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@#Abstract: Objective To investigate the epidemiological characteristics of pathogens causing bloodstream infection in hematology patients during treatment and to compare the effects of allogeneic hematopoietic stem cell transplantation (HSCT) on them, so as to provide evidence for the diagnosis and treatment of bloodstream infection. Methods A total of 292 cases with bloodstream infection in hematology wards of the PLA General Hospital were collected from 2017 to 2021, which were divided into HSCT group and N-HSCT group according to whether performed HSCT or not. The epidemiological characteristics and influence of pathogenic bacteria in blood stream infection were analyzed and compared between the two groups. Results A total of 362 strains of pathogenic bacteria were collected from 292 cases, including 106 strains in HSCT group (84 cases) and 256 strains in N-HSCT group (208 cases). Bloodstream infections were more common in acute myeloid leukemia (130/392, 44.52%), followed by non-Hodgkin's lymphoma (74/292, 25.34%). The rate of once bloodstream infection in HSCT group was higher than that in N-HSCT Group, but the rate of twice bloodstream infections in N-HSCT group was higher. Gram-negative Bacilli were the most common pathogens (56.08%), with Escherichia coli being absolutely dominant (109/362, 30.11%), followed by Klebsiella pneumoniae (39/362, 10.77%). Coagulase-negative staphylococci (CoNS) (107/362, 29.56%) were the most common Gram-positive cocci. The detection rate of fungi in HSCT group (10/106, 9.43%) was significantly higher than that in N-HSCT Group (3.52%). The drug resistance rate of the common pathogenic bacteria was at a high level, and there was a certain proportion of multi-drug resistant strains (except for Pseudomonas aeruginosa). The resistance rates of CoNS to penicillin, gentamicin, moxifloxacin, clindamycin and rifampicin in HSCT group were higher than those in N-HSCT Group. The resistance rate of Escherichia coli to piperacillin/tazobactam, cephalosporins and etapenem in HSCT group was significantly higher than that in N-HSCT group. Conclusions The pathogens of blood stream infection in hematology patients are complicated and various. It is difficult for clinical diagnosis and treatment to detect multiple infections and multiple pathogens. HSCT patients have a higher risk of fungal bloodstream infection and more multi-drug resistant strains detected. Therefore, the identification of bloodstream infection and multi-drug resistant strains associated with HSCT patients should prompt surveillance.
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@#Abstract: Objective To analyze the antimicrobial resistance rate and risk factors of multi drug resistant organisms (MDRO) in bloodstream infection for rational treatment. Methods A total of 696 cases of bloodstream infections of Staphylococcus aureus, Enterococcus, Enterobacteriaceae (excluding Salmonella and Shigella), Pseudomonas aeruginosa and Acinetobacter in our hospital from 2017 to 2021 were selected, and 711 pathogenic strains were isolated from their whole blood samples. The antimicrobial resistance rates of various multi drug resistant strains were analyzed and the risk factors of MDRO infection were analyzed. Results 696 non repeated cases were screened out from 13 187 whole blood culture specimens, with a positive rate of 5.3%, and a total of 711 blood influenza pathogens were detected, among them, 350 strains of MDRO were detected with a detection rate of 49.23% (350/711). Among the pathogenic bacteria of bloodstream infection, Escherichia coli was the most, with 277 strains accounting for 38.96% (277/711), of which 201 strains were MDRO, accounting for 57.43% (201/350); followed by Klebsiella pneumoniae and Staphylococcus aureus, with 155 strains accounting for 21.80% (155/711) and 89 strains accounting for 12.52% (89/711), among which 43 strains of Klebsiella pneumoniae MDRO accounted for 12.29% (43/350) and 38 strains of Staphylococcus aureus MDRO accounted for 10.86% (38/350). The change trend of the three pathogens during 2017-2021 was not obvious. The drug sensitivity test showed that Escherichia coli and Klebsiella pneumoniae were highly resistant to cephalosporins and fluoroquinolones, and the drug resistance rate of aminoglycosides was relatively low. They had almost no resistance to cephalosporins and carbapenems. Staphylococcus aureus has a high resistance rate to lincomycin and macrolides, but no resistance to oxazolidinone, glycopeptides and glycylcyclins. There were 350 cases of MDRO infection and 361 cases of non MDRO infection. Univariate analysis showed that the age, sex, cardiovascular and cerebrovascular history, renal insufficiency, lung disease, hypoalbuminemia, hepatobiliary disease, electrolyte disorder and anemia of the patients had no statistical significance in MDRO infection (P>0.05); diabetes, urinary tract infection, surgical operation and burn were the influencing factors of MDRO (P<0.05). According to logistic analysis, diabetes, urinary tract infection, surgical operation and burn were the risk factors of MDRO infection (P<0.05). Conclusion The infection of MDRO in patients with bloodstream infection is serious, and early prevention and control should be paid attention to, and the principle of graded use of antibiotics should be strictly observed, and the rational application should be carried out to actively and effectively control the production of MDRO.
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Objective:To realize the bacterial distribution and antibiotic resistance in children with severe pneumonia in this region.Methods:A total of 203 children with severe pneumonia diagnosed in Gansu Provincial People′s Hospital from April 2018 to March 2020 were divided into 0-1, 1-3, 3-7 and 7-14 years old groups.Bronchoalveolar lavage fluid was collected for bacterial culture and identification, and antibiotic susceptibility tests were performed.Results:The positive rate of pathogens was 69.5% (141/203), including 72.3% (102 strains) of Gram-negative bacteria and 30.5%(43 strains)of Gram-positive bacteria.The infection rates were highest in 0-1 years old group and the lowest in 7-14 years old group, which were 45.2%(19/42) and 16.9%(10/59), respectively.The infection rates of Haemophilus influenzae, Escherichia coli and Branhamella catarrhalis in the 1-3 years old group were 30.30%(10/33), 33.33% (11/33), and 21.21% (7/33), respectively, which showed significant differences compared with other groups( P<0.05). The infection rate of Streptococcus pneumoniae in the 0-1 years old group was 42.9%(18/42), which was significantly different compared with other groups ( P<0.001). The resistance rate of Haemophilus influenzae to trimethoprim/sulfamethoxazole was 89.5%(34/38), and the Streptococcus pneumoniae to trimethoprim/sulfamethoxazole and tetracycline were both 82.4%(28/34). The highest antibiotic resistance rate of Escherichia coli was 34.6%(9/26), and the Branhamella catarrhalis to clindamycin was 56.3%(9/16). Conclusion:The dominant bacteria for severe pneumonia in children are Haemophilus influenzae, Streptococcus pneumoniae, Escherichia coli and Branhamella catarrhalis.The bacterial infection rate is highest within 1 year old, but gradually decreases with the increase of age.Haemophilus influenzae and Streptococcus pneumoniae have severe resistance to several antibiotics.
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Objective:To understand the trend of Helicobacter pylori （Hp） resistance to clarithromycin and levofloxacin and to provide guidance for Hp eradication therapy. Methods:From January 2014 to December 2018， a total of 66 515 patients with gastrointestinal symptoms were enrolled in the First People's Hospital of Wenling. The patients were divided into the following groups： childhood （0 to 6 years old）； juvenile （7 to 17 years old）； youth （18 to 40 years old），middle age （41 to 65 years old），and old age （≥66 years old）. All patients received gastroscopy， gastric mucosal biopsy， Hp culture and drug sensitivity test of clarithromycin and levofloxacin. Results:The Hp positive rate showed a significant downward trend in 2016， 2017 and 2018 （χ2=14.317， 47.079， 88.054， all P<0.05）. The average resistance rate of Hp to clarithromycin from 2014 to 2018 was 22.72% （4 732/20 831） showing an increasing trend， but the increase was slower after 2017. The average resistance rate to levofloxacin was 30.55% （6 364/20 831）， and the overall trend showed a sharp rise from 2015 to 2017 （χ2=38.383， 49.569， both P<0.05）， and a significant decline was detected after 2017 （χ2=18.841， P<0.05）. The resistance rate of Hp to levofloxacin in patients increased with age. The clarithromycin resistance rate first decreased and then increased with age， and the resistance rate in old age （32.52%， 763/2 346） was higher than that in youth （22.09%， 1 086/4 916） and middle age patients （21.21%， 2 854/13 458）， and the differences were significant （χ2=991.071， 144.968， both P<0.05）. The resistance rate of Hp rose from 12.73% （14/110） in juvenile to 43.31% （1 016/2 346） in old age （χ2=228.867， P<0.05）. Conclusion:In recent years， the positive rate of Hp infection in Wenling area has a decreasing trend. Although the resistance rate of Hp to clarithromycin and levofloxacin has been rising slowly or decreasing， it is still at a high level. In the selection of Hp eradication program， the differences between patients in different age groups should be considered with particular attention on the minors.
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Objective To analyze the genotypes of Neisseria gonorrhoeae ( N. gonorrhoeae) epi-demic strains in Wenzhou, eastern China, and to study the mechanism of tetracycline resistance in these strains. Methods A total of 77 N. gonorrhoeae strains were isolated from patients with gonorrhea. Antimi-crobial susceptibility of these strains to penicillin, tetracycline, ciprofloxacin, spectinomycin, ceftriaxone and azithromycin was analyzed using E-test. PCR and DNA sequencing were used to detect the genes associ-ated with tetracycline resistance, such as Tet-M, mtrR promoter region and mtrR coding region. N. gonor-rhoeae multi-antigen sequence typing ( NG-MAST) and multilocus sequence typing ( MLST) were used to determine the molecular characteristics of all clinical isolates and tetracycline-resistant isolates, respectively. Results Among the 77 N. gonorrhoeae isolates, 74 (96. 10％), 27 (35. 06％) ,70 (90. 91％) and 15 (19. 48％) were resistant to penicillin, tetracycline, ciprofloxacin and azithromycin, respectively. All tested isolates were susceptible to spectinomycin and ceftriaxone. Nineteen isolates were resistant to tetracycline and all of them carried Tet-M gene. Among them, 17 had one deletion mutation of base A in mtrR promoter region and three had G45D mutation in mtrR coding region. NG-MAST classified the 19 tetracycline-resistant isolates into 11 different sequence types (ST). ST14781, ST1766 and ST1866 each accounted for 15. 79％(three strains). Two ST (10. 52％, 2/19) found in the present study had not been reported previously in the NG-MAST database. MLST showed the 19 tetracycline-resistant isolates belonged to 12 different STs, in which ST10899 accounted for 26. 32％ (five strains) and ST1600 accounted for 15. 79％ (three strains). Conclusions Mutations in mtrR promoter region and carrying Tet-M gene were associated with tetracycline resistance in N. gonorrhoeae. Clinical strains isolated in Wenzhou showed considerable molecular diversity. Measures should be implemented to monitor the spread of NG-MAST ST1766 and MLST ST1600 N. gonor-rhoeae clones with high resistance to tetracycline in Wenzhou.
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Objective To analyze the correlation between antimicrobial use density (AUD) and change in antimicrobial resistance rate of Stenotrophomonas maltophilia (SM), and explore the influencing factors of antimicrobial resistance of SM. Methods Antimicrobial resistance rate of SM and AUD of commonly used antimicrobial agents in patients in a hospital from 2012 to 2017 were summarized, correlation was analyzed with Pearson correlation method. Results A total of 23 994 strains of gram-negative bacteria were isolated, of which 1 331 strains (5.55％) were SM, mainly from sputum (54.02％) and distributed in intensive care unit (21.49％). Resistance rates of SM to ceftazidime, levofloxacin, and compound sulfamethoxazole were 21.79％, 7.66％, and 13.37％ respectively, resistance rates to levofloxacin showed an increasing trend year by year (P＜0.05). Resistance rate of SM to levofloxacin was positively correlated with the use intensity of β-lactamase inhibitors, carbapenems, fluoroquinolones, and oxazolidinones (all P＜0.05); resistance rate to compound sulfamethoxazole was positively correlated with the use intensity of macrolides (P＜0.05).Conclusion Change in resistance rates of SM to levofloxacin and compound sulfamethoxazole are positively correlated with the use intensity of some commonly used antimicrobial agents, reducing AUD is beneficial to the control and reducing of the resistance of SM.
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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.
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OBJECTIVE:To provide reference for rational use of antibiotics in clinic.METHODS:The quarterly information about the consumption of antibiotics in inpatients of our hospital during Jan.2012-Dec.2016 were collected from Center for Antibacterial Surveillance.DDDs of various antibiotics and Escherichia coli were analyzed statistically;the detection of E.coli,producing ESBLs and drug resistance during the same period were also analyzed statistically.The correlation between DDDs of antibiotics and resistance rate was investigated by Pearson test.RESULTS:During 2012-2016,DDDs of cephalosporins was the highest in inpatients of our hospital,followed by cephamicins and macrolides.Total DDDs of antibiotics showed a decreasing trend and a slight rebound in 2016.After 2013,DDDs of most antibiotics were basically same to the change of total DDDs.However,DDDs of compound preparations of penicillin and β-lactamase inhibitors,cephalomycm,carbapenems and glycopeptides showed an upward trend.In 2012,DDDs of second-generation cephalosporin was the highest among cephalosporins;since 2013,DDDs of first-generation cephalosporin was the highest in this category.Anti-E.coli drugs included piperacillin sodium and tazobactam sodium,ceftazidime,ceftriaxone,cefepime,cefoxitin,aztreonam,meropenem,gentamicin,levofloxacin.Among anti-E.coli drugs,DDDs of cefatriaxone was the highest in 2012,while that of cefoxitin was the highest in 2016;the consumption of aztreonam decreased most obviously.During 2012-2016,110,132,104,131,243 strains of E.coli were detected in our hospital respectively.The rate of producing ESBLs decreased to 56.6％,57.0％,50.6％,48.4％,45.0％.E.coli was highly resistant to ampicillin,cefazolin,ceftriaxone and compound sulfamethoxazole,while poorly resistant to piperacillin sodium and tazobactam sodium,cefoxitin,imipenem and amikacin.Resistance rate of piperacillin sodium and tazobactam sodium was positively correlated with DDDs of ceftriaxone,aztreonam,gentamicin,levofloxacin,cephalosporins (fast-,third-generation cephalosporins),tetracyclines,quinolones and total DDDs (r were 0.880 to 0.929,P＜0.05).Resistance rate of ceftazidime was positively correlated with DDDs of ceftriaxone,aztreonam,gentamicin,levofloxacin,cephalosporins (fast-,second-,third-generation cephalosporins),tetracyclines,quinolones and total DDDs (r were 0.888 to 0.991,P＜0.05).Resistance rate of cefepime was positively correlated with DDDs of aminoglycosides(r was 0.901,P＜0.05).Resistance rate of gentamicin was negatively correlated with DDDs of compound preparations of penicillin and β-lactamase inhibitors,cefepime (r were-0.914,-0.921,P＜0.05).Resistance rate of imipenem was negatively correlated with DDDs of ceftriaxone,aztreonam,gentamicin,levofloxacin,cephalosporins (fast-,second-,third-generation cephalosporins),aminoglycosides,tetracyclines,quinolones and total DDDs (r were-0.994 to-0.878,P＜0.05).Resistance rates of anti-E.coli drugs were all independent from their DDDs (P＞0.05).The rate of E.coli producing enzyme was positively correlated with resistance rate of gentamicin(r was 0.955,P＜0.05),while was independent from resistance rate or DDDs of other drugs (P＞0.05).CONCLUSIONS:After antibiotics special rectification,total consumption of antibiotics in inpatients of our hospital show a downward trend,and the varieties also change greatly.Although drug resistance is serious,the rate of producing enzyme is decreasing.Antibiotics should be selected carefully according to the monitoring data of bacterial resistance,drug sensitivity test results,the correlation between the consumption of antibiotics and resistance rate so as to reduce the occurrence of bacterial resistance.
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Objective To analyze the drug resistance of Helicobacter pylori (Hp) strains isolated from teenagers (aged 13 to 19) in Xiaoshan area to metronidazole,clarithromycin,levofloxacin,amoxicillin and furazolidone. Methods A retrospective study was conducted on 1 452 teenagers who had endoscopic examination in the First People′s Hospital of Xiaoshan District from January 2012 to December 2017. Statis-tical analysis was performed to analyze the antibiotic resistance of Hp to various antibiotics. Results Teen-agers who were positive for Hp infection accounted for 16.46% (239). The resistance rates of Hp isolates to metronidazole and clarithromycin were 71.55% and 16.74% with an upward trend in the past two years. Among all Hp isolates, those resistant to levofloxacin, amoxicillin and furazolidone accounted for 5.02%, 0.0% and 0.84%,respectively. No significant change in the antibiotic resistance patterns of Hp was ob-served. There were 15.06% of Hp isolates resistant to both metronidazole and clarithromycin. No statistical-ly significant difference in antibiotic resistance patterns was found between Hp isolates from male and female teenagers in Xiaoshan area. Conclusion This study suggested that the Hp isolates showed high resistance to metronidazole,moderate resistance to clarithromycin and levofloxacin,and low resistance to amoxicillin and furazolidone. Attention should be paid to monitoring the antibiotic resistance patterns in teenagers and pro-moting individualized treatment with regard to the eradication strategy of Hp infection.
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Objective To detect the antibiotic resistance of four kinds of gram-negative bacilli strains against seven antibiotics and to analyze the differences in antibiotic resistance between the strains isolated in intensive care unit (ICU) and common wards.Methods This study involved 3 238 gram-negative bacilli strains isolated in Beijing Tongren Hospital from January to December 2016.Of all strains, 46.6% were isolated in ICU (severe group) and 53.4% were isolated in common wards (general group).Resistance of these strains to seven kinds of antibiotics was detected and the differences between the two groups were analyzed.Results Antibiotic resistance rates of Pseudomonas aeruginosa strains to ceftriaxone, cefepime and imipenem were 41.7%, 41.2% and 39.5% in severe group and 20.9%, 21.7% and 17.1% in general group.Moreover, the differences between the two groups were all statistically significant (χ2Cefatriaxone=56.72, P<0.01;χ2Cefepime=49.12, P<0.01;χ2Imipenem=69.81, P<0.01).Antibiotic resistance rates of Klebsiella pneumoniae strains to imipenem was 17.2% in severe group and 8.8% in general group, and the difference between the two groups was statistically significant (χ2Imipenem=11.48, P<0.01).Resistance rates of Escherichia coli strains to ceftriaxone and cefepime were 72.9% and 35.8% in severe group and 44.7% and 13.3% in general group, and the differences between the two groups were statistically significant (χ2Ceftriaxone=40.13, P<0.01;χ2Cefepime=41.61, P<0.01).More than 60% of Acinetobacter baumanii strains whether they were isolated in ICU or in common wards were resistant to all the seven antibiotics, and there were no significant differences between the two groups.Conclusion Gram-negative bacilli strains isolated in ICU have higher resistance rates than those isolated in common wards and therefore antibiotics should be used differently.Regular monitoring of drug resistance should be strengthened to provide references for empirical clinical medication.
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Objective To explore the effect of antimicrobial use density (AUD) on the detection rate of methicillin-resistant Staphylococcus aureus (MRSA) and antimicrobial resistance rate of healthcare-associated Staphylococcus aureus (HA-SA) half a year later.Methods From 2012 to 2015,all types of AUD,detection rate of MRSA,and antimicrobial resistance rate of HA-SA were calculated semiannually,correlation between antimicrohial resistance rate of HA-SA and all types of AUD in the same first half of year were analyzed with correlation analysis and multiple linear regression.Results From the first half of 2012 to the latter half of 2015,the total AUD declined from 128.2 to 49.0,except the AUD of carbapenems rose,AUD of other antimicrobial agents declined.From the latter half of 2012 to the latter half of 2015,104 249 patients were admitted to the hospital,and 1 008 strains of SA were isolated from 40 884 specimens,857 (85.02％) of which were community-associated SA(CA SA) and 151 (14.98％) were HA-SA.Isolation rate of HA-MRSA declined from 31.25％ in the latter half of 2012 to 12.50％ in the latter half of 2015;isolation rate of CA-MRSA rose from 7.08％ to 16.08％,resistance rate of HA-SA was generally higher than that of CA-SA.Antimicrobial resistance rate of HA-SA to ciprofloxacin remained the same,to levofloxacin increased,to 8 other antimicrobial agents all declined;resistance rates of CA-SA to oxacillin,ciprofloxacin,clindamycin,gentamicin,and levofloxacin increased,but to other antimicrobial agents declined;no SA strains was found to be resistant to vancomycin and linezolid.The resistance rate of HA-SA to azithromycin and erythrocin was correlated with the AUD of macrolides,resistance rate of HA-SA to clindamycin was correlated wvith the AUD of aminoglycosides,to gentamicin was correlated with the AUD of macrolides and the total AUD.Conclusion The selective pressure of antimicrobial agents is still the important cause of the occurrence of antimicrobial resistance,decreasing the AUD of antimicrobial agents will help for reducing the detection rate of HA-MRSA and drug resistance rate of HA-SA.
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Objective:To analyze the indicators and resistance rate of antibacterial drugs for special use in our hospital before and after the implementation of network online approval process to provide reference for the management and rational use of antibacterial drugs for special use. Methods:A retrospective analysis was performed, and the consumption amount, sales amount, utilization ratio, AUD, submission rate of microbial specimen and resistance rates for the main pathogenic bacteria of antibacterial drugs and ones for special use were investigated during 2012 and 2015 in our hospital. Results:The approval process of antibacterial drugs for special use developed from handwork to network online. The consumption amount of antibacterial drugs increased slightly year by year from 2012 to 2015 in our hospital, the mean expense of antibacterial drugs for the inpatients increased from 1602. 85 yuan to 1888. 63 yuan,and AUD increased from 54. 50 DDDs/(100 persons × d) to 65. 47 DDDs/(100 persons × d). The sales amount proportion of antibacterial drugs for special use (13. 90%) was the lowest in 2013, and the highest (17. 34%) in 2015, and AUD increased from 4. 85 DDDs/(100 person × d)to 6. 37 DDDs/(100 person × d), and the submission rate of microbial specimen before the treatment increased from 85. 5% to 90. 0%. The main pathogenic bacteria were Staphylococcus aureus, Escherichia coli, Klebsiella pneumonia, Pseudomonas aeruginosa and Acinetobacter baumannii,and their ratio had slight change. Except Staphylococcus aureus, the resistance rate of the other four pathogenic bacteria kept increasing, and the resistance rates of Acinetobacter baumannii to cefepime and carbapenems were over 50%. Conclusion:The approval process management of antibacterial drugs for special use must be strengthened in order to truly a-chieve reasonable use of antibacterial drugs for special use.
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Objective To explore the status of infection, biotype and resistant background of epi-demic strains of Haemophilus influenza ( Hi ) in neonates, and the clinical features of neonatal pneumonia caused by Hi. Methods The multicenter prospective epidemiological cross-sectional design was used; four hospitals in west Sichuan China were chosen as research field,sputum bacterial culture was done and biologi-cal typing,PCR identification and drug sensitivity test of Hi epidemic strains were carried out among 0 to 28 days hospitalized neonates with infectious pneumonia in four hospitals located in west Sichuan China. The ca-ses with discharge diagnosis of neonatal infectious pneumonia with Hi positive separation were assumed as case group,and the same number of cases with Hi negative separation were assumed as control group accord-ing to 1∶1 extraction at the same time. Results Totally 757 cases with admitting diagnosis of neonatal infec-tious pneumonia in four hospitals were investigated in west Sichuan from November 2014 to October 2015, and the rate of sputum culture was 95. 51%(723/757). The total pathogenic bacteria positive rate of sputum culture was 15. 63%(113/723),and Hi positive rate was 1. 94%(14/723),Hi accounting for 12. 39%(14/113) of the pathogenic bacteria in respiratory system. All the Hi strains(100%) were non-typeable Hae-mophilus influenzae( NTHi) indentified by PCR. The main biotypes of 14 Hi strains were typeⅠwith 57. 1%(8/14),type Ⅲ with 14. 3%(2/14) and type Ⅳ with 28. 6%(4/14). The total of 35. 7%(5/14) bacterial strains of β-lactamase distributed in four hospitals,7. 1%(1/14) bacterial strains of β-lactamase-nonproduc-ing-ampicillin-resistant,and 35. 7%(5/14) bacterial strains of β-lactamase-positive-ampicillin-resistant were found in four hospitals. The rate of resistance and mediation to cefuroxime were 14. 2%(2/14) respectively, the resistance rate to cefaclor was 35. 7%( 5/14 ) , and 21. 4%( 3/14 ) to ofloxacin. None of the 14 strains was resistant to amoxicillin clavulanic acid and cefotaxime. The 1∶1 matching analysis had been done for 10 cases with discharge diagnosis of neonatal pneumonia caused by Hi. There were no statistical differences in general conditions,main symptoms, lung signs, X-ray appearance, classification of leukocyte and C-reactive protein levels between case group and control group(P>0. 05). Conclusion All the Hi isolated from spu-tum were NTHi among 0 to 28 days inpatients with neonatal pneumonia and the main biotype were typeⅠ, type Ⅲand typeⅣin west Sichuan China. There were no significant differences in the clinical manifestations of neonatal pneumonia with NTHi infection and other infectious pneumonia.
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Objective To study the isolation and antimicrobial resistance of pathogens isolated from patients with brain damage in hyperbaric oxygenation department,so as to provide reference for clinical anti-infective treatment.Methods Bacterial culture and antimicrobial susceptibility testing results of pathogens isolated from blood,sputum,and urine specimens of 975 patients with brain damage in the hyperbaric oxygenation department of a hospital between January 2013 and December 2014 were analyzed retrospectively.Results A total of 1 328 strains of pathogens were detected,877(66.04%)of which were gram-negative bacteria,213(16.04%)were gram-positive bacteria,and 238(17.92%)were fungi.The top five isolated pathogens were Pseudomonas aeruginosa,Klebsiella pneumoniae,Escherichia coli,Acinetobacter baumannii,and Candida albicans.Specimens mainly isolated from sputum and urine,accounting for 58.59%and 35.24%respectively,resistance rates of Klebsiella pneumoniae,Pseudomonas aeruginosa,Acinetobacter baumannii,and Escherichia coli to imipenem were 16.67%,81.82%,82.44%,and 4.65%respectively.Vancomycin-resistant strains was not found among gram-positive bacteria,resistance rates of Enterococcus faecalis to most antimicrobial agents were lower than those of Enterococcus faecium.Conclusion Respiratory and urinary tract infection account for most of the infection in patients with brain damage in hyperbaric oxygenation department,gram-negative bacteria are the predominant pathogens causing infection.
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Objective To analyze the clinical characteristics of acinetobacter baumannii infection and drug resistance tendency of our hospital in 2014 ,so as to promote the clinical rational use of antibiotics .Methods The study was a retrospective review ,the re‐sults of clinical distribution and drug resistance of acinetobacter baumannii isolated from our hospital in 2014 were analyzed .The an‐timicrobial susceptibility testing(AST) of acinetobacter baumannii was determined by K‐B disk diffusion method and minimal inhib‐itory concentration(MIC) test ,respectively .The AST was performed as recommended by CLSI 2010 .Results A total of 299 strains of acinetobacter baumannii were isolated from clinical specimens throughout the year .Of the 299 Acinetobacter baumannii isolates , 268 strains(89 .63% ) were isolated from sputum ,165 strains(55 .18% ) of Acinetobacter baumannii were from intensive care unit (ICU) and 52 strains(17 .39% ) were from neurosurgery .The resistance rate of Acinetobacter baumannii to cefoperazone/sulbactam was 5 .02% while its resistance to Imipenem and Meropenem significantly increased to 52 .17% and 56 .86% ,respectively .And the resistance rates ofβ‐lactams ,fluoroquinolones and aminoglycosides were higher than 60% .Conclusion The isolation rate of Acine‐tobacter baumannii is increasing in recent year in our hospital ,as well the resistance rate to the common Antibiotics .Monitoring the resistance of Acinetobacter baumannii should be strengthened for preventing resistant bacteria from spreading .
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Objective To analyze the correlation between the resistance of Acinetobacter baumannii and the utilization of antimicrobial agents in the hospitalized patients of Beijng Chuiyangliu Hospital,and provide the basis for clinical rational use antimicrobial agents.Methods A retrospective analysis was conducted for the drug resistance rate and specimen source of the 2 194 strains of Acinetobacter baumannii from 2010 to 2014 in the hospital and DDDs/DUI of antimicrobial agents was analyzed by Pearson correlation.Results The resistance rate of Acinetobacter baumannii was positively correlated with the DDDs and DUI of imipenem/cilastatin(r=0.991,0.994,all P<0.01), and was positively correlated with the DDDs of cefepime(r=0.934,P=0.020).The resistance rate of Acinetobacter baumannii to amikacin was positively correlated with the DDDs of etimicin(r=0.931,P=0.022).The resistance rate of Acinetobacter baumannii was negatively correlated with the DUI of levofloxacin(r =-0.986,P =0.002). Conclusion The resistance rate of Acinetobacter baumannii was high and there was correlation between the drug resistance and the utilization of some antimicrobial agents.
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BACKGROUND/AIMS: We evaluated the trend in the rates of drug-resistant tuberculosis (TB) over time, as well as the difference in the drug-resistance pattern between pulmonary tuberculosis (PTB) and extrapulmonary tuberculosis (EPTB) at a private referral center in South Korea. METHODS: All patients with culture-confirmed TB from 2006 to 2013 were included. RESULTS: In total, 1,745 patients were included: 1,431 (82.0%) were new cases, and 314 (18.0%) were cases treated previously; 1,610 (92.3%) were diagnosed with PTB, and 135 (7.7%) were diagnosed with EPTB. Multidrug-resistant (MDR) and extensively drug-resistant (XDR) TB were detected in 5.8% and 2.0% of new cases and in 20.1% and 8.6% of previously treated cases, respectively. The MDR TB rate during the study period decreased remarkably, whereas the MDR and XDR TB rates decreased significantly in previously treated cases. No difference in the drug-resistance rate was detected between PTB and EPTB. CONCLUSIONS: The TB drug-resistance rate, particularly that of MDR TB, remained high at a private referral hospital, and the drug-resistance rate did not decrease significantly from 2006 to 2013. This finding underscores the need for a national survey regarding the prevalence of drug-resistant TB to obtain the most accurate and current drug-resistance status in South Korea, including the private sector.
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Antitubercular Agents/therapeutic use , Drug Resistance, Multiple, Bacterial , Extensively Drug-Resistant Tuberculosis/drug therapy , Hospitals, Private , Microbial Sensitivity Tests , Mycobacterium tuberculosis/drug effects , Prevalence , Republic of Korea/epidemiology , Retrospective Studies , Tertiary Care Centers , Time Factors , Treatment Outcome , Tuberculosis, Multidrug-Resistant/diagnosis , Tuberculosis, Pulmonary/diagnosisABSTRACT
Objective To investigate the separation rate ,clinical distribution ,antibiotic susceptibility rate of Staphylococcus au‐reus from skin and soft tissue infections and provide the reference for clinical diagnosis and treatment .Methods Retrospective sta‐tistical analysis of 214 strains of Staphylococcus aureus from skin and soft tissue infections from September 2011 to August 2014 by Whonet 5 .6 .Results 1 228 pathogens were isolated from 2 152 cases of the secretion of operative and skin wound ,of which there were 214 strains of Staphylococcus aureus ,which accounted for 17 .43% ,48 strains of MRSA ,which accounted for 22 .43% ;Mainly distributed in bone surgery ,burns orthopaedic ,breast surgery ,with skin venereal division ,accounting for 40 .2% ,22 .3% ,12 .1% , 8 .4% respectively .The resistance rate of Staphylococcus aureus to penicillin ,erythromycin ,clindamycin were 96 .3% ,46 .7% , 37 .4% respectively ,high sensitivity to vancomysin ,linezolid ,fusidic acid ,mupirocin .Conclusion Surgical infection rates of SSTIs are high in our hospital .It should be according to SAU susceptibility analysis results to choose high sensitivity of the first and sec‐ond generation cephalosporins for treatment in clinic ,and vancomycin ,linezolid only in severe Staphylococcus aureus(including MR‐SA) infection to choose .
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Objective To investigate the prevalence of H.Pylori infection and antibiotic resistance in patients with peptic ulcer.Methods A retrospective analysis of 429 endoscopy and H.Pylori culture results in the First People's Hospital of Hangzhou from 2012 to 2013 was conducted.The rate of H.Pylori infection in patients with peptic ulcer, and the resistance rates of H.Pylori to metronidazole, levofloxacin, clarithromycin,amoxicillin, gentamicin, furazolidone were analysed.Results The positive rate of H.Pylori in people with peptic ulcer was 53.1％ (228/429).The resistance rates to metronidazole, levofloxacin, clarithromycin,amoxicillin, gentamicin and furazolidone were 94.7％ (216/228), 18.9％ (43/228), 18.9％ (43/228), 0, 0 and 0.Double antibacterial resistant rates of metronidazole and clarithromycin, metronidazole and levofloxacin were 18.0％ (41/228) and 17.1％ (39/228).Triple antibacterial resistant percentage of levofloxacin + metronidazole + clarithromycin was 8.3％ (19/228).The resistance rate of clarithromycin in 43 patients who were also resistant to levofloxacin was 46.5％ (20/43), while the resistance rate of clarithromycin in 185 patients who were also sensitive to levofloxacin was 12.4％ (23/185)with significant difference(x2 =26.480,P =0.000).A positive association between the resistance to levofloxacin and to clarithromycin was found.Conclusion The H.Pylori infection is closely related to the occurrence of peptic ulcer.Without the basis of culture results in patients with H.Pylori positive, amoxicillin, gentamicin and furazolidone could be the first choices in clinical,because of their low resistance rates.Clarithromycin can be used as an alternative.
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Objective To analyze the status of mycoplasma infection and drug resistance in the local area,and provide the ba-sis for clinical rational drug use.Methods The specimens obtained from 1 9 530 patients with urogenital tract infection were detec-ted by adopting mycoplasma culture,identification and drug sensitivity integration kit.Mycoplasma infection and drug susceptibility were analyzed.Results In the total of 1 9 530 suspected patients specimens,1 1 1 78 cases were positive with a positive rate 57.24%.The positive rate of ureaplasma urealyticum (Uu)and mycoplasma hominis (MH)was 44.63% and 0.44% respectively and the positive rate of Uu and Mh mixed infection was 12.1 7%.The positive rate of female was higher than that of male and the difference was statistically significant(P <0.05).The positive rate of mycoplasma in 2008-2014 was on the rise;The sensitive rate of mycoplasma to josamycin,doxycycline,minocycline element,clarithromycin was 88.57%,84.32%,76.09% and 71.53% respec-tively,mycoplasma was highly drug resistance to quinolone antibiotics;mixed infection resistance was higher than that of single in-fection;The number of drug resistance of Uu,MH and Uu+MH to 12 kinds of antibiotics increase.Conclusion Mycoplasma infec-tion in urogenital tract is mainly caused by Uu and Mh infection is in mixed infection way;josamycin,doxycycline is the first choice for treatment of mycoplasma in this region.Rational drug choise can be based on the drug susceptibility test.Multiple drug resist-ance of mycoplasma is serious and should be paid attention to.