Survey on the Inpatient’s Antibiogram Affected by Sampling Day Difference / 医薬品情報学

Objective: Antibiogram preparation is important for the proper selection of antimicrobial agent in empiric therapy. It is recommended to prepare the antibiogram separately for inpatients and outpatients. However, the antimicrobial agent susceptibility of bacteria detected from an inpatient is thought to be different when detected at an early date after admission and after a certain period after admission.Methods: In this study, we defined the bacteria detected from an inpatient within 3 days after admission as “brought bacteria” and those over 3 days after admission as “bacteria detected after admission.” Antimicrobial agent susceptibilities of brought bacteria and bacteria detected after admission in our hospital between April 2018 and March 2019 were compared for Escherichia coli, Klebsiella pneumoniae, and Pseudomonas aeruginosa.Results: The occurrence rate of Escherichia coli producing an extended β-lactamase of bacteria detected after admission was found to be significantly higher compared with that of brought bacteria. The sulbactam/ampicillin susceptibility rate of bacteria detected after admission was significantly lower than that of brought bacteria. The occurrence rate of the two drug-resistant Pseudomonas aeruginosa detected after admission tends to be higher compared with that of brought bacteria.Conclusion: Our findings showed that the susceptibility rate of some drugs differed substantially between brought bacteria and bacteria detected after admission. Therefore, the inpatient’s antibiogram is thought to be prepared by separating bacteria detected at an early date after admission and after a certain period after admission, leading to the proper selection of antimicrobial agent in empiric therapy tailored to a patient’s number of days in the hospital.

Cross⁃sectional study of nosocomial infection among inpatients in a tertiary hospital in Chengdu， 2020 / 上海预防医学

Objective To investigate the prevalence of nosocomial infection among inpatients in a tertiary hospital， and provide scientific evidence for hospital infection control and targeted surveillance. Methods A cross-sectional survey was conducted to investigate a total of 543 hospitalized patients using the hospital information system. Results The prevalence of hospital-acquired infection （HAI） was 4.24%， and that of community-acquired infection （CAI） was 23.39%. HAI prevalence differed significantly among the departments （ χ 2=148.870， P <0.05）， and was highest in the department of intensive care medicine （72.73%）. Sites of infection were significantly different between HAI and CAI （ χ 2=22.942， P =0.011）； however， the most frequent site of infection was lower respiratory tract in both HAI and CAI. Major pathogens for nosocomial infection were Gram-negative bacteria （56.92%）， mainly Escherichia coli and Klebsiella pneumoniae . Antimicrobial usage was observed in 31.68% of the patients， principally for therapeutic use of antibacterial drugs （80.23%） and a combination of drugs （88.95%）. Examination rate of pathogens following the antimicrobial usage was 72.08%. Conclusion The investigation on the prevalence of nosocomial infection may facilitate fully understanding the nosocomial infection. It warrants strengthening the monitoring in the departments of intensive care medicine and on multi-resistant bacteria， and achieving antimicrobial stewardship， so as to improve the awareness of hospital infection control in medical staff' and effectively reduce the occurrence of nosocomial infection.

Cross⁃sectional study of nosocomial infection among inpatients in a tertiary hospital in Chengdu， 2020 / 上海预防医学

Objective To investigate the prevalence of nosocomial infection among inpatients in a tertiary hospital， and provide scientific evidence for hospital infection control and targeted surveillance. Methods A cross-sectional survey was conducted to investigate a total of 543 hospitalized patients using the hospital information system. Results The prevalence of hospital-acquired infection （HAI） was 4.24%， and that of community-acquired infection （CAI） was 23.39%. HAI prevalence differed significantly among the departments （ χ 2=148.870， P <0.05）， and was highest in the department of intensive care medicine （72.73%）. Sites of infection were significantly different between HAI and CAI （ χ 2=22.942， P =0.011）； however， the most frequent site of infection was lower respiratory tract in both HAI and CAI. Major pathogens for nosocomial infection were Gram-negative bacteria （56.92%）， mainly Escherichia coli and Klebsiella pneumoniae . Antimicrobial usage was observed in 31.68% of the patients， principally for therapeutic use of antibacterial drugs （80.23%） and a combination of drugs （88.95%）. Examination rate of pathogens following the antimicrobial usage was 72.08%. Conclusion The investigation on the prevalence of nosocomial infection may facilitate fully understanding the nosocomial infection. It warrants strengthening the monitoring in the departments of intensive care medicine and on multi-resistant bacteria， and achieving antimicrobial stewardship， so as to improve the awareness of hospital infection control in medical staff' and effectively reduce the occurrence of nosocomial infection.

Study of the scientific production of the antibacterial activity of the chemical compounds of the essential oil of Lippia sidoides / Estudo da produção científica da atividade antibacteriana dos componentes químicos do óleo essencial de Lippia sidoides

Lippia sidoides Cham. has widespread use in folk medicine because its essential oil (EO) presents great antibacterial properties. In Brazil, this plant has been introduced in governmental programs for herbal medicine, due to its recognized therapeutic activities. This promoted greater interest in the search for new molecules with antimicrobial activity in this EO which have been described by several authors. Thus, this work aimed to present a study of the scientific production of antibacterial activity of the chemical compounds from L. sidoides essential oil (LSEO). The inclusion criteria were articles which assessed the chemical components and antibacterial activity through the inhibition diameter, Minimum Inhibitory Concentration (MIC), and Minimal Bactericidal Concentration (MBC), published between 2000 and 2020. Of the 996 studies identified, 55 met the inclusion criteria. In descending order, the most frequently detected chemical components found in LSEO were: thymol, p-cymene, and caryophillene. Regarding to the origin, the results showed that the extraction of EO were carried out mainly in the Northeast (55.5%) and Southeast (19%) regions of Brazil; and the part of the plant most used for the production were the leaves. In addition, the essential oil showed strong antibacterial activity against most of the bacteria tested.(AU)

Lippia sidoides Cham. é amplamente utilizada na medicina popular devido às propriedades antibacterianas atribuídas ao seu óleo essencial (OE). No Brasil, esta planta tem sido introduzida em programas governamentais de fitoterapia, por causa de suas atividades terapêuticas. Isso promoveu um maior interesse na busca por novas moléculas com atividade antimicrobiana presentes neste óleo, as quais foram relatadas por diversos autores. Assim, este trabalho objetivou apresentar um estudo da produção científica da atividade antibacteriana dos compostos químicos do OE da L. sidoide. Para tanto, foram utilizados artigos que abordaram os componentes químicos e atividade antibacteriana por meio de dados de diâmetro de inibição, Concentração Inibitória Mínima (CIM) e Concentração Bactericida Mínima (CBM), publicados entre 2000 e 2020. De um total de 996 estudos identificados, 55 preencheram os critérios de inclusão. Em ordem decrescente, os componentes químicos mais comumente encontrados no OE da L. sidoide foram: timol, p-cimeno e cariofileno. Com relação à origem, os resultados mostraram que a extração do OE foi realizada principalmente nas regiões Nordeste (55,5%) e Sudeste (19%) do Brasil; e a parte da planta mais utilizada para a produção foram as folhas. Além disso, o OE apresentou uma forte atividade antibacteriana contra a maioria das bactérias testadas. (AU)

Review of studies on Bulbine natalensis Baker (Asphodelaceae): Ethnobotanical uses, biological and chemical properties

Bulbine natalensis Baker is a native succulent herb that belongs to the family Asphodelaceae, and is regarded asprecious, highly valued, and extensively used throughout the continent for medicinal purposes and in treating maleimpotency due to the aphrodisiac and invigorating effect. This study reviews the status of B. natalensis ethnobotanicaluses, biological and chemical properties. This review was conducted from April 2019 to February 2020 by applyingthe mixed-method review approach, and in the framework of a complete description of B. natalensis species, dataon morphology, distribution, and economic importance were discussed. Pharmacological screening reported thatB. natalensis possesses anti-inflammatory and broad-spectrum antimicrobial properties. The bulbous plant vapourcontains substances such as tannins, anthraquinones, cardiac glycosides, saponins, and alkaloids. Scientific evaluationsfrom various researchers have substantiated the use of B. natalensis in the enhancement of male sexual disorders, cureof wounds, rashes, itches, ringworm, diabetes, rheumatism, cracked lips and herpes, diarrhea, and paroxysms amongother diseases.

Effect of Chitosan Addition in Whey-based Biodegradable Films

Abstract Whey, a by-product of dairy industry, is a feedstock widely employed in the production of biodegradable films. However, these films present some limitations when considering the performance of synthetic polymers, especially biological transformation by decomposition. This work aimed to evaluate the effects of chitosan addition to whey-based films to improve films physical-chemical properties and resistance to microbial degradation. The results showed that there was an interaction effect between the chitosan concentration and the storage time for the physical-chemical properties of elongation at break and opacity. There was statistical difference among the formulations; however, for the moisture content and film thickness, there was no interaction effect between the formulation and the storage time. The films with 1.5 and 3.0 wt.% chitosan presented a yellowish hue, characteristic of the polysaccharide; this could also be detected by SEM analysis. The films presented an excellent biodegradability, being decomposed in about 8 days. Considering all chitosan contents tested had similar performances, the chitosan content of 0.15 wt.% was the one with the better cost-benefit relation.

Evaluation of triclosan toxic effects on the methanogenic activity

BACKGROUND: Triclosan (TCS) is an antimicrobial agent widely used in health care and consumer products. This compound is present in sludge of wastewater treatment plants (WWTPs), and because of its bactericidal characteristics, it can inhibit the methanogenic activity in anaerobic digestion (AD) technology. The aim of this study was to evaluate the toxic effects of TCS on the methanogenic activity. RESULTS: Batch anaerobic reactors were used with TCS concentrations of 7.8, 15.7, 23.5, and 31.4 mg/L. These assays consisted in three successive feedings (I, II, and III), wherein the sludge was exposed to each TCS concentration and volatile fatty acid (VFA) substrate. For evaluation of the residual sludge activity during feeding III, only VFA was used. The results showed that the increase in TCS concentrations correlated with the reduction in methane (CH4) production. In this case, the minimum values were achieved for TCS concentration of 31.4 mg/L with CH4 levels between 101.9 and 245.3 during feedings I, II, and III. Regarding the effect of TCS on VFA consumption, an inhibitory effect was detected for TCS concentrations of 23.5 and 31.4 mg/L, with concentrations of acetic, butyric, and propionic acids at the end of the assay (37 d) between 153.6 and 206.8, 62.5 and 60.1, and 93.4 and 110 mg/L, respectively. Regarding the removal of TCS during AD, these values were above 47%. Conclusion: TCS is an inhibitor of methanogenic activity with a decrease between 63 and 70% during the different feedings. The CH4 production was not recovered during feeding III, with inhibition percentages of 21­72%.

How to deal with severe challenge of healthcare-associated infection due to multidrug-resistant organisms / 中国感染控制杂志

In recent years, with the widespread use of broad-spectrum antimicrobial agents, multidrug-resistant organisms (MDROs) have emerged and become more and more common, such as methicillin-resistant Staphylococcus aureus (MRSA) and carbapenem-resistant Enterobacteriaceae (CRE), which pose severe challenge to clinical anti-infective treatment and prevention and control of healthcare-associated infection. The new antimicrobial agents and bacterial resistance have developed at the same time, development of bacterial resistance seems to have a tendency to overwhelm the development of antimicrobial agents. Antimicrobial resistance (AMR) is now recognized as one of the major threat to human health worldwide. The Center for Disease Control and Prevention (CDC) of America has proposed four core plans to address the challenge of MDROs: surveillance, antimicrobial management, improvement of antimicrobial agents and diagnosis, as well as prevention and control of transmission. In response to the severe threat of MDRO infection, prevention of infection should be focused on, antimicrobial management and HAI management should be grasped at the same time and attached sufficient importance, effective measures should be taken based on the source, route, and susceptible people of infection, multiple details and constant innovation should be paid attention to, the final victory can be achieved.

Healthcare-associated infection and community-acquired infection: Cross-sectional survey of 37 hospitals in Tangshan / 实用医学杂志

Objective To understand the status and the risk factors of healthcare-associated infection (HAI) and community-acquired infection (CAI) , and to provide guidance and basis for prevention and control of nosocomial infections. Methods We investigated and analyzed HAI and CAI of 37 hospitals by the cross-sectional survey method. Results 16 650 patients were investigated, the HAI occurred in 171 and 267 ases with the prevalence rate of 1.54％ and 5.24％ in the second-class and the third-class hospitals. The CAI occurred in 1 889 and 831 cases with the prevalence rate of 17.04％ and 16.31％. HAI prevalence rate in the third-class hospitals was higher than the second-class hospitals, while there was no difference in the rate of CAI. There was statistical significance in constituent of infection sites in different levels of hospitals. There was no difference in community infection. A total of 148 pathogens were isolated from patients with HAI, and the top four bacteria were Pseudomonas aeruginosa, Escherichia coli, Klebsiella pneumonia, Acinetobacter baumannii. The detection rate of multidrug-resistant bacteria were 26.32％ and 31.82％ respectively in the second-class and the third-class hospitals. The utilization rates of antimicrobial agents in the second-class and the third-class hospitals were 42.97％ and 31.82％ respectively. Pathogen detection rate in third-class hospitals was higher than that of the second-class hospitals (47.10％, 32.76％) , and the difference was statistically significant. The survey was found that the use of catheters, urinary tract catheters, ventilators and immunosuppressive agents were risk factors in hospital infection. Conclusion Hospitals should strengthen the monitoring of hospital infection and take various measures to control the rate of hospital infection.

Studies on Green Synthesis of Copper Nanoparticles Using Punica granatum

Aim: The present study aimed at green synthesis of copper nanoparticles using various plant extracts as reducing and stabilizing agents. It would also study the antibacterial effect of the synthesized copper nanoparticles. Place and Duration of Study: Department of Microbiology, Bhavan’s Vivekananda college of Science, Humanities and Commerce, Hyderabad, India. The duration of the study is for six months between May 2017 to October 2017. Methodology: The aqueous solutions of different plant extracts were mixed with CuSO4 solution and incubated for green synthesis of stable copper nanoparticles. These were tested by UV-Visible spectroscopy and SEM analysis. Antibacterial tests of the biosynthesized nanoparticles were carried out on Gram-positive Bacteria Staphylococcus aureus by Agar well assay. Results: The aqueous solutions of different plant extracts yielded stable copper nanoparticles as indicated by the O.D values tested using UV-Visible spectroscopy. The best plant extract that yielded higher amount of copper nanoparticles was fruit rind extract of Punica granatum. The synthesized nanoparticles were found to be 56-59 nm, characterized by Scanning Electron Microscopy (SEM). The synthesized copper nanoparticles exhibited a strong antibacterial activity against Staphylococcus aureus. Conclusion: The copper nanoparticles can be green synthesized using fruit rind extract of Punica granatum and these can be used as efficient antimicrobial agents against Staphylococcus aureus and the study is significant currently as drug resistant infections of Staphylococcus aureus are gaining much prevalence and prominence.

Research Advancement on The Economic Impact of Antimicrobial Resistance / 中国药学杂志

Antimicrobial resistance (AMR) has become one of the largest concern globally, as well as the growing global health threat. By literature reviewing, this paper summarized and listed the studies in terms of economic impact of AMR both domestically and internationally, and introduced the research advancement on the economic impact of AMR from the perspective of estimating AMR burden in order to provide literature evidence for conducting AMR burden related research in China in the future. AMR increases the clinical burden through affecting the clinical endpoint, thus causes economic burden under different perspectives. Compared with studies conducted in other countries, China is lack of high-quality, multicenter and longitude studies with long time span. Since AMR will cause enormous economic and clinical burden, estimating the economic impact of AMR is a fundamental basis for rationally allocating medical resources.

Surveillance of antibiotic resistance in the clinical isolates in Xinhua Hospital Chongming Branch, Shanghai Jiaotong University School of Medicine from 2015 to 2017 / 中国感染与化疗杂志

Objective To investigate antimicrobial susceptibility profile of clinical isolates in Xinhua Hospital Chongming Branch affiliated to Shanghai Jiaotong University School of Medicine for rational use of antibiotics. Methods WHONET 5.6 software was used to analyze the distribution and susceptibility testing data of clinical isolates. Results A total of 5 278 bacterial isolates were collected from 2015 to 2017. The top three bacterial species were Escherichia coli, Klebsiella pneumoniae, and Pseudomonas aeruginosa, accounting for 24.8％, 16.1％ and 8.4％, respectively. The prevalence of major antibiotic-resistant bacteria was increasing. The prevealence of carbapenem-resistant Enterobacteriaceae (CRE) was 0.8％, 3.5％ and 7.0％ in the 3 years. The prevalence of MRSA was 32.4％, 41.9％, and 51.3％, respectively. The prevalence of the Acinetobacter strains resistant to antibiotics, especially to imipenem and meropenem, increased from 20.3％ to 64.6％. No vancomycin-or linezolid-resistant isolates were found in gram-positive bacteria. Conclusions The clinical bacterial isolates show increasing resistance to most antibiotics during the 3-year period in this secondary care general hospital. Especially, carbapenem-resistant Enterobacteriaceae poses a serious threat. Attention should also be paid to surveillance of antimicrobial resistance in secondary care general hospital.

Surveillance of antimicrobial resistance in Peking Union Medical College Hospital in 2017 / 中国感染与化疗杂志

Objective To investigate the antimicrobial resistance of clinical bacterial isolates in Peking Union Medical College Hospital (PUMCH) in 2017. Methods A total of 9 515 non-duplicate clinical isolates were collected from January 1 to December 31, 2017. Disc diffusion test (Kirby-Bauer method) and E-test method were employed to determine antimicrobial susceptibility. Results Gram-negative bacilli and gram-positive cocci accounted for 68.2％ and 31.8％, respectively among the 9 515 clinical isolates. Methicillin-resistant strains in S. aureus (MRSA) and coagulase-negative Staphylococcus (MRCNS) accounted for 25.6％ and 73.3％, respectively. Extended-spectrum β-lactamases (ESBLs) -producing strains accounted for 47.6％ (877/1 842), 27.6％ (335/1 213) and 33.0％ (59/179) in E. coli, Klebsiella spp (K. pneumoniae and K. oxytoca) and P. mirabilis, respectively. Enterbacteriaceae strains were still highly susceptible to carbapenems, with an overall resistance rate of ≤ 3.8％. The resistance rates of K. pneumoniae to imipenem and meropenem were 8.5％ and 8.2％, respectively. About 72.7％ and 70.4％ of A. baumannii isolateswere resistant to imipenem and meropenem. The resistance rate of P. aeruginosa to imipenem and meropenem was 14.8％ and 10.0％, respectively. The prevalence of extensively drug-resistant strains in A. baumannii, P. aeruginosa and K. pneumoniae was 31.7％ (239/753), 1.0％ (10/1 035), and 3.0％ (33/1 117), respectively. Conclusions The common bacterialisolates show various level of resistance to antimicrobial agents. Laboratory staff should improve communication with clinicians to prevent the spread of resistant strains.

Surveillance report of antimicrobial resistance in the clinical isolates from the First Affiliated Hospital of Anhui Medical University during 2016 / 中国感染与化疗杂志

Objective To report the distribution and antibiotic resistance of bacterial strains isolated in the First Affiliated Hospital of Anhui Medical University during 2016 for improving clinical treatment of bacterial infections. Methods Antimicrobial susceptibility testing was carried out according to a unified protocol using Kirby-Bauer method or automated systems. The results were interpreted according to the clinical and laboratory standards institute (CLSI) 2015 breakpoints, and analyzed using WHONWT 5.6. Results A total of 5 406 clinical isolates were collected during 2016, of which gram positive organisms accounted for 25.6％ (1 386/5 406) and gram negative organisms 74.4％ (4 020/5 406). The strains were mainly isolated from respiratory tract (35.4％, 1 913/5 406) and urine (26.7％, 1 441/5 406). The most frequently isolated microorganisms were E. coli (23.1％, 1 247/5 406), followed by K. pneumoniae (12.1％,654/5 406). The prevalence of MRSA was 52.2％ (166/318). The prevalence of MRCNS was 80.3％ (462/575). Of the ESBLs producers, E. coli accounted for 59.7％ (745/1 247), and K. pneumoniae accounted for 30.6％(200/654). ESBLs-producing strains showed significantly higher resistance rates to most antibiotics than non-ESBLs-producing strains. All the E. faecalis strains were susceptible to vancomycin. A few (0.2％) of the E. faecium strains were resistant to vancomycin, which were all from urine specimens. A total of 1 046 (19.3％, 1 046/5 406) carbapenemresistant strains were isolated. Most Enterobacteriaceae isolates were still highly sensitive to carbapenems. Carbapenem-resistant isolates were mainly A. baumannii (41.1％, 430/1 046), P. aeruginosa (17.4％, 182/1 046)) and K. pneumoniae (12.0％, 126/1 046). Most Acinetobacter strains were resistant to most of the antibiotics tested. Conclusions Antimicrobial resistance is increasing in the clinical isolates in this hospital. We should continue to strengthen antimicrobial stewardship, prescribe antibiotics for strict indications, and improve rational antibiotic use.

Potential of Calcium Carbonate Nanoparticles for Therapeutic Applications

@#The application of nanoparticles (NPs) has attracted considerable attention as targeted delivery systems. CaCO3 has become the focus due to its advantages including affordability, low toxicity, biocompatibility, cytocompatibility, pH sensitivity and sedate biodegradability and environment friendly materials. In this article, we will discuss the potential roles of CaCO3-NPs in three major therapeutic applications; as antimicrobial, for drug delivery, and as gene delivery nanocarrier.

Consideration for the Common Problems of the Preclinical Part in Medical Devices including Antimicrobial Agents Registration / 中国医疗器械杂志

This article summarizes and analyzes the common problems of the preclinical part in medical devices including antimicrobial agents registration. It is hoped to be helpful for researchers and manufacturers in the registration of medical devices including antimicrobial agents.

Surveillance of antimicrobial resistance in Dongguan Tungwah Hospital during 2016 / 中国感染与化疗杂志

Objective To investigate the antimicrobial resistance profile of clinical isolates in Dongguan Tungwah Hospital during 2016.Methods Antimicrobial susceptibility testing was carded out for the clinical isolates collected from Dongguan Tungwah Hospital according to a unified protocol using Kirby-Bauer method or automated systems.Result were analyzed according to CLSI 2016 breakpoints.Results Of the 3 482 clinical isolates,gram positive cocci and gram negative bacilli accounted for 34.4％ (1 199/3 482) and 65.6％ (2 283/3 482),respectively.The prevalence of methicillin-resistant strains was in 28.7％ (86/300) in S.aureus and 77.7％ (300/386) in coagulase-negative Staphylococcus isolates.No staphylococcal strains were found resistant to vancomycin or linezolid.Overall,one E.faecium strain was identified as resistant to vancomycin by instrument method and confirmed by vancomycin E test.The prevalence of ESBLs-producing strains was 59.6％ (337/565) in E.coli and 29.8％ (115/386) in Klebsiella spp.(K.pneumoniae and K.oxytoca).Enterobacteriaceae strains were still highly susceptible to carbapenems.Overall,0.4％ and 0.2％ of the Enterobacteriaceae strains were resistant to imipenem and meropenem,respectively.About 38.3％ and 36.9％ of Acinetobacter strains were resistant to imipenem and meropenem,respectively.Conclusions Surveillance of antimicrobial resistance is most important and valuable for understanding the changing resistant pattern in local hospital and rational selection of antimicrobial agents.More attention should be paid to surveillance of antimicrobial resistance to avoid the spread of drug resistant strains.

Implementing antimicrobial management toimprove susceptibility of Pseudom onas aeruginosa to carbapenems / 中国感染控制杂志

Objective To analyze susceptibility of clinically isolated Pseudomonas aeruginosa(PA)to carbape-nems,and observe the effect of classified management of antimicrobial agents on carbapenem susceptibility.Methods PA isolated from Peking University Cancer Hospital between October 2012 and March 2014 were collected,uni-variate analysis and multivariate logistic regression analysis were adopted to study the risk factors for non-suscepti-bility to carbapenems,susceptibility of PA to carbapenems before and after the implementation of classified manage-ment of antimicrobial agents was analyzed.Results A total of 125 strains of PA were isolated,mainly from patients with esophageal cancer(n=30,24.0%)and colorectal cancer(n=29,23.2%);the main specimens were drainage fluid and wound secretion(n=62,49.6%);the main source departments were surgical wards(n=86,68.8%). Univariate analysis showed that non-susceptibility of PA to carbapenems was related to strains from surgical wards,hospitalization within 3 months,carbapenem exposure,and length of hospital stay>4 weeks. Logistic regression analysis showed that 3 independent risk factors were:strains from surgical wards,exposure to carbapenems,and length of hospital stay>4 weeks. Susceptibility of PA to carbapenems after implementation of antimicrobial man-agement was 74.6%,which was higher than 53.4% before management(P= 0.015).Conclusion Strains from surgical wards,carbapenem exposure,and length of hospital stay>4 weeks are independent risk factors for no-sus-ceptibility of PA to carbapenems;susceptibility of PA to carbapenems is increased after strict implementation of antimicrobial classified management system.

Distribution and antimicrobial resistance of 1 061 pathogenic strains isola-ted from blood specimens / 中国感染控制杂志

Objective To investigate the distribution and antimicrobial resistance of pathogens isolated from blood specimen,and provide laboratory basis for clinical treatment of bloodstream infection. Methods Pathogens isolated from blood specimen in a hospital laboratory from January 1,2015 to December 31,2016 were identified and per-formed antimicrobial susceptibility testing.Results A total of 1 061 pathogenic strains were isolated from blood speci-men,of which gram-negative bacillus,gram-positive coccus,and fungus accounted for 53.35%(n= 566),36.10%(n=383),and 10.55%(n= 112)respectively,the major gram-negative bacillus,gram-positive coccus,and fungus were Escherichia coli(E.coli)and Klebsiella pneumoniae(K.pneumoniae),coagulase-negative Staphylococcus,and Candida parapsilosis respectively. Strains were mainly isolated from intensive care unit(ICU,n= 308,29.03%),followed by hematology department and pediatric internal medicine department. Resistance rates of E.coli and K. pneumoniae to imipenem were 2.65% and 40.12% respectively.Extended-spectrum beta-lactamase(ESBL)-produ-cing E.coli and K.pneumoniae accounted for 62.96% and 33.14% respectively. Linezolid- and vancomycmin-re-sistant Staphylococcusspp. Were not found,isolation rates of methicillin-resistant coagulase-negative Staphylococ-cus and methicillin-resistant Staphylococcus aureus were 83.61% and 45.45% respectively,one vancomycin-resis-tant Enterococcus faeciu m and one linezolid-resistant Enterococcus faecium were isolated respectively.Conclusion There are multiple species of pathogens isolated from blood specimen,distribution and antimicrobial resistance of pathogens casing bloodstream infection should be monitored regularly to guide the empiric antimicrobial therapy.

Clinical distribution and heterogeneity of antimicrobial resistance of Pseudomonas aeruginosa / 中国感染控制杂志

Objective To understand clinical distribution and antimicrobial resistance characteristics of Pseudomonas aeruginosa(P.aeruginosa)isolated from hospitalized patients, so as to provide reference for the empiric use of antimicrobial agents and control of healthcare-associated infection(HAI).Methods Clinical distribution and antimicrobial susceptibility testing results of P.aeruginosaisolated from patients in a hospital between 2012 and 2016 were analyzed retrospectively, statistical analysis were conducted based on different wards, specimen types and age groups.Results A total of 2 432 strains of P.aeruginosa were isolated from2012 to 2016, most of which were isolated from intensive care unit(ICU)(n=727, 29.89％), the main specimen was sputum(n=2 064, 84.87％). Resistance rates of P.aeruginosa to other antimicrobial agents except piperacillin/tazobactam in each year from 2012 to 2016 were significantly different(all P＜0.05).Resistance to piperacillin, ceftazidime, cefepime, imipenem, meropenem, levofloxacin, and ciprofloxacin decreased after peaked in2014;resistance rates to amikacin, gentamicin, and tobramycin were all low, showing decreased trend year by year(all P＜0.05).Except resistance rates to cefepime and tobramycin, resistance rates of P.aeruginosafrom sputum specimen were all higher than other specimens(all P＜0.05).Resistance rates of P.aeruginosaisolated from patients aged≥65 years to most antimicrobial agents were significantly higher than those isolated from patients aged＜65 years(all P＜0.05).Except resistance rates to gentamicin and tobramycin, resistance rates of P.aeruginosaisolated from ICU were higher than those isolated from other departments, which were 7.71％-66.02％.Resistance rate of P.aeruginosaisolated from department of surgery were relatively low, which were 1.69％-11.86％.Conclusion Clinical distribution of antimicrobial resistance of P.aeruginosais obviously heterogeneity, empiric antimicrobial use and formulation of HAI monitoring measures should be based on the data of antimicrobial resistance in different wards, different infection sites, and different age.