[Surveillance on drug resistance of gram-negative bacilli isolated from hospital acquired infections and community acquired infections (2000 - 2001)].

OBJECTIVE: To determine the resistance rates of gram-negative bacilli isolated from patients with hospital acquired infections (HAI) or community acquired infections (CAI) in the 34 study wards of 13 hospitals located at different areas in China. METHODS: 1596 strains of gram-negative bacilli from the 2401 pathogenic strains isolated from 13 hospitals 1 July 2000 to 30 June 2001 were collected for susceptibility test using international standard two-fold agar dilution method. According to the criteria of guidelines of NCCLS (2001), MIC(50) and MIC(90) were detected for antibacterial activity of antimicrobial agents and R%, I%, and S%, were calculated to show the resistant, intermediate and susceptible rates of bacteria to the compounds tested. RESULTS: 15 species of gram-negative pathogens were isolated and most of them could be isolated from both CAI and HAI patients. The resistance rates of isolates, especially Enterobacter cloacae, Serratia spp. and Acinetobacter spp. from HAI were higher than those of CAI. The carbopenems were the most active compounds tested against Enterobacteriaceae. Cefoperozone/sulbactam and cefprime demonstrated excellent activity against most of Gram-negative bacilli. Most of the Gram-negative bacilli were still rather susceptible to cefatazidime, a third generation cephalosporin, with a susceptibility rate of 70% to 100%. Fluoroquinolones showed strong and broad-spectrum activity against Gram-negative bacilli, but more than 50% of Escherichia coli strains were resistant to fluoroquinolones, and the susceptible rates to fluoroquinolones of Pseudomonas aeruginosa and Haemophilus influenzae had decreased. CONCLUSION: (1) The results obtained in the two surveillance-years, 2000 - 2001 and 1998 - 1999, were similar in the bacterial resistance pattern and the trend of rising of resistant rates for some Gram-negative pathogens. (2) The resistance rates of isolates from HAI patients were higher than those of CAI.

[Surveillance on gram-positive bacteria isolated from patients with hospital acquired infections or community acquired infections].

OBJECTIVE: To determine the drug-resistance rates of gram-positive cocci isolated from patients with hospital acquired infection (HAI) or community acquired infection (CAI) in 34 study wards of 13 hospitals located at different areas in China. METHODS: According to the previous protocol, from July 1(st) 2000 to June 30(th) 2001, a total of 2401 pathogenic strains were isolated from 13 hospitals. Among them, 805 strains of gram-positive cocci were collected for in vitro susceptibility test using international standard plate dilution method. According to the criteria of guidelines of NCCLS (2001), MIC(50) and MIC(90) were detected to represent the antibacterial activity of antimicrobial agents and R%, I%, and S%, were calculated to show the resistant, intermediate and susceptible rates of the bacteria to the compounds tested. RESULTS: The detectable rates of methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-resistant Staphylococcus epidermidis (MRSE) were 37.4% (89/238) and 33.8% (51/151) respectively. Among a total of 238 strains of S. aureus, 139 were isolated from patients with CAI and 37 were from HAI patients, the rate of MRSA from HAI patients (89.2%, 33/37) was significantly higher than that of MRSA from CAI patients (30.2%, 42/139) (P < 0.01). The total resistant rate of penicillin resistant Streptococcus pneumoniae (PRSP) was 26.7% (8/30), including a R% of 3.3% (1/30) and an I% of 23.3% (7/30). 331 strains of Enterococcus were isolated, including 178 strains from the study wards and 153 strains from other wards. The ratio of number of strains of E. faecalis to E. faecium was 6.8:1 (286/42). The rate of ampicillin resistant E. faecium (AREF) was 73.8% (31/42), significantly higher than the rate of ampicillin resistant E. faecalis (16.4%, 47/286). Neither strains of S. aureus nor strains of coagulase negative Staphylococcus were found resistant to vancomycin. No strains of Enterococcus were found resistant to vancomycin, the intermediate rates of E. faecalis and E. faecium to vancomycin were 3.5% (10/286) and 9.5% (4/42) respectively. All strains of Enterococcus were found 100% susceptible to teicoplanin. CONCLUSION: The resistance patterns of Gram-positive cocci including MRSA, PRSP, and AREF are similar to the results of the 1998 - 1999 surveillance. No strain of vancomycin-resistant Staphylococcus aureus, including VRSA and VISA or vancomycin resistant enterococcus, VRE is found in this study.

[Efficacy and safety of cefditoren pivoxil in treatment of respiratory infections, a clinical study].

OBJECTIVE: To evaluate the efficacy and safety of cefditoren pivoxil in treatment of respiratory infections. METHODS: 199 cases of respiratory infection confirmed by etiological and clinical examinations were treated with cefditoren pivoxil tablets taken orally. Therapeutic evaluation was conducted among 196 cases and safety evaluation was conducted among 199 cases. RESULTS: The total effective rate was 94.9%, and the causative bacteria -elimination rate was 96.7%. Clinical adverse events, including moderate diarrhea, mild nausea and vomiting, and stomach discomfort, were seen in 9 cases with an incidence rate of 4.5%. Laboratory adverse events, including increase of with an incidence rate of 3.5%. CONCLUSION: Cefditoren pivoxil is effective and safe in treatment of mild and moderate respiratory infections. The resistance rate to cefditoren pivoxil of pathogens of respiratory infections and the efficacy of cefditoren pivoxil show no difference from those tested 7 years ago.

Pharmacokinetics of multiple intravenous instillation of levofloxacin in Chinese healthy subjects.

AIM: To study the pharmacokinetics of multiple doses intravenous infusion of levofloxacin instillation in Chinese healthy volunteers. METHODS: Intravenous infusion of levofloxacin instillation 200 mg within 60 min was given to 10 male healthy volunteers for 7 d, on d 1 and d 7, once-daily, from 2-6 d twice-daily dosing. The concentrations of levofloxacin in serum and urine were assayed by HPLC. RESULTS: The main pharmacokinetic parameters af ter the first dosing were as follows: Cmax was (2.4+/-0.4) mg/L; AUC0- was (16.1 +/- 1.4) mg . h . L-1; T1/2beta was (6.3 +/- 0.3) h. The concentration in serum reached steady state within 72 h. The main parameters after the last dosing were as follows: Cssmax was (2.9 +/- 0.4) mg/L; Cssmin was (0.71 +/- 0.19) mg/L; Cav was (1.40 +/- 0.29) mg/L; AUCss0-12 was (17 +/- 3) mg . h . L-1; T1/2beta was (6.2 +/- 0.8) h. The 24-h cumulative urinary excretion rate was (88 +/- 5) %. From the calculation, the cumulative rate was 1.20; the fluctuation index was 1.30. The difference of T1/2beta and AUC between the first dosing and the last dosing was not significant, and the elimination rate of levofloxacin was not changed after multiple dosing. No clear adverse events were noted during this study. CONCLUSION: There was no accumulation of drug after the repeated intravenous infusion with 200 mg levofloxacin instillation for 7 d.