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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 explore the main pathogenic bacteria and sensitive antibiotics and related factors in bile in patients with acute biliary pancreatitis (ABP).Methods 176 patients with ABP from September2015 to September 2017 were selected as the study subjects.Bile was collected for bacterial culture and antibiotic susceptibility testing.The relationship between different obstruction sites and total bilirubin levels and bacterial detection rates was compared.Results The positive rate of bacterial culture was 68.18％.There were 155 aerobic bacteria and 25 anaerobic bacteria.Among the G-bacteria, E.coli (62.85％) accounted for the largest proportion, Enterococcus (12.26％) accounted for the highest proportion of G+ bacteria, and Bacteroides fragilis (52.00％) accounted for the majority of anaerobes..The sensitivity of G-bacteria to meropenem, cefepime and ciprofloxacin was greater than 80％, which was 96.77％, 91.13％ and 84.68％, respectively.The sensitivity rate of G+ to vancomycin was 100％, and the sensitivity rate to meropenem, tetracycline, and azithromycin was higher than 80％.The positive rate of bacterial culture in high obstruction was significantly higher than that in middle-low obstruction (P＜0.05).The low-level group was significantly higher than the middle-level group and the high-level group (P＜0.05), and the middle-level group was significantly higher than the high-level group (P＜0.05).Conclusion For the early anti-infection treatment of ABP patients, aminoglycosides+third-generation cefquinolones+ metronidazole can be used for treatment.Patients with high obstruction and low TB levels need to strengthen anti-infection treatment.
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Objective To analyze the epidemiology,infection status,risk factors and microbiological characteristics of Trichosporon asahii in urinary tract infection for guidance of selecting the prompt and effective antifungal drugs in clinical therapy.Methods A total of 18 strains of Trichosporon asahii isolated from the patients with urinary tract infection were selected from 2013 to 2016.The isolation and identification of pathogenic bacteria,results of antimicrobial susceptibility test and clinical data were investigated by retrospective epidemiological survey.Results The 5 antifungal drugs,i.e.,5-fluorocytosine,amphotericin B,fluconazole,itraconazole and voriconazole,exhibited favorable antibacterial activity for the 18 strains of Trichosporon asahii with resistance rate of 0,5.6％,0,0 and 0 except itraconazole which showed only 50％ of sensitive rate.The risk factors of Trichosporon asahii infection in urinary system mainly included such as male,basic diseases (100％),long-term use of broad-spectrum antimicrobial agents (100％),indwelling catheter (83.3 ％),application of corticosteroids (50.0％) and immunosuppressive agents (38.9％) as well as a small proportion of granulocytopenia (5.6％).The 16 cases treated with fluconazole were improved,while the other 2 cases died following the treatment with itraconazole or voriconazole for reasons irrelevant to antifungal treatment.Conclusion Trichosporon asahii could cause urinary tract infections with high risk factors including basic diseases,long-term use of broad-spectrum antimicrobial agents,indwelling catheter,etc.The drug of top choice should be fluconazole.The key elements for successful treatment of Trichosporon asahii infection include early diagnosis of pathogens and correct selection of antifungal agents based on sensitivity and resistance tests of drugs.
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Objective To investigate the bacterial vaginosis(BV) and mycoplasma infection status in female patients with infertility.Methods The vaginal discharge samples were collected from 541 female patients with infertility in the gynecological department of the Hainan Provincial People's Hospital from June to December 2013.The BV detection,mycoplasma culture and drug susceptibility test were simultaneously conducted.Results The mycoplasma culture positive rate was 44.5％ (241/541),in which ureaplasma mycoplasma (UU) had the highest detection rate,there were 223 cases ofinfection with the positive rate of 41.2 ％,there were 5 cases of mycoplasma hominis(Mh) infection with the positive rate of 0.9 ％,13 cases were UU + Mh mixed positive with the positive rate of 2.4％.BV infection was in 325 cases with the positive rate of 60.1％ (325/541).Among 241 cases of mycoplasma positive,the BV detection rate was 70.1％ (169/241),while among 300 cases of mycoplasma negative,the BV detection rate was 52.0％ (156/300),the BV detection rate had statistical difference between the mycoplasma positive group and mycoplasma negative group,the difference was statistically significant (P＜0.05).Ofloxacin in fluoroquinolones had the highest drug resistance,the sensitivity was only 7.1％.Josamycin had the lowest drug resistance,accounting for 3.7 ％.Conclusion The female patients with infertility is closely correlated with BV and mycoplasma infection.Therefore BV and mycoplasma census should be strengthened to achieve early diagnosis and early treatment.Mycoplasma drug susceptibility test shows that doxycycline,minocycline and josamycin have the highest sensitivity,which can be used as the first selection drugs for clinical doctor.
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Objective To study the distribution of pathogens,the positive time and drug resistance of pathogenic bacteria by blood culture of adult patients,in order to provide the basis for the early clinical discovery and treatment of bacteremia. Methods 3 537 specimens of adult blood culture were collected from July 2016 to December 2016,then identified the posi-tive bacteria strains,and analysed the antimicrobial susceptibility.Results In 3 537 specimens of adult blood culture,485 positive samples were detected,and the positive rate was 13.7%(485/3 537).Including 203 cases(41.9%)of both aerobic and anaerobic positive bottles,220 cases(45.3%)of aerobic positive bottles,and 62 cases(12.8%)of anaerobic positive bottles.About pathogens,229 specimens were gram-negative bacteria strains,accounting for 47.2%.The great majority of bacteria was E.Coli,Klebsiella pneumoniae,Pseudomonas aeruginosa,and they all showed sensitivity to imipenem.202 specimens were gram-positive bacteria strains,accounting for 41.7%,mainly on Staphylococcus aureus and Staphylococcus epidermidis,they all showed sensitive to vancomycin.54 strains were Fungi,accounting for 11.1%.For analysis of 203 ca-ses of aerobic and anaerobic both positive bottles,the results showed that:there were 121 cases of gram-negative bacteria strains,95(78.5%)specimens anaerobic jar to positive time earlier than aerobic bottle to positive time,26(21.5%)speci-mens aerobic bottle jar to positive time earlier than anaerobic bottles to positive time.78 cases of gram positive bacteria,an-aerobic jar to earlier than aerobic bottle to positive time had 45 strains,accounting for 57.7%.Aerobic bottle to positive time earlier than anaerobic bottles to positive time had 33 strains,accounting for 42.3%.Fungi,a total of 4 strains,50% each. Positive pathogens were mainly distributed in I,emergency surgery,respiratory medicine department.Conclusion Pathogen-ic bacteria isolated from the adult blood culture was given priority to gram-negative bacteria,pathogenic bacteria species and drug susceptibility difference was obviously.Clinicians should be combined with blood culture and drug susceptibility results of use of antimicrobial drugs to patients.
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Objective To guide proper clinical medication through analysing the main pathogen and the drug resistant situation of suppurative otitis media of the local children .Methods Making the bacterial culture and antibiotic susceptibility tests with the ear secretion collected randomly of 133 children with suppurative otitis media .Results Among the 133 cases ,110 pathogenic germs were separated totally ,as the detectable rate was 98 .23% ,and Among them ,56 streptococcus pneumoniae ,26 staphylococcus au‐reus (3 multi‐drug resistant to oxacillin) ,11 streptococcus pyogenes ,4 Haemophilus influenza and 13 others .Streptococcus pneu‐moniae was susceptible of ceftriaxoneo ,cefotaxime ,chloramphenicol ,levofloxacin ,quinupristin/dalfopristin and vancomycin ,while was resistant to clindamycin ,tetracycline ,sulfamethoxazole and erythromycin .11 .54% of the total detectable rate of MRSA in Staphylococcus aureus ,produce to β‐ lactamase detection rate was 84 .61% .Streptococcus pyogenes had a high resistance rate to erythrocin ,while a low rate to the other antimicrobial .Conclusion The main pathogen of the local children suppurative otitis media are Streptococcus pneumonia ,Staphylococcus aureus and Streptococcus pyogenes .The clinicians should use antibiotics reasonably according to the antimicrobial susceptibility results .
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OBJECTIVE:To study the feature of fungus infection and the drug susceptibility for the fungus in our hospital.METHODS:Fungi were cultured and isolated by routine procedure and identified by VITEK microbe automatic system.Drug susceptibility test was performed using Rosco paper disk diffusion and broth dilution method with NCCLS M27-A.RESULTS:519 strains of fungi were all Blastocystis,with Monilia albicans making up 70.3%.Mycostatin showed the highest susceptibility,followed by amphotericin B.Fluconazol and itraconazole showed poor susceptibility.CONCLUSION:The resistant strains to common antifungal drugs experienced an obvious increase in clinical practice;therefore,it is imperative to monitor the drug susceptibility of fungi.
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OBJECTIVE To explore the drug-resistant situation of clinical isolated Escherichia coli in our hospital from Jun to Dec in 2007,the aim is to offer evidence for drug-resistant monitoring and clinical antibiotics usage in our hospital. METHODS All clinical specimens isolated and cultured from patients were identified by using the automatic microorganism analyzer VITEK-2 as well as bacteria's drug susceptibility tests were performed using counterparts panel. RESULTS A total of 352 strains E. coli were isolated. The isolated ratio of extended spectram-?-lactamases (ESBLs) producing E. coli was 66.2% (233/352),no ESBLs producing E. coli was 33.8% (119/352). From them 111 strains E. coli were isolated in sputum and 89 strains were ESBLs producing and 22 strains were no ESBLs producing; 111 strains E. coli were isolated in urine and 62 strains were ESBLs producing and 49 strains were no ESBLs producing. The drug-resistance difference was obvious between them as well as between strains isolated from different sites. Better to select piperacillin/tazobactam,cefotetan,ertapenem,imipenem,amikacin,and nitrofurantoin to cure all isolated E. coli infection.CONCLUSIONS The drug-resistance of ESBLs producing E. coli is severe (66.2%) so that hospital administers should strengthen antibiotics usage management and improve antibiotics rational usage,inorder to decrease occurrance of bacterial resistance.