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OBJECTIVE:To provide reference for rational drug use and hospital infection control. METHODS:AmpC enzyme-producing Enterobacter cloacae were isolated from non-sputum specimen of a hospital during Jan. 2011-Oct. 2017. Drug sensitivity test was conducted by using MIC. The situation of AmpC enzyme production was confirmed by three dimensional test, and that of ESBLs-producing stain was detected with double-disk synergy test. RESULTS:There were 546 strains of AmpC enzyme-producing E. cloacae isolated from non-sputum specimen of the hospital,accounting for 4.80% of non-sputum specimen (546/11 375)and 38.97% of E. cloacae(546/1 401). Top 3 non-sputum samples in the list of detection rate were wound secretion (27.29%),midstream urine(25.82%)and blood(21.79%),and the departments with high detection rate were ICU(22.89%), neurosurgery department(18.68%)and general surgery department(16.67%). Resistance rate of AmpC enzyme-producing E. cloacae to most commonly used antibiotics was higher than 40%. There was statistical significance in resistant rate of the bacteria to ceftriaxone, cefotaxime, gentamicin, nitrofurantoin, levofloxacin, piperacillin/tazobactam, cefoperazone, ceftazidime,cefepime,tobramycin and minocycline among different years (P<0.05). The resistant rate to imipenem and meropenem was lower than 2%. Among 546 strains of AmpC enzyme-producing E. cloacae,68 strains of ESBLs were detected,and detection rates were 5.77%,6.06%,8.70%,10.26%,13.79%,17.35%,18.75% during 2011-2017. CONCLUSIONS:AmpC enzyme-producing E. cloacae are mainly isolated from samples as wound secretion and midstream urine,and mainly come from ICU and neurosurgery department. The drug resistance of the bacteria is severe,and drug resistance of the bacteria to antibiotics as β-lactams and quinolones is increased significantly. The detection rate of ESBLs-producing strain increases year by year. The bacteria are sensitive to carbapenems antibiotics,which can be regarded as first choice. It is necessary to strengthen drug resistance and enzyme production monitoring of AmpC enzyme-producing E. cloacae,select antibiotics combined with results of drug sensitivity test so as to prevent or delay the rapid increase of its resistance rate.
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Objective To investigate the distribution and antimicrobial resistance of bacteria isolated from sputum of patients in respiratory intensive care unit (RICU).Methods Non-repetitive bacteria isolated from sputum specimens of 557 hospitalized patients in RICU of a tertiary first-class hospital between January 2013 and December 2015 were collected,antimicrobial resistance of bacteria was analyzed.Results A total of 1 131 bacterial strains were isolated,212 (18.8 ％) were gram-positive bacteria and 919 (81.2 ％) were gram-negative bacteria.The top five species were Acinetobacter baumannii (30.2 ％),Pseudomonas aeruginosa (21.1 ％),Staphylococcus aureus (18.2％),Klebsiella pneumoniae (9.8％),and Serratia marcescens (8.3％).In 2013-2015,isolation rate of Staphylococcus aureus and non-fermentative bacteria showed no obvious changing tendency,but isolation rate of Enterobacteriaceae strains had increasing tendency.Antimicrobial susceptibility testing results showed that Acinetobacter baumannii and Pseudomonas aeruginosa exhibited high resistance rates to imipenem,levofloxacin,and gentamicin (all ＞ 60％),resistance rate of Pseudomonas aeruginosa to ceftazidime showed a downward trend (from 59.4％ to 37.5％);isolation rate of methicillin-resistant Staphylococcus aureus (MRSA) was 96.1％,susceptibility to tigecycline,vancomycin,linezolid,compound sulfamethoxazole,quinupristin/dalfopristin were almost 100％;resistance rates of Enterobacteriaceae strains to sulfonamide decreased from 55.6％ to 14.3 ％,but resistance rates to ceftazidime,cefotaxime,imipenem,levofloxacin,and gentamicin were all ＞60％.Conclusion The major bacteria isolated from sputum of patients in RICU are Acinetobacter baumannii,Pseudomonas aeruginosa,and Staphylococcus aureus,antimicrobial resistance of isolated bacteria is serious.
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OBJECTIVE To survey the qualification rate of sputum specimen.METHODS The specimen collecting and delivering time(morning,after deep coughing and gargling or not) was investigated.Aerobic bacteria isolated rate was evaluated.RESULTS The mean transportation time in positive aerobic bacteria isolated specimens and negative ones was 75 min and 124 min,respectively.Aerobic bacteria isolated rate was higher in sputum specimen that were microscopically screened for greater than 25 neutrophils,than in sputum specimen that were less then 25 neutrophils and greater than 10 BSE(buccal squamous epithelial) cells per 100? field.CONCLUSIONS Lower respiratory tract specimens should be delivered to the laboratory within 1 hour.Sputum specimen should be collected in the morning and after deep coughing and gargling.Microscopic examination should be mandatory in sputum microbiology,both for specimen evaluation and as a guide to what to look for in culture.
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Objective By detecting microsatellite instability(MSI) and loss of heterozygosity(LOH) in FHIT gene in sputum specimen,we intended to evaluate the sensitivity of FHIT gene detection to early diagnosis of lung cancer and explore effective method to screen lung cancer.Methods Based on liquid-based cytology,we collected and isolated sputum specimens in high risk group,abstracted DNA,and detected MSI and LOH in FHIT gene.Results The positive rate of MSI or LOH at single locus was between 41.6% and 49.5%;the site D3S1300 was the highest and it was 49.5%.At least 1 site out of 3 sites that had abnormal microsatellite accounted for 72.3% in lung cancer patients,two sites that appeared to change accounted for 45.5%,which was significantly different compared to non-lung cancer patients(P