Analysis of the clinical distribution of Acinetobacter baumannii infection and its drug resistance / 中国基层医药

Objective To investigate the clinical distribution of Acinetobacter Baumann in our hospital and its drug resistance,provide a reference for clinical medical thereby.Methods A retrospectively analysis for 406 Acinetobacter baumannii detected in our hospital from January 2010 to January 2012 was made,the clinical distribution was observed,and the resistance rates of several commonly used antimicrobial agents was calculated.Results Acinetobacter baumannii infections was mainly detected in respiratory medicine and intensive care unit,the detection rate were 27.3％ and 19.0％,the primarily infection site was the respiratory system,Acinetobacter baumannii was detected mainly from sputum specimens and the detection rate was 56.2％,the resistance rate of imipenem,meropenem and cefoperazone sulbactam was relatively low,which were 8.6％,10.6％ and 17.0％.Conclusion Acinetobacter baumannii is an important cause of nosocomial infections and prone to multidrug-resistant pathogens,it is a serious threat to patients,we must make a strict selection of appropriate antibiotic therapy based on susceptibility to reduce nosocomial transmission of Acinetobacter baumannii.

Clinical study of capacity index monitoring by PiCCO in fluid resuscitation in septic shock patients / 中国基层医药

Objective To investigate the value of fluid resuscitation strategy in septic shock patients by pulse indicator continuous cardiac out ( PiCCO ) .Methods 42 septic shock patients were divided into the PiCCO group(n=26) and the control group(n=16).All patients measured heart rate(HR),mean artery pressure(MAP), central venous pressure(CVP);CI,GEDVI,SVRI,EVLWI,CVP as indicator of fluid resuscitation after 0h,6h,24h of the diagnosis were measured respectively in PiCCO group;CVP as guiding volume resuscitation was measured in the control group .The effect of fluid resuscitation was compared between two groups .To analyse the relationship between CVP,GEDVI and CI in PiCCO group .according to CVP increase 2mmHg ,GEDVI whether elevated 10%.Results After 6h EGDT treatment bundle HR ,MAP,APACHEII score and clearance rate of lactic in PiCCO group improved more than those in control group [(101.3 ±7.8) and (119.4 ±7.2),t=-7.520,P0.05;(53.6 ±11.5) and (-16.5 ±5.2),t =9.283,P 0.05),but ICU hospitalization time decreased in PiCCO group [(13.8 ±2.6) and (23.3 ±2.2),t=-5.075,P0.05).Conclusion Hemodynamic monitoring by PiCCO directed fluid resuscitation strategy can elevate reversal rate .Compared with pressure index CVP ,GEDVI is a sensitive indicator of cardiac preload .Correlation between CVP and GEDVI can reflect cardiac function ,Especially for septic shock patients with cardiac depression .