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Objective@#To retrospectively analyze the distribution of non-fermentative bacteria causing bloodstream infection in hospitalized patients in Sichuan Province and their drug susceptibility to common antibiotics for better understanding their epidemiological characteristics.@*Methods@#From January 1, 2015 to December 31, 2017, all of the non-fermentative bacteria isolated from patients with bloodstream infection in nine hospitals in Sichuan Province were collected. Species distribution and drug resistance test results were retrospectively analyzed.@*Results@#A total of 6 291 strains of pathogenic bacteria were isolated, including 3 674 strains of gram-negative bacteria (58.4%) and 2 617 strains of gram-positive bacteria (41.6%). The gram-positive bacteria were 1 895 strains of Staphylococcus (30.1%), 372 strains of Streptococcus (5.9%), 317 strains of Enterococcus (5.1%) and 33 strains of other gram-positive bacteria (0.5%). The gram-negative bacteria were 3 191 Enterobacteriaceae strains (50.7%), 389 non-fermentative strains (6.2%) and 94 other gram-negative strains (1.5%). The isolated non-fermentative bacteria were mainly Pseudomonas aeruginosa (136 strains, 35.0%), Acinetobacter baumannii (126 strains, 32.0%) and Stenotrophomonas maltophilia (33 strains, 8.5%). There were 167 (42.9%), 112 (28.8%) and 82 (21.1%) non-fermentative bacteria isolated in internal medicine departments, ICUs and surgery departments, respectively. The drug resistance rates of Pseudomonas aeruginosa to cefepime, ciprofloxacin and gentamicin were 16.5%, 10.7% and 9.9%, respectively. Carbapenems-resistant Pseudomonas aeruginosa (CR-PA) accounted for 13.6%. No polymyxin-resistant Pseudomonas aeruginosa was found. The resistance rates of Acinetobacter baumannii to all antibiotics were over 30% except for minocycline and polymyxin and 75.7% of carbapenem-resistant Acinetobacter baumannii (CR-AB) were isolated. The drug resistance rates to levofloxacin, trimethoprim/sulfamethoxazole and ceftazidime were 0%, 0% and 37.0% in Stenotrophomonas maltophilia isolates and 10.5%, 4.2% and 19% in Burkholderia cepacia isolates, respectively.@*Conclusions@#Non-fermentative bacteria causing 6.2% of bloodstream infection in Sichuan, mainly by Pseudomonas aeruginosa and Acinetobacter baumannii. There were significant differences in the isolation rate of non-fermentative bacteria in different departments and most of the strains were isolated in internal medicine departments. The detection rate of Acinetobacter baumannii with multiple drug resistance was high, while other non-fermentative bacteria had good sensitivity to antibiotics.
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Objective To retrospectively analyze the distribution of non-fermentative bacteria cau-sing bloodstream infection in hospitalized patients in Sichuan Province and their drug susceptibility to com-mon antibiotics for better understanding their epidemiological characteristics. Methods From January 1, 2015 to December 31, 2017, all of the non-fermentative bacteria isolated from patients with bloodstream in-fection in nine hospitals in Sichuan Province were collected. Species distribution and drug resistance test re-sults were retrospectively analyzed. Results A total of 6291 strains of pathogenic bacteria were isolated, including 3674 strains of gram-negative bacteria ( 58. 4％) and 2617 strains of gram-positive bacteria (41. 6％). The gram-positive bacteria were 1895 strains of Staphylococcus (30. 1％), 372 strains of Strep-tococcus (5. 9％), 317 strains of Enterococcus (5. 1％) and 33 strains of other gram-positive bacteria (0. 5％). The gram-negative bacteria were 3191 Enterobacteriaceae strains (50. 7％), 389 non-fermenta-tive strains (6. 2％) and 94 other gram-negative strains (1. 5％). The isolated non-fermentative bacteria were mainly Pseudomonas aeruginosa ( 136 strains, 35. 0％), Acinetobacter baumannii ( 126 strains, 32. 0％) and Stenotrophomonas maltophilia ( 33 strains, 8. 5％). There were 167 ( 42. 9％), 112 (28. 8％) and 82 (21. 1％) non-fermentative bacteria isolated in internal medicine departments, ICUs and surgery departments, respectively. The drug resistance rates of Pseudomonas aeruginosa to cefepime, cipro-floxacin and gentamicin were 16. 5％, 10. 7％ and 9. 9％, respectively. Carbapenems-resistant Pseudo-monas aeruginosa ( CR-PA) accounted for 13. 6％. No polymyxin-resistant Pseudomonas aeruginosa was found. The resistance rates of Acinetobacter baumannii to all antibiotics were over 30％ except for minocy-cline and polymyxin and 75. 7％ of carbapenem-resistant Acinetobacter baumannii ( CR-AB) were isolated. The drug resistance rates to levofloxacin, trimethoprim/sulfamethoxazole and ceftazidime were 0％, 0％ and 37. 0％ in Stenotrophomonas maltophilia isolates and 10. 5％, 4. 2％ and 19％ in Burkholderia cepacia iso-lates, respectively. Conclusions Non-fermentative bacteria causing 6. 2％ of bloodstream infection in Si-chuan, mainly by Pseudomonas aeruginosa and Acinetobacter baumannii. There were significant differences in the isolation rate of non-fermentative bacteria in different departments and most of the strains were isolated in internal medicine departments. The detection rate of Acinetobacter baumannii with multiple drug resistance was high, while other non-fermentative bacteria had good sensitivity to antibiotics.
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Objective:To study the clinical characteristics,prognosis and drug resistance caused by the non fermenting bacteria in the infants,and to provide reference for the doctors to recognize the infection features and its treatment.Methods:A total of 91 cases of non-fermentative bacteria infection were selected and the clinical materials were retrospectively analyzed.The clinical data and prognosis of the pediatric patients were analyzed,as well as the distribution and drug resistance of non-fermentative bacteria.The bacterial resistance genes were detected by PCR method,and the positive results were analyzed by gene sequencing.Results:In the past 5 years,the nonfermentative bacteria strains were isolated in 91 infant patients,including 35 cases of newborn (19 cases were premature infants),29 cases aged less than 1 year old,27 cases aged from 0 year to 3 years old.Among these patients,60 were male and 31 were female.There were 41 cases with underlying diseases (45.05 ％),16 cases with organ dysfunction (17.58％),3 cases discharged automatically (3.29 ％),and 1 case dead (1.09 ％).A total of 102 strains of non-fermentative bacteria included 42 strains of Pseudomonas aeruginosa,33 strains of Acinetobacter baumannii,21 strains of Stenotrophomonas maltophilia and 6 strains of other non-fermentative bacteria.Forty-four strains were isolated from neonatal ward,33 strains (32.35％) from neonatal ICU (43.13 ％),25 strains (24.50％) were isolated from general pediatric ward.These strains were mainly from respiratory tract secretions and blood samples,nearly 84.31％.The isolation rates of MDR,XDR,PDR Acinetobacter baumannii and Pseudomonas aeruginosa were 63.63％ and 19.04％,respectively.There were 40.48％ of Pseudomonas aeruginosa isolates were resistant to imipenem,blaPER had the highest positive gene rate (28.57％).There were 36.36％ of Acinetobacter baumannii isolates were resistant to imipenem,all resistant strains carried blaOXA-51 and blaOXA-23 genes.Conclusion:The infants with underlying diseases or invasive diagnosis and treatment are easy to infect non fermentative bacteria.Most strains of them are drug-resistant and difficult to be treated with long duration and high risk.
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Objective:To study the clinical characteristics,prognosis and drug resistance caused by the non fermenting bacteria in the infants,and to provide reference for the doctors to recognize the infection features and its treatment.Methods:A total of 91 cases of non-fermentative bacteria infection were selected and the clinical materials were retrospectively analyzed.The clinical data and prognosis of the pediatric patients were analyzed,as well as the distribution and drug resistance of non-fermentative bacteria.The bacterial resistance genes were detected by PCR method,and the positive results were analyzed by gene sequencing.Results:In the past 5 years,the nonfermentative bacteria strains were isolated in 91 infant patients,including 35 cases of newborn (19 cases were premature infants),29 cases aged less than 1 year old,27 cases aged from 0 year to 3 years old.Among these patients,60 were male and 31 were female.There were 41 cases with underlying diseases (45.05 ％),16 cases with organ dysfunction (17.58％),3 cases discharged automatically (3.29 ％),and 1 case dead (1.09 ％).A total of 102 strains of non-fermentative bacteria included 42 strains of Pseudomonas aeruginosa,33 strains of Acinetobacter baumannii,21 strains of Stenotrophomonas maltophilia and 6 strains of other non-fermentative bacteria.Forty-four strains were isolated from neonatal ward,33 strains (32.35％) from neonatal ICU (43.13 ％),25 strains (24.50％) were isolated from general pediatric ward.These strains were mainly from respiratory tract secretions and blood samples,nearly 84.31％.The isolation rates of MDR,XDR,PDR Acinetobacter baumannii and Pseudomonas aeruginosa were 63.63％ and 19.04％,respectively.There were 40.48％ of Pseudomonas aeruginosa isolates were resistant to imipenem,blaPER had the highest positive gene rate (28.57％).There were 36.36％ of Acinetobacter baumannii isolates were resistant to imipenem,all resistant strains carried blaOXA-51 and blaOXA-23 genes.Conclusion:The infants with underlying diseases or invasive diagnosis and treatment are easy to infect non fermentative bacteria.Most strains of them are drug-resistant and difficult to be treated with long duration and high risk.
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Objective To study the distribution characteristics and drug resistance of non-fermenting bacterial infection in intensive care unit (ICU) at a tertiary hospital during seven consecutive years,and to provide evidence for rational use of antibiotics in ICU.Methods A retrospective analysis was conducted.The related data about non-fermentative bacteria obtained from clinical specimens,collected from lower respiratory tract,blood,urine,bile and other secretions of ICU patients admitted to Binzhou Medical University Hospital from January 2009 to December 2015 were retrospectively analyzed.The distribution characteristics and drug resistance of non-fermentative bacteria,and isolation rate of multiple drug resistance (MDR) strains were analyzed.Results 2 672 strains of nonfermentative bacteria were isolated during seven consecutive years,accounting for 57.9％ gram negative (G-) bacilli (2 672/4 613),and 35.2％ of all bacteria (2 672/7 587).The top five were Acinetobacter baumannii (38.4％),Pseudomonas aeruginosa (34.6％),Onion burkholderia cepacia (9.9％),Stenotrophomonas maltophilia (6.2％),and Pseudomonas fluorescens (5.6％).Non-fermentative bacteria were mainly isolated from the lower respiratory tract (60.9％).Isolation of the non-fermentative bacteria accounted for over 50％ of G-bacilli during seven consecutive years,and the isolation rate of the top five types of bacteria showed no obvious change,while positive rate of Acinetobacter baumannii showed a tendency to increase (obviously from 26.5％ in 2009 to 50.2％ in 2015),and a lowering trend of positive rate of Onion burkholderia cepacia,Stenotrophomonas maltophilia,and Pseudomonas fluorescens was obvious (from 15.6％,10.6％,13.0％ in 2009 to 5.6％,7.4％,1.4％ in 2015 respectively) was observed.The isolation rate of Pseudomonas aeruginosa was stable (about 30％) during seven consecutive years.The drug susceptibility results showed that the resistant rates of Acinetobacter baumannii against imipenem,meropenem,aminoglycosides and third-generation cephalmsporins were all higher than 70％,while its resistant rate to cefoperazone-sulbactam was relatively lower (40.2％-68.1％)with relatively higher sensitivity rate (23.6％-46.0％).In contrast,the resistant rates of Pseudomonas aeruginosa against antibiotics were low,while the sensitivity rate to fourth-generation cephalmsporins cefepime (58.3％-87.7％)and third-generation cephalmsporins was high (ceftazidime:55.6％-79.3％,piperacillin-tazobactam:62.5％-86.2％,cefoperazone-sulbactam:46.0％-89.8％).From 2009 to 2015,the incidence of MDR strains of Acinetobacter baumannii showed an obvious increasing tendency (from 68.0％ to 84.1％);in contrast,the incidence of MDR strains of Pseudomonas aeruginosa did not show an obviously increase in incidence from 2009 to 2012,on the other hand,it showed a decreasing tendency from a peak 68.6％ in 2012 to 23.5％ in 2015.Conclusions The isolation rate of non-fermentative bacteria was high and the drug resistance situation was serious.Therefore,it is important to grasp the knowledge regarding distribution characteristics,drug resistance and variation of non-fermentative bacteria in ICU.It is not only beneficial for both rational use of antibiotics,improve efficacy but also helpful in reducing the emergence of drug resistance stains.
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Objective To analyze the pathogen distribution and drug‐resistance characteristics in the patients with lung cancer complicating non‐fermentative bacteria lung infection to provide the basis for clinicians to prevent infection and rationally use anti‐bacterial drugs .Methods The clinically submitted respiratory tract specimens in the patients with lung cancer in our hospital from January 2009 to July 2015 were retrospectively analyzed .The isolated pathogenic bacteria were identified by adopting the France Bio‐plum‐Egyptian company Vitek2‐Compact identification instrument ,the drug sensitivity test was conducted by using the K‐B disk diffusion method .The statistical analysis of data was performed by adopting the WHONET 5 .6 software .Results 176 strains of non‐fermentative bacteria mainly came from sputum ,accounting for 80 .1% ,the detection rate of Pseudomonas aeruginosa was highest ,accounting for 48 .2% ,followed by Acinetobacter baumannii and Stenotrophomonas maltophilia ,accounting for 32 .4% and 16 .5% respectively ;the drug susceptibility test results showed that non‐fermentative bacteria had different degrees of resistance to antibacterial drugs or even multiple drug resistance ,in which the resistance of Pseudomonas aeruginosa to amikacin ,tobramycin and cefoperazone/sulbactam ,the resistance of Acinetobacter baumannii to amikacin ,cefoperazone/sulbactam and the resistance of Stenotrophomonas maltophilia to minocycline ,cotrimoxazole and cefoperazone/sulbactam were less than 30 .0% ,which to other an‐tibacterial drugs were more than 30 .0% .Conclusion Non‐fermentative bacteria are common pathogenic bacteria in hospital infec‐tion ,non‐fermentative bacteria isolated from the patients with lung cancer complicating pulmonary infection have serious resistance to commonly used antibacterial drugs ,therefore clinic should strengthen the monitoring of pathogenic bacteria and drug resistance . Cefoperazone/sulbactam is the first choice for treating these bacterial infections .
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BACKGROUND: Cerebral stroke is a disease with a high disability rate and a high fatality rate. This study was undertaken to assess the risk of stroke associated pneumonia (SAP) in patients with ischemic stroke using A2DS2 score. METHODS: Altogether 1279 patients with ischemic stroke who were treated in our department from 2009 to 2011 were retrospectively analyzed with A2DS2 score. A2DS2 score was calculated as follows: age ≥75 years=1, atrial fi brillation=1, dysphagia=2, male sex=1; stroke severity: NIHSS score 0–4=0, 5–15=3, ≥16=5. The patients were divided into three groups according to A2DS2 score: 620 in score 0 group, 383 in score 1–9 group, and 276 in score ≥10 group. The three groups were comparatively analyzed. The diagnostic criteria for SAP were as follows: newly emerging lesions or progressively infiltrating lesions on post-stroke chest images combined with more than two of the following clinical symptoms of infection: (1) fever ≥38 °C; (2) newly occurred cough, productive cough or exacerbation of preexisting respiratory tract symptoms with or without chest pain; (3) signs of pulmonary consolidation and/or wet rales; (4) peripheral white blood cell count ≥10×109/L or ≤4×109/L with or without nuclear shift to left, while excluding some diseases with clinical manifestations similar to pneumonia, such as tuberculosis, pulmonary tumors, non-infectious interstitial lung disease, pulmonary edema, pulmonary embolism and atelectasis. The incidence and mortality of SAP as well as the correlation with ischemic stroke site were analyzed in the three groups respectively. Mean± standard deviation was used to represent measurement data with normal distribution and Student'st test was used. The chi-square test was used to calculate the percentage for enumeration data. RESULTS: The incidence of SAP was significantly higher in the A2DS2 score≥10 group than that in the score 1–9 and score 0 groups (71.7％ vs. 22.7％, 71.7％ vs. 3.7％, respectively), whereas the mortality in the score≥10 group was signifi cantly higher than that in the score 1–9 and score 0 groups (16.7％ vs. 4.96％, 16.7％ vs. 0.3％, respectively). The incidences of cerebral infarction in posterior circulation and cross-MCA, ACA distribution areas were significantly higher than those in the SAP group and in the non-SAP group (35.1％ vs.10.1％, 11.4％ vs. 7.5％, respectively). The incidence of non-fermentative bacteria infection was significantly increased in the score≥10 group. CONCLUSIONS: A2DS2 score provides a basis for risk stratification of SAP. The prevention of SAP needs to be strengthened in acute ischemic stroke patients with a A2DS2 score≥10.