Objective To analyze the species distribution and resistance of the pathogens isolated fromblood cultures of the patients in intensive care unit ( ICU) , and provide a basis for prevention and control of bloodstream infections in critically ill patients. Methods The data of blood cultures of the patients in ICUduring January 2009 to December 2011 was investigated retrospectively.Results In the last 3 years, positive rate of blood cultures of ICU patients was 15. 4% , 15. 7% , and 17. 6% respectively. Among the isolates, Gram-positive bacteria were predominant ( 52. 3% ) , followed in order by gram-negative bacteria ( 33. 1% ) and fungi ( 14. 7% ) . Aerobe and facultative anaerobe were the predominant bacterial isolates ( 99. 7% ) . Enterococcus faeciumand Staphylococcus spp. were the most common gram-positive bacteria, and 4. 5% of E. faecium isolates were resistant to vancomycin. Rate of methicillin-resistance for S. aureus and S. epidermidis was 73. 5% and 93. 7% respectively. In terms of gram-negative bacteria, Acinetobacter calcoaceticus- A. baumannii complex were the leading species, 96. 9% of the isolates had multi-drug resistance and 14. 1% of the isolates had extra-drug resistance. Klebsiella pneumonia and Escherichia coli isolates were less frequently isolated and those producing extended spectrum beta-lactamases accou ted for 70. 3% and 80. 0% of the isolates respectively. Candida spp. was the most common fungi isolates ( 96. 7% )with an annual change of species distribution and declining susceptibility to azoles.Conclusions Gram-positive bacteria should be the major target for prevention and control of bloodstream infections in critically ill patients. Whereas, more attention should be paid to the infection caused by candida spp. and multidrug resistant gram-negative bacteria.
Objective To explore the clinical epidemiological characteristics of the lung infection after orthotopical liver transplantation. Methods The clinical data included infection morbidity, mortality, infectious times and relative factors, clinical manifestations, the bacterial strains and distributions of the pathogens, the bacterial resistances of the 53 liver transplantation recipients from 2003.3～2006.12 were summarized and analyzed retrospectively. Results Among 53 recipients, 33 developed lung infectious and 6 died .The mobidity was 62.3% and mortality was 18.2%, with a OR of 1.0. Lung infection predominantly occurred in the first month, especially in the first week after transplantation.There were many factors related to lung infections.Various pathogens, especially Klebsialla, Escherichia Coli and Staphylococus Hominis were isolated from sputum, airway suction drainages and throat swabs. Most of the G- bacteria were sensitive to aminoglycosides,β lactam and lactamase compounds and carbapenems while G+ bacteria were sensitive only to glycopeptides. All the bacteria were resistant to quinolones, β lactams of third and forth generation. Conclusions After liver transplantation, the morbidity and mortality of the lung infections are high.The infections develope at earlier stage, manifest nontypical clinical features.Many factors are revealed to be relevant to the lung infections,meanwhile, various drug-resistant pathogen strains are isolated.
Objective To investigate the drug resistance and homogeneous analysis of Acinetobacter baumanii in emergency intensive care unit ( EICU) . Methods Four multidrug-resistant Acinetobacter baumannii ( MDR-Ab) strains isolated fromnosocomial inpatients fromJuly 25 to September 7 in 2009 were collected and tested for drug sensitivity and MIC determination as well. The A. baumannii isolates were typed with pulsed-field gel electrophoresis ( PFGE) to determine whether they derived fromthe same clone.Results Four isolates from nosocomial inpatients were resistant to multiple antibiotics including carbapenem. The PFGE types identified from four isolates were A and B. The A. baumannii isolates did not derived from the same clone. Conclusion The prevalence of nosocomial infection is not due to transmission of the same strains among different individuals in EICU.
ObjectiveTo analyze the pathogenic bacteria distribution, structure and characteristics of drug resistance in patients with acute stroke complicated with pulmonary infection, in order to provide reference for the prevention of hospital infection and rational use of antimicrobial agents. MethodsA total of 864 clinical specimens of acute stroke complicated with pulmonary infection were chosen for study between January 2012 and December 2014. Separation and cultivation were done in accordance with the operation procedures regulated by the Ministry of Health. Drug sensitivity examination was done by Kirby-Bauer (k-b). Super-extensive spectrum β lactamase (ESBL) and methicillin resistant staphylococcus aureus (MRSA) were detected to analyze the bacterial species and resistance transition. ResultsA total of 864 samples were cultivated, in which G-bacteria accounted for 61.2%. The main pathogenic bacteria was Klebsiella pneumoniae bacteria, Escherichia coli, Pseudomonas aeruginosa, Acinetobacter baumanmii and Staphylococcus aureus. Imipenem had high antimicrobial activity to G-bacilli, especially to Escherichia coli and Klebsiella pneumoniae bacteria. Linezolid, vancomycin and teicoplanin had high antibacterial activity to staphylococcus aureus. Vancomycin resistant Staphylococcus aureus was not found. Ciprofloxacin had high antibacterial activity to Pseudomonas aeruginosa, while imipenem had low antibacterial activity to Pseudomonas aeruginosa. Amikacin had high antibacterial activity to acinetobacter. ConclusionG-bacilli are predominant in acute stroke complicated with pulmonary infection. ESBLs and MRSA detection rate is high, and we should pay attention to the rational use of antibiotics to reduce drug resistance.
Objective To investigate the clinical characteristics and drug resistance changes of nosocomial infection caused by carbapenem-resistant Klebsiella pneumoniae (CRKP) in different types of clinical departments, and to provide evidence for prevention and control of CRKP infection. Methods The hospital infection real-time monitoring system was used to retrospectively collect the inpatients with CRKP nosocomial infection in the First People’s Hospital of Lianyungang from January 2019 to December 2023 as the research objects. According to the different sources of departments, they were divided into intensive care unit (ICU) group, internal medicine group and surgery group. The changes of clinical characteristics and drug resistance to common antibiotics were analyzed. Results A total of 636188 inpatients were monitored, and 225 cases were infected with CRKP, with an overall infection detection rate of 0.035%. The detection rates of CRKP infection in the ICU group, internal medicine group, and surgery group were 0.736% (138/18749), 0.013% (44/336777), and 0.015% (43/280662), respectively, with the ICU group demonstrating a significantly higher rate than the other groups (P<0.05). The detection rates fluctuated in the early stage and then decreased rapidly in different years. The main infection site of CRKP in all groups was lower respiratory tract, but the proportion of device-related infections in the ICU group was higher than that in the internal medicine and surgery groups (P<0.05). In terms of the infected population, there was no significant difference in gender among groups (P>0.05) with the proportion of males more than 60%, while the difference in the proportion of patients aged ≥65 years among groups was statistically significant (P<0.05), with the highest in the internal medicine group (86.36%). The burden of underlying diseases and invasive operation exposure of the infected patients were high, and the proportion of cardiovascular and cerebrovascular diseases and indwelling catheters were as high as 69.33% and 83.56%, respectively. The differences in the proportions of cardiovascular and cerebrovascular diseases, diabetes mellitus, ≥3 underlying diseases, and surgical and invasive procedures among groups were statistically significant (P<0.05). The distribution of infection specimens in each group showed no statistically significant difference (P>0.05), with sputum, blood, and mid-stream urine specimens being the main detected specimens in all groups. The resistance rates of CRKP to penicillins and cephalosporins were more than 93%, and the resistance rates to aminoglycosides and sulfonamides were relatively low and showed a decline year by year. The resistance rate to ceftazidime/avibactam was only 7.41%, but the resistance rate to tigecycline increased. The difference in resistance rate of CRKP to co-trimoxazole among groups was statistically significant (P<0.05), while the differences in resistance to other antimicrobial agents were not statistically significant (P>0.05). Conclusions The detection rate, clinical characteristics and drug resistance of CRKP infection in different types of departments of medical institutions are different and changing. It is necessary to strengthen the rational use of antibiotics and the prevention and control of nosocomial infection.
Objective To survey and analyze the drug resistance of clinical isolated strains of bloodborne infectious staphylococci, in order to provide references for clinical diagnosis of aureus septicemia and rational use of antimicrobial agents. Methods We retrospectively studied the clinical data of 496 patients with staphylococcal septicemia confirmed by blood culture between June 2008 and May 2015 in West China Hospital of Sichuan University. The microbiological characteristics of the disease were analyzed. Results In the included 496 cases, there were 216 (43.55%) cases of coagulase-positive Staphylococcus (CPS) septicemia and 280 (56.45%) of coagulase-negative Staphylococcus (CNS) septicemia; 85 (17.14%) cases were caused by community infection, while the other 411 (82.86%) resulted from hospital infection. The drug resistance rate of CPS and CNS toward oxacillin was respectively 27.78% (60/216) and 87.50% (245/280), with a significant difference (P < 0.05). In al l the clinical isolated strains of CPS, the drug resistance rate of community infected strains and hospital infected strains toward oxacillin was respectively 9.67% (6/62) and 35.06% (54/154), with a significant difference (P < 0.05). For the clinical isolated strains of CNS, the drug resistance rate of community infected strains and hospital infected strains toward oxacillin was respectively 69.57% (16/23) and 89.11% (229/257), also with a significant difference (P < 0.05). Conclusions The drug resistance of hospital infected staphylococcal strains is stronger than community infected strains. The CNS strains are more drug-resistant than CPS strains.
ObjectiveTo analyze and summarize the clinical characteristics, risk factors, pathogenic bacteria type, and drug tolerance of diabetes complicated with hospital-acquired pulmonary infection, in order to reduce the incidence of hospital-acquired pulmonary infection in patients with diabetes. MethodsThe clinical data of diabetic patients with hospital-acquired pulmonary infection from 2011 to 2013 were taken for retrospective clinical analysis. ResultsA total of 78 diabetic patients had hospital-acquired pulmonary infection among all the 572 hospitalized patients with diabetes. Age, complications of diabetes, chronic underlying disease, duration of hospital stay, glycated hemoglobin and invasive procedures were all correlated with the incidence of hospital-acquired infection (P<0.05). Through sputum culture and throat culture, 59 strains of pathogens were found, and they were mainly multidrug-resistant Gram-negative bacteria, accounting for 71.2%. ConclusionThe rate of acquired pulmonary infection in diabetic patients is particularly high, and the pathogens are mostly Gram-negative and multidrug-resistant. Glycemic control, rational use of antimicrobial drugs, shorter hospital stay, effective prevention and treatment of diabetes complications and chronic underlying diseases, and aseptic techniques can be effective in preventing acquired pulmonary infection for diabetic patients.
目的 了解2011年1月－2012年12月临床分离病原菌的分布和耐药情况，为指导临床合理用药和医院感染的控制提供依据。 方法 采用法国梅里埃API半自动微生物鉴定分析系统进行细菌鉴定和药物敏感试验，对所得数据用WHONET 5.4软件完成统计分析。 结果 送检的3 073份临床标本中共分离出病原菌696株，阳性率22.1%。其中，G+菌占31.3%，G?菌占64.1%，主要为金黄色葡萄球菌（25.6%）、大肠埃希菌（17.8%）、肺炎克雷伯菌（16.4%）、铜绿假单胞菌（11.5%）。在葡萄球菌中，青霉素、红霉素的耐药率最高，分别是95.6%、78.5%；尚无耐万古霉素菌株。肠道杆菌中，阿莫西林的耐药率最高，为95.0%；替卡西林的耐药率为91.0%；头孢噻吩的耐药率为72.0%；尚无耐亚胺培南菌株。多重耐药的大肠埃希菌、肺炎克雷伯菌对亚胺培南具有良好的敏感性。 结论 该院临床分离的致病菌耐药情况不严重，对病原菌的分布和耐药情况的研究较好地指导了临床合理用药和控制了医院感染。
ObjectTo investigate the pathogenesis of drug-resistant epilepsy by examining the expression of mRNA and protein of Cell Division Cycle 42 GTP-binding protein (Cdc42), Neural Wiskott-Aldrich Syndrome Protein (N-WASP) and Actin-related protein 2/3(Arp2/3) in peripheral blood of patients with drug-resistant epilepsy (DRE).MethodsSeventy two essential epilepsy patients who were attended at outpatients and inpatients in the Department of Neurology of the Affiliated Hospital of Youjiang Medical University for Nationalities were selected from October 2016 to October 2018. According to the 2010 International League Against Epilepsy’s definition of Drug-Resistant Epilepsy, the patients were divided into 2 groups: 32 patients with DRE were defined as DRE group, 40 patients with anti-epilepsy drugs (AEDs) well controlled were defined as the well controlled group. Thirty two healthy persons were selected as control group. The expression of mRNA and protein of Cdc42, N-WASP and Arp2/3 in peripheral blood were measured by quantitative real-time PCR (RT-qPCR) and Western blot(WB). Experimental data were analyzed by ANOVA or rank-sum test.ResultsCompared with well-controlled group and healthy persons group, Cdc42, N-WASP, Arp2/3 in DRE group were significantly increased, the differences were statistically significant (P<0.05). Compared with the control group, Cdc42, N-WASP, Arp2/3 in well-controlled group were significantly increased, with statistically significant differences (P<0.05).ConclusionThe expression of Cdc42, N-WASP, Arp2/3 in peripheral blood of patients with DRE significantly increased, being closely related to the occurrence and development of DRE, and used as indicators in peripheral blood predicting the occurrence of DRE.
【Abstract】ObjectiveTo establish adriamycin (ADM) resistant pancreatic cancer cell line SW1990/ADM and to investigate its drug resistance mechanism.MethodsADM-resistant pancreatic cancer cell line SW1990/ADM was obtained by culture of pancreatic cancer cell line SW1990 in vitro with intermittently increasing the concentration of ADM in the culture medium for ten months. After two months of drug free culture, its biological characteristics, drug sensitivity as well as the expression and function of multidrug resistant gene 1 (mdr1) were detected, respectively. ResultsCompared with the parental cell line, SW1990/ADM showed great changes in biological characteristics and developed a cross resistance to various chemotherapy drugs. The drug resistance indexes of cell line SW1990/ADM to ADM, mitomycin, fluorouracil and gemcitabine were 49.60, 7.25, 3.80 and 1.25, respectively. The level of mdr1 mRNA expression in cell line SW1990/ADM was much higher than that of the parental cell line（P＜0.01). ConclusionWe have established adriamycin resistant pancreatic cancer cell line SW1990/ADM with multidrug resistance phenotype, its multidrug resistance is positively relevant to the expression of mdr1.