RÉSUMÉ
Objective To investigate the antimicrobial resistance profile of the clinical isolates collected from selected hospitals across China. Methods Twenty-nine general hospitals and five children's hospitals were involved in this program. Antimicrobial susceptibility testing was carried out according to a unified protocol using Kirby-Bauer method or automated systems. Results were interpreted according to CLSI 2017 breakpoints. Results A total of 190 610 clinical isolates were collected from January to December 2017, of which gram negative organisms accounted for 70.8％ (134 951/190 610) and gram positive cocci 29.2％ (55 649/190 610). The prevalence of methicillin-resistant strains was 35.3％ in S. aureus (MRSA) and 80.3％ in coagulase negative Staphylococcus (MRCNS) on average. MR strains showed much higher resistance rates to most of the other antimicrobial agents than MS strains. However, 91.6％ of MRSA strains were still susceptible to trimethoprim-sulfamethoxazole, while 86.2％ of MRCNS strains were susceptible to rifampin. No staphylococcal strains were found resistant to vancomycin. E. faecalis strains showed much lower resistance rates to most of the drugs tested (except chloramphenicol) than E. faecium. Vancomycin-resistant Enterococcus (VRE) was identified in both E. faecalis and E. faecium. The identified VRE strains were mainly vanA, vanB or vanM type based on phenotype or genotype. The proportion of PSSP or PRSP strains in the non-meningitis S.pneumoniae strains isolated from children decreased but the proportion of PISP strains increased when compared to the data of 2016. Enterobacteriaceae strains were still highly susceptible to carbapenems. Overall, less than 10％ of these strains (excluding Klebsiella spp.) were resistant to carbapenems. The prevalence of imipenem-resistant K. pneumoniae increased from 3.0％ in 2005 to 20.9％ in 2017, and meropenem-resistant K. pneumoniae increased from 2.9％ in 2005 to 24.0％ in 2017, more than 8-fold increase. About 66.7％ and 69.3％ of Acinetobacter (A. baumannii accounts for 91.5％) strains were resistant to imipenem and meropenem, respectively. Compared with the data of year 2016, P. aeruginosa strains showed decreasing resistance rate to carbapenems. Conclusions Bacterial resistance is still on the rise. It is necessary to strengthen hospital infection control and stewardship of antimicrobial agents. The communication between laboratorians and clinicians should be further improved in addition to surveillance of bacterial resistance.
RÉSUMÉ
Objective To investigate the clinical significance of human papillomavirus(HPV )genotype combined with thinprep cytologic test(TCT )in the diagnosis of cervical lesion .Methods A total of 473 patients were checked for 21 subtypes of HPV by diversion hybrid gene chip technology ,TCT and colposcope biopsy were also detected at the same time .The histology was selected as a gold standard to analyze the tested results .Results The over all positive rate of HPV in 473 patients was 35 .7% .The positive rate of high risk HPV(HR‐HPV) was 32 .1% ,the positive rate of TCT was 26 .6% ,the sensibility ,specificity ,false negative rate , positive predictive value and negative predictive value between HR‐HPV detection and TCT detection were no statistical signifi‐cance(χ2 = 3 .444 ,P= 0 .063) .The sensibility ,specificity ,false negative rate ,positive predictive value and negative predictive value of combining test were 95 .8% ,77 .7% ,4 .2% ,52 .3% and 98 .7% ,the sensibility and negative predictive value improved notably , and the omission diagnose rate decreased significantly(P< 0 .05) .Conclusion HPV genotype combined with TCT detection could significantly improve sensibility and negative predictive value and decrease omission diagnose rate in diagnosis of cervical lesion .