ABSTRACT
Objective To investigate the effect of targeted monitoring on the control of central venous catheter associated infection, study the difference of CVC?RI infection rate and the distribution of pathogenic bacteria in the general hospital and the maternal and child hospital, and analyse the main pathogenic bacteria drug resistance characteristics. Methods From January 2013 to December 2014,685 cases patients with central venous catheterization in the Port Hospital of Hebei Port Group Company Limited,and four cooperative hospitals ( Affiliated Hospital of North China University of Science and Technology, People′s Hospital of Tangshan, Tangshan Port Economic Development District Hospital, Maternal and Child Health Care Hospital of Laoting County) were selected as the research objects. The difference of infection rate before and after the targeted monitoring in 2014 was compared. The tip of the catheter and the peripheral blood were cultured in the patients with suspected infection,bacterial identification and drug sensitivity test were carried out using Compact VITEK2 automatic bacteria identification/drug sensitivity analyzer. Results The infection rate of CVC?RI of five hospitals was 18. 75%( 60/320 ) in 2013, 11. 51%( 42/365 ) in 2014, the difference of infection rate was statistically significant before and after the implementation of the target monitoring(χ2=7. 059,P0. 05). In 102 cases of CVC?RI,105 bacterial strains were detected in 91 cases,gram positive bacteria accounted for 51. 43%( 54/105) ,gram negative bacilli accounted for 40. 95%( 43/105) ,fungi accounted for 7. 62%( 8/105) . There was no significant difference in the proportion of pathogenic bacteria in the general hospital and the maternal and child hospital(P>0. 05). Grampositive cocci were mainly staphylococcus aureus and coagulase negative staphylococci,they were completelysensitive to linezolid, quinupristin/ dalfopristin, tigecycline, and vancomycin. They were high sensitivity torifampicin,while highly resistant to gentamicin, tetracycline, penicillin; Gram negative bacilli were mainlypseudomonas aeruginosa and escherichia coli,they were high sensitivity to meropenem,imipenem,while resistantto multiple antimicrobia1s. Conclusion Adhere to the implementation of targeted monitoring help to reduce theoccurrence of CVC?RI. The isolation of pathogenic bacteria from multiple drug resistance should be paid moreattention.
ABSTRACT
Objective To investigate the changes of pathogens and antimicrobial susceptibility in patients with biliary tract infection during the past 30 years.Methods During the periods of 1981-1984,1988-1998 and 2003-2013,each 100 patients treated with common bile duct exploratoration were selected from every period.Biopsied bile specimens were performed with bacteria culture and antimicrobial susceptibility tests.This study reviewed the changes in bilary pathogens and antimicrobial susceptibility test.Results From 1981 to 1984,the most common pathogens were Escherichia coli (59.2％) and Klebsiella pneumonia (28.9％).Mixed infection of these pathogens accounted for 16.9％.From 1988 to 1998,the types of pathogens significandy increased.Escherichia coli (33.1％) and Klebsiella pneumonia (16.5％) accounted for less than 50％.Mixed infection with Escherichia coli and Pseudomonas aeruginosa was the most common type.From 2003 to 2013,gram-negative bacteria were still the main pathogens,accounting for 61.8％.Escherichia coli and Pseudomonas aeruginosa accounted for 20.1％ and 10.4％,respectively.Gram-positive bacteria increased sigrnificantly.Enterococcusfaecium (22.2％) ranked the first.Mixed infection increased (36％),of which more than 50％ was mixed pathogens of Escherichia coli and Enterococcusfaecium.The incidence of fungi infection also increased (5.6％).Conclusions There was a remarkable change of pathogen category in the biliary infections over the past years.With an increase of gram-positive bacteria and fungi infection in clinical practice,antimicrobial susceptability results could be considered in choosing appropriate drug to avoid bacterial resistance.
ABSTRACT
Objective To explore the differences in antimicrobial resistance of bacteria isolated from different samples ,and to guide antibiotic chemotherapy in clinic .Methods The sputum ,blood ,pus and urine specimens were collected from 2009 to 2013 in our hospital for bacterial identification and drug sensitivity tests by using automatic system .The drug resistance rate of Staphylo‐coccus aureus ,Escherichia coli ,Klebsiella pneumoniae isolated from different samples were compared .Results All isolates of E .co‐li ,Klebsiella pneumoniae were sensitive to imipenem ,ertapenem ,piperacillin/tazobactam and amikacin .All isolates of S .aureus were sensitive to vancomycin ,linezolid ,nitrofurantoin ,quinupristin/dalfopristin .The ESBLs positive rate of E .coli(71 .5% )and the MR‐SA detection rate(79 .9% ) of Staphylococcus aureus from sputum samples were significantly higher than that from other samples (P<0 .05) .The ESBLs positive rate(44 .4% ) of Klebsiella pneumoniae isolates from urine was significantly higher than that from other samples(P<0 .05) .Conclusion The same bacteria isolated from different samples have different antimicrobial resistance rates ,so the selection of antibiotics should based on drug sensitivity tests results for the treatment of the same pathogen infection confirmed by bacterial cultures from different samples .
ABSTRACT
Objective To investigate the pathogenic bacteria and drug resistance in orthopedics patients, so as to guide the clinical use of antibiotics.Method708 secretions and pus samples from orthopedic outpatients and inpatients were cultured aerobically.The detectable bacteria were subjected to drug sensitivity test in vitro by the K-B assay.Result259 pathogenic strains were detected, and 47.9% of them were Gram-positive (Staphylococcus aureus, 33.0%: coagulase-negative staphylococci, 14.9%),and the remaining 52.1% were Gram-negative (Pseudomonas, 7.3%; Acinetobacter, 6.1%). The drug-resistant rate of Gram-positive cocci to penicillin and oxcillin tended to raise over the three years : however, all the detected Gram-positive cocci were sensitive to vancomycin (100%).Most Gram-negative bacilli were sensitive to imipenem (95.8%) in the past three years and the sensitivity to ceftazidime was also high; however, the sensitivity tended to fall over the past three years. The drug-resistant rates of Gram-negative bacilli to CiprofIoxacin. amikacin and piperacillin were 46.0%. 47.0% and 51.2% respectively.ConclusionGram-negative bacilli dominate the pathogenic bacteria in orthopaedic patients and they tend to increase. The incidence of infections by Gram-positive cocci is lower than that of infections by Gram-negative bacilli. In terms of individual bacteria ,staphylococcus aureus leads among all of these pathogenic bacteria, Vancomycin, Oxacillin and Norfloxacin are preferred drugs against Gram-positive cocci, while imipenem and ceftazidime are preferred for Gram-negative bacilli.The incidence of infections by Gram-negative bacilli tend to raise and drug resistance of Gram-negative bacilli becomes serious:hence, it is crucialOto emphasize the detection of infectious bacteria and drug sensitive test and to use antibiotics rationally.
ABSTRACT
OBJECTIVE To investigate the distribution and drug resistance of Pseudomonas aeruginosa.METHODS All specimens isolated and cultured from patients in our hospital were identified by using the automatic microorganism analyzer WalkAway-40,Dade Behring made in America,and bacteria′s drug susceptibility test and identifications were performed on strains using NC21 Microscan Panel.RESULTS From sixty-two strains of P.aeruginosa 36 strains were isolated of sputum.The resistance rate to the third generation of cephalosporins cefotaxime and ceftriaxone was 55.6% and 47.5%,respectively.The resistance rate to the other ?-lactamases antibiotics such as ceftazidime was 7.5%,piperacillin/tazobactam 11.0%,cefepime 14.8% and penicillin was 30.0%,the ratio of resistance for imipenem was 20.0%,the lowest one was amikacin(4.6%).CONCLUSIONS P.aeruginosa is one of the main bacteria in the lower respiratory tract infection.The drug-resistant mechanism of P.aeruginosa is very complex,including multidrug resistance characteristics,and it is originally resistant to several antibiotics.To avoid being produced ?-lactamases and result in resisting drug widely,the antibiotics should be selected according to low drug-resistant rate and taking into account sufficiently its drug resistance mechanism in the treatment of P.aeruginosa infection.
ABSTRACT
OBJECTIVE With surveillance of the distribution and antibiotic resistance of Escherichia coli during the last six years in our hospital,the basis for the reasonable clinical use of antibiotic is provided to doctor.METHODS A total of 1 907 strains of E.coli isolated during the last six years were analyzed by Kirby-Bauer disk or VITEK-2 system.RESULTS Among 1 907 strains of E.coli,1 114 strains were isolated from urine,accounted for 58.4%;215 from pus or secret,accounted for 11.3%;165 from sputum,accounted for 8.7%;and 159 from blood,accounted for 8.3%.ESBLs production rate of E.coli increased steadily from 5.11%,10.34%,14.56%,15.14%,33.79% to 29.96%,separately during the six years.The resistance of E.coli with ESBLs to most antibiotics was much higher than those without ESBLs.And E.coli demonstrated much higher resistant rate to ciprofloxacin,penicillins,and first or second generation cephalosporins,and much lower to amikacin and cefoperazone/sulbactam.No strains were found to be resistant to imipenem.CONCLUSIONS E.coli is the major pathogen,causing nosocomial infection with multi-resistant mechanism, since ESBLs-producing strain is increasing as years gone,reasonable choice of antibiotic should be in term of result of antibiotic resistant test and patient symptom to cure the E.coli infection induced.