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Objective@#To investigate the epidemiologic features of interhospital, intrahospital, interdepartmental and intradepartmental infections of carbapenem-resistant Acinetobacter baumannii (CRAB) isolated from clinical specimens. @*Methods@#From September 2015 to September 2016, 540 non-repetitive strains of Acinetobacter baumannii were clinically isolated from 38 tertiary hospitals in Anhui Province, of which 460 strains were confirmed by antimicrobial resistance surveillance in Anhui Province. Agar plate dilution method was used to determine the MIC of 16 antibiotics and to select 312 CRAB isolates for drug sensitivity test. Pulsed field gel electrophoresis (PFGE) was used to analyze homology of 145 strains. PCR and clonal sequencing were used to determine the corresponding genotypes. @*Results@#All the 312 CRAB strains were multiple antibiotic resistant strains. The drug resistance rates to imipenem and meropenem were 67.9% and 70.6%, respectively. All the 145 strains were divided into 80 different types (PT1-PT80) by PFGE. Only one strain was found in the 60 types and two or more strains were found in the other 20 types. Genotype blaOXA-51 was detected in 145 strains (100%), genotype blaOXA-23 was detected in 134 of strains (92.41%), genotype blaOXA-24 was detected in 1 strain (0.69%), and subtype of blaIMP-4 was detected in 4 strains (2.76%). Genotype blaOXA-58, blaVIM, blaSIM, blaNDM and blaKPC were undetectable. @*Conclusions@#Homologous analysis indicates that all 145 strains of CRAB exhibit the interhospital, intrahospital, interdepartmental and intradepartmental transmission. Genotype blaOXA-51 is the inherent drug resistant associated gene in the chromosome of AB and genotype blaOXA-23 is the most common carbapenemase gene in Anhui Province and the main genotypes of resistance transmission.
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Objective To observe the clinical effect of treatment of duodenal trauma intubation duodenal decompression jejunostomy jointly by the duodenal catheter decompression.Methods 60 patients with duodenal trauma were randomly divided into two groups,30 cases were treated with simple duodenal catheter decompression as control group,30 cases treated with duodenal catheter decompression joint jejunum ostomy intubation duodenal decompression as the observation group,generally observed two groups of patients surgery and postoperative complications,in the day of surgery and postoperative 7d evaluation of patients with nutritional status.Results The surgical time and blood loss of the two groups had no statistically significant difference(P＞0.05),the observation group had no case of duodenal fistula and four cases in the control group(13.33％)occumed duodenal fistula.The difference between the two groups was statistically significant(x2=4.286,P＜0.05).Postoperative concurrent abdominal abscess,lung infection,wound infection had no statistically significant differences(P＞0.05).After observation group 7d body mass and right upper arm muscle circumference stability was significantly higher than that in the control group(x2=7.519,9.868,both P＜0.05).Conclusion Jejunostomy joint duodenal catheter decompression intubation duodenal decompression in treatment of duodenal trauma surgical decompression had significant effect,can significantly reduce the incidence of fistula,improve patients nutritional status,promote the duodenal wound healing.