Analysis of distribution, drug resistance and risk factors of pathogens isolated from septicemic patients / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate distribution, drug resistance and risk factors of pathogens isolated from septicemic patients in a hospital in the past 6 years.</p><p><b>METHODS</b>Most of the bacterial isolates were identified with BD Phoenix, and a few isolates were identified manually and with K-B method. Candida isolates were identified with color display plates and K-B method. WHONET5.4 software was used for analysis.</p><p><b>RESULTS</b>The common bacteria isolated form the blood included E. coli, P. aeruginosa, K. pneumoniae, and S. aureu. The gram-negative bacillus from the blood exhibited relatively low resistance to such antibiotics as cefoperazone/sulbactam, imipenem, amikacin, piperacillin/tazobactam, and ceftazidime, and the incidences of E.coli and K. pneumoniae isolates producing extended spectrum beta-lactamase (ESBLs) ranged between 33.3% and 34.9% and between 32.9% and 36.0%, respectively. The gram-positive coccus from blood showed a sensitivity rate of 100.0% to vancomycin and low resistant rates to amikacin and chloramphenicol; the methicillin-resistant rates of S. aureu and coagulase-negative staphylococcus were 26.9%-35.5% and 72.7%-74.3%, respectively. The risk factors of septicemia included hospital stay for over 5 days, venous catheterization, surgeries, puncture, oxygen therapy, urine tract catheterization, and chemotherapy.</p><p><b>CONCLUSION</b>Blood culture can be of importance in patients with septicemia, and the use of antibiotics should be carefully weighed according to the results of bacterial culture and sensitivity tests of the pathogens isolated from the blood.</p>

Distribution and drug resistance spectrum analysis of 2478 clinical bacterial and Candida isolates / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the distribution and drug resistance spectrum of clinical bacterial and Candida isolates.</p><p><b>METHODS</b>Most of the bacterial isolates were identified using automated BD Phoenix, and a few with K-B method carried out manually. Candida isolates were identified by color-display plate and K-B method.</p><p><b>RESULTS</b>The most common isolates in the 2478 strains were P. aeruginosa (15.6%), E. coli (11.5%), C. albicans (9.6%), K. pneumoniae (9.3%), S. aureu (8.2%), and S. epidermidis (7.5%). In gram-negative isolates, the antibiotics with the lowest resistance rate were meraopenem (14.4%), cefoperazone/Sulbactam (14.8%), Imipenem (21.9%), piperacillin/tazobactam (27.4%), ceftazidime (30.0%), amikacin (31.1%), and cefepime (33.1%). The detection rate of E.coli and K. pneumoniae isolates producing extended spectrum beta-lactamase (ESBLs) were 47.4% and 37.3% respectively. In gram-positive isolates, the antibiotics with the lowest resistance rate were vancomycin (0.9%), teicoplanin (1.1%), nitrofurantoin (6.9%), amikacin (20.1%), chloramphenicol (30.7%), and cefoperazone/sulbactam (31.5%). The methecillin-resistant rates of S. aureu , S. epidermidis, and S. haemolyticus were 57.1%, 65.0%, and 66.0%. For Candida isolates, the most sensitive antibiotics were amphotericin B (0.3%), nystain (0.3%), itraconazole (5.6%), fluconazole (9.4%), and fluorocytosine (9.4%).</p><p><b>CONCLUSION</b>The results suggest high rate of ESBL production and oxacillin resistance of the bacteria isolated in the hospital. More rational use of antimicrobial agents is crucial for reducing the drug-resistance of the bacteria, and effective measures must be taken to reduce dissemination of multidrug-resistant bacteria.</p>