were detected to be ESBLs-producing.By using Vitek2,62 isolates(92.5%) were ESBLsproducing.No SHV-12,CTX-M-14 and SHV-28 were detected by the 3 automatic systems.The results of MICs analysis indicated these isolates showed either high resistance for multiple antibiotics or around the boundary areas of MICs test.Conclusions The three automatic analysis systems are able to provide a detectable rate of more than 98% for ESBLs.However,it is needed to further improve the detection for high resistant strain or the strains carrying multiple resistant genes.