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Introduction@#Major outbreaks of infectious diseases caused by enteroviruses (EV) have been reported in recent years. As of 2017, in Mongolia, hand, foot and mouth disease, or HFMD, accounts for 13.7% of all infectious diseases. The purpose of this study was to investigate the circulation of EV among healthy children, and clinical characteristics of infection.@*Materials and Methods @#The analysis of EV circulation was conducted on Polio Laboratory data of 1172 specimens, collected in 2013-2018, from 9 districts of UB and 21 provinces of Mongolia. Also specimens of 239 patients, who underwent outpatient and inpatient treatment at the NCCD in 2014-2018, were randomly selected and stool samples were collected. Clinical symptoms of patients were analyzed and virus isolation analysis was performed in order to confirm the diagnosis.@*Results@#Children from 1 month of age to 5 years have participated in the study and the average age was 2 years and 5 months. The enterovirus rate among healthy children was 20.1%. Virus circulation rate was highest in 2013 (37.2%), lowest in 2014 (11.8%). The peak of circulation is observed in May and October, while the minimum rate is in July. </br> Out of selected patients 52.7% (n=126) were diagnosed with HFMD, rash infection occurred in 28.5% (n=68), acute flaccid paralysis-18.8% (n=45). EV was detected in 56.4% (n=135) of the collected stool samples.</br> Children from 1 month of age to 5 years have participated in the study and the average age was 2 years and 5 months (95% CI:2.5 ±0.1). 49% (n=578) of participants were female, 50.7% (n=594) were male. The enterovirus rate among healthy children were 20.1% (n=236; 95% CI: 20.1 ± 0.55). Virus circulation rate was highest in 2013 (37.2%), lowest in 2014 (11.8%). The peak of circulation is observed in May and October, while the minimum rate is in July. Although the enterovirus isolation rate was relatively high among children under 3, there was no statistically significant difference (p>0.05), as well as there was no difference in gender (p>0.05). As for the EV circulation by region, the highest prevalence rate is found in Central region (27.5%), while the lowest is in the Eastern region (12.7%) with no statistical significance by regions (p>0.05).@*Conclusions@#Among children, HFMD is a common disease, that caused by EV. Enterovirus infection can often cause fever, flu like symptoms as well as spotted, maculopapular rash. The EV isolation rate of 20.1% indicates that the incidence of enterovirus is characterized by symptoms of influenza-like illness or is asymptomatic.
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BACKGROUND: Candidemia has increased with an increasing number of people in the high risk group and so has become more important. This study was conducted to investigate the isolation rate of Candida species from candidemia patients and the change in rate of antifungal resistance. METHODS: At a single tertiary care hospital, 1,120 blood cultures positive for Candida species from 1997 to 2016 were investigated according to date of culture, gender, age, and hospital department. RESULTS: During the investigation period, the number of candidemia patients increased from 14 in 1997 to 84 in 2016. The most common organism identified during the two decades was Candida albicans (40.8%), followed by Candida parapsilosis (24.1%), Candida tropicalis (13.2%), and Candida glabrata (12.8%). C. glabrata was relatively common in females (45.5%) compared to males. The age group 40-89 years was more frequently infected than other age groups, and the most frequent isolates according to age group were C. albicans in neonate (66.7%), C. parapsilosis in 1-9-year-olds (41.7%), and C. glabrata in those aged ≥60 years (range; 13.3%–20.0%). According to the visited departments, C. albicans, C. glabrata, and Candida haemulonii were more common in medical departments, while C. parapsilosis was more common in surgical departments. In the antifungal susceptibility test, a rising trend of azole resistance among C. albicans and C. glabrata was observed in recent years. CONCLUSION: In this study, it was confirmed that the isolation rate of Candida species in blood is different by age, gender, and hospital department, and the distribution of isolated Candida species changed over time. The resistance patterns of antifungal agents are also changing, and continuous monitoring and proper selection of antifungal agents are necessary.
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Female , Humans , Infant, Newborn , Male , Antifungal Agents , Candida albicans , Candida glabrata , Candida tropicalis , Candida , Candidemia , Danazol , Drug Resistance, Fungal , Hospital Departments , Prevalence , Tertiary HealthcareABSTRACT
Objective To analyze the effect evaluation of modified TT enrichment broth in the separation of intestinal pathogenic Salmonella and Shigella bacteria .Methods The routine inoculation of Macconkey agar and SS agar were adopted ,meanwhile two different methods for adding the modified TT enrichment broth(sodium thiosulfate and calcium carbonate) were used to screen Sal‐monella and Shigella bacteria .Serum coagulation was performed by referring to the bacterial isolation situation over the years .The SPSS 18 .0 software was adopted to process the data .Then the difference in the separation rate of Salmonella and Shigella bacteria between the two different stool culture methods was compared .Results Totally 790 stool culture samples during 2013-2015 were included into the statistical analysis ,30 cases of Salmonella bacteria were isolated by adopting the routine method ,the positive rate was 3 .80% ;5 cases were Shigella bacteria ,the positive rate was 0 .63% ;but 77 cases of Salmonella bacteria were isolated by adop‐ting the modified TT enrichment broth method ,the positive rate was 9 .75% ,7 cases were Shigella bacteria ,the positive rate was 0 .89% ;the detection rate of Salmonella bacteria by adopting the modified TT enrichment broth method was 2 .57 times of the con‐ventional culture method ,which of Shigella bacteria was 1 .41 times ,showing that the difference of Salmonella and Shigella bacteria isolation between the two different methods had statistical significance(P<0 .05) .Conclusion The modified TT enrichment broth can significantly improve the positive isolation rate of Salmonella and Shigella stool culture ,which provides larger help for clinical doctor′s correct diagnosis and treatment of patients .
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Objective To evaluate the change of extended spectrum β-lactamase (ESBLs) Producing Klebsiella Pneumoniae (ESBLs-KPN) and Escherichia coli (ESBLs-ECO) causing nosocomial infection after antimicrobial intervention. Methods We regularly monitored the data on the yearly consumption [defined as daily dose (DDD) per 1 000 patient-days] of frequently used antibiotics from Dec. 2004 to Dec. 2007. From Jan. 2005 to Dec. 2007, we monitored the resistance of frequently used antibiotics and the timely integrative antimicrobial intervention was based on the outcome of antimicrobial resistance. We also monitored the isolation rate of ESBLs-KPN and ESBLs-ECO causing nosocomial infection. The departments studied were the experimental group and other comparable medical departments were the control group(ICU was excluded).Results The isolation rate of ESBLs-KPN ((43.90%)) and ESBLs-ECO (45.83%) in the experimental group was higher than that in the control group (28.04% and 24.90%, respectively) before the intervetion (P＜0.05). The isolation rate of ESBLs-KPN decreased (from 26.47% to 17.65%) in the experimental group and that in the control group increased ( ESBLs-KPN: from 34.18% to (52.94%;) ESBLs-ECO: from 47.13% to 63.78%) from 2005 to 2007 (P＜0.05). The isolation rate of ESBLs-KPN and ESBLs-ECO in the experimental group was lower than that in the control group after the antimicrobial intervention (P＜0.05). Usage of ceftazidime and cefoperazone/sulbactam and imipenem was reduced and the consumption of cefepime was increased in the experimental group ((P＜0.05)). Consumption of ceftazidime and cefoperazone/sulbactam and cefepime was increased. Conclusion The prevalence of ESBLs-KPN and ESBLs-ECO may be decreased after the integrative antimicrobial intervention.
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Objective To investigate the trend of omtibacterial resistance rate of Acinetobater baumannii in our hospital from Jan.2000 to Jun.2005,and for the guidance of rational use of antibacterials.Methods A.baumannii strain was isolated and tested by K-B method from clinical samples and antibiotic resistance was analyzed and studied retrospectively.Results There was an elevated tendency of the resistance rates to common antibacterial in A baumanii for past six years. The resistance rate to imipenem was the lowest (3.6%) and to amikacin, cefoperazone/sulbactam was 29.5%-77.4%.Conclusion The resistance rates to common the antibacterial in A.baumanii are high and the resistance pattern is wide. It is important to select antibiotics according to the antibiotics sensitivity in vitro.
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OBJECTIVE To study the isolation rate of Acinetobacter baumannii, characteristics of infection distribution and antimicrobial resistance rates. METHODS Surveillance data of A. baumannii infection of wards, its distribution and resistance rates to 20 kinds of antibiotics in our hospital for 5 years were analyzed . RESULTS During the 5-year infection surveillance, 523 strains of A. baumannii were isolated in our hospital mostly from sputum. The commonest site was lower respiratory tract. The ward with the highest incidence of A. baumannii infection was ICU. The isolation rate was 11.1% in 2004, though 3.9% in 2000. A. baumannii was resistant to 20 kinds of antibiotics, especially to imipenem, cefoperazone /sulbactam and ampicillin/sulbactam. CONCLUSIONS The isolation rate of A. baumannii and antimicrobial resistance rate are increasing year by year. The increased rate of multidrug-resistance should be payed more attention .
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OBJECTIVE To study the isolation and resistance tendency of Acinetobacter calcoaceticus-baumannii to antimicrobial agents from 1998 to 2004 to provide valuable data for infection prevention and therapy. METHODS We reviewed the isolation rates,distribution in clinical specimens and wards,and the resistance rates of(A.calcoaceticus-baumannii)to 14 kinds of antimicrobial agents from 1998 to 2004. RESULTS There was an increasing tendency of isolation rates of A.calcoaceticus-baumannii every year,which was 0.18% in 1998 but 1.48% in 2004.In the seven years,there was the highest isolation rate of 70.58% in specimens from respiratory tract,the next was from the urine(9.42%),and blood(4.63%).Concerning the wards distribution,ICU had the highest rate of 47.28%.In 1998,A.calcoaceticus-baumannii had resistance rates more than 50% only to one kind of antimicrobial agents(aztreonam),but in 2004,it had increased to thirteen kinds(except cefoperazone/sulbactam).About the fourteen kinds of antimicrobial agents we inspected,that were increased in their resistance rate.The highest increasing of resistance rate was ceftazidime from 11.1% in 1998 to 88.9% in 2004,the imipenem was second for 0.0% to 64.8%,and the third was sulfamethoxazole/trimethoprim form 0.0% to 64.0%,while there still was an increasing resistance tendency to them. CONCLUSIONS The clinical isolation rate of A.calcoaceticus-baumannii is increasing,and it has higher resistance rates to many antimicrobial agents as well as an increasing resistance tendency to relatively susceptive antimicrobial agents every year.So physicians should prescribe on the basis of antimicrobial agents susceptibility tests in vitro.
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BACKGROUND: Methicillin-resistant Staphylococcus aureus (MRSA) is highly prevalent in hospitals in Korea. The overall rate of MRSA in hospitals in Korea was estimated over 60%. Recently hospital infections caused by MRSA are getting increased and problematic in Korea, Our hospital Seoul Paik Hospital, has been trying to solve this problem. We had not applied exact methods for hospital infection control. Therefore, we adapted strict methods under the control of hospital infection control committee (HICC) and assessed the effectiveness of these methods. METHODS: Every month, the number of MRSA isolates was collected and analyzed; the results of the analysis were reported to every ward. All wards were supplied with Microshild(R) (Johnson & Johnson, Australia), Clean N' Fresh(R) (Carroll, USA), and standard paper towels. Health care workers were regularly educated for hospital infection control. The use of antibiotics was controlled by the HICC. We compared MRSA isolation rate between before and after applying the strict infection control methods under the regulation of HICC. Mann-Whitney U test, one-way ANOVA, and Chi-square test were used for statistical analysis of the results. RESULTS: After restricting the uses of antibiotics, glycopeptides and carbapenems were prescribed 15% less (20.3 vs 17.3 DDD /1000 patient-days) and 35% less (9.3 vs 6.0 DDD /1000 patient-days) respectively, compared to before restricting antibiotics. Methicillin resistance rate was decreased from 78% to 69% compared to before the methods(p=0.02). The isolation rate of MRSA was reduced by 31-42% from 2.33 to 1.35-1.60/1000 patient-days compared to before adapting strict infection control methods (p=0.04-0.07). CONCLUSION: This study showed that applying the strict infection control methods in the hospital can be effective to reduce the isolation rate of MRSA.
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Anti-Bacterial Agents , Carbapenems , Cross Infection , Delivery of Health Care , Dichlorodiphenyldichloroethane , Glycopeptides , Infection Control , Korea , Methicillin Resistance , Methicillin , Methicillin-Resistant Staphylococcus aureus , Seoul , Staphylococcus aureus , StaphylococcusABSTRACT
OBJECTIVE To investigate the distribution and drug resistance of common bacteria isolated from our hospital in 2001-2005,and to guide the appropriate use of antibiotics.METHODS The resistant patterns were analyzed by retrospective analysis from 2001 to 2005.RESULTS There were 268 Gram-positive strains(27.21%) and 717 Gram-negative strains(72.79%).The most prevalent isolated strains were Escherichia coli,Pseudomonas aeruginosa,Staphylococcus aureus,Stenotrophomonas maltophilia,Klebsiella pneumoniae and Staphylococcus epidermidis,which were increasing year by year.Imipenem was the most sensitive for Gram-negative rods,and vancomycin was the most sensitive for Gram-positive cocci.The resistance rate of E.coli to imipenem and ceftazidime was below 30%.All S.aureus strains were susceptiple to vancomycin.CONCLUSIONS The rapid emergency of nosocomial multidrug resistant strains presents significant therapeutic challenges and therefore,the rational use of antibiotic therapy based on susceptibility tests should be emphasized.Understanding the distribution of isolates and drug susceptibility test results of different bacteria could help doctors to decide the rational antimicrobial therapy.
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OBJECTIVE To explore bacteria distribution and changing status in infectious species from our hospital. METHODS The infectious species were collected from daily work.After bacteria culturing and genus identification by VITEK system,bacteriology data and corresponding clinical data were analyzed. RESULTS From Jan 2001 to Dec 2004,Staphylococcus aureus,S.epidermidis,Escherichia coli,Klebsiella pneumoniae,Pseudomonas aeruginosa and fungi were isolated most frequently in order. CONCLUSIONS Dynamic supervision of causative bacteria of nosocomial infection is strongly recommended.
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OBJECTIVE To assay retrospectively the isolation rate and susceptibility of Staphylococcus aureus(SAU) in our hospital during five years.METHODS Qualified sputa had been collected by the clinical(microbiological)(laboratory) and cultured to identify the SAU,then evaluated its susceptibility to some commonly used antibiotics in clinic.At the same time,the ratio of SAU to all the other isolated pathogenic bacteria and to the Gram-positive bacteria was calculated.The standard criteria were based on 2000 National Committee for Clinical(Laboratory) Standards of the USA.RESULTS The ratio of SAU to all isolated bacteria was 16%,and to Gram-positive ones was more than 70%.There was no obvious difference among every two isolation rate per year.The(resistance) rate to the most of commonly used antibiotics was higher than 50%,while the resistance rate to(imipenem),amikacin,and netilmicin was very low.And the vancomycin-resistant SAU was not isolated.(CONCLUSIONS) The resistance of SAU is still a serious problem and in our lab there is no vancomycin-resistant strain.