RESUMO
Objective To investigate the antibiotic resistance in clinical isolates in the Second Hospital of Hebei Medical University from 2015 to 2016.Methods A total of 16 292 strains of non-duplicate bacterial strains were collected.The isolates were subjected to identification and antimicrobial susceptibility testing on VITEK 2-Compact system.The data were processed and analyzed using WHONET 5.6 software.Results Specifically,7 961 and 8 331 strains of pathogens were collected in 2015,2016,respectively.Gram-negative bacteria accounted for 62.0％ in 2015 and 66.9％ in 2016,respectively.The top five pathogens isolated in these two years were still Klebsiella pneumoniae,Escherichia coli,Acinetobacter baumannii,Pseudomonas aeruginosa,and Staphylococcus aureus.The proportion of K.pneumoniae increased to the first place in 2016 which accounted for 16.1％.Coagulase negative Staphylococcus in blood samples decreased from 42.6％ in 2015 to 30.0％ in 2016.Vancomycin resistant strains were not found in Staphylococcus.In 2015 and 2016,the prevalence of methicillin-resistant Staphylococcus aureus (MRSA) was 56.2％ and 51.3％,respectively.The prevalence of methicillinresistant coagulase negative Staphylococcus (MRCNS)was 79.3％ and 63.1％,respectively.Enterococcus faecalis and Enterococcus faecium accounted for 25.2％ and 73.2％ respectively in the 911 strains of Enterococcus.In 2015 and 2016,3.1％ and 2.9％ of the E.faecium strains were resistant to vancomycin,respectively.In 2016,the prevalence of carbapenemresistant strains increased in K.pneumoniae,E.coli and E.cloacae.K.pneumoniae showed increasing resistance rate to all the antimicrobial agents tested except for gentamicin and amikacin.The percentage of the K.pneumoniae strains resistant to imipenem and meropenem increased from 19.3％,18.5％ in 2015 to 24.2％,23.1％,respectively.A.baumannii isolates were still highly resistant to the commonly used antibiotics in these two years,but relatively susceptible to polymyxin B,tigecycline,cefoperazone-sulbactam and minocycline (＜30％ resistant).P.aeruginosa isolates showed lower resistance rate to amikacin (11.7％),cefoperazonesulbactam (15.5％),piperacillin-tazobactam (18.7％),ceftazidime (20.1％),cefepime (21.9％).P.aeruginosa presented a trend of declining resistance to all the antimicrobial agents tested from 2015 to 2016,except aztreonam,to which the resistant P.aeruginosa strains increased from 27.0％ in 2015 to 34.7％ in 2016.Conclusions The antimicrobial susceptibility profile of clinical bacterial isolates has been changing constantly.We need to adopt effective infection prevention and control measures in hospital and further standardize and control the use of antibacterial agents.
RESUMO
Objective To investigate the distribution and antibiotic resistance profile of clinical isolates in the First Hospital of Qiqihar during 2015.Methods Antimicrobial susceptibility test was carried out according to a unified protocol using automated system from January 1,2015 to December 31,2015.The results were analyzed with WHONET 5.6 software according to the 2014 breakpoints of Clinical and Laboratory Standards Institute.Results A total of 5 162 clinical isolates were collected,of which 28.1％ (1 450/5 162) were gram-positive cocci and 71.9％ (3 712/5 162) were gram-negative bacilli.About 36.5％ (255/698) ofS.aureus isolates and 81.4％ (180/221) of coagulase negative Staphylococcus isolates were resistant to methicillin.No S.aureus and coagulase negative Staphylococcus isolate were found resistant to vancomycin or linezolid.Enterococcus isolates showed low resistance to vancomycin and linezolid.One strain of E.faecium was found resistant to vancomycin.ESBLs were produced in 39.9％ (298/747) ofE.coli,26.1％ (294/1 127) ofKlebsiella spp.,and 15.6％ (12/77) ofP mirabilis strains.The Enterobacteriaceae strains were less resistant to imipenem,beta-lactam/beta-lactamase inhibitor combination and amikacin.About 36.6％ (163 / 445) of A.baumannii isolates and 1.8％ (13/715) of P.aeruginosa isolates were extensively drug-resistant strains.Conclusions Antibiotic resistance poses a serious threat to clinical practice,to which more attention should be paid.Clinical microbiology lab should make more efforts to provide better support to clinical therapy.
RESUMO
Objective To analyze the serotype distribution and antibiotic resistance characteristics of Salmonella strains isolated in Guangdong province for better understanding the condition of Salmonella infection in patients with diarrhea.Methods Fecal samples collected from patients with diarrhea in Guangdong province were used to isolate Salmonella strains.Biochemical analysis was performed to identify these isolated strains.Serotyping and antimicrobial susceptibility testing were carried out for further analysis of the isolated Salmonella strains.Results The rate of Salmonella infection was 7.64％in 2015, and the male to female patient ratio was 1.52∶1.A total of 2 377 patients of all age groups were positive for Salmonella infection and the patients aged 0-6 years accounted for 81.74％.The isolation rate of Salmonella strains in the summer and autumn was higher than that in the winter and spring (10.73％ vs 4.24％;X2=463.77, P<0.01).The Salmonella isolation rates in different areas were as follows: 16.82％ in Zhuhai, 15.85％ in Heyuan, 11.81％ in Yangjiang, 10.68％ in Jiangmen, 8.49％ in Zhongshan, 8.07％ in Maoming, 8.05％ in Jieyang, 7.35％ in Shaoguan, 6.97％ in Foshan, 6.03％ in Dongguan, 5.48％ in Guangzhou and 0.00％ in Zhanjiang.And the differences between different regions were statistically significant (X2=367.67, P<0.01).The 2 377 isolated Salmonella strains were classified into 108 serotypes except for oneSalmonella strain that could not be classified.The top four predominant serotypes were 4,5,12:i:-, Salmonella enteritidis,Salmonella stanley and Salmonella typhimurium.Most Salmonella strains were sensitive to imipenem, azithromycin, ceftazidime, cefotaxime and trimethoprim/sulfamethoxazole, but multidrug resistance was common among those strains.Conclusion Salmonella serotypes of 4,5,12:i:-and Salmonella enteritidis are the predominant pathogens causing human Salmonella infections in Guangdong province.Ceftazidime and cefotaximeare are preferred in the treatment of Salmonella infections.Surveillance for drug resistance in Salmonella should be strengthened as multidrug resistant strains have become a serious problem in Guangdong province.
RESUMO
Objective To investigate the antimicrobial resistance of clinical strains of K lebsiella spp .isolated from 15 hospitals in China CHINET during 2012 .Methods Kirby-Bauer method and automatic microbiology analysis system were employed to study the antimicrobial resistance . WHONET 5 .6 software was applied for data analysis according to Clinical and Laboratory Standards Institute (CLSI) 2012 breakpoints .Results A total of 9 621 clinical K lebsiella isolates were analyzed ,including 8 772 strains of K . pneumoniae and 804 strains of K . oxytoca . About 54 .9% (5 285/9 621) of the K lebsiella strains were isolated from sputum ,and 16 .3% (1 564/9 621) were isolated from pediatric patients .Antimicrobial susceptibility testing showed that about 8 .9% ,10 .8% and 12 .9% of the strains were resistant to imipenem ,meropenem and ertapenem ,respectively .About 14 .1% and 17 .0% of the strains were resistant to piperacillin-tazobactam and cefoperazone-sulbactam , respectively . Carbapenem-resistant K lebsiella strains were identified from all the 15 hospitals ,including 945 strains of K .pneumoniae and 45 strains of K .oxytoca ,which were resistant to either imipenem ,meropenem or ertapenem .Conclusions The Klebsiella isolates collected from 15 hospitals in China during 2012 are relatively sensitive to carbapenems ,cefoperazone-sulbactam and piperacillin-tazobactam .The prevalence of carbapenem-resistant strains is still increasing in China ,about 10 .3% in 2012 ,and relatively higher in Eastern China .More efforts should be made to control the superbug .
RESUMO
Objective To investigate the antimicrobial resistance of E.faecalis and E.faecium isolated from the Hospital from 2009 to 2013.Methods Minimum inhibitory concentration method was used for antimicrobial susceptibility test of the clinical iso-lates.Results were judged according to Clinical and Laboratory Standards Institute′s 2013 version of criterias.Results A total of 819 nonduplicated E.Faecalis and 726 nonduplicate E.faecium isolates were collected.The strains were still highly susceptible to linezolid and vancomycin,to which the drug-resistance rates were both less than 1.5%.The prevalence of vancomycin-resistant E. faecalis and E.faecium was 0.1% and 1.5%,respectively.The ratio of E.faecalis resistant to ampicillin,penicilin and nitrofuran-toin was 4.3%,1.6% and 1.6%,respectively.More than 87% E.faecium strains were resistant to ampicillin and penicillin,and the E.faecium strains were more resistant to most drugs tested than E.faecalis .Conclusion There was an obvious difference of anti-biotic resistance beween E.Faecalis and E.Faecium isolates.Therefore,Continuous monitoring the drug resistance is helpful to guide the clinical rational drug use.
RESUMO
Objective To investigate the antimicrobial resistance of Enterococcus f aecalis and Enterococcus f aecium isolated from the First Affiliated Hospital of Chongqing Medical University between 2009 and 2012 .Methods Antimicrobial susceptibility testing was carried out according to the unified protocol .The dates were analyzed by WHONET 5 .6 software according to clinical and laboratory standards institute(CLSI) of 2012 .Results A total of 783 non-repetitive Enterococcus f aecalis and 664 non-repeti-tive Enterococcus f aecium isolates were collected .The strains were still highly susceptible to linezolid and vancomycin .The resist-ance rates were all less than 2 .0% .The resistance rates of vancomycin to Enterococcus f aecalis and Enterococcus f aecium were 0 .1% and 1 .4% ,respectively .The percentage of Enterococcus f aecalis resistant to ampicillin ,penicilin and nitrofurantoin were 5 .7% ,2 .6% and 2 .2% ,respectively .About 32 .9% of Enterococcus f aecalis isolates were resistant to gentamicin .The resistance rates of ampicillin and penicillin to Enterococcus f aecium were more than 90 .0% .Conclusion Enterococcus f aecalis is main En-terococcus in the First Affiliated Hospital of Chongqing Medical University .There is an obvious difference between the antibiotic re-sistance of the Enterococcus f aecalis and Enterococcus f aecium .So ,monitoring drug resistance of the Enterococcus shows great sig-nificance to the clinical treatment .