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Objective To summarize the isolation and drug resistance rate of Escherichia coliin The First Hospital of China Medical University over the past 10 years,in order to provide evidence for the efficacies of clinical anti-infection treatments.Methods The data was collected from Escherichia coli isolated from patients treated at The First Hospital of China Medical University between 2013 and 2022.VITEK 2 and VITEK MS were used for bacterial identification,VITEK2 and KB method were used for drug sensi-tivity testing,and WHONET 5.6 software was used for analysis.Results From 2013 to 2022,6 845 strains were isolated,including 80.5%from inpatients and 19.5%from emergency and outpatients.The specimens were most commonly found in the urine(57.8%),blood(15.0%),secretions(9.2%),and drainage fluid(8.1%).The isolation rate of extended-spectrumβ-lactamase(ESBL)producing Escherichia coli was 57.2%(54.3%to 61.5%).The drug resistance rate of Escherichia coli to carbapenems was low,at only 1.2%(0.2%to 2.6%).Conclusion Escherichia coli remains an important pathogen in clinical infections,with varying degrees of resist-ance to multiple antibiotics,and the resistance rate is increasing.Clinical physicians should pay sufficient attention to this issue.
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Objective To analyze the pathogenic characteristics and drug sensitivity of candidaemia,and construct a short-term mortality risk prediction scoring model.Methods The clinical data of patients with candidaemia admitted to the 909 Hospital of Joint Logistics Support Force from January 2011 to December 2020 were retrospectively analyzed,and the composition of pathogen composition,drug sensitivity test results and incidence of hospitalized patients were analyzed.324 cases of candidaemia were randomly divided into modeling group(190 cases)and validation group(134 cases),and the risk factors were screened by binary logistic regression.According to the odds ratio(OR)score,the 30 day mortality risk prediction scoring model was constructed,and the predictive performance of the model was verified both in modeling and validation groups.Results 356 strains of Candida including 126 strains of C.albicans(35.39%),79 strains of C.tropicalis(22.19%),74 strains of C.parapsilosis(20.79%),48 strains of C.glabrata(13.48%),14 strains of C.guilliermondii(3.93%),8 strains of C.krusei(2.25%),and 7 strains of other Candida(1.97%)were detected in 336 patients with candidemia.The incidence of candidaemia among hospitalized patients increased from 0.20 ‰ in 2011 to 0.48 ‰ in 2020.The resistance rate of candida to amphotericin B was significantly lower than that of fluconazole,voriconazole and itraconazole(P＜0.05).Among the 324 cases included in the model,95 patients died in 30 days after diagnosis,and the mortality rate was 29.32%.The proportion of males,fever,and parenteral nutrition in modeling group was significantly higher than that in validation group(P＜0.05),while the proportion of chronic lung disease and surgical history within one month were lower than those in validation group(P＜0.05).Logistic regression analysis showed that chronic renal failure,mechanical ventilation,severe neutropenia,failure to receive anti-fungal treatment within 72 hours,and APACHE Ⅱ≥20 were risk factors for short-term death of candidaemia,the OR values were 3.179,1.970,2.979,2.080,and 2.399,and the risk scores were 6,4,6,4,and 5,respectively.The area under the curve(AUC)of the risk scoring model for modeling group was 0.792(95%CI 0.721-0.862),and the result of Hosmer-Lemeshow(H-L)test was P=0.305;The AUC of validation group was 0.796(95%CI 0.735-0.898),and the H-L test result was P=0.329.A risk score≤8 indicated a low risk group for short-term mortality,a score of 9-15 indicated a medium risk group,and a score≥16 indicated a high risk group.Conclusions The incidence of candidemia in hospitalized patients is increasing and the mortality is high.The risk prediction score model can effectively predict the short-term prognosis and facilitate the early identification of the prognosis.
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@#Abstract: Objective To investigate the type and distribution of drug resistance of Mycobacterium tuberculosis (MTB) in Hainan tuberculosis hospital from 2019 to 2021, and to provide reference for the development of drug resistant tuberculosis prevention and control strategy. Methods From 2019 to 2021, a total of 1 687 strains of sputum were isolated and cultured and identified as MTB. Drug sensitivity testing was performed on eight anti-tuberculosis drugs: isoniazid (INH), rifampicin (RFP, R), ethambutol (EMB), streptomycin (SM), kanamycin (KM), capreomycin (CPM), ofloxacin (OFX), and propylthioisoniacamide (PTO). The drug resistance analysis was conducted. Results Among the 1 687 MTB strains, the overall drug resistance rate was 41.32% (697), with a single drug resistance rate of 11.62% (196), a multi-drug resistance rate of 4.10% (69), a extensive drug resistance rate of 23.71% (400), a pan-drug resistance rate of 1.90% (32), and a rifampicin resistance rate of 28.10% (474), and the main drug resistance types were extensive drug resistance and rifampicin resistance. The order of resistance to the eight drugs was OFX (64) > SM (62) > INH (48) > RFP (19) > CPM (2) > KM (1) > EMB (0) and PTO (0). The rate of resistance to INH and RFP of first-line drugs in newly treated patients was lower than that in retreated patients (χ2=0.110, 0.765; P>0.05); the rate of resistance to second-line drugs OFX, CPM and KM in initially treated patients was lower than that in retreated patients (χ2=1.037, 1.212, 1.653; P>0.05). The total drug resistance rate in 2019 was 51.16%, which was higher than that in 2020 (35.08%) and 2021 (38.89%). The difference between groups was significant (χ2=29.25,16.60; P=0.000), but there was no significant difference in overall drug resistance rate between 2020 and 2021 (χ2=1.823, P=0.177). Among the occupational types of tuberculosis patients, farmers were the main ones, accounting for 56.25% (949). The patients with drug-resistant tuberculosis were mainly distributed in Haikou City (165) > Wanning City (72) > Chengmai County(64) > Wenchang City (51) = Dongfang City (51) > Danzhou City (48), and patients in these six areas accounting for 64.71%(451/697). Conclusions The drug resistance rate of tuberculosis in Hainan Province is relatively high, with OFX and SM resistance being the main types of drug resistance. The extensive drug resistance rate is higher than the national average level. Therefore, surveillance and treatment should be strengthened and optimized to reduce the prevalence of drug-resistant tuberculosis.
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Objective:To investigate the in vitro antibacterial effects of imipenem combined with common antibiotics on bla KPC-2 type carbapenem resistant klebsiella pneumoniae (CRKP) targeting bla KPC-2 gene. Methods:Six strains of unrepeated bla KPC-2 type confirmed by polymerase chain reaction and DNA sequence were isolated in Yueqing People's Hospital, China between January 2018 and January 2019 were included in this study. The susceptibility rate of imipenem against nine conventionally used antibiotics was determined. The sensitivity test of imipenem combined with eight antibiotics was performed with the checkerboard method. Fractional inhibitory concentration was calculated to assess the efficacy of imipenem combined with common antibiotics. The in vitro treatment time-antibacterial effect curve was drawn to evaluate the antibacterial effects. Results:The resistance rate of six strains of bla KPC-2 type was 100.00% (6/6) for imipenem, meropenem, ceftazidime, ciprofloxacin, rifampicin and cefotaxime, and it was 66.67% (4/6) for minocycline and clavulanic acid and 33.33% (2/6) for tigecycline. Imipenem combined with tigecycline had a better antibacterial effect and exhibited a synergistic effect on four strains of bla KPC-2 type CRKP and an additive effect on two strains of Bla KPC-2 type CRKP. The curve of time for in vitro treatment of KPN2 with imipenem combined with tigecycline against bactericidal effect revealed that the antibacterial rate of imipenem at the 1/2 minimum inhibitory concentration combined with tigecycline at the 1/4 minimum inhibitory concentration was > 95% at (t+2) and the antibacterial effect could maintain (t+10) hours to (t+12) hours. The antibacterial rate of imipenem combined with tigecycline against strain 002 was gradually decreased with time, and the growth curve of strain 002 rised gradually. Conclusion:In vitro drug sensitivity test revealed that imipenem combined with tigecycline exhibits a good synergistic effect on bla KPC-2 type CRKP. Findings from this study provide a reference for clinical treatment of bla KPC-2 type CRKP.
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Objective:Analyze the drug resistance of Mycobacterium tuberculosis (MTB) to commonly used anti-tuberculosis drugs and its spatial distribution in Dali Bai Autonomous Prefecture from 2017 to 2019, which would provid a reference for the treatment of tuberculosis and the prevention and control of drug-resistant tuberculosis. Methods:A total of 1 013 Mycobacterial strains were isolated from sputum samples in the tuberculosis laboratories of the designated People′s hospital of 12 counties (cities) of Dali Bai Autonomous Prefecture from January 2017 to December 2019. Proportional method was used to conduct drug susceptibility tests and strain identification of 6 anti-tuberculosis drugs. Further used ArcMap10.2 and GeoDa1.14 software to visualize the map display and spatial autocorrelation analysis of the drug resistance of MTB.Results:From 2017 to 2019, the drug resistance rates of MTB in Dali Prefecture were 10.33%(28/271), 10.35%(55/531) and 30.00%(51/170), respectively, showing an rising trend ( χ2=26.62, P<0.05). Among 1 030 samples, 972 strains (95.95%) was MTB and 41 strains (4.05%) was non-tuberculous Mycobacterium (NTM). The total resistance rate of 972 strains of MTB was 13.79% (134/972), of which the single resistance rate was 6.59% (64/972), the multi-drug resistance rate was 4.84% (47/972), and the poly-drug resistance rate was 2.06% (20/972), the rate of extensive drug resistance is 0.31% (3/972). There are 25 combinations of drug resistance patterns. The detection rate of NTM was 4% (41/1 013), among which Midu County had the highest detection rate (0.89%, 9/1 013). The spatial distribution showed that the number of MTB resistant strains among counties and cities had a negative spatial correlation (Moran′s I value was -0.367, P<0.05). It shows that there is no clustering of drug resistance among counties and cities, and the resistance is serious in individual counties and cities. Yongping County and Nanjian Yi Autonomous County had low and high aggregation, and Yunlong County had high and low aggregation. Conclusions:The drug resistance of MTB showed an rising trend in Dali Bai Autonomous Prefecture from 2017 to 2019. The number of drug-resistant strains among regions was not randomly distributed, the regional difference was large, and spatial autocorrelation analysis provided theoretical clues and basis for the formulation of drug resistance prevention and control measures for tuberculosis in the whole state.
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The purpose of this study is to provide a simple and reliable genetic typing approach for molecular drug susceptibility test of Mycobacterium tuberculosis, through the developing of fluorescence molecular marker of rifampicin resistance gene rpoB. Eleven fluorescent molecular markers of the rpoB gene were established by using the sequence difference between the amino acid positions 531, 526, 516, 511 and 513 of rpoB gene of rifampicin-resistant strains and the alleles of rifampicin-sensitive strains, combined with the PARMS technique (Penta-primer amplification refractory mutation system). We used 104 clinical isolates of Mycobacterium tuberculosis to validate this marker and it was verified by sequencing as 100% correct. These samples were also tested with proportional drug sensitivity test. The coincidence rate was 94.23%. The molecular markers had high reliability for genotyping of rpoB gene. It can also detect low-concentration drug-resistant samples (511/533 unit point mutations) whose phenotypic susceptibility cannot be detected. The eleven sets of fluorescent molecular markers could cover 92%-96% of rpoB gene mutation types of rifampicin-resistant strains, and provide new idea for rapid detection of rifampin-resistant Mycobacterium tuberculosis.
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Bacterial Proteins/genetics , DNA-Directed RNA Polymerases/genetics , Drug Resistance, Bacterial/genetics , Microbial Sensitivity Tests , Mutation , Mycobacterium tuberculosis/genetics , Reproducibility of Results , Rifampin/pharmacology , TechnologyABSTRACT
Objective To investigate the distribution of pathogenic bacteria and the results of drug sensitivity test in children with acute lung injury (respiratory distress syndrome), so as to guide rational clinical drug use. Methods A total of 254 cases of children diagnosed with acute lung injury (respiratory distress syndrome) in Wuhan Children's Hospital from May 2017 to May 2019 were retrospectively analyzed. Sputum samples were collected from all children for pathogenic microorganisms detection and drug sensitivity test. Results Of 127 strains of pathogenic bacteria were isolated from 254 children. Gram-negative bacilli were the main pathogenic bacteria, among which 38 strains of acinetobacter baumannii were infected, accounting for 29.92%, and 13 strains of pseudomonas aeruginosa were infected, accounting for 10.23%. There were 10 strains of stenotrophomonas maltophilia (7.87%) and 42 strains of fungal infection (33.07%). There were 26 cases of mixed infection, of which 16 cases were infected with acinetobacter baumannii and candida albicans, accounting for 61.54%. Acinetobacter baumannii was resistant to a variety of antibacterial drugs and had a sensitivity of >50% to imipenem. Conclusion Gram-negative bacilli were the main pathogenic bacteria in children with acute lung injury (respiratory distress syndrome). Given that acinetobacter baumannii with the highest infection rate is resistant to various drugs, it is necessary to dynamically detect the resistance of pathogenic bacteria and reasonably choose antimicrobial agents for treatment.
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Eradication of Helicobacter pylori (Hp) is important for the prevention and treatment of chronic gastritis, peptic ulcer and gastric cancer. The Chinese consensus on the management of Hp infection has taken "confirmed Hp infection" as an indication for eradication. The World Gastroenterology Organisation global guideline states the "test-and-treat strategy" for Hp infection. Accurate diagnosis of Hp infection is a prerequisite for standardized eradication. There are many methods to diagnose Hp infection. Each has its advantages and disadvantages. Different methods are suitable for different diseases and patients, and each method has strict requirements for reagents, equipment, testers and patients. Therefore, increasing the awareness of physicians and testers about the standardized diagnosis of Hp infection is essential to improve the diagnostic accuracy.
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Objective@#To survey the bacterial spectrum and drug sensitivity in patients with necrotizing pancreatitis (NP) complicating with extra-pancreatic infection(EPI).@*Methods@#The clinical data of 79 NP with EPI patients from Jan 1, 2016 to Dec 31, 2018 were retrospectively analyzed. The strain identification and drug sensitivity test of positive specimens were statistically analyzed.@*Results@#A total of 219 strains of pathogenic bacteria were isolated, including 106(48.4%) gram-negative bacteria, 69(31.5%) gram-positive bacteria and 44(20.1%) fungi. The common pathogenic bacteria were Pseudomonas aeruginosa (10.1%), Staphylococcus epidermidis (9.1%) and Acinetobacter baumannii (9.1%). The resistance of common extrapancreatic pathogenic bacteria to penicillin and first and second generation cephalosporins was common.@*Conclusions@#The pathogenic bacteria of NP complicated with EPI were mainly Gram-negative bacteria, and the common sites of extra-pancreatic infection were bacteremia and respiratory tract. The third, fourth generation cephalosporins or carbapenems can be used empirically.
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Objective To Analyze the etiology and antibiotic susceptibility in exacerbated bronchiectasis, and guide rational drug use in clinic. Methods Pathogenic microorganism culture and drug sensitivity of sputum samples of 496 cases were collected from 2015 to 2016 in Shengjing Affiliated Hospital, China Medical University. The Excel software was used to analyze the screening data and the SPSS 22.0 was used for statistical analysis to obtain the drug resistance of the bacteria to the commonly used antibiotics. Results In 469 patients, there were 551 pieces of sputum , with 198 strains positive bacterium. Positive rate was 35.93％(198/551), and bacterium was 171 strains (86.36％). Bacteria of top three positive rate was 86 strains of Pseudomonas aeruginosa (50.29％), 54 strains of Acinetobacter baumannii (31.58％) and 10 strains of Klebsiella pneumoniae (5.85％). The resistance rate of Acinetobacter baumannii and Pseudomonas aeruginosa was higher, and other pathogens also showed various degrees of tolerance to antibiotic. Conclusions The pathogens in patients with acute exacerbation of bronchiectasis are Gram-negative bacteria. Considering the characters of Pseudomonas aeruginosa, it is not suggested to use cephalosporin of the third and fourth generation in treating Pseudomonas aeruginosa. Clinical selection of antibiotics should combine with the disease characteristics of patients in our hospital.
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Objective To survey the bacterial spectrum and drug sensitivity in patients with necrotizing pancreatitis (NP) complicating with extra-pancreatic infection (EPI).Methods The clinical data of 79 NP with EPI patients from Jan 1,2016 to Dec 31,2018 were retrospectively analyzed.The strain identification and drug sensitivity test of positive specimens were statistically analyzed.Results A total of 219 strains of pathogenic bacteria were isolated,including 106 (48.4％) gram-negative bacteria,69 (31.5％) gram-positive bacteria and 44 (20.1％) fungi.The common pathogenic bacteria were Pseudomonas aeruginosa (10.1％),Staphylococcus epidermidis (9.1％) and Acinetobacter baumannii (9.1％).The resistance of common extrapancreatic pathogenic bacteria to penicillin and first and second generation cephalosporins was common.Conclusions The pathogenic bacteria of NP complicated with EPI were mainly Gram-negative bacteria,and the common sites of extra-pancreatic infection were bacteremia and respiratory tract.The third,fourth generation cephalosporins or carbapenems can be used empirically.
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OBJECTIVE: To identify and analyze drug sensitivity of Corynebacterium glucuronolyticum iscolated from clinic, and to provide reference for clinical drug use. METHODS: Two strains isolated from the urine specimens of urolithiasis-induced urinary tract infection patients in our hospital were inoculated into Columbia blood plate and the MacConkey plate. The growth of strains was observed and counted. Protein mass spectrometry of strains was detected by MALDI-TOF-MS. DNA of strains was extracted, and PCR was used to amplify the 16S ribosome RNA (rRNA) sequence. Bi-directional sequencing of 1 500 bp target bands was conducted. Blast comparison between it and GenBank database was conducted to identify bacterial strain. Drug resistance of 2 strains was monitored by Etest assay. RESULTS: Two strains grew on the Columbia blood plate (with colony forming unit ＞105 CFU/mL) and did not grow on the MacConkey plate. Two strains were Gram-positive Corynebacterium and showed palisading or eight type arrangement. Two strains were C. glucuronolyticum by MALDI-TOF-MS identification, with reliability of 99. 9％. The characteristic peaks of m/z 2 431, 3 089, 3 364, 3 378, 4 200, 5 508, 6 302, 6 637, 6 730, 6 946, 12 603 appeared. Blast comparison showed that the sequence homology of 2 strains compared with C. glucuronolyticum strain known in GenBank were higher than 98 ％. Results of drug sensitivity test showed that strain 1 was resistant to ceftriaxone and ciprofloxacin, and sensitive to 14 other antibiotics as penicillin G; strain 2 was resistant to ceftriaxone, erythromycin, ciprofloxacin, tetracycline and clindamycin, moderately sensitive to cefotaxime, and sensitive to 10 other antibiotics. CONCLUSIONS: Two strains are C. glucuronolyticum, and drug resistance of them to commonly used antibiotics is different. The strains are rare pathogen of urinary tract and show multidrug resistance. Antibiotics should be selected according to the results of strain identification and drug sensitivity test.
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Objective Broth dilution method was used as a reference method to observe the capability of Kirby-Bauer disc diffusion assay(K-B)for correcting automated ampicillin susceptibility detection of He-mophilus influenzae(HI).Methods A total of 228 HI strains isolated were collected,broth dilution assay,K-B and automated microdilution broth test(ATB)were used to determine the susceptibility of HI to ampicillin. Analyze the essential agreements of the three methods and the correction of K-B to the errors of A TB. Results The essential agreement of K-B or ATB with broth dilution method were 77.19%,70.18% respec-tively,combination of K-B and ATB could make the essential agreement increase up to 86.0%,which was sig-nificantly higher than ATB(χ2=16.600,P=0.000).Major error of ATB(42.0%)was higher than that of K-B(10.0%)(χ2=13.306,P=0.001),but very major error and minor error showed no significant difference be-tween the two methods(χ2=1.208,P=0.272;χ2=1.182,P=0.227),meanwhile,76.19% of major error of ATB could be corrected by K-B.For the very major error of ATB,53.57% could be corrected by K-B.Howev-er,the corrective capability of K-B to minor error of ATB was relative low.Conclusion K-B test could correct some errors generated by ATB.For the β-lactamase negative strains which were judged as ampicillin resistance by A TB,K-B test should be used to correct the errors by ATB.Moreover,it is necessary to apply K-B to confirm am-picillin sensitivity of the β-lactamase positive strains which were judged as ampicillin susceptible by ATB.
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Objective To analyze the current status of bacterial spectrum and drug resistance in community-acquired biliary tract infection to provide a basis for clinical medication .Methods The patients with community-acquired biliary tract infection (ex-periment group) and the patients with biliary tract diseases without biliary tract infection (control group) derived from the native ar-ea treated in this hospital from September 2014 to January 2016 were selected .The bile juice was intraoperatively extracted for con-ducting the bacterial culture and drug susceptibility test .Results Thirteen specieses (60 strains) of bacteria were isolated in the ex-periment group .The top 3 specieses were Escherichia coli (35 .0% ) ,Klebsiella pneumonia (21 .7% ) and Enterobacter cloacae (10 .0% ) .Eight specieses (13 strains) of bacteria were isolated in the control group .The top 3 specieses were Escherichia coli (30 .8% ) ,Klebsiella pneumonia(15 .4% ) and Lactococcus garvieae (15 .4% ) .The proportions of drug resistant strains in the two groups were 95 .0% and 84 .6% respectively (P>0 .05) .The proportions of multiple drug resistant strains in the two groups were 30 .0% and 7 .7% respectively(P>0 .05) .The occurrence rates of multiple drug resistance in the top 3 specieses of bacteria in the experiment group were 61 .9% ,7 .7% and 16 .7% respectively .Conclusion The bacterial spectra of community-acquired acute bili-ary tract infection in the native area are dominated by Gram negative bacteria .The total bacterial drug resistance is serious ,but the drug resistance situation in different bacteria pathogens is different .
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Objective To evaluate the sensitivity to 5 clinically commonly used anticancer drugs in vivo using the zebrafish xenotransplantation models of human lung cancer,stomach cancer,and liver cancer cells,respectively. Methods Zebrafish xenotransplantation models of A549 lung cancer cells,SGC-7901 stomach cancer cells and HepG2 liver cancer cells were established. The xenograft models of A549 cells were treated with three different doses of cis-platinum, paclitaxel, vinorelbine, endostar and bevacizumab, respectively. The SGC-7901 model was treated with three concentrations or doses of paclitaxel, irinotecan, hydroxyurea, cis-platinum and 5-fluorouracil, respectively. And the HepG2 model was treated with three concentrations or doses of adriamycin,gemcitabine,hydroxyurea,cis-platinum and 5-fluorouracil. The tumors were analyzed and quantified in vivo by fluorescence microscopy,and the inhibition rates of tumor growth with each drug were calculated and compared with the model control group for statistical significance. Results All of the tested anticancer drugs showed inhibitory effect on tumor cells in the zebrafish xenograft models with statistical significance in a dose-dependent manner. During the drug sensitivity test,the inhibition rate of bevacizumab on A549 lung cancer cells decreased in the order(65%)> cis-platinum(55%)> vinorelbine(40%)> endostar(39%)>paclitaxel(27%). As for the SGC-7901 stomach cancer cells, the tumor growth inhibition rate decreased in the order hydroxyurea(46%)> 5-FU(31%)= irinotecan(31%)> paclitaxel(26%)> cis-platinum(24%). And the therapeutic effect of cis-platinum on the HepG2 liver cancer cells decreased in the order(64%)> hydroxyurea(56%)>gemcitabine(46%)> adriamycin(45%)> 5-FU(38%). Conclusions Zebrafish xenotransplantation models of cancer cells are suitable for in vivo sensitivity test of anticancer drugs.
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Objective To investigate the changes of drug resistance related genes and drug resistance of Acinetobacter Bau-mannii in hospital,and provide evidence for rational use of antibiotics in clinic.Methods A retrospective analysis of Shaanxi Corps Hospital of Chinese Peoples’s Armed Police Forces from 2011 to 2015 from clinical samples of 11 521 specimens were isolated and cultured 1 861 strains of Acinetobacter Baumannii,drug susceptibility test by K-B method.The antimicrobial minimum inhibitory concentration (MIC)according to the 2014 edition of the CLSI judgment criteria of judgment.Results 1 861 strains of Acinetobacter Baumannii were detected drug resistance genes gyrA,parC,OXA-51,OXA-23,int on the 1,I TEM,AAC (6’)-1,AAC (3’)-1,ant (3)-1,ant (2)-1 and Caro gene detection rates were 50.4%,72.1%,70.9%,55.7%, 56.2%,65.6%,12.9% and 89.9% respectively,and SHV,IMP and VIM genes were not detected.The sequencing results showed that gyrA and parC gene mutation was the main cause of quinolone resistance.The antibiotic resistance of Acineto-bacterBaumannii was an increasing trend year by year,and 1 861 strains has 1 419 strains showed multiple drug resistance, all strains were sensitive to polymyxin.In 2015,quinolones aminoglycosides resistance rate was more than 65%.To imipen-em,meropenem and Cefoperazone/sulbactam were 35.17%,36.01% and 42.40%.Conclusion The detection rate of Acine-tobacter Baumannii is increasing year by year,and the drug resistance and multi drug resistance is increasing year by year.It is necessary to strengthen the clinical rational drug use andcontrol the hospital infection.
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Objective To study the difference of in vitro drug susceptibility test of biomembrane-producing Klebsiella pneumoni-ae to provide accurate drug reference for clinical treatment.Methods The drug susceptibility test was carried out in clinically isola-ted and screened16 strains of biomembrane-producing Klebsiella pneumoniae by K-B paper diffusion method ,and the results at 24 , 48 ,72 h were recorded.Then the strains were reproduced for several generations until not producing biofilm.Then the above opera-tions were taken again.Finally ,the results of twice drug susceptibility tests were performed the contrastive analysis.Results The mm number of inhibition zone of biomembrane-producing Klebsiella pneumoniae at 24 h had statistical difference compared with that at 48 ,72 h(P<0.05).Conclusion When the in vitro drug susceptibility test of biomembrane-producing Klebsiella pneumoniae is conducted by K-B paper diffusion method ,it is suitable to report the results after 48 h ,this has a certain reference value for pre-venting this bacterium.
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Objective To explore the infection and drug sensitivity of ureaplasma urealyticum(Uu)and mycoplasma hominis (Mh)in vaginal secretion of gynecological outpatients.Methods The infection and drug sensitivity test of Uu and Mh in va-ginal secretion samples of 1 800 patients collected from January 2015 to April 2016 were detected with mycoplasma culture i-dentification and counting drug sensitivity kit produced by Zhengzhou Antu Luke Bioengineering Co.,Ltd.Results The positive rate of Uu(57.27%)was significantly higher than that of Mh(2.78%,χ2=33.69,P<0.001).The positive rate of mycoplasma was highest in the age group of 31~35(77.09%),but that of Uu was highest in the age group of 21~25 (65.83%)and that of Mh in 36~40 years old group(9.09%),in addition that of multiple infection by Uu and Mh was highest in less than 20 years old group(20.51%).There were statistical difference for Un,Mh and co-infection by Un and Mh between age groups(χ2=15.505~36.574,P<0.01).The top three drugs sensitive for mycoplasma were josamycin, minocycline and doxycycline and that last three ones were clindamycin,thiamphenicol and sparfloxacin.The drug sensitive rates for 12 antibiotics against Uu were higher than those against co-infection by Uu and Mh,but those of erythromycin,gat-ifloxacin,azithromycin,clarithromycin and Luo Hongmei against Mh were lower than those against co-infecion of Uu and Mh.Conclusion The detection of mycoplasma and drug sensitivity in vaginal secretions provides the experimental basis for clinical diagnosis and treatment.
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Objective To analyse distribution and antibacterial resistance status of pathogenic bacteria isolated from blood cul‐tures of hospitalized infants ,in order to provide references for rational use of antimicrobial agents in the treatment of bloodstream infection .Methods A total of 299 strains of pathogenic bacteria isolated from positive blood culture specimens from infants(3 or less than 3 months of age) suspected with bloodstream infections in this hospital from January 2011 to May 2015 were collected ,the bacteria identification and drug sensitivity test were carried out by using the VITEK 2 Compact automatic microorganism analyzer . The composition and antibacterial resistance of these isolates were analyzed .Results Among the 299 strains of pathogenic bacteria , there were 169 strains of gram‐positive cocci(accounted for 56 .5% ) ,including 95 strains of coagulase negative Staphylococcus (ac‐counted for 31 .8% ) which was the main isolates ,and followed by 28 strains of Staphylococcus aureus(accounted for 9 .4% );there were 120 strains of gram‐negative bacilli (accounted for 40 .1% ) and mainly were Escherichia coli (53 strains ,accounted for 17 .7% );otherwise ,there were 8 strains of fungi (accounted for 2 .7% ) and 2 strains of gram‐positive bacillus (accounted for 0 .7% ) .The results of drug susceptibility test indicated that the gram‐positive cocci had multiple drug resistance to antibacterial a‐gents except for vancomycin and linezolid;the gram‐negative bacilli shown multiple drug resistance except for amikacin ,imipenem and meropenem .The fungus ,however ,displayed high sensitivty to all antifungal drugs .Conclusion Gram‐positive and gram‐nega‐tive bacteria are the main pathogens of hospitalized infants with bloodstream infection ,and are severely resistant to antibacterial a‐gents .Rational use of antimicrobial agents should be recommend for improving clinical efficacy and prohibiting the emergence of drug‐resistant strains .
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OBJECTIVE:To investigate the pathogen distribution and drug resistance situation in bronchoalveolar lavage fluid (BALF) from patients with refractory pulmonary infection,and provide reference for clinical rational drug use. METHODS:The sputum and BALF specimen of 136 inpatients with refractory pulmonary infection from the First People’s Hospital of Zhenjiang City from Jan. 2012 to Dec. 2015 were cultured and identified,pathogen detection was compared,and results of drug sensitivity test for pathogen in BALF specimen was analyzed. RESULTS:The positive rates of sputum and BALF specimen of 136 inpatients were 22.06%and 47.79%,with statistical significance(P<0.01);a total of 32 and 72 strains were isolated,they mainly were Ste-notrophomonas maltophilia,Pseudomonas aeruginosa,Acinetobacter baumannii and Staphylococcus aureus. S. maltophilia in BALF was sensitive to minocycline and levofloxacin;resistance rate of P. aeruginosa to common antibiotics was lower than 50%;A. baumannii was sensitive to imipenem,ampicillin sodium and sulbactam sodium,amikacin and minocycline;S. aureus was sen-sitive to linezolid,chloramphenicol and vancomycin. CONCLUSIONS:The positive rate of BALF specimen is higher than spu-tum,the pathogens are mainly Gram-negative bacteria. Clinic should rationally select antibiotics based on the drug sensitivity test and clinical symptoms.