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Objective To investigate the infection status and changing trend of hepatitis C virus(HCV)infection in hospitalized patients in medical institutions,and provide reference for formulating HCV infection prevention and control strategies.Methods HCV infection surveillance results from cross-sectional survey data reported to China Healthcare-associated Infection(HAI)Surveillance System in 2020 were summarized and analyzed,HCV positive was serum anti-HCV positive or HCV RNA positive,survey result was compared with the survey results from 2003.Results In 2020,1 071 368 inpatients in 1 573 hospitals were surveyed,738 535 of whom underwent HCV test,4 014 patients were infected with HCV,with a detection rate of 68.93％and a HCV positive rate of 0.54％.The positive rate of HCV in male and female patients were 0.60％and 0.48％,respectively,with a statistically sig-nificant difference(x2=47.18,P＜0.001).The HCV positive rate in the 50-＜60 age group was the highest(0.76％),followed by the 40-＜50 age group(0.71％).Difference among all age groups was statistically signifi-cant(x2=696.74,P＜0.001).In 2003,91 113 inpatients were surveyed.35 145 of whom underwent HCV test,resulting in a detection rate of 38.57％;775 patients were infected with HCV,with a positive rate of 2.21％.In 2020,HCV positive rates in hospitals of different scales were 0.46％-0.63％,with the highest in hospital with bed numbers ranging 600-899.Patients'HCV positive rates in hospitals of different scales was statistically signifi-cant(X2=35.34,P＜0.001).In 2020,12 provinces/municipalities had over 10 000 patients underwent HCV-rela-ted test,and HCV positive rates ranged 0.19％-0.81％,with the highest rate from Hainan Province.HCV posi-tive rates in different departments were 0.06％-0.82％,with the lowest positive rate in the department of pedia-trics and the highest in the department of internal medicine.In 2003 and 2020,HCV positive rates in the depart-ment of infectious diseases were the highest,being 7.95％and 3.48％,respectively.Followed by departments of orthopedics(7.72％),gastroenterology(3.77％),nephrology(3.57％)and general intensive care unit(ICU,3.10％)in 2003,as well as departments of gastroenterology(1.35％),nephrology(1.18％),endocrinology(0.91％),and general intensive care unit(ICU,0.79％)in 2020.Conclusion Compared with 2003,HCV positive rate decreased significantly in 2020.HCV infected patients were mainly from the department of infectious diseases,followed by departments of gastroenterology,nephrology and general ICU.HCV infection positive rate varies with gender,age,and region.
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Objective To understand the distribution of frequently isolated pathogenic bacteria from clinical speci-mens and their antimicrobial resistance changes in Hunan Province from 2012 to 2021,and to provide scientific evi-dence for the formulation and evaluation of antimicrobial clinical administration policies.Methods Species identifi-cation,selection of quality control strains and antimicrobial susceptibility testing agents were conducted according to the technical scheme of the China Antimicrobial Resistance Surveillance System(CARSS).Duplicate strains were excluded based on the principle of counting the first strain in each case.Statistical analysis was performed by WHO-NET 5.6 software.The the variations in constituent ratio and resistance rate of strains were analyzed with linear trend test,and the magnitude of change was described with Pearson correlation coefficient.Results From 2012 to 2021,the number of clinically isolated bacteria in the analysis increased from 82 759 to 312 914,with Gram-negative bacteria accounting for 69.5％-72.4％.The major Gram-positive bacteria were Staphylococcus aureus,Staphylo-coccus epidermidis,Streptococcus pneumoniae,Enterococcus faecalis and Enterococcus faecium,and the major Gram-negative bacteria were Escherichia coli,Klebsiella pneumoniae,Pseudomonas aeruginosa,Acinetobacter baumannii and Enterobacter cloacae.Isolation rate of Gram-positive bacteria increased yearly(r=0.022,P=0.001).Isolation rate of methicillin-resistant Staphylococcus aureus(MRSA)decreased from 34.3％to 24.8％.Isolation rates of vancomycin-resistant Enterococcus faecium and Enterococcus faecalis were less than 3％and 2％,respectively,presenting a downward trend.The detection rate of penicillin-resistant Streptococcus pneumoniae(PRSP)decreased from 5.6％to 1.0％.Except cefoperazone sulbactam,resistance rates of Escherichia coli to other tested antimicrobial agents showed decreasing trends(r＜0,P=0.001).Isolation rates of third-generation cephalo-sporin-resistant Escherichia coli(CTX/CRO-R-EC)and carbapenem-resistant Escherichia coli(CREC)decreased year by year(from 70.5％to 45.3％,and 12.2％to 2.0％,respectively).Resistance rates of Klebsiella pneumo-niae to imipenem and meropenem have increased year by year,reaching 9.1％and 11.0％respectively in 2021,while isolation rate of carbapenem-resistant Pseudomonas aeruginosa(CRPA)decreased from 28.5％to 15.0％.Resistance rates of Acinetobacter baumannii to most antimicrobial agents were 40％-60％,and remained relatively stable.Isolation rate of carbapenem-resistant Acinetobacter baumannii(CRAB)ranged from 39.5％ to 59.6％.Conclusion The clinical isolation rates of most important special antimicrobial-resistant bacteria have been decrea-sing year by year,while the resistance rate of Klebsiella pneumoniae to carbapenem agents gradually increased.Antimicrobial stewardship as well as the prevention and control of healthcare-associated infection on specific antimi-crobial-resistant bacteria should continue to be implemented in the future.The coverage and quality of antimicrobial resistance surveillance in H unan Province should continue to be improved.
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Objective To understand the distribution and antimicrobial resistance changes of bacteria isolated from pleural and peritoneal effusion in Hunan Province,and provide reference for correct clinical diagnosis and rational antimicrobial use.Methods Data reported by member units of Hunan Provincial Antimicrobial Resistance Survei-llance System from 2012 to 2021 were collected.Bacteria antimicrobial resistance surveillance method was imple-mented according to technical scheme of China Antimicrobial Resistance Surveillance System(CARSS),and WHO-NET 5.6 software was used to analyze the data of bacteria isolated from pleural and peritoneal effusion as well as antimicrobial susceptibility testing results.Results From 2012 to 2021,a total of 28 934 bacterial strains were iso-lated from specimens of pleural and peritoneal effusions from member units of Hunan Provincial Antimicrobial Re-sistance Surveillance System,with 5 752 strains from pleural effusion and 23 182 from peritoneal effusion.The top five bacteria isolated from pleural effusion were Escherichia coli(n=907,15.8％),Staphylococcus aureus(n=535,9.3％),Klebsiella pneumoniae(n=369,6.4％),Staphylococcus epidermidis(n=452,7.9％),and Staphy-lococcus haemolyticus(n=285,5.0％).The detection rate of methicillin-resistant Staphylococcus aureus(MR-SA)from pleural effusion was 24.3％-39.2％,and that of methicillin-resistant coagulase negative Staphylococcus(MRCNS)was 58.8％-77.1％.The top five bacteria isolated from peritoneal effusion were Escherichia coli(n=8 264,35.6％),Klebsiella pneumoniae(n=2 074,9.0％),Enterococcus faecium(n=1 458,6.3％),Staphylo-coccus epidermidis(n=1 383,6.0％),and Pseudomonas aeruginosa(n=1 152,5.0％).The detection rate of MRSA from peritoneal effusion was 22.1％-52.4％,which presented a decreasing trend(P=0.004).The detec-tion rate of MRCNS was 60.4％-79.4％.The resistance rates of Enterobacterales from peritoneal effusion to ce-fazolin,cefuroxime,ceftriaxone and cefepime all showed decreasing trends(all P＜0.05).Vancomycin-,linezo-lid-,and teicoplanin-resistant Staphylococcus strains were not found in pleural and peritoneal effusions.The resis-tance rates of Enterococcus faecium to most tested antimicrobial agents were higher than those of Enterococcus fae-calis.The resistance rates of Enterobacterales to imipenem and meropenem were ≤8.5％.The resistance rates of non-fermentative Gram-negative bacilli to imipenem and meropenem were ≤43.3％.Conclusion The data structure of Hunan Antimicrobial Resistance Surveillance System for pleural and peritoneal effusions from 2012 to 2021 is relatively complete.The constituent and antimicrobial susceptibility of isolated pathogenic bacteria vary in different years.
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Objective To understand the distribution and changes in antimicrobial resistance of clinically isolated Pseudomonas aeruginosa(P.aeruginosa)in the member hospitals of Hunan Provincial Antimicrobial Resistance Surveillance System from 2012 to 2021.Methods Antimicrobial susceptibility testing by disk diffusion or automa-ted instrument was performed on clinical isolates.Testing results were determined according to the standards of 2022 edition from American Clinical Laboratory Standards Institute(CLSI).Statistical analysis was performed by WHONET 5.6 software.Data were analyzed by trend test(Cochran-armitage)and Chi-square test with SPSS.Results A total of 176 441 strains of P.aeruginosa were surveilled by Hunan Provincial Antimicrobial Resistance Surveillance System from 2012 to 2021.99.4％of the strains were isolated from hospitalized patients,and about 70％of the strains were isolated from respiratory specimens.8.4％of P.aeruginosa were from children(0-17 years old),91.6％were from adults.Antimicrobial susceptibility testing results showed that P.aeruginosa was most sensitive to polymyxin B over 10 years,with a resis-tance rate of less than 6％.Resistance rates to piperacil-lin,piperacillin/tazobactam,ceftazidime,cefepime,aztreonam,imipenem,amikacin,gentamicin,tobramycin,cip-rofloxacin,levofloxacin,and polymyxin B all showed downward trends.A total of 29 920 carbapenem-resistant P.aeruginosa(CRPA)strains were detected.The average isolation rate of CRPA in this province was 18.0％over 10 years.CRPA detection rate from adult was 18.5％,higher than that from children(12.3％),and both showing downward trends.Conclusion The resistance rate of clinically isolated P.aeruginosa in Hunan Province to most commonly used antimicrobial agents is decreasing.
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Objective To understand the epidemiology of clinically isolated Acinetobacter baumannii(A.bauma-nnii)in Hunan Province.Methods Bacterial antimicrobial resistance surveillance was carried out according to the requirements of the technical program of National Antimicrobial Resistance Surveillance System.Clinical data of Acinetobacter spp.reported to Hunan Provincial Antimicrobial Resistance Surveillance System by multiple centers in Hunan Province from 2012 to 2021 were summarized and analyzed with reference to the standards of the American Clinical and Laboratory Standards Institute.Results A total of 169 438 strains of Acinetobacter spp.were detected during the 10-year period,with the detection rate of A.baumannii being the highest(82.74％).70 923 strains(53.63％)of carbapenem-resistant A.baumannii(CRAB)and 58 149 strains(43.97％)of carbapenem-sensitive A.baumannii(CSAB)were detected respectively.Both CRAB and CSAB were detected most frequently in the age group＞70 years,which were 34.44％and 32.02％,respectively.The percentage of CRAB and CSAB detected in the intensive care unit were 34.80％and 11.31％,respectively.CRAB and CSAB were mainly isolated from spu-tum/bronchoalveolar lavage fluid,followed by pus/secretion,urine,and blood.The resistance rates of CRAB to commonly used antimicrobial agents didn't change much during the 10-year period.Resistance rates of CRAB to ceftazidime and cefepime were both＞84％,to ampicillin/sulbactam and piperacillin/tazobactam were both＞82％,to aminoglycosides and quinolones were both＞59％,to minocycline and polymyxin B were 15.9％-25.0％and 1.3％-6.9％,respectively.CSAB were sensitive to commonly used antimicrobial agents.Conclusion The isolation rate of CRAB is high and there is no significant change in resistance to commonly used antimicrobial agents.
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In the context of the coronavirus disease 2019 (COVID-19)pandemic,thousands of health care wor- kers (HCWs)worldwide infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2),some even have lost their lives.At the early stage of the epidemic,some Chinese HCWs were infected.Owing to limited knowledge of characteristics of SARS-CoV-2,more than 3,000 HCWs in Hubei Province contracted SARS-CoV-2 at the early stage of the outbreak.Due to overloaded work of HCWs in local hospitals,more than 42,000 HCWs (including HCWs from the military)were dispatched to Hubei Province from all over the country.At the peak of epidemic,one in 10 intensive care HCWs in China were working in Wuhan.During fighting against COVID-19 in China,although a certain number of HCWs were infected with SARS-CoV-2 at the early stages of the epidemic, effective prevention was achieved through timely adoption of prevention measures,including fast diagnosis,timely isolation of patients,strengthening of HCWs'safety,intensified training on basic protective knowledge and unified management of HCWs,there was no report about infection among the 42,632 members of the national medical teams sent to Hubei,and the number of COVID-19 cases among HCWs in local hospitals also significantly de- creased,thereby indicating that healthcare-associated infection (HAI)of COVID-19 among HCWs are fully pre- ventable.This paper explores how to prevent HCWs from contracting SARS-CoV-2 through effective measures during the epidemic in Wuhan,China.
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In recent years, with the widespread use of broad-spectrum antimicrobial agents, multidrug-resistant organisms (MDROs) have emerged and become more and more common, such as methicillin-resistant Staphylococcus aureus (MRSA) and carbapenem-resistant Enterobacteriaceae (CRE), which pose severe challenge to clinical anti-infective treatment and prevention and control of healthcare-associated infection. The new antimicrobial agents and bacterial resistance have developed at the same time, development of bacterial resistance seems to have a tendency to overwhelm the development of antimicrobial agents. Antimicrobial resistance (AMR) is now recognized as one of the major threat to human health worldwide. The Center for Disease Control and Prevention (CDC) of America has proposed four core plans to address the challenge of MDROs: surveillance, antimicrobial management, improvement of antimicrobial agents and diagnosis, as well as prevention and control of transmission. In response to the severe threat of MDRO infection, prevention of infection should be focused on, antimicrobial management and HAI management should be grasped at the same time and attached sufficient importance, effective measures should be taken based on the source, route, and susceptible people of infection, multiple details and constant innovation should be paid attention to, the final victory can be achieved.
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Objective To determine the mRNA expression of transforming growth factor β2 (TGF-β2) in human brain glioma stem cells (BGSCs),and investigate its effect onimmunotherapy of glioma. Methods BGSCs were grown from 8 specimens resected from glioma from October 2008 to January 2009,then,they were isolated and identified.The expressions ofCD133,GFAP and TU-20 in the tumor cell spheres were detected by immunofluorescence staining; the TGF-β2 mRNA expression in BGSCs was detected by RT-PCR,and then,this result was compared with that of respective differentiated glioma cells. Results Positive expression of CD133 was noted in the tumor cell spheres,and GFAP and TU-20 could be expressed in the tumor cell spheres. A quantitative determination exhibited higher TGF-β2 mRNA expression in BGSCs than that in their counterparts of primary cultured glioma cells,which was statistically significant (t=3.619,P=0.009). Conclusion High TGF-β2 mRNA expression is noted in BGSCs,which might be the main producer of overproduction of TGF-β2 in gliomas leading to immune escape and resistance to current therapies.
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Glioma is the most malignant tumor in the brain, the origin of glioma is still unknown. Recently some papers indicated that glioma may be developed from cerebral cavernous malformation (CCM). We describe a man with a right temporal lobe CCM, after gamma-knife radiotherapy, the patient developed a low-grade astrocytoma in the area of the preexistent CCM. This case, together with other reports, may indicated an oncogenetic properties of CCM, and we proposed that CCM may be a pre-glioma lesion.
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Humains , Mâle , Gliome , Imagerie diagnostique , Anatomopathologie , Hémangiome caverneux du système nerveux central , Imagerie diagnostique , Anatomopathologie , RadiographieRésumé
<p><b>BACKGROUND</b>Previous studies have shown that glioma patients have lower blood IgE levels than controls. To evaluate its potential as a surrogate biomarker for glioma, we measured plasma IgE levels in glioma patients and healthy controls, and correlated them with clinicopathological factors and the patients' outcome.</p><p><b>METHODS</b>We used enzyme-linked immunosorbant assay (ELISA) to determine the plasma IgE levels of 25 normal subjects and 252 glioma patients (85 patients with grade II glioma, 46 patients with grade III glioma, and 121 patients with glioblastoma). We also collected longitudinal plasma samples from glioblastoma patients and compared the plasma IgE levels before operation, one week after operation, in the middle of radiotherapy, after two cycles of chemotherapy, and after recurrence. The correlations between plasma IgE levels and the outcomes of the patients were determined.</p><p><b>RESULTS</b>Plasma IgE levels were significantly lower in glioma patients (P = 0.004); patients with low-grade glioma have lower IgE levels than patients with high-grade glioma do (P = 0.029). In 24 patients with both preoperative plasma and two-cycle chemotherapy plasma samples, IgE levels increased after successful removal of the tumor (P = 0.021), and the increase correlated with the patients' survival (increase > 100 ng/ml vs. ≤ 100 ng/ml, 127.5 weeks vs. 62.3 weeks. P = 0.012, log-rank). Plasma IgE level increase of > 100 ng/ml has a specificity of 80% and a sensitivity of 78% to predict the patients' long survival (> 18 months).</p><p><b>CONCLUSIONS</b>Our results suggest that plasma IgE level correlates with clinical and pathological factors in glioma patients. It has the potential to be a biomarker for glioma patients.</p>
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Adulte , Femelle , Humains , Mâle , Marqueurs biologiques , Sang , Test ELISA , Glioblastome , Sang , Thérapeutique , Gliome , Sang , Thérapeutique , Immunoglobuline E , Sang , Sensibilité et spécificité , Résultat thérapeutiqueRésumé
Objective To explore the efficacy of microsurgery on petroclival meningiomas.Methods A retrospective analysis of the clinical data and the prognosis of microsurgery was performed on 21 patients with petroclival meningioma.Suboccipital retrosigmoid approach was adopted in 3 and supra-or infra-tentorial transpetrosal presigmoid approach was adopted in 18.The clinical manifestations and surgical outcomes were analyzed to evaluate the significance of microsurgery. Results Of the 21 patients with petroclival meningioma,total resection(Simpson I,Ⅱ)and sub-total resection(Simpson Ⅲ)were achieved in 11 and 5,respectively;resection of major part was obtained in 4 and partial resection was obtained in 1 with 1 postoperative death.At the early stage of postoperation,5 patients developed oculomotor palsy and 4 developed dysfunction of facial nerve;2 were found caudal cranial nerve palsy and 2 were found hemiplegia contralateral to the tumor.All these patients were followed up for about 3 months to 4 years:3 recovered from the oculomotor palsy 1 month after the operation and 3 recovered from the dysfunction of facial nerve 3 months after the operation;2 recovered from caudal cranial nerve palsy 1 week after the operation and 2 recovered from hemiplegia 1 month after the operation.5 were performed γ knife radiotherapy without tuinor recurrence. Conclusion Choosing the fight approach is the key to petroclival meningiomas management and presigmoid approach is the most effective way at present.
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<p><b>OBJECTIVE</b>To explore the surgical strategy of the tumors of petroclival region.</p><p><b>METHODS</b>The surgical data of 55 cases presented with meningioma and trigeminal nerve sheath tumors from January 2002 to February 2009 was retrospectively analyzed. All the cases were divided into full-cut group, sub-total resection group, part of resection group or divided into full-cut group and no-total resection group, in terms of various surgical strategy. The incidence of postoperative neurological disorder and quality of life status were focused and statistical analysis was carried out.</p><p><b>RESULTS</b>There were 21 patients with complete cut, 22 patients with sub-total resection and 12 patients with part of resection. There were 12 patients with neurological deterioration in full-cut group and 10 patients in no-total resection group. There was significant difference between total resection group and no-total resection group (χ(2) = 4.16, P < 0.05). All the patients were assessed based on the criterion of KPS, 12 patients of full-cut whose KPS ≥ 80, 29 patients were the same in no-total resection group. There was significant difference between the two groups (χ(2) = 5.42, P < 0.05). The mean follow-up time was 3 years. No recurrence was found in full-cut group and 5 recurrence of no-total resection group.</p><p><b>CONCLUSIONS</b>The pursuit of full-cut for the tumors of petroclival region may result in serious neurological dysfunction and poor life quality after the operation. Non-full-cut combination of postoperative radiotherapy may receive a relative better results.</p>
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Adulte , Sujet âgé , Femelle , Humains , Mâle , Adulte d'âge moyen , Études de suivi , Tumeurs des méninges , Chirurgie générale , Méningiome , Chirurgie générale , Neurinome , Chirurgie générale , Études rétrospectives , Résultat thérapeutique , Nerf trijumeauRésumé
<p><b>OBJECTIVE</b>To investigate the treatment of chronic subdural hematoma (CSDH) with burr-hole craniotomy in our hospital.</p><p><b>METHODS</b>From January 2004 to December 2009, 398 patients with CSDH, 338 males and 60 females (male/female equal to 5.63/1), received burr-hole craniotomy in our hospital. The median age was 60 years with the mean age of (58.1 ± 18.1) years, (65.0 ± 14.5) years for females and (57.0 ± 18.2) years for males. Trauma history was determined in 275 patients (69.1%). Burr-hole craniotomy was performed under local anesthesia in 368 patients and general anesthesia in 30 patients. CSDH was classified into 3 groups according to the density on CT scan. Clinical data concerning etiologies, symptoms and signs, concomitant diseases, diagnosis, therapies and outcomes were investigated retrospectively. Patients'neurological status on admission and at discharge was also classified to judge the outcomes.</p><p><b>RESULTS</b>Generally, trauma history showed few differences between those over 60 years old and under 60 years old, but showed obvious differences when gender was taken into account. Totally 123 male patients (60.0% of 204 cases) suffering from head injuries were under 60 years, whereas 35 female patients (85.4% of 41 cases) with trauma histories were over 60 years. The duration from trauma to appearance of clinical symptoms was (84.0 ± 61.7) days (range, 0-1493 days). Traumatic accident was the leading etiology, other accompanying diseases such as cerebral vascular disease, hypertension, etc, were also predisposing factors. Commonly, the elderly presented with hemiplegia/hemidysesthesia/hemiataxia and the young with headache. Most CSDH patients (95.6%) treated with burr-hole craniotomy successfully recovered. However, postoperative complications occurred in 17 cases, including recurrence of CSDH in 15 cases, subdural abscess in 1 case and pneumonia in 3 cases.</p><p><b>CONCLUSION</b>Burr-hole craniotomy is an easy, efficient and reliable way to treat CSDH.</p>
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Adolescent , Adulte , Sujet âgé , Sujet âgé de 80 ans ou plus , Enfant , Enfant d'âge préscolaire , Femelle , Humains , Nourrisson , Mâle , Adulte d'âge moyen , Craniotomie , Méthodes , Hématome subdural chronique , Chirurgie générale , Complications postopératoires , Facteurs de risque , TomodensitométrieRésumé
<p><b>OBJECTIVE</b>To explore the clinical manifestation, diagnosis and surgical treatment of cerebrospinal fluid rhinorrhea in sphenoidal sinus.</p><p><b>METHODS</b>Nine cases of cerebrospinal fluid rhinorrhea in sphenoidal sinus from 2007 to 2009 were retrospectively analyzed consisting of their possible etiological factors, clinical manifestations, localization of the leakage site and treatment methods. Among them, there were 3 cases of traumatic rhinorrhea, 4 postoperative rhinorrhea and 2 spontaneous rhinorrhea. All 9 patients underwent 3-dimensional CT scan in sellar region including all para-nasal sinus. Leakage site was identified and repairing procedure was performed through trans-sphenoidal approach.</p><p><b>RESULTS</b>All cases were cured with the trans-sphenoidal microsurgical procedure. They were followed up for 9 months to 2 years. No recurrence, no infection and epilepsy complications were observed.</p><p><b>CONCLUSION</b>For the cerebrospinal fluid rhinorrhea at sphenoidal sinus, it is critical to identify the leakage site accurately and the trans-sphenoidal approach is a microinvasive and effective way to repair the leakage, which is worthy to be advocated.</p>
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Adulte , Femelle , Humains , Mâle , Adulte d'âge moyen , Rhinorrhée cérébrospinale , Imagerie diagnostique , Chirurgie générale , Imagerie tridimensionnelle , Microchirurgie , Méthodes , Études rétrospectives , Sinus sphénoïdal , Chirurgie générale , TomodensitométrieRésumé
<p><b>OBJECTIVE</b>To investigate the spread and antimicrobial susceptibility of methicillin-resistant Staphylococcus aureus (MRSA) at hospital.</p><p><b>METHODS</b>Totally 110 strains of Staphylococcus aureus (SA) were isolated from the clinical samples of patients in 4 hospitals and 30 strains of SA were isolated from the hospital environment and personnel in Xiangya Hospital. MRSA was detected using oxacillin disk diffusion test, cefoxitin disk diffusion test and MecA, FemA gene PCR assay. Beta-lactamase was detected using nitrocephin sticks. The antimicrobial susceptibility of MRSA was tested by K-B disk diffusion test.</p><p><b>RESULTS</b>Among the 140 strains, 89 were MRSA, accounting for 63.57% of the total SA. The isolation rates of MRSA in clinical strains and environment strains were 64.55% and 60.00% (P > 0.05). All MRSA strains were sensitive to vancomycin and linezolid, 87 MRSA strains (97.75%) were sensitive to teicoplanin, most of which, however, were resistant to other antibiotics. Among the 89 strains, 85 MRSA strains (95.51% ) expressed beta-lactamase.</p><p><b>CONCLUSIONS</b>MRSA is highly prevalent in hospitals. Most MRSA strains are multi-drug resistant, but are still sensitive to vancomycin, linezolid, and teicoplanin.</p>
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Humains , Antibactériens , Pharmacologie , Infection croisée , Microbiologie , Multirésistance bactérienne aux médicaments , Hospitalisation , Résistance à la méticilline , Staphylococcus aureus résistant à la méticilline , Génétique , Tests de sensibilité microbienne , Infections à staphylocoques , MicrobiologieRésumé
<p><b>OBJECTIVE</b>To investigate the antibiotics use in inpatients with hospitals under different scales.</p><p><b>METHODS</b>On the day of August 7, 2003, antibiotics use among inpatients were investigated, medical order to each inpatient was checked and forms were filled.</p><p><b>RESULTS</b>Data showed that 54.86% of the 89,539 inpatients from 151 hospitals were using antibiotics, out of which 48.98% were used for therapeutic purposes while 35.44% for prophylaxis, and 15.58% for both therapy and prophylaxis. Among those who had received antibiotics, 61.43% received one, 33.65% received two and 4.92% received 3 or more agents. In patients who were on antibiotics for therapy, only 23.92% of the samples were sent for pathogens detection. The prevalence of antibiotics use was different among different hospitals, with teaching hospitals having the lowest and hospitals with less than 300 beds were higher than those with more than 300 beds. Departments of respiratory diseases, intensive care unit, and pediatrics had the higher use of antibiotics.</p><p><b>CONCLUSION</b>Inpatients in 151 hospitals had high prevalence of antibiotics use, especially for prophylaxis use but pathogen detection was seldomly done. It is necessary to strengthen the rational use and management of antibiotics use in the hospitals.</p>