The Effects of Combined Use of Cefoperazone/sulbactam,Meropenem with Levofloxacin on Mutant Pre-vention Concentration for Acinetobacter baumannii / 中国药房

OBJECTIVE:To study the effects of combined use of cefoperazone/sulbactam(CFS),meropenem(MRP)with le-vofloxacin (LVX) on mutant prevention concentration for Acinetobacter baumannii so as to provide a experimental foundation for preventing bacterial drug resistance. METHODS:In the test,there were groups of single use of CFS,MRP and LVX,and groups of combined use of CFS+LVX and MRP+LVX. Double dilution agar method was used to respectively detect minimal inhibitory con-centration (MIC) for standard Acinetobacter baumannii strains ATCC 19606 and 36 clinically isolated strains in all groups,and then the index of fraction inhibitory concentration(FIC)was calculated. Agar dilution method on plates was employed to detect mu-tant prevention concentration (MPC) for Acinetobacter baumannii in all groups,and then corresponding selection index (SI) was calculated. RESULTS:After combined use of CFS or MRP with LVX,synergistic effect accounted for 55%(20/36)and 50%(18/36). For standard strain ATCC 19606,after combined use of CFS+LVX and MRP+LVX,MPC reduced from 32.0 and 4.0 mg/L to 1.8 and 0.8 mg/L;For 36 clinically isolated strains,after combined use of CFS+LVX and MRP+LVX,MPC reduced from 8.0-32.0 and 1.0-2.0 mg/L to 0.25-1.0 and 0.25-0.5 mg/L. SI were all obviously reduced after combination. CONCLUSIONS:The combina-tion of CFS or MRP with LVX can reduce MPC for Acinetobacter baumannii more significantly than the single use,and narrow mu-tant selection window.

Clinical distribution and changing resistant pattern of Enterobacter cloacae / 中国感染与化疗杂志

Objective To investigate the distribution and resistant pattern of Enterobacter cloacae to antimicrobial agents for reasonable use of antibiotics .Methods E .cloacae strains were isolated from patients from January 2009 to December 2013 .The strains were identified by VITEK‐2 Compact System of BioMerieux and tested for antimicrobial susceptibility by Kirby‐Bauer disk diffusion method .The results were analyzed .Results A total of 397 nonduplicate E .cloacae strains were isolated during 5 years ,accounting for 5 % of the total gram‐negative isolates . The strains were mainly isolated from sputum (48 .9% ) , followed by secretions (30 .5% )and urine (7 .3% ) .The percentage of E .cloacae strains resistant to all the antibiotics tested was on decline except carbapenems ,cefoxitin and amoxicillin‐clavulanic acid .Carbapenems were relatively more active against E .cloacae strains .The E .cloacae strains showed higher resistance rate toβ‐lactams .Conclusions It is necessary to strengthen the monitoring of clinical isolates to guide rational use of antimicrobial agents .

The ability to identify the yeast-like fungi by YST identification cards and pyrosequencing analysis / 中华检验医学杂志

Objective To evaluate the ability of Vitek 2 Compact YST identification cards and pyrosequencing analysis for identifying the clinical isolates of yeast-like fungi.Methods Vitek 2 Compact YST identification cams and ITS1 region pyrosequencing analysis were used to identify the clinical isolates of yeast-like fungi at Jinan Military General Hospital in 2011.The strains which could not be identified to species by pyrosequencing analysis were identified again by the method of ITS1 region Sanger sequencing.The strains with inconsistent identified results by YST and pyrosequencing were identified again using API 20C.Results A total of 282 srtains were isolated from various clinical specimens for culturing in 2011.In addition to the three which could only be identified to similar species,other strains could be clearly identified to species by the method of ITS1 reverse pyrosequencing.Three strains which failed identified to species by pyrosequencing couldn't be distinguished fully by the method of Sanger sequencing.There were 7 strains unidentified,14 strains low discrimination(％ id ＜ 80％),and 6 strains misidentification using YST cams.The identification coincidence rate was 90.4％.The identification coincidence rates were various in different species of yeast-like fungi using YST cards.Conclusions The vast majority of clinical isolates of yeast-like fungi could be identified by ITS1 reverse pyrosequencing analysis.Vitek 2 Compact YST caRD basically meets the needs.But attention should be paid to the standard operating and regular internal quality control.For some rare species it is also needed to combine the source of specimen,colonies and characteristics to determine the identification results for the rare stains.

Mutant prevention concentration of moxifloxacin combined with cefoperazone/sulbactam against carbapenem-resistant acinetobacter baumannii / 中国药理学通报

Aim To study the change of mutant pre- vention concentration (MPC) in carbapenem-resistant Acinetobacter baumannii (CRAB) treated with moxi- floxacin ( MFX ) and/ or cefoperazone/ sulbactam (CFS) in vitro, and provide a theoretical support for preventing the bacterial resistance. Methods To cal- culate the fractional inhibitory concentration (FIC) in- dex, the minimum inhibitory concentration (MIC) of 20 clinical isolates of CRAB treated with MFX and/ or CFS was determined by checkerboard microdilution as- say. In addition, to calculate the selection index (SI), the MPC of 20 clinical isolates of CRAB treated with MFX and/ or CFS was determined by agar plate di- lution assay. Results Our study showed that there was synergistic/ addictive action, rather than antago- nism action against clinical isolates of CRAB when treated with MFX + CFS. The SI of the 20 isolates trea- ted with MFX or CFS alone was 4 ~128 and 8 ~64 re- spectively, but reduced to 1 ~8 and 4 ~16 when trea- ted with MFX + CFS, which decreased by 2 ~16 and 2 ~4 times respectively compared with the single treat- ment. Conclusion These results suggest that the combination treatment of MFX + CFS against clinical isolates of CRAB might lower the MPC of the isolates treated with MFX/ CFS alone, narrow the mutant selec- tion window, and prevent the generation of drug - re- sistant mutants.

The perioperative nursing of microsurgical denervation of the spermatic cord to treat idiopathic chronic orthialgia / 中国实用护理杂志

Objective To summarize the perioperative nursing experience of microsurgical denervation of the spermatic cord to treat idiopathic chronic orthialgia.Methods We retrospectively analyzed the clinical record data of two patients with idiopathic chronic orthialgia,who received microsurgical denervation of the spermatic cord in our hospital,including pre-and postoperative symptom scores,evaluation of mental state and wound nursing.Results Both patients got complete pain relief and were discharged one week after operation.No would infection and mental fluctuation was noted.Conclusions The reasonable individual perioperative nursing is an elemental component of recovery for patients with chronic orthialgia who experienced microsurgical management.

Comparison of Ability of BACTEC 9120 Blood Culture System to Detect Fungemia with Four Kinds of Blood Culture Bottles / 中华医院感染学杂志

OBJECTIVE To discuss the best scheme for fungemia detection by analyzing and comparing the ability and performance characteristics of the BACTEC 9120 automated blood culture system and 4 kinds of blood culture bottles in the detection of simulated fungemia.METHODS Simulated blood culture was produced using 65 fungi isolates from clinical specimens and BACTEC Plus Aerobic/F,Plus Anaerobic/F,Peds Plus/F and Myco/F Lytic blood culture bottles and detected by BACTEC 9120 automated blood culture system.The final inoculum densities were 1-5 CFU/ml blood.The(time to detection TTD) of simulated blood culture with different concentrations of suspension produced using 2 kinds of standard strains and 4 kinds of blood culture bottles was compared.RESULTS From the 260 bottles in this study 216 had growth detected by the BACTEC 9120 blood culture system.The positive rates of BACTEC Plus Aerobic/F and Anaerobic/F,which were 90.77%and 41.54%,respectively,were significantly(P