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Objective:To investigate the characteristics and changes of bacterial infection and drug resistance in PICU at Children′s Hospital of Fudan University from 2016 to 2020.Methods:All the strains were collected at Children′s Hospital of Fudan University from January 1 st, 2016 to December 31 st, 2020.Antimicrobial susceptibility test was carried out according to a unified protocol using Kirby-Bauer method or automated systems.Results were analyzed according to CLSI 2020 breakpoints. Results:(1)Bacterial distribution: 2 551 bacteria were monitored from 2016 to 2020 in our center.The top 3 bacteria were all gram-negative bacteria.Among them, Burkholderia cepacian showed a tortuous downward trend(13.45% to 1.18%), and Klebsiella pneumoniae showed an upward trend(6.05% to 10.61%).The most common infected site was respiratory tract, although the strains in the respiratory tract decreased year by year.Baumanii was the most common bacteria in respiratory infections.Staphylococcus epidermidis was the most common bacteria from 2016 to 2017 in blood infections, but Achromobacter xylosoxidans were became the most common bacteria from 2018 to 2020.Enterococcus faecium was the most common bacteria in urinary infections.(2) Drug resistance: Baumanii had a high drug resistance rate to amikacin, gentamicin, cefepime, and cefitadine, with no obvious changes over the years, which had a gradually decreasing drus resistance rate to cefoperazone sulbactam, showing a tortuous upward trend to imipenem and meropenem.Baumanii and Pseudomonas aeruginosa had a low drug resistance to levofloxacin over the years, but with high resistance rates in 2020.Escherichia coliand and Klebsiella pneumoniae still had high resistance rates to beta-lactam antibiotics, and their resistance rates to levofloxacin were decreasing.Escherichia coli and Klebsiella pneumoniae showed decreasing resistance rates to imipenem and increased resistance rates to meropenem.The resistance rate of Enterococcus faecium to levofloxacin decreased and always showed a high susceptibility rate to polypeptide antibiotics.Neither Staphylococcus epidermidis nor Staphylococcus aureus were currently resistant to tetracycline antibiotics, and the resistance rates of aminoglycoside antibiotics, such as gentamicin, was also declining.Conclusion:The bacterial infection in PICU shows as the main characteristics of respiratory infection and gram-negative bacteria infection.Carbapenem-resistant Enterobacteriaceae bacteria, Enterococci and Staphylococcus species are becoming increasingly more resistant.
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O autor apresenta, de forma sucinta, sua experiência como professor dePsicoterapia de Orientação Analítica junto aos alunos do terceiro ano de residênciaem psiquiatria do Hospital de Clínicas de Porto Alegre. O programa deensino da disciplina é discutido, bem como a forma de avaliação dos alunos.São feitas considerações sobre algumas das dificuldades próprias dessa atividade.
Assuntos
Psicoterapia/educação , Psicoterapia/históriaRESUMO
OBJECTIVE To investigate the antimicrobial resistance profile of Burkholderia cepacia isolated from clinical specimens in past 3 years.METHODS The B.cepacia strains were isolated from various clinical specimens by routine method from Jan 2004 to Dec 2006.In our hosptial the identification and antimicrobiol susceptibility test were determined by VITEK-32 Full Automated Microbiology Analyzer.RESULTS A total of 126 strains of B.cepacia were isolated.From them 75.14% and 15.08% of isolates were from lower respiatory tract and blood.All isolates were resistant to aminoglycosides,ampicillin,ampicillin/sulbactam,amoxicillin/CLAB,cefazolin,nitrofurantoin,and imipenem.The antibiotic resistant rates of the isolates to SMZ+TMP,cefepime,cefoperazone/sulbactam,meropenem,ceftazidime and piperacillin/tazobactam were 5.10%,16.99%,39.18%,39.61,39.65% and 48.12%,respectively.CONCLUSIONS The detection and antimicrobial resistance of the isolates of B.cepacia are increasing gradually.Multidrug resistance in the isolates of B.cepacia is serious.