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@#Abstract: Objective To analyze the distribution and drug resistance of pathogenic bacteria in blood culture specimens of patients with bloodstream infections before and after COVID-19 (2018-2019 and 2020-2021), and to provide scientific basis and reference for rational treatment and effective control of bloodstream infections in the post-epidemic period. Methods Blood culture specimens were collected from patients in Zhongnan Hospital of Wuhan University in the two years before and after the COVID-19 outbreak (2018-2021). The Automated Blood Culture Systems were used to perform blood culture on blood specimens sent for clinical inspection, and the Vitek MS automatic bacterial identification mass spectrometer was used for strain identification and the Vitek 2 automatic bacterial drug susceptibility analyzer was used for drug susceptibility testing and drug resistance analysis. Results Blood culture specimens were performed on 28 736 patients with suspected bloodstream infection submitted for inspection from January 2018 to December 2019, and a total of 2 181 strains of pathogenic bacteria were detected after removing duplicate strains, with a positive rate of 7.69%, including 1 046 strains of Gram-negative bacteria, accounting for 47.96%. From January 2020 to December 2021, blood culture specimens from 26 083 patients with suspected bloodstream infection were submitted for inspection, and a total of 2 111 strains of pathogenic bacteria were detected after excluding duplicate strains, with a positive rate of 8.09%, including 1 000 strains of Gram-negative bacteria accounted for 47.37%. The drug resistance of Klebsiella pneumoniae was relatively serious, and the sensitivity rate to ertapenem, polymyxin B and tigecycline was more than 90%. The main non-fermentative bacteria Acinetobacter baumannii was more than 50% sensitive to piperacillin/tazobactam, amikacin and polymyxin B. The sensitivity rates of Pseudomonas aeruginosa to piperacillin/tazobactam, ceftazidime, cefepime, amikacin, gentamicin, tobramycin, ciprofloxacin, levofloxacin, piperacillin and meropenem were more than 50%. Conclusions In the two years before and after COVID-19, there are many types of pathogenic bacteria in bloodstream infection, but the distribution do not differ significantly. The pathogens of bloodstream infection are mainly distributed in ICU, hepatobiliary research institute, and nephrology department. Among them, Gram-negative bacteria such as Escherichia coli, Klebsiella pneumoniae and Acinetobacter baumannii are the main ones, and different pathogens showed great differences in drug resistance.
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@# Objective To investigate the drug resistance of Enterobacter cloacae isolated from blood samples in 75 member units of the Bacterial Drug Resistance Monitoring Network in Hebei, 2016- 2021, so as to provide a basis for rational drug use in clinic. Methods WHONET 5.6 software was used to retrospectively analyze drug susceptibility of Enterobacter cloacae isolated from 32 secondary hospitals and 43 tertiary hospitals. SPSS19.0 software was used for statistical analysis. Results After removing the duplicate strains, 1 225 strains of E. cloacae were isolated from blood samples of 75 hospitals during 6 years, including 157 strains from secondary hospitals and 1 068 strains from tertiary hospitals. In this study, the resistance of Enterobacter cloacae to 16 kinds of antibiotics was analyzed. The drug resistance rates to cefuroxime (52.4%-67.8%), piperacillin (27.4%-31.2%), ceftazidime (27.8%-35.5%), ceftriaxone (29.5%-45.0%), aztreonam (22.2%-32.3%), cotrimoxazole (21.6%-28.7%) were higher; the resistance rates to amikacin and tobramycin were lower than 15.0%. The resistance rates to imipenem and meropenem were 3.6%-12.3% and 5.1%-11.4%, respectively. The resistance rate to ciprofloxacin in tertiary hospitals was 22.4%, and the resistance rate to cotrimoxazole was 23.9%. Except for these two antimicrobials, the resistance rates to other antimicrobial drugs in tertiary hospitals were higher than that in secondary hospitals. A total of 121 carbapenem-resistant Enterobacter cloacae strains were detected in the past 6 years, with an increasing detection rate (χ2trend=6.305, P=0.012). Conclusions Enterobacter cloacae has great differences in antimicrobial resistance to different antibiotics, and is sensitive to carbapenems. The drug resistance in tertiary hospitals is generally higher than that in secondary hospitals. Drug resistance monitoring and drug resistance mechanism research should be strengthened to better guide clinical drug use and curb the rise of drug resistance.
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@#Abstract: Objective In order to provide reference for emergency treatment of a sudden food poisoning incident, pathogen detection and drug resistance analysis were carried out. Methods Diarrheal stool and surplus food samples were detected by GB 4789 and the isolates were identified by VITEK2 and matrix assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS), at the same time, the bacterial drug sensitivity test was carried out by using the method of microbroth dilution, and the isolates from different sources were molecularly classified by pulsed field gel electrophoresis (PFGE), and the correlation between the strains was analyzed by BioNumerics software. Results Totaly 13 leftovers and 3 diarrhea patients were isolated and identified, The total number of colonies and coliforms in 7 leftovers samples all exceeded the standard, and Citrobacter freundii was detected in 5 leftovers and 2 stools. The results of drug sensitivity test showed that seven strains of Citrobacter freundii were sensitive to ciprofloxacin, tetracycline, chloramphenicol, gentamicin, amikacin, cefotaxime and meropenem, but completely resistant to ampicillin, and there was no multiple drug resistance. The results of pulsed field gel electrophoresis (PFGE) showed that 7 strains of Citrobacter freundii had the same PFGE bands and 100% homology, showing the same clone. Conclusions This food poisoning incident was caused by Citrobacter freundii. The pathogen of food poisoning can be quickly and accurately determined by MALDI-TOF MS, which is beneficial to the early diagnosis and treatment of infectious diseases. It is suggested to strengthen the corresponding management, improve food safety awareness and prevent similar incidents.
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@#Abstract: Objective To investigate the clinical distribution characteristics, drug resistance trends and the carrying of antiseptic resistance gene of Pseudomonas aeruginosa infection in children in Suzhou, in order to provide theoretical basis for the prevention and treatment of Pseudomonas aeruginosa infection in children. Methods The clinical distribution characteristics and drug resistance trends of Pseudomonas aeruginosa isolated from Children's Hospital of Soochow University from 2016 to 2021 were retrospectively analyzed. Forthermore, 101 strains of Pseudomonas aeruginosa were randomly selected to detect the expression of 9 antiseptic resistance genes (qacEΔ1-sul1, qacE, qacEΔ1, qacG, sugE(p), sugE©, emrE, ydgE, ydgF) by polymerase chain reaction. Results Pseudomonas aeruginosa in Soochow University Children's Hospital was mainly isolated from respiratory specimen (47.83%), pus (28.60%) and urine (11.72%); the main departments were intensive care unit(21.45%), general surgery department (15.71%) and respiratory department (12.31%). Patients were mainly aged from 1 month to 1 year old and older than 6 years old (34.31% and 25.38%). The top three drug resistance rates of Pseudomonas aeruginosa were imipenem (11.25%), aztreonam (9.26%) and meropenem (8.02%). Among the 853 strains of Pseudomonas aeruginosa, the drug-resistant strains were mainly from the intensive care unit (58/183), hematology department (33/91), neonatology department (31/96), and there were 57 strains of multi-drug-resistant strains with the detection rate of 6.68%. There were 98 strains (11.49%) of Carbapenem resistant Pseudomonas aeruginosa, and the annual detection rates were 22.06%, 8.40%, 3.60%, 5.67%, 9.85% and 17.20%, respectively. Among the 9 antiseptic resistance genes, the carrying rate of ydgF, sugE© and qacE was 98.02%, 94.06% and 0 respectively. Conclusion Pseudomonas aeruginosa has high resistance to some drugs, so attention should be paid to rational drug use. The carriage rates of of two antiseptic resistance genes exceeded 90%, indicating the need to strengthen research on the mechanism of antiseptic resistance research and rational use of disinfectants
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Objective To analyze the variations and drug resistance of influenza A (H3N2) viruses in Jiangsu Province in 2017, and provide evidence for prevention and control strategies on influenza. Methods Reverse transcription polymerase chain reaction (RT-PCR) was used for the sequencing of H3N2 subtype influenza strains. The influenza reference sequences were obtained from the global shared influenza site GISAID. The sequence alignment and phylogenetic analysis were performed using MAGE7.0 software. Viral resistance was analyzed by a neuraminidase inhibition assay. Results The H3N2 subtype influenza isolates and vaccine strains belonged to the 3C.2a branch of the H3 subtype. Some of the strains showed amino acid mutations on the immune-related sites named N121K, T135K and N171K. The isolates were sensitive to the flu drugs oseltamivir and zanamivir. Conclusion The H3N2 epidemic strains in Jiangsu have genetic recombination within subtypes and are still sensitive to neuraminidase inhibitors. As the H3N2 influenza virus mutations continue, a close monitoring of the viral genetic evolution and the drug resistant genes should be guaranteed.
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Objective To investigate the epidemiological characteristics and drug sensitivity of non-typhoid salmonella in Zhongshan city.Methods We collected the positive cases of non-typhoid salmonella in children of Zhongshan city from 2013 to 2015.The sex,age,place of residence,onset time and main serum type of these cases were collected.The characteristics of the cases were described by descriptive epidemiologi-cal study.Results From 2013 to 2015,3 040 stool specimens from patients with enteritis were collected and 402 strain of non-typhoid salmonella were separated out. The total detection rate was 13.22%,the annual detection rate were 10.26%,12.21% and 16.76%,respectively.The peak period was from July to August every year.Of the 402 children,240 were male,162 were female,and the ratio was 1.48:1.The minimum age was 1 month,the maximum was 5 years and 8 months,the mean age was 13.62 months.All patients were characterized by diarrhea and fever,including 64 cases of bloody stool and 1 case of sepsis.The most com-mon serotypes were 4,5,12:i:-and 4,12:i:-.The resistant strains were salmonella typhimurium and variety salmonella typhimurium strains.From 2013 to 2015,the resistance rate of ceftriaxone and ceftazidime in non-typhoid salmonella isolates increased linearly (ceftriaxone: 17.35%, 26.23%, 39.01%; ceftazidime:12.24%,17.21%,30.77%).The differences were statistically significant(χ2=30.3,P<0.01;χ2=26.3, P<0.01).Conclusion The positive rate of nontyphoid salmonella increased year by year from 2013 to 2015.The most common serotype was salmonella typhimurium, and the resistant strains were salmonella typhimurium and salmonella typhimurium variety.The resistance rate of non-typhoid salmonella to ceftriaxone and ceftazidime increased year by year,and the highest rate of ceftazidime resistance was in July 2015.Non-typhoid salmonella was more resistant to ceftriaxone than ceftazidime.
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Objective To explore the risk factors,the distribution of etiology and drug resistance status of patients with early infection (3 months) after liver transplantation,and to provide reference for clinical diagnosis and treatment.Methods The clinical data of 112 recipients from February 2014 to December 2015 were collected,and logistic regression analysis was performed on the risk factors of early postoperative infection in liver transplant patients.The independent risk factors of infection after liver transplantation were screened out.At the same time,the results of pathogen culture and drug sensitivity test were statistically described.Results The independent risk factors for infection at 3th month after liver transplantation included the operative time ≥600 min [P =0.003,odds ratio (OR) =9.996,95 ％ confidence interval (95 ％ CI),2.221-44.981],intensive care unit (ICU) ≥6 days (P =0.010,OR =6.306,95％ CI =1.563-25.437),Child-Pugh grade of C (P =0.023,OR =6.298,95％ CI =1.294-30.659).Of the 112 liver transplant recipients,59 had an infection (52.68％),and 168 stains of pathogens were isolated.The positive rate of the specimens was highest in sputum,followed by bile,ascites,drainage and catheter end,blood,deep vein catheter,middle urinary,pleural effusion and peripherally inserted central catheter (PICC).The detectable rate of gram-negative bacteria,gram-positive bacteria,fungi and viruses was 46.43％ (78 strains),29.76％ (50 strains),18.45％ (31 strains),and 5.36％ (9 strains) respectively.Infection occurred mainly within 1 month after surgery,accounting for about 80.36％ (135 strains),especially at 1st week after surgery,accounting for about 34.52％ (58 strains).Gram-positive bacteria had a higher drug resistance rate,including penicillins,macrolides,aminoglycosides,quinolones,linamides,etc.especially in the highest rate of Enterococcus faeciurr.Gram-negative bacteria were individualized based on the different strains of the bacteria,and they were relatively low in the resistance of the carbapene.Conclusion Infection is one of the most common complications after liver transplantation.To reduce the incidence of infection after liver transplantation,efforts should be made to shorten the duration of operation and ICU stay time,improve the basic nutritional status of recipients,and enhance monitoring of the recipient's infection after liver transplantation,to further increase the survival rate of postoperative liver transplantation recipients and improve the quality of life.
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Objective To study the drug resistance situation of Mycobacterium tuberculosis strains isolated from the patients with HIV/AIDS complicating tuberculosis (TB).Methods One hundred and ninety-six inpatients with AIDS complicating TB in our hospital from January 2012 to December 2015 were collected.The drug resistance situation of Mycobacterium tuberculosis strains cultured from sputum/tissue fluid/fiber liquid and pathological tissue submitted samples in the patients with AIDS complicating active TB was analyzed.The BACTEC MGIT960 systems was adopted to perform the bacterial identification.The drug sensitivity test was conducted by using 960 culture testing system.Results One hundred and ninety-six strains of Mycobacterium tuberculosis were cultured,the total drug resistance rate of Mycobacterium tuberculosis was 26.02％.These cases were divided into the ＞100/μL and ≤100/μL groups according to different CD4+ T cells count.The drug resistance situation of Mycobacterium tuberculosis to 4 kinds of first line anti-TB drugs were compared between these two groups.The comparison results found that the resistance rate of Mycobacterium tuberculosis strains to the first line anti-TB drugs had no statistical difference between the two groups (P＞0.05).The resistance rates of first line anti-TB drugs from high to low were isoniazid,rifampicin,streptomycin and ethambutol.The drug resistance rate of Mycobacterium tuberculosis strains to 5 types of drug resistant TB had no statistical difference(P＞0.05).Conclusion The drug resistance rate in the initial patients with HIV complicating TB is consistent with the average initial drugresistance level of TB patients in our country.The TB drug resistance rate in the patients with HIV complicating TB has no correlation with CD4+ T cells count.
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Objective To analyse the distribution of main pathogens and drug resistance in a tertiary hospital during 2014 ,and to provide the reference for the clinical rational use of antimicrobial agents .Methods Conventional methods were used for bacterial culture ,VITEK-2 automatic detection system of French BioMerieux company was used for bacteria identifica-tion ,and bacterial resistance analysis ,and WHO NET 5 .5 software was used for data analysis .Results Gram negative bacte-ria accounted for 78 .09% ;Gram positive bacteria accounted for 21 .91% .K lebsiella pneumoniae detection rate was the high-est ,that is 16 .07% ,followed by EscherichiaColi (12 .75% ) ,Bauman Acinetobacter (12 .69% ) and Pseudomonas aeruginosa (10 .91% ) .The resistant rate of methicillin resistant Staphylococcus aureus(MRSA)was 42 .8% (101) ,and the resistant rate of methicillin resistant coagulase negative staphylococci (MRCNS) was 75 .62% (152) .Resistant rates of Staphylococcus au-reus ,both coagulase negative staphylococcus and enterococcus faecalis to vancomycin and linezolid were zero .Resistant rates of enterococcus faecium to vancomycin and linezolid were 5 .5% and zero respectively .Pathogens were detected mainly in emer-gency department ,and the main pathogens were widely distributed .Conclusion Conducting monitoring of bacterial drug re-sistance and grasping the change trend of drug resistance have important significance to guide clinical rational drug use .
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Objective To retrospective analysis the distribution of Staphylococcus aureus infection ,and to study their drug re‐sistance change ,then to provide the basis for clinical anti‐infection treatment .Methods The clinical infection distribution and drug susceptibility test results was tested in 406 strains of Staphylococcus aureus which were isolated from the specimens of 13175 cases from January 2012 to December 2012 ,then analysis these results using statistical methods ;Isolated strains were identified by VITEK 2 Compact type automatic microbial identification and drug susceptibility system ,accompanied with drug sensitive test using Staphylococcus aureus identification and drug susceptibility analysis system test plate of Zhuhai Meihua Medical Technology com‐pany .Results The highest separation rates of Staphylococcus aureus in all clinical departments infection distribution were in de‐partment of pediatrics and neurosurgery .The highest separation rates of all kinds of clinical specimen were sputum and pus .For Staphylococcus aureus ,the lowest resistant rates were in daptomycin and vancomycin ,whose rates were both zero ;the drug resist‐ance of MRSA strains was obviously higher than that of the drug resistance of non‐MRSA strains .The reduced susceptibility to vancomycin in Staphylococcus aureus in screening showed that the drug resistance rate was rising .Conclusion Staphylococcus au‐reus in Sanya kept a good sensitivity of daptomycin and vancomycin ,these two drugs can still be the first choice drug for clinical an‐ti‐infection treatment .
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Objective To investigate the distribution and drug resistance situation of clinical isolated bacteria in our hospital to provide the basis for rational selection of antibacterial drugs in clinic .Methods The pathogenic bacteria isolated from the clinical sepcimens in our hospital from January 2012 to December 2013 were performed the idenitification and drug susceptibility test by a‐dopting the the bioMerieux VITEK‐2 compact automatic bacterial analyzer .The detection results were judged according to the standard of the Clinical and Laboratory Standard Institute (CLSI) .The WHONET5 .6 software was used for conducting the statisti‐cal analysis .Results 2 274 strains were isolated during 2012-2013 ,in which 1986 strains (72 .4% ) were Gram‐negative bacteria , 675 strains(24 .6% )were Gram‐positive bacteria and 94 ccases(3 .0 % ) were fungi .The top 3 of Gram‐negative bacteria were Esch‐erichia coli(694 strains ,25 .3% ) ,Klebsiella pneumoniae (303 strains ,11 .0% ) and Pseudomonas aeruginosa (266 strains ,9 .7 % ) respectivley .The top 3 of Gram‐‐positive bacteria were Staphylococcus aureus (184 strians ,.6 .7% ) ,coagulase negative staphylococ‐cus(146 strains ,5 .3% )and enterococcus faecium (119 strians ,4 .3% ) .The respiratory tract infection ,urinary tract infection and blood infection were predominant .The detection rate of methicillin‐resistant Staphylococcus aureus (MRSA) was 45 .7% ,while which of methicillin‐resistant coagulase negative Staphylococcus (MRCNS) was 84 .6% .MRSA showed the multiple resistance to fluoroquinolones and aminoglycosides antibcatieral drugs ,the resistance rate> 90 .00% ,but resistance rate macrolide antibiotic was<50 .0% ;no vancomycin‐and linezolid‐resistant Staphylococcus was found ;the resistance rate of enterococcus faecium to vancomy‐cin was 1 .7% and no linezolid‐resistant enterococcus faecium was detected .The detection rates of extended‐spectrum β‐lactamase‐producing K .pneumoniae and E .coli were 65 .2% and 39 .9% respectively ,and which of E .coli and K .pneumoniae to imipenem were 0% and 6 .3% respectively .The resistance rate of Acinetobacter baumannii to commonly used antibacterial drugs was more than 50% .The resistant rate of pseudomonas aeruginosa to common antipseudomonal drugs was <40 .0% .Conclusion The drug resistance phenomena of pathogenic bacteria isolated from our hospital is relatively universal ,especially multi‐drug resistant non‐fer‐mentative bacteria ;the enzyme‐producing mechanism leads to increase the detection rate of multi‐antibacterial resistant Enterobacte‐riaceae bacteria ,which causes the enormous difficulty for clinical anti‐infection therapy .Conducting the bacterial drug‐resistance mo‐nitoring has an important significance for guiding clinically rational drug use ,reducing the nosocomial infection rate and controlling the bacterial drug resistance .
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Objective To analyze the clinical distribution and drug resistance of clinically isolated strains of Acinetobacter Bau-mannii(ABA)in our hospital from January 2007 to December 2012 so as to provide the basis for the rational use of antibacterial drugs in clinic.Methods The API microbiological culture and identification system was adopted to conduct the ABA culture,identi-fication and drug susceptibility analysis on the clinical specimens submitted by various clinical department and the drug resistance of the strains was analyzed by using WHONET5.6 software.Results 791 strains of ABA were isolated in the recent 6 years,and the isolating rate of ABA in the pathogenic bacteria was 7.8%;The ABA detection was dominated by the sputum (80.4%)and the throat swab(10.9%)specimens;the distribution of isolated ABA strains were relatively widespread;the infection rates of the pa-tients were higher in ICU (18.8%),cadre wards(17.6%),respiratory medicine department(13.3%)and neurosurgery department (12.3%).During these 6 years,the drug resistance rate of less than 50% included imipenem(IPM)and cefoperazone sodium/sul-bactam,and the resistance rate in most of commonly used antibacterial drugs showed an increasing trend,especially IPM.Conclusion The drug resistance of ABA is more serious and the resistance rate of clinically isolated strains to most of antibacterial drugs in our hospital during 2007- 2012 showed an increasing trend.Dynamically monitoring the ABA distribution and the drug resistance changes conduces to guide the rational use of antibacterial drugs in clinic,prevent the nosocomial infection and reduce the generation of pan-drug resistant strains.
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Objective To understand the distribution of detected pathogens in blood culture specimens in our hospital and the drug resistance to provide the basis for clinical reasonable selection of antibacterial drugs.Methods The blood culture results in our hospital from January 2011 to June 2012 were analyzed retrospectively.Results Among 3 164 blood culture samples,418 cases were positive,accounting for 13.21%,176 strains were Gram-positive bacteria(42.11%),Staphylococcus aureus and coagulase neg-ative staphylococcus were predominant;235 stains were Gram-negative bacteria(56.22%),Escherichia coli and Klebsiella pneumon-iae were predominant;7 stains were Candida(1.67%).The most of submitted specimens were the neonatology department(627 specimens),hematology department (367 specimens),respiratory department (272 specimens),paediatric department (207 speci-mens),neurology department(185 specimens)and ICU(158 specimens).The top departments in the strain separation rate were the hepatobiliary surgery(22.22%),endocrinology(18.18%),spinal surgery(16.36%),ICU(15.96%),neurosurgery(15.62%),neu-rology(15.13%),oncology(13.92%),urological surgery (12.23%),burns and pediatric surgery (12.15%),and bone surgery (10.25%).Among mainly Gram-positive bacteria,Staphylococcus had the high resistance to penicillin,erythromycin,clindamycin and trimethoprim-sulfamethoxazole,coagulase-negative staphylococci had the high resistance to quinoiones,but vancomycin-resistant and linezolid-resistant Staphylococcus was not found.Among Gtam-negative bacilli,Enterobacteriaceae had the strong sensitivity to imipenem,ertapenem and amikacin;Escherichia coli had the higher resistance to penicillins,cephalosporins,aztreonam,quinolones, cotrimoxazole,gentamicin and tobramycin,which was more than 40%,the resistance rate to ampicillin,ampicillin/sulbactam was a-bout 90%,but Escherichia coli was more sensitive to piperacillin / tazobactam,the resistance rate was less than 5%;Klebsiella pneumoniae had the low drug resistance,only the resistance rates to ampicillin and nitrofurantoin were more than 90%,the others were 30 % or less;Enterobacter cloacae had the higher resistance to ampicillin,ampicillin/sulbactam,third generation cephalospo-rins,tobramycin,cefotetan and nitrofurantoin and the low resistance to the fourth generation cephalosporins,piperacillin / tazobac-tam and quinolones.Conclusion The pathogenic bacterial species of blood culture are complex and dominated by the conditional pathogens with strong drug resistance.Therefore,the detection of clinical blood culture specimens in the patients with suspected septicemia should be strengthened for accurately and rationally using antibacterial drugs as early as possible and increasing the cure rate.
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Objective To study the pathogenic bacteria species and drug resistance rate in the intensive care unit(ICU)in county hospital to guide clinical rational use of antibiotics. Methods 263 various specimens were chosen from January 2013 to December 2013 in the ICU of Zigui County People's Hospital in Hubei Province,these were applied to perform the bacterial culture and identification,and disc AGAR diffusion method was used to test the in vitro drug susceptibility and observe the specimens distribution,pathogenic distribution and the rate of drug resistance. Results In the 263 specimens,the top three isolated were 131 sputum(49.8%),49 blood(18.6%) and 38 ascites specimens(14.4%)respectively,and the pleural effusion was the least isolated with 5(1.9%). A total of 125 strains bacteria were isolated with positive detection rate of 47.5%(125/263). In the 125 strains,80(64.0%) were Gram-negative(G-)bacilli at the pioneer position,and the top four were:Klebsiella pneumonia 23(18.4%), Acinetobacter Baumanni 19(15.2%),Escherichia coli 18(14.4%)and Pseudomonas aeruginosa 12 strains(9.6%). There were 33 strains(26.4%)of Gram positive(G+)cocci including mainly Staphylococcus aureus 25 strains(20.0%);fungi strains were 12,the least(9.6%). The drug resistance rates of the top four G- bacillus were as follows:the rate of Klebsiella pneumoniae to ampicillin sodium was the highest(100%),while its rate to imipenem,meropenem and ciprofloxacin was 0;the rates of Acinetobacter baumannii to tobramycin and ceftriaxone were very high(100%, 92.3%),while to imipenem,meropennem were much lower respectively(26.3%,15.4%);the rates of Escherichia coli to ampicillin sodium and piperacillin were relatively high(88.9%,83.3%),while the rates to amikacin,imipenem, meropennem respectively were 0;the rates of Pseudomonas aeruginosa to ceftriaxone,cefotaxime sodium were very high(both 100%),while the resistant rate to levofloxacin was 0. The G+ cocci had no drug-resistance to linezolid, teicoplanin and vancomycin;the rates of Staphylococcus aureus to azithromycin,clindamycin,erythromycin and penicillin were higher than 80%,and those of Excrement enterococcus to erythromycin,gentamycin,levofloxacin were also higher than 80%. Conclusions The ICU infection of our hospital is primarily respiratory tract infection, the pathogenic bacteria are mainly G- bacilli and the antibacterial drug resistance is very serious. Therefore it is necessary to monitor the trend of bacterial resistance closely,and according to the results of bacteria identification and drug susceptibility,the antimicrobial agents are reasonably chosen to effectively reduce and control the ICU hospital infection.
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OBJECTIVE To investigate the distribution of 2916 strains and analyze the antimicrobial susceptibility of major pathogens and to provide evidences for clinical therapy.METHODS The distribution,and the antimicrobial susceptibility of pathogens,which were collected and isolated from all of the clinical specimens from Jan 2007 to Oct 2008 in our hospital,were studied restrospectively.RESULTS Totally 2916 strains(except fungi) of pathogens were isolated from patients,among which 1857 strains were Gram-negative bacteria(63.7%) and 1056 strains were Gram-positive cocci(36.2%).The five common bacteria isolated from the specimens were Escherichia coli(14.3%),Klebsiella pneumoniae(11.8%),Pseudomonas aeruginosa(10.7%),Staphylococcus aureus(10.5%),and Acinetobacter baumanii(8.7%).The ESBLs producing E.coli and K.pneumoniae accounted for 31.4% and 33.7%,respectively;meticillin-resistant S.aureus(MRSA) accounted for 53.3% and meticillin-resistant coagulase-negative staphylococci(MRCNS) accounted for 49.6%;vancomycin-resistant S.aureus was not isolated Gram-negative bacilli had the lowest resistance to carbapenems,and then to piperacillin/tazobactam(TZP) and cefoperazone/sulbactam(CFS),showing multi-resistantce.Gram-positive cocci were more sensitive to vancomycin,rifampicin,nitrofurantoin than to other antibacterials.CONCLUSIONS The drug resistance of the isolated bacteria is common.It is very important to monitor the drug resistance of the bacteria regularly,for guiding the clinic use of antibiotics rationally,and infection control.
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OBJECTIVE To study the frequency of fungal infection and its drug resistance in tumor patients, and to provide the reference for clinical treatment. METHODS From Aug 2006 to Jul 2008, the drug sensitivity test and pathogen distribution of 960 patients in our hospital were retrospectively analyzed. RESULTS A total of 308 fungal strains were detected from 960 patients (32.1%). Candida albicans infection rate reached 73.1%, and C. krusei and C. glabrata were 13.3% and 9.1%, respectively. Drug sensitivity showed that the drug resistance of C. albicans to ECC, KET and MIC was 43.9%, 34.2 and 27.1%, respectively, and that of the C. krusei to the ECC, KET and MIC were 53.3%, 42.2% and 48.8%, respectively, while their fungal infection was depressed by AMB, NYS and 5-FC. CONCLUSIONS C. albicans is the major fungus in patients of tumor hospital, and the infection rate of C. krusei and C. glabrata is also high. Clinical doctors should control the distribution and drug resistance of fungal infection in therapeutic process for a reasonable antibiotics usage.
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OBJECTIVE: To analyze the drug resistance of common pathogenic bacteria in our hospital.METHODS: A retrospective analysis was conducted on the pathogenic bacteria clinically isolated in 2006.RESULTS: Of the total 1 723 clinical isolated strains,77.9% were gram negative bacteria.Leading the first 6 places on the list of common clinical pathogenic bacteria were Escherichia coli,klebsiella pneumoniae,pseudomonas aeruginosa,acinetobacter baumannii,enterobacter cloacae,and staphylococcus aureus.CONCLUSION: Drug resistance is a very severe problem faced by the clinic.It is urgent to carry out monitoring of bacterial resistance and rational use of antibacterials.