Drug Resistance of Pathogens in Blood Culture Specimens in Shaanxi Antimicrobial Resistant Investigation Net from 2013 to 2015 / 现代检验医学杂志

Objective To explore the Gram-positive bacterial drug resistance in blood culture in 2013 to 2015 from the members of Antimicrobial Resistant Investigation Net of Shaanxi province,and guide the clinicians touse antimicrobial drugs rationally.Methods All the objective bacterial isolates were collected and identified susceptibility date by software WHONET 5.6.Results 8 824 Gran positive bacterial isolates and their antibacterial susceptibilitydata were collected.The top five populations of Gram-positive bacterial isolates were Staphylococcus epidermidis,Staphylococcus hominis,Staphylococcus haemolyticus,Staphylococcus aureus and Enterococcus feacium.The isolating rates of methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-resistant coagulase negative Staphylococcus(MRCNS) were 33.9 ～ 54.9％ and 72.1 ～88.6 ％ respectively.No vancomycin,Linezolid and teicoplanin resistant Staphylococcus isolates were found.There were 0.9 ～2％ E.faecium vancomycin-resistant isolates.Conclusion The composition of blood culture from 2013 to 2015 was not changed,The rate of MRSA and MRSE showed downward trend.But it was severe that the situation of bacterial drug resistance in blood culture in Shaanxi province.Should fully use bacterial drug resistance surveillance results for supervision and administration,and take effective measures for controlling the spread of resistant isolates.

Drug Resistance of Pathogens in Blood Culture Specimens in Shaanxi Antimicrobial Resistant Investigation Net in 2 0 1 5 / 现代检验医学杂志

Objective To explore the bacterial drug resistance in blood culture in 2015 from the members of Antimicrobial Re-sistant Investigation Net of Shaanxi province,and to guide the clinicians touse antimicrobial drugs rationally.Methods All the objective bacterial isolates were collected and identifiedsusceptibility date by software WHONET 5.6.Results 6 871 bacterial isolates and their antibacterial susceptibilitydata were collected which included 3 199 (46.56%)Gram-negative bac-terial isolates and 3 672 (53.44%)Gram-positivebacterial isolates.The top five populationsof Gram-positive bacterial iso-lates were Staphylococcus epidermidis (30.94%),Staphylococcus hominis (17.84%),Staphylococcus haemolyticus (11.74%),Staphylococcusaureus (9.69%)and Enterococcus feacium (6.29%).The top five populationsof Gram-negative bacterial isolates were E.coli (43.67%),Stenotrophomonas maltophilia (14.63%),K.pneumoniae (13.47%), P.aeruginosa (4.13%)and Acinetobacter baumannii (3.63%).Theisolating rates of methicillin-resistant Staphylococcus aureus (MRSA)and methicillin-resistant coagulase negative Staphylococcus (MRCNS)were 31.2% and 76.1%,respec-tively.No vancomycin resistant Staphylococcusisolates were found.There were 0.9% E.faecium vancomycin-resistant iso-lates.The isolates of Enterobacteriaceae were still highly susceptible to carbapenem,whosetotal resistance rate was below 4.0%.The resistance rates of A.baumannii to most surveillance drugs in cludingimipenem were above 50.0% and the iso-lates of P.aeruginosa were still highly susceptible to most surveillancedrugs.Conclusion It is severe that the situation of bacterial drug resistance in blood culture in Shaanxi province.Should fullyuse bacterial drug resistance surveillance results for supervision and administration,and take effective measures forcontrolling the spread of resistant isolates.

Study on Biological Characters and Genetic Characteristics of Oidiomycetes Mutant Strains Like Bacterial Morphology / 现代检验医学杂志

Objective To investigate the changes of the morphology,structure and biological characters of mutated Candida and through its genetic characteristics,research and reveal the mechanism of the variation at the molecular level.Methods Used different nutritional conditions,different growth conditions and different azole antifungal agents to induce mutation of the standard strains of Candida albicans.In clinical study,Candida mutant strains was isolated from vaginal secretions,pleu-ral effusion and gastric juice samples in patients of poor effect with Antifungal therapy,and studied on the morphological characteristics,and the nuclear structure,the biochemical reaction,the drug resistance,the bacterial composition and the ge-netic characteristics of above variants,etc.Results Mycelial?morphology:Candida were prone to mutation like bacteria, mutant bacteria could show G+ Aureus shape,G+ Bacillus,G+ long filamentous,G- Aureus shape,G- Bacillus and G- long filamentous;Nuclear structure:Candida mutant strains changed like prokaryotes under the electron microscope because it lost the original structure of eukaryotic cells.Biochemical reaction:there were 5 different items in 20 biochemical test ob-served.Drug sensitivity test:Candida mutated to antifungal drugs being originally sensitive was completely resistant,sensi-tive and resistant originally was completely sensitive,and the same as ordinary bacteria resistant.The cell component chan-ges:there was significantly different in Candida variant strain and the atavism of variant strain identified by mass spectrome-try.The most conservative fungalgene expression:Candida mutated had conservative gene expression of eukaryotes.It could be demonstrated that oidiomycetes mutant strains like bacterial morphology with prokaryotic cell biological characteristics was derived from Candida with eukaryotic cells.Conclusion Candida was prone to variation like bacterial morphology.The biological characteristics of mutant resembled prokaryote.There was a qualitative change among the standard strains of Can-dida albicans,mutant strains of oidiomycetes like bacterial morphology and the atavism of variant strain with clear genetic re-lationship under the electron microscope in the form of nuclear matter.The study on biological evolution,especially contact in prokaryotic cells and eukaryotic evolution has very important significance.

Analysis of the Reasons of the Higher Result of CK-MB with Immune Suppression Method for Detecting Serum CK-MB / 现代检验医学杂志

Objective To investigate the reasons of higher result of CK-MB than the total CK with the immune suppression method for deteting serum CK-MB and solution methods.Methods Selected 68 cases of inpatients with myocardial infarc-tion from Department of Cardiology,32 cases of malignant tumor from Internal Medicine-Oncology,including 8 cases of liver cancer,6 cases of lung cancer,6 cases of gastric cancer,5 cases of neuroblastoma,4 cases of breast cancer and 3 cases of o-varian cancer and 16 cases of cirrhosis from Department of Gastroenterology,and at the same time,selected 100 cases of healthy persons as control group from Out-patient Health Examination Center of Shaanxi Provincial People’s Hospital.Used Roche MODUALR automatic biochemical analyzer to detected the activity of serum CK-MB with the immune suppression method and the activity of total CK with the enzyme coupling rate method.Results In 68 cases of inpatients with myocardial infarction,the activity of serum CK-MB of 2 1 cases were individually increased,the activity of total CK of 3 9 cases were in-creased,and the two indexes of 30 cases were increased in the same period.In 32 cases of inpatients with malignant tumor, the activity of serum CK-MB of 1 1 cases were individually increased,the activity of total CK of 3 cases were increased and the two indexes of 3 cases were also increased.The activity of serum CK-MB of 6 cases were individually increased in 1 6 ca-ses of cirrhosis.Conclusion The immune inhibition assay for the detection of CK-MB as the diagnosis index of myocardial infarction had certain defects,and the higher activity of CK-MB could be highly associated with some severe inflammation, malignant tumor.

Comparison of TB-IGRA and Protein Chip in the Diagnosis of Mycobacterium Tuberculosis / 现代检验医学杂志

Objective To evaluate the advantages of TB-IGRA and protein chip to detect the Mycobacterium tuberculosis. Methods From October 2013 to March 2014,collected 78 cases of clinical diagnosis of tuberculosis and normal control’s pe-ripheral blood specimens,used TB-IGRA kits and Mycobacteriumtuberculosis IgG kit(protein chip)to detected respectively. The results were analyzed and compared.Results The sensitivity of protein chip and TB-IGRA in the detection of Mycobac-teriumtuberculosis were 34.5% and 89.7% respectively,which was statistically significant (χ2=26.95,P 0.05).The positive rate of TB-IGRA and Protein chip in tuberculosis were 90.5% and 42.9%.The positive rate of TB-IGRA and Protein chipin extrapulmonary tuberculosis were 89.20% and 29.7% respectively.Conclusion Compared TB-IGRA and protein chip,either diagnose tuberculosis or extrapulmonary tuberculosis has highly positive rate and sensitivity, TB-IGRA can be widely used in the early screening of tuberculosis.

Construction of clinical microbiological laboratory with fast-responsibility / 中华检验医学杂志

Inadequate empirical antibiotic therapy and delayed target therapy have been demonstrated to be significantly associated with higher mortality.Because microbiological results based on the traditional culture and identification require quite a long time,empirical broad-spectrum antimicrobial therapy is often initiated according to the clinical presentation,which may resulting in the development of antimicrobial resistance.One of the strategies to alter the dilemma situation is that the initial empirical therapy is adjusted to definitive therapy as early as possible,which can only be done on the basis of rapid microbiological reports.Clinical microbiology laboratories should integrate a variety of rapid detection methods,improve working process,present reports as soon as possible,and bear fast-responsibility.

Antimicrobial resistance surveillance study among Streptococcus pneumoniae clinically isolated from 14 teaching hospitals in 2005-2008 in China / 中华检验医学杂志

Objective To investigate antimicrobial resistance among Streptococcus pneumoniae clinically isolated from 14 teaching hospitals located at different areas in China in 2005-2008 and to give logical guidance for clinical empirical therapy.Methods A total of 1 317 non-repetitive S.pneumoniae isolates in 14 teaching hospitals from 2005-2008 were collected and sent to the central lab for reidentification and susceptibility testing, including 271 isolates collected in 2005, 391 isolates collected in 2006, 363 isolates collected in 2007 and 292 isolates collected in 2008. Most of the isolates were from community-acquired respiratory tract infections, which were isolated from outpatient or emergency department patients with respiratory tract infections or those patients with respiratory tract infections within ≤48 hours hospitalization.The districts where the organisms were isolated include North China, Northeast China, South China, Central and Northwest China and East China.The patients included adults, teenagers and children.The minimum inhibitory concentrations (MICs) or inhibitory zone diameter of 17 antimicrobial agents were determined by Etest method, agar dilution method or disk diffusion method.WHONET5.5 software was used to analyze susceptibility rate, intermediate rate, resistance rate, MIC50 and MIC90.Results Linezolid (100%) and fluoroquinolones (95.2%-99.7%) showed excellent activities against S.pneumoniae.Among β-lactams, amoxicillin-clavulanic acid remained high activities (73.8%-92.1%),followed by penicillin, ceftriaxone and cefepime with year-over-year decrease in activities.The activities of three second-generation cephalosporins were low (36.3%-38.4% in 2008).The activities of erythromycin, azithromycin, clindamycin, trimethoprim/sulfamethoxazole and tetracycline against S.pneumoniae were poor and decreased year over year.The incidence of penicillin non-susceptible S.pneumoniae (PNSP) was increasing especially for PISP (from 4.4% in 2005 to 20.2% in 2008).The incidence of PNSP in North China was low (6.0%), while this value were high in central China and East China (30.1% and 38.7%, separately).The incidence of PNSP in adults (15.7%) was obviously lower than that in children(≤5 years:33.0%) and teenagers (6-17 years:38.2%).Conclusions linezolid and fluoroquinolones showed excellent in vitro activity against S.pneumoniae, followed by penicillin and cephalosporins with year-over-year decrease of activity. Clinicians should pay more attention when using those antimicrobial agents with poor activity against S.pneumoniae, which include macrolides, clindamycin, trimethoprim/sulfamethoxazole and tetracycline.

Screening of Anti - Staphylococcus Active Components from Extracts of Flos Caryophyln / 中药新药与临床药理

Objective To explore the antibacterial active components of Flos Caryophylii. Methods The components were distilled by extraction and big - hole colophony. The minimum antibacterial concentration of components was detected. Results and conclusion The and - staphylococcus aureus active components of of Flos Caryophylii. include fat - soluble ingredients and water - soluble ingredients.