Objective:To investigate the influencing factors of multi-drug resistant bacterial infections in patients with severe disease and establish a predictive model.Methods:207 infected patients in our hospital from 2018 to...Objective:To investigate the influencing factors of multi-drug resistant bacterial infections in patients with severe disease and establish a predictive model.Methods:207 infected patients in our hospital from 2018 to May 2020 were selected for the study,of which 73 carried drug-resistant bacteria.Results:The risk factor network of people infected with multidrug resistant bacteria is higher than that of people infected with non-multidrug resistant bacteria,and the interaction between risk factors of the former is stronger.Conclusion:Antibiotics must be used appropriately after surgery.When the elderly was abnormal in indicators such as fever and procalcitonin in the ward,they should be considered as high-risk groups of MDRO infection.They need special care and preventive measures.展开更多
Bacterial infections are highly prevalent and a frequent cause of hospitalization and short-term mortality in patients with cirrhosis. Due to their negative impact on survival, antibiotic prophylaxis for bacterial inf...Bacterial infections are highly prevalent and a frequent cause of hospitalization and short-term mortality in patients with cirrhosis. Due to their negative impact on survival, antibiotic prophylaxis for bacterial infections in high-risk subgroups of patients with cirrhosis has been the standard of care for decades. Patients with prophylaxis indications include those at risk for a first episode of spontaneous bacterial peritonitis(SBP) due to a low ascitic fluid protein count and impaired liver and kidney function, patients with a prior episode of SBP and those with an episode of gastrointestinal bleeding. Only prophylaxis due to gastrointestinal bleeding has a known and short-time duration. All other indications imply longlasting exposure to antibiotics-once the threshold requirement for initiating prophylaxis is met-without standardized criteria for re-assessing antibiotic interruption. Despite the fact that the benefit of antibiotic prophylaxis in reducing bacterial infections episodes and mortality has been thoroughly reported, the extended use of antibiotics in patients with cirrhosis has also had negative consequences, including the emergence of multi-drug resistant bacteria.Currently, it is not clear whether restricting the use of broad and fixed antibiotic regimens, tailoring the choice of antibiotics to local bacterial epidemiology or selecting non-antibiotic strategies will be the preferred antibiotic prophylaxis strategy for patients with cirrhosis in the future.展开更多
The escalating issue of lung infections induced by multi-drug resistant(MDR)bacteria is threatening human health.Thus,the development of efficient drug delivery systems is essential to eliminate MDR bacterial lung inf...The escalating issue of lung infections induced by multi-drug resistant(MDR)bacteria is threatening human health.Thus,the development of efficient drug delivery systems is essential to eliminate MDR bacterial lung infections effectively.Herein,we designed inhalable drug-loaded nano-assemblies by the electrostatic interaction between negatively charged sodium alginate and a positively charged antibacterial polymer,quaternized polyethyleneimine(QPEI-C_(6)),as well as a kind of typical antibiotic for therapy of lung infection,azithromycin(AZT).By adjusting the feed ratios,we optimized the size of the nano-assembly to approximately 200 nm(STQ_(12)),which was beneficial for penetration through the mucus layer and biofilm.In the slightly acidic environment of the infected site,the nano-assembly could dissemble responsively and release AZT and QPEI-C_(6).Because of the combined bactericidal effect,STQ_(12)exhibited high bactericidal efficiency against MDR bacteria.In animal experiments,STQ_(12)showed notable efficacy against MDR bacterial lung infection.Gene transcriptomic results showed that the main effects of STQ_(12)against bacteria were through influencing the bacterial cell components and metabolic processes,and affecting their growth and reproduction.This work provides a promising strategy to treat MDR bacterium-induced lower respiratory tract infections.展开更多
目的分析风险评估联合计划-执行-检查-处理(plan-do-check-act,PDCA)循环法在多重耐药菌感染(multiple drug-resistant organism,MDRO)防控中的应用效果。方法选取2021年7月—2023年6月菏泽市中医医院重症加强护理病房(intensive care u...目的分析风险评估联合计划-执行-检查-处理(plan-do-check-act,PDCA)循环法在多重耐药菌感染(multiple drug-resistant organism,MDRO)防控中的应用效果。方法选取2021年7月—2023年6月菏泽市中医医院重症加强护理病房(intensive care unit,ICU)收治的患者360例,按照干预时间将2021年7月—2022年6月的180例患者作为对照组,2022年7月—2023年6月的180例患者作为研究组。对照组采取常规管理措施防控MDRO,研究组在其基础上采用风险评估联合PDCA循环法进行MDRO防控。比较2组MDRO防控措施的执行情况与MDRO的检出率。结果研究组的危急值报告、规范隔离、开具隔离医嘱、诊疗用品专用、诊疗时个人防护、手卫生、终末消毒的执行情况评分均高于对照组,差异有统计学意义(P<0.05)。研究组MDRO检出率为5.56%,低于对照组的12.22%(P<0.05)。结论风险评估与PDCA循环法联合应用可以进一步提升MDRO防控工作的执行情况,降低MDRO发生风险。展开更多
文摘Objective:To investigate the influencing factors of multi-drug resistant bacterial infections in patients with severe disease and establish a predictive model.Methods:207 infected patients in our hospital from 2018 to May 2020 were selected for the study,of which 73 carried drug-resistant bacteria.Results:The risk factor network of people infected with multidrug resistant bacteria is higher than that of people infected with non-multidrug resistant bacteria,and the interaction between risk factors of the former is stronger.Conclusion:Antibiotics must be used appropriately after surgery.When the elderly was abnormal in indicators such as fever and procalcitonin in the ward,they should be considered as high-risk groups of MDRO infection.They need special care and preventive measures.
文摘Bacterial infections are highly prevalent and a frequent cause of hospitalization and short-term mortality in patients with cirrhosis. Due to their negative impact on survival, antibiotic prophylaxis for bacterial infections in high-risk subgroups of patients with cirrhosis has been the standard of care for decades. Patients with prophylaxis indications include those at risk for a first episode of spontaneous bacterial peritonitis(SBP) due to a low ascitic fluid protein count and impaired liver and kidney function, patients with a prior episode of SBP and those with an episode of gastrointestinal bleeding. Only prophylaxis due to gastrointestinal bleeding has a known and short-time duration. All other indications imply longlasting exposure to antibiotics-once the threshold requirement for initiating prophylaxis is met-without standardized criteria for re-assessing antibiotic interruption. Despite the fact that the benefit of antibiotic prophylaxis in reducing bacterial infections episodes and mortality has been thoroughly reported, the extended use of antibiotics in patients with cirrhosis has also had negative consequences, including the emergence of multi-drug resistant bacteria.Currently, it is not clear whether restricting the use of broad and fixed antibiotic regimens, tailoring the choice of antibiotics to local bacterial epidemiology or selecting non-antibiotic strategies will be the preferred antibiotic prophylaxis strategy for patients with cirrhosis in the future.
基金Beijing Outstanding Young Scientist Program,Grant/Award Number:BJJWZYJH01201910010024National Natural Science Foundation of China,Grant/Award Numbers:52073024,52122304,52221006,52293382Beijing Municipal Science and Technology Project,Grant/Award Number:Z191100006619099。
文摘The escalating issue of lung infections induced by multi-drug resistant(MDR)bacteria is threatening human health.Thus,the development of efficient drug delivery systems is essential to eliminate MDR bacterial lung infections effectively.Herein,we designed inhalable drug-loaded nano-assemblies by the electrostatic interaction between negatively charged sodium alginate and a positively charged antibacterial polymer,quaternized polyethyleneimine(QPEI-C_(6)),as well as a kind of typical antibiotic for therapy of lung infection,azithromycin(AZT).By adjusting the feed ratios,we optimized the size of the nano-assembly to approximately 200 nm(STQ_(12)),which was beneficial for penetration through the mucus layer and biofilm.In the slightly acidic environment of the infected site,the nano-assembly could dissemble responsively and release AZT and QPEI-C_(6).Because of the combined bactericidal effect,STQ_(12)exhibited high bactericidal efficiency against MDR bacteria.In animal experiments,STQ_(12)showed notable efficacy against MDR bacterial lung infection.Gene transcriptomic results showed that the main effects of STQ_(12)against bacteria were through influencing the bacterial cell components and metabolic processes,and affecting their growth and reproduction.This work provides a promising strategy to treat MDR bacterium-induced lower respiratory tract infections.
文摘目的分析风险评估联合计划-执行-检查-处理(plan-do-check-act,PDCA)循环法在多重耐药菌感染(multiple drug-resistant organism,MDRO)防控中的应用效果。方法选取2021年7月—2023年6月菏泽市中医医院重症加强护理病房(intensive care unit,ICU)收治的患者360例,按照干预时间将2021年7月—2022年6月的180例患者作为对照组,2022年7月—2023年6月的180例患者作为研究组。对照组采取常规管理措施防控MDRO,研究组在其基础上采用风险评估联合PDCA循环法进行MDRO防控。比较2组MDRO防控措施的执行情况与MDRO的检出率。结果研究组的危急值报告、规范隔离、开具隔离医嘱、诊疗用品专用、诊疗时个人防护、手卫生、终末消毒的执行情况评分均高于对照组,差异有统计学意义(P<0.05)。研究组MDRO检出率为5.56%,低于对照组的12.22%(P<0.05)。结论风险评估与PDCA循环法联合应用可以进一步提升MDRO防控工作的执行情况,降低MDRO发生风险。
文摘目的探究腹腔感染患者腹腔引流液中病原菌分布及其耐药性情况.方法选择2015-01/2017-11天津市宁河区医院就诊并行腹腔引流术的腹腔感染患者92例进行回顾性分析,统计患者的腹腔引流液细菌培养和药敏结果 ,分析不同菌群和耐药性的差异,并应用Cox回归分析模型探究影响患者预后的独立危险因素.结果共培养出菌株145例,其中革兰氏阳性菌44株、革兰氏阴性菌97株和真菌4株;大肠埃希菌(31.72%),肺炎克雷伯杆菌(24.14%),金黄色葡萄球菌(15.86%),肠球菌属(11.72%),铜绿假单胞菌(7.59%)的构成比较高.金黄色葡萄球菌和肠球菌属的耐药率较高,但均对万古霉素高度敏感;其中,肠球菌属对红霉素、氯霉素、左氧氟沙星的耐药率高于金黄色葡萄球菌,金黄色葡萄球菌对氨苄青霉素的耐药性较高.G-菌属均存在较高的耐药率,但均对β-内酰胺类/β-内酰胺酶(extended-spectrumβ-lactamase,ESBLs)抑制剂、亚胺培南/西司他丁和阿米卡星具有较高的敏感性;其中,超广谱ESBLs+的菌属以及铜绿假单胞菌对头孢曲松、头孢他啶、头孢吡肟和左氧氟沙星的耐药率较高.多因素Cox回归分析显示,多重耐药菌(multi drug resistance bacteria,MDRO)、ESBLs+和发热至培养时间是腹腔感染患者死亡的独立危险因素.结论腹腔感染患者腹腔引流液中病原菌分布以革兰氏阴性菌为主,且病原菌对常用抗菌素具有较高的耐药性,MDRO、ESBLs+和发热至培养时间是腹腔感染患者死亡的独立危险因素.
