ABSTRACT
With multi-drug-resistant bacteria being more prevalent over years, diabetic foot complicated with multi-drug-resistant bacteria infection emerges as a significant challenge for clinicians and patients. Diabetic foot is predisposed to multi-drug resistant bacterial infection. Growing body of evidence shows that ulcer type, ulcer grade, ulcer area, history of antibiotics treatment, previous hospitalization history, osteomyelitis, and proliferative retinopathy are risk factors. Among multi-drug-resistant bacteria, methicillin-resistant Staphylococcus aureus and extended-spectrum β-lactamase-producing bacteria are the most common strains. Infection with multiple drug-resistant bacteria contributes to the amputation rate and mortality in patients with diabetic foot ulcers. The aim of this review is to give an update on multi-drug resistant bacteria infection and clinical outcome of diabetic foot, with a goal to improve clinical awareness and management.
ABSTRACT
Objective:To observe the clinical effect of Tanreqing injection combined with western medicine on pneumonia caused by multi-drug resistant bacteria （MDRB） in elderly patients. Method:A total of 140 MDRB-induced pneumonia inpatients with the syndrome of phlegm-heat obstructing lung in the intensive care unit （ICU） of Dalian Hospital of Traditional Chinese Medicine from December 2018 to December 2020 were divided into an observation group （70 cases） and a control group （70 cases）） according to the random number table method. The patients in the control group received conventional treatment by western medicine， and those in the observation group received conventional treatment by western medicine combined with Tanreqing injection. The course of treatment was 7 days. The main efficacy indexes of the two groups before and after treatment were recorded，including the total clinical efficacy of traditional Chinese medicine （TCM） syndrome，total TCM syndrome score，clinical pulmonary infection score （CPIS）， and the clearance rate of MDRB. Secondary efficacy indexes included temperature recovery and cough remission time，procalcitonin （PCT），C-reactive protein （CRP），white blood cell count （WBC），interleukin-6 （IL-6），interleukin-8 （IL-8）， and oxygen partial pressure （PO<sub>2</sub>）. Result:The total effective rates of the observation group and the control group were 90.00% （63/70） and 75.70% （53/70），respectively，and the observation group had superior curative efficacy （<italic>Z</italic>=-2.147，<italic>P</italic><0.05）. After treatment，CPIS and total TCM syndrome scores in both groups decreased compared with those before treatment，and the decrease was more significant in the observation group （<italic>P</italic><0.01）. The clearance rate of MDRB in the observation group was 67.1% （47/70），superior to 48.6% （34/70） in the control group （<italic>χ</italic><sup>2</sup>=4.951，<italic>P</italic><0.05）. The temperature recovery and cough remission time in the observation group was shorter than that in the control group （<italic>P</italic><0.01）. After treatment，the levels of PCT，CRP，WBC，IL-6， and IL-8 in both groups were reduced compared with those before treatment，while the levels of PO<sub>2</sub> increased （<italic>P</italic><0.01）. The improvement of various inflammatory indexes and the PO<sub>2</sub> level in the observation group was better than that in the control group （<italic>P</italic><0.01）. Conclusion:The clinical efficacy of Tanreqing injection combined with western medicine in the treatment of MDRB-induced pneumonia in elderly patients is significant，which can control infection，reduce inflammatory damage，improve the clearance rate of MDRB and PO<sub>2</sub>，and alleviate clinical symptoms. It is worthy of clinical application.
ABSTRACT
The discovery of new antimicrobial agents is necessary due to the emergence of multi-drug bacterialresistance. The aim of this work was to study the direct and indirect antimicrobial activity of a Beninesesample of Cymbopogon giganteus essential oil (EOCG) on multi-drug resistant clinical bacteria, its chemicalcomposition, and its cytotoxicity. Direct antimicrobial activity was tested by determination of minimalinhibitory concentration (MIC), and indirect activity, by determining Fractional Inhibitory ConcentrationIndex using checkerboard [fractional inhibitory concentration indices (FICI); synergy: FICI ≤ 0.5; additivity:0.5 < FICI ≤ 1]. EOCG composition was determined by GC-MS and GC-FID and cytotoxicity was determinedby 3-(4,5-dimethylthiazol-2-yl)-2,5-diphényltetrazolium bromide (MTT) assay. p-Menthane derivatives(54.87%) and limonene (12.07%) were detected as major compounds by GC analysis. Our results confirmedthe direct antimicrobial activity of EOCG, but here on clinical resistant strains (MIC from 0.125% v/v to 0.5%v/v). We also show synergistic effects between EOCG and amoxicillin with FICI ranges of 0.12–0.5 againsttwo Escherichia coli resistant clinical strains, synergistic to additive effects between EOCG and colistin oroxacillin/ampicillin, respectively, against Pseudomonas aeruginosa PA544 and Staphylococcus epidermidisSECN361 (two resistant clinical isolates). Our results also indicate that EOCG had low cytotoxicity(IC50: 67.06 ± 2.694 μg/ml).
ABSTRACT
Liver transplantation is an effective treatment of severe liver disease. However, the pathophysiological changes of patients with severe liver disease are complicated, which significantly increase the difficulty of perioperative management of liver transplantation. Therefore, it is of great significance to strengthen postoperative management of the recipients with severe liver disease after liver transplantation. In this article, the pathophysiological characteristics of severe liver disease, the selection of immunosuppressant after liver transplantation, and the prevention and treatment of infection after liver transplantation in patients with severe liver disease were summarized.
ABSTRACT
Objective To understand the distribution characteristics of clinical multi-drug resistant bacteri-a,provide a scientific evidence for control of infection and rational use of antibiotics.Methods The distribu-tion of multi-drug resistant bacteria in the hospital for three years was analyzed retrospectively.Results There were 19 354 non-repeating strains from 2014 to 2016,and 21.9%(4 234)of the total strains were multi-ple resistant strains.Among them,ESBLs-producing Escherichia coli was the most,followed by carbapene-re-sistant Acinetobacter baumannii(MDR-AB),ESBLs-producing Klebsiella pneumoniae,multidrug-resistant Pseudomonas aeruginosa(MDR-AB),Production of carbapene-enzyme Enterobacteriaceae bacteria(CRE), vancomycin-resistant enterococci(VRE),concentrate mainly on the ICU for high-risk areas of infection.The most were from the respiratory system specimens,followed by the urinary system specimens.Conclusion Multiple resistant bacteria are growing critical.There should be more attention to be paid in bacteriological ex-amination for clinic,the clinical isolation of pathogenic microorganisms in the hospital should be grasped.The antimicrobial agents should be rationally applied according to the results of bacterial susceptibility,in addition the management of antimicrobial agents and multi-drug monitoring should be strengthened.
ABSTRACT
Objective To filter the traditional Chinese medicine with strong antibacterial activity and effects of reversing drug resistance of bacteria for providing new ideas for the treatment of multi-drug resistant bacteria infection.Methods Six kinds of antibacterial Chinese traditional medicines commonly used in clinic treatment as Radix Paeoniae Rubra,Indigo Naturalis,Galla Chinensis,Flos Chrysanthemi Indici,Herba Hout-tuyniae,and Berberine were used in this study.After preparation of the extract using decocting method,bacte-riostatic effects of these six kinds of Chinese medicine on multiple resistant bacteria were detected by double dilution method.To evaluate the effects of Chinese medicines on reversing drug resistance of multi-drug resist-ant bacteria,minimum inhibitory concentrations for multi-drug resistant bacteria and the original strain were detected by K-B method and calculated the difference of the bacterial inhibition rings.Results T he six kinds of traditional Chinese medicines had different degrees of inhibitory effects on MDR-AB and MDR-PA,and the bacteriostatic effect sequence were Galla Chinensis,Herba Houttuyniae,Flos Chrysanthemi Indici,Radix Pae-oniae Rubra,Indigo Naturalis,and Berberine.The bacteriostatic titer of Galla Chinensis on MDR-AB and MDR-PA was 512-1 024,whose antibacterial activity was the strongest in the six antibacterial Chinese tradi-tional medicines.Galla chinensis and Berberine had significant effects on reversing drug resistance of MDR-AB MDR-PA(P<0.05),but the difference value of inhibition zone diameters before and after reversing were less than 3 mm.Conclusion Radix Paeoniae Rubra,Indigo Naturalis,Galla Chinensis,Flos Chrysanthemi Indici, Herba Houttuyniae,and Berberine could inhibit MDR-AB and MDR-PA in different degrees,in which Galla Chinensis was the most effective antibacterial Chinese Medicine.Ggalla chinensis and Berberine could reverse drug resistance of MDR-AB and MDR-PA to some extent.
ABSTRACT
Over the past two decades, multiple drug-resistant infections have escalated globally with the significantly increased morbidity and mortality due to the unreasonable uses of antimicrobial agents in areas such as animal husbandry, industry and medicine. As the situation of drug resistance has been progressively serious, anti-drug-resistant clinical strategies have attracted widely social concerns. This review will report the current status of antibiotic resistance and the mechanism of antibiotic-resistance all over the world. The anti-drug resistance strategies are the emphasis of our report, including the new indication of old antibiotics, the combination of existing antibiotics, the development of new antibiotics, nano-antibiotics, and non-infection treatment with immunomodulators and phage. This review aims to further understand the current situation of drug resistance, which optimizes the strategies of drug-resistant bacteria and clinical services.
ABSTRACT
Objective To analyze the clinically isolated bacterial distribution and drug resistance characteristics in the our hospital during 2016 to provide the pathogenic drug resistance monitoring data for rational bacterial drugs use in clinic.Methods The clinicaly submitted samples were performed the pathogenic bacterial isolation according to the routine method.The isolated pathogens were identified by the Vitek2-Compact system and the drug susceptibility test was performed by adopting the MIC and KB methods.The results were statistically analyzed by adopting the WHONET5.6 software.Results A total of 2 214 non-repeat strains of bacteria were isolated in 2016,including 1 614 strains of Gram-negative bacilli,accounting for 72.9％,600 strains of Gram-positive bacteria,accounting for 27.1 ％.The top five isolated bacteria were Klebsiella pneumoniae,Escherichia coli,Pseudomonas aeruginosa,Acinetobacter baumannii and Staphylococcus aureus.The detection rates of ESBLs producing Escherichia coli and Klebsiella pneumoniae were 51.8％ and 27.6％ respectively.The detection rates of methicillin-resistant Staphylococcus aureus (MRSA) was 26.5％.No vancomycin or linezolid resistant staphylococcal strains were found.Conclusion The main isolated pathogens in our hospital are dominated by Gram-negative bacteria.Hospital should strengthen reasonable and standardized use of antibacterial drugs to reduce the generation of drug resistant bacterial strains.
ABSTRACT
Objective To explore the effectiveness and safety of Linezolid (LIZ) in treating children with infective endocarditis (IE).Methods The clinical data of 112 children with IE and treated in the Shanghai Children's Medical Center of Shanghai Jiao Tong University School of Medicine from August 2008 to September 2015 were retrospectively analyzed.There were 64 boys and 48 girls,and the age of IE onset ranged from 1 month to 17 years [(6.0 ± 4.8) years].Twenty-nine patients received LIZ treatment ＞ 7 days (LIZ treatment group),including 21 males and 8 females,and the age ranged from 5 months to 15 years [(6.9 ±5.2) years].The remaining 83 patients were identified without LIZ treatment(non-LIZ treatment group),including 43 boys and 40 girls,and the age ranged from 1 month to 17 years [(5.7 ±4.7) years].The etiological results,curative effect and adverse reactions of the LIZ treatment group were observed.Results Among the LIZ treatment group,22 cases had congenital heart disease and 1 case had intravenous catheter.There were 10 cases with infection of staphylococcus aureus,6 cases with coagulase negative staphylococcus,5 cases with oral streptococci and Streptococcus bovis group,3 cases with streptococcus pneumonia,2 cases with enterococcus faecium and 3 cases with negative blood culture results.All cases of the LIZ treatment group received Vancomycin therapy at first,LIZ was given when the Vancomycin therapy failed(16 cases with temperature reiteration,1 case inadequate microbiological response),Vancomycin intolerance (6 neutropenia,2 renal toxicity,2 allergy),and oral maintenance therapy (2 cases).The duration of LIZ treatment ranged from 9 to 135 days [(39.2 ±27.2) days].Three patients (10.3％) had adverse effects during LIZ treatment,1 case with severe digestive symptoms after treatment,1 case with teeth discoloration,1 case with the indicators decreasing by 2 routine blood test.Meanwhile,16 cases of 85 patients (18.8％) had side effects during Vancomycin treatment,in which 7 cases with neutropenia,6 cases with rash and 3 cases with renal insufficiency.But there were no significant differences in adverse effects between LIZ and Vancomycin treatment (x2 =1.l19,P ＞0.05).Twenty-five cases were cured (86.2％) and 2 cases dead (6.9％) in the LIZ treatment group.And no significant difference was found in cure rate,or mortality between LIZ treatment group and non-LIZ treatment group (86.2％ vs.77.1％,x2 =1.090;6.9％ vs.8.4％,x2 =0.069,all P ＞ 0.05) at 6 to 84 (23.9 ± 19.1) months follow-ups.Conclusions LIZ can be used to deal with Vancomycin failure and IE caused by gram positive coccus.LIZ was generally well tolerated in patients with IE.It may be useful in cases of IE complicated by brain abscesses for the good distribution.It is 100％ orally bioavailable,allowing oral administration for outpatients.
ABSTRACT
Objective To investigate the clinical characteristics, prevention and treatment of multi-drug resistant organisms (MDROs) infection early after renal transplantation from donation after citizen's death. Methods Clinical data of 166 patients undergoing allogeneic renal transplantation and regular follow-up in Xijing Hospital from November 2011 to September 2016 were retrospectively analyzed. General conditions were statistically compared between the recipients undergoing renal transplantation from donation after cardiac death (DCD) and their counterparts receiving living related donor renal transplantation. The incidence of MDROs infection, onset time, course of diseases, complications, infection site and etiological type were observed. The therapeutic methods and clinical prognosis were summarized. Results The incidence of MDROs infection early after renal transplantation in the recipients undergoing DCD renal transplantation was 14%, significantly higher than 2% in those receiving living related donor renal transplantation, and 13% and 2% for the incidence of delayed graft function with statistical significance (both P<0.05). The incidence of renal graft loss was 8%and 2%, and 5% and 1% for the mortality rate without statistical significance between two groups (both P>0.05). MDROs infection occurred in 11 patients after DCD renal transplantation. The most common infection site was urinary system(n=6) and the most prevalent pathogenic bacterium was Escherichia coli (n=4). All patients infected with MDROs were treated with a sufficient dosage of effective antibiotics according to the outcomes of bacterial culture and drug sensitivity test. Eight patients obtained favorable clinical prognosis, one underwent nephrectomy and two died. Conclusions The incidence of MDROs infection early after DCD renal transplantation is higher than that after living related-donor renal transplantation. Strict donor screening, early detection, intimate monitoring and timely treatment can effectively reduce the risk of MDROs and enhance clinical prognosis.
ABSTRACT
Objective To investigate the bacterial distribution and antibiotic resistance profile in Tongling People's Hospital during 2016.Methods All the clinically isolated bacterial strains in Tongling People's Hospital during 2016 were identified and tested for their susceptibility to antimicrobial agents.The results were analyzed with WHONET 5.6 software.Results A total of 2 949 strains of bacteria were collected,including 2 134 strains of gram-negative bacteria and 815 strains of gram-positive bacteria.The top five gram-negative bacteria were E.coli,4.baumannii,K.pneumoniae,P.aeruginosa and Enterobacter.The top five gram positive bacteria were coagulase-negative Staphylococcus,S.aureus,E.faecalis,E.faecium and Streptococcus.The prevalence of ESBLs-producing strains was 42.3％ in E.coli and 31.1％ in K.pneumoniae,The prevalence of carbapenem-resistant strains was 1.2％ (8/640) in E.coli isolates and 29.4％ (108/367) in K.pneumoniae isolates.Majority (94.3％) ofA.baumannii strains were susceptible to tigecycline.However,74.3％ and 74.9％ of these strains were resistant to imipenem and meropenem,respectively.Most P aeruginosa strains (78.2％) were resistant to piperacillin,but about 70％ were susceptible to carbapenem antibiotics.The prevalence of methicillin-resistant strains was 32.0％ (74/231) in S.aureus and 65.6％ (170/259) in coagulase-negative Staphylococcus.No staphylococcal strains were found resistant to teicoplanin or vancomycin.No enterococcal isolates were resistant to teicoplanin or linezolid.Conclusions The number of bacterial isolates in this hospital is increasing year by year.The prevalence of multidrug-resistant bacteria is also on rise,especially the pandrug-resistant Enterobacteriaceae and A.baumannii.It is urgently required to strengthen the control of hospital infections.
ABSTRACT
Objective: Present retrospective study was aimed to analyze comparative efficacy of fixed dose combination (FDC) (ceftriaxone + sulbactam + disodium edetate) and meropenem used alone or in combinations with other antibiotics for management of intensive care unit (ICU) patients suffering with infections from piperacillin-tazobactam (pip-taz) resistant bacteria and to assess the costs associated with respective therapies. Methodology: Patients records were collected and their demographic characteristics, infection types, co-morbidities, antibiotic therapy, dosage, treatment duration microbial and clinical success rates were evaluated. Effectiveness and costs analysis between antibiotic regimens were estimated in Indian rupees (INR). A total of 136 patients data treated at a tertiary-care hospital was analyzed. These 136 patients included 28, 18, 19, 17, 31 and 23 patients of urinary tract infection (UTI), blood stream infection (BSI), community acquired infection (CAI), skin structure infection (SSI), intra-abdominal infection (IAI) and ventilator associated pneumonia (VAP), respectively. Out of 136 patients, 56 patients received FDC and another 80 patients were administered with meropenem empirically. Results: Clinical cure observed was 71.42% and 67.50% in FDC and meropenem groups, respectively. The patients in whom meropenem and FDC treatment regime failed to show improvement, colistin was given as an additional cover, which resulted in clinical cure of 86.95% and 85.71% patients respectively. Comparative cost expenditure analysis of these two drug treatment regimens revealed that, the overall treatment cost for patients cured with antibiotic regimen containing meropenem was 107.39% more than that of FDC. The strongest contributors of the increase in treatment costs were cost of antibiotic, number of dosages, average treatment duration and clinical failure rates. Conclusion: Infections with pip-taz resistant bacteria are frequent in ICU patients and the present study demonstrates that FDC has comparatively similar efficacy as that of meropenem which is considered as an appropriate option to treat pip-taz resistant cases. Pharmacoeconomic analysis clearly advocates in favor of FDC as a cheaper and safer alternative to meropenem to treat ICU patients with infections caused due to pip-taz resistant bacteria.
ABSTRACT
Objective To investigate the resistance of clinically isolated bacteria to commonly used antibacterial drugs in the First Affiliated Hospital of Chongqing Medical University .Methods The bacterial susceptibility testing in clinically isolated bacte‐ria collected during January to December 2014 was carried out .The detection results were judged according to the standards by CLSI in 2014 .Results Among 7 740 clinical isolated strains of bacteria collected during this period ,Gram negative bacteria and Gram positive bacteria accounted for 70 .6% and 29 .4% respectively .Methicillin resistant(MR) strains in S .aureus and coagulase negative Staphylococcus accounted for 30 .2% and 77 .2% respectively .The resistance rates of MR strains to main antimicrobial a‐gents were much higher than those of methicillin sensitive(MS) strains .No staphylococcal strain was resistant to vancomycin or lin‐ezolid .The resistance rates of E .faecalis strains to main antibacterial agents was much lower than those of E .faecium .Some strains (2 .3% ) of E .faecium were found resistant to vancomycin ,while some strains(0 .9% ) of E .faecalis were found resistant to linezol‐id .The ESBLs producing strains were 59 .5% in Escherichia coli and 31 .8% in Klebsiella pneumoniae .Strains of Enterobacteriaceae were highly susceptible to imipenem and meropenem ,the overall resistance rates being less than 2 .0% .Resistance rates of P .aerug‐inosa to imipenem and meropenem were 24 .5% and 17 .9% ,respectively .The resistance rates of A .baumanii to the two carbapene‐ms were 71 .9% and 75 .0% ,respectively .The multi‐drug resistant K .pneumoniae and A .baumanii were increased markedly .Con‐clusion Bacterial drug resistance is serious ,especially the multi‐drug resistant bacteria constitute a serious threat to clinic .There‐fore it is urgent to strengthen the infection control measures .
ABSTRACT
Objective To assess the efficacy and safety of oral fosfomycin trometamal in patients with lower urinary tract infections ( UTIs) caused by multi drug resistant ( MDR) bacteria in the clinical setting in China.Methods Multicenter study was conducted from January 2011 to December 2011 in 12 hospitals in China.Three hundred and fifty-six patients with non-fever lower UTls were treated by fosfomycin trometamal 3 g once daily.Three hundred and fifty cases with complete data were further evaluated .One hundred and twenty ( 34.3%) were male and 230 ( 65.7%) were female.The average age was ( 49.9 ± 16.6) years.Depending of the results of urine culture at the first visit ,142 patients with E.coli, Klebsiella pneumonia, proteus, Staphylococcus aureus, Staphylococcus epidermidis and entercocous were analyzed.The susceptibility of MDR bacteria to fosfomycin trometamol were calculated . The clinical efficacy , bacteriological efficacy of fosfomycin trometamol to these patients was evaluated .Results For the gram-negative bacteria detected by culture , among the E.coli, Klebsiella pneumonia and proteus, 50%(52/104) were Extended-Spectrum β-lactamases producing organisms . For the gram-positive bacteria ( n =38 ) detected by culture, methicillin-resistant staphylococcus accounts for 55%(11/20) of all the Staphylococcus and the other gram-positive bacteria were Enterococcus ( n=18 ) .Higher susceptibility rates to fosfomycin trometamol were observed among MDR bacteria (85.7%) and the clinical effective rate and bacteriological effective rate of fosfomycin trometamol were 96.4%( 53/55 ) and 87.5%( 42/48 ) , respectively .The incidence of drug-related adverse events (AEs) was 5.6%(20/356).The most common AE was diarrhea. No drug-related serious adverse events were found .Conclusions The distributions of uropathogens in China are complicated. The detection rate of MDR uropathogens is high . The dosing regimen of fosfomycin trometamal 3 g once daily is effective and tolerable for the patients with lower UTIs caused by MDR bacteria . It may represent good options for the empiric therapy for the patients with lower UTIs .
ABSTRACT
With the inappropriate use of antibiotics, the situation of bacterial resistance is more and more severe. The emergence of multidrug-resistant (MDR) bacteria has made it difficult to cure the infections in clinical. For treatment the infections caused by MDR and reducucton of the generation of resistant bacteria, researchers are actively studying on the non-antibiotic substances for antibacterial activity. In this paper, the advances in those with conifrmed effects such as phage therapy, metal/chelation therapy, immunization therapy, photodynamic therapy, and nitric oxide (NO)-based therapies, small molecule inhibitors, antimicrobial peptides and Chinese herb were reviewed.
ABSTRACT
Objective: To evaluate antibacterial activity of the Indonesian water soluble green tea extract,Camellia sinensis, against clinical isolates of methicillin-resistant Staphylococcus aureus (S. aureus) (MRSA) and multi-drug resistant Pseudomonas aeruginosa (MDR-P. aeruginosa). Methods:Antimicrobial activity of green tea extract was determined by the disc diffusion method and the minimum inhibitory concentration (MIC) was determined by the twofold serial broth dilutions method. The tested bacteria using in this study were the standard strains and multi-drug resistant clinical isolates of S. aureus and P. aeruginosa, obtained from Laboratory of Clinical Microbiology, Faculty of Medicine, University of Indonesia. Results:The results showed that the inhibition zone diameter of green tea extracts for S. aureus ATCC 25923 and MRSA were (18.970±0.287) mm, and (19.130±0.250) mm respectively. While the inhibition zone diameter for P. aeruginosa ATCC 27853 and MDR-P. aeruginosa were (17.550±0.393) mm and (17.670±0.398) mm respectively. The MIC of green tea extracts against S. aureus ATCC 25923 and MRSA were 400 μg/mL and 400 μg/mL, respectively, whereas the MIC for P. aeruginosa ATCC 27853 and MDR-P. aeruginosa were 800 μg/mL, and 800 μg/mL, respectively. Conclusions: Camellia sinensis leaves extract could be useful in combating emerging drug-resistance caused by MRSA and P. aeruginosa.
ABSTRACT
Azadirachta indica have been widely used in traditional systems of medicine for a variety of diseases. In the present study, Cow urine extract of Azadirachta indica was evaluated for its antimicrobial activity against MDR Clinical isolates. Antimicrobial activity was evaluated towards five MDR pathogenic strains of bacteria. The results indicated that Cow urine extract of A.indica more antibacterial activity in comparison of its organic fraction for MDR E.coli and, Klebseilla pneumonia . The phytochemical test suggests that constituents for all the 20 days were positive for flavonoids, alkaloids, quinine, coumarin, tannin, saponin and phenol. Antimicrobial activities were correlated with chemical compositions of both organic extracts and Cow urine extract of A. indica.
ABSTRACT
OBJECTIVE To control the spread of multi-drug resistant(MDR) bacteria in hospital and to ensure patients′ medical safety.METHODS We had established a network monitoring system,improved MDR monitoring,enhanced management of antibiotics rational use and cut off the transmission of MDR bacteria.RESULTS After taken these measures,the standard preventing of medical workers,handwashing compliance and specimen censorship rate had been greatly improved.Antimicrobial drug use was more standardized.In the last two years,we hadn′t found any epidemic outbreak due to MDR bacteria event.CONCLUSIONS Taking comprehensive prevention and control measures can prevent and control the development and proliferation of MDR bacteria and ensure patients′ medical safety.