Development of Spectral Features for Monitoring Rice Bacterial Leaf Blight Disease Using Broad-Band Remote Sensing Systems

As an important rice disease, rice bacterial leaf blight (RBLB, caused by the bacterium Xanthomonas oryzae pv.oryzae), has become widespread in east China in recent years. Significant losses in rice yield occurred as a result ofthe disease’s epidemic, making it imperative to monitor RBLB at a large scale. With the development of remotesensing technology, the broad-band sensors equipped with red-edge channels over multiple spatial resolutionsoffer numerous available data for large-scale monitoring of rice diseases. However, RBLB is characterized by rapiddispersal under suitable conditions, making it difficult to track the disease at a regional scale with a single sensorin practice. Therefore, it is necessary to identify or construct features that are effective across different sensors formonitoring RBLB. To achieve this goal, the spectral response of RBLB was first analyzed based on the canopyhyperspectral data. Using the relative spectral response (RSR) functions of four representative satellite or UAVsensors (i.e., Sentinel-2, GF-6, Planet, and Rededge-M) and the hyperspectral data, the corresponding broad-bandspectral data was simulated. According to a thorough band combination and sensitivity analysis, two novel spectralindices for monitoring RBLB that can be effective across multiple sensors (i.e., RBBRI and RBBDI) weredeveloped. An optimal feature set that includes the two novel indices and a classical vegetation index was formed.The capability of such a feature set in monitoring RBLB was assessed via FLDA and SVM algorithms. The resultdemonstrated that both constructed novel indices exhibited high sensitivity to the disease across multiple sensors.Meanwhile, the feature set yielded an overall accuracy above 90% for all sensors, which indicates its cross-sensorgenerality in monitoring RBLB. The outcome of this research permits disease monitoring with different remotesensing data over a large scale.

Six-year analysis of key monitoring for bacterial strain distribution and antibiotic sensitivity in a hospital

BACKGROUND With the widespread use of antimicrobial drugs,bacterial resistance has become a significant problem,posing a serious threat to public health.The prevalence of clinical infection strains in hospitals and their drug sensitivities are key to the appropriate use of antibiotics in clinical practice.AIM To identify prevalent bacteria and their antibiotic resistance profiles in a hospital setting,thereby guiding effective antibiotic usage by clinicians.METHODS Specimens from across the institution were collected by the microbiology laboratory.The VITEK 2 compact fully automatic analyzer was used for bacterial identification and antibiotic sensitivity testing,and the WHONET5.6 software was utilized for statistical analysis.RESULTS A total of 12062 bacterial strains of key monitoring significance were detected.Staphylococcus aureus demonstrated widespread resistance to penicillin,but none of the strains were resistant to vancomycin or linezolid.Moreover,219 strains of methicillin-resistant coagulase-negative staphylococci and 110 strains of methicillin-resistant Staphylococcus aureus were detected.Enterococcus faecalis showed moderate resistance to the third-generation quinolones ciprofloxacin and levofloxacin,but its resistance to nitrofurantoin and tetracycline was low.Enterococcus faecium displayed significantly lower resistance to third-and fourthgeneration quinolones than Enterococcus faecalis.The resistance of two key monitoring strains,Escherichia coli and Klebsiella pneumoniae,to piperacillin/tazobactam was 5%-8%.However,none of the Escherichia coli and Klebsiella pneumoniae strains were resistant to meropenem.The resistance of Acinetobacter baumannii to piperacillin/sulbactam was nearly 90%.Nonetheless,the resistance to tigecycline was low,and Pseudomonas aeruginosa demonstrated minimal resistance in the antibiotic sensitivity test,maintaining a resistance of<10%to the cephalosporin antibiotics cefotetan and cefoperazone over the last 6 years.The resistance to amikacin remained at 0.2%over the past 3 years.CONCLUSION Our hospital’s overall antibiotic resistance rate was relatively stable from 2017 to 2022.The detection rates of key monitoring strains are reported quarterly and their resistance dynamics are monitored and communicated to the entire hospital,which can guide clinical antibiotic selection.

Study of the Effect of Bacterial Resistance Monitoring in Clinical Microbiology Testing

Objective:To observe and analyze the effect of bacterial resistance monitoring in clinical microbiology testing.Methods:600 microbial specimens collected in our hospital in the past year(April 2021 to April 2022)were used as the test subjects of this study.The specimens were divided into Group A(control group)and Group B(research group),with 300 cases in each group.Group A consisted of blood culture specimens,while Group B consisted of sputum specimens.After the tests were completed,the rates of unfavorable and favorable results,bacterial species distribution,and bacterial drug resistance of the specimens in both groups were compared.Results:Among group A specimens,29 cases were positive(9.67%)and 271 cases were negative(90.33%);among group B specimens,99 cases were positive(33.00%)and 201 cases were negative(66.00%);the difference between the two groups of data was statistically significant(P<0.05).As for the distribution of the types of bacteria,there were 472 cases of Gram-negative bacteria and 128 cases of Gram-positive bacteria.Conclusion:Bacterial resistance monitoring is helpful in clinical microbiology testing.Through proper monitoring,bacterial resistance can be well understood.In this way,patients get to receive appropriate treatment measures and suitable antibacterial prescriptions,thereby improving the patient outcome.

Extensively drug-resistant bacteria are an independent predictive factor of mortality in 130 patients with spontaneous bacterial peritonitis or spontaneous bacteremia

AIM: To evaluate the epidemiology and outcomes of culture-positive spontaneous bacterial peritonitis (SBP) and spontaneous bacteremia (SB) in decompensated cirrhosis.METHODS: We prospectively collected clinical, laboratory characteristics, type of administered antibiotic, susceptibility and resistance of bacteria to antibiotics in one hundred thirty cases (68.5% males) with positive ascitic fluid and/or blood cultures during the period from January 1, 2012 to May 30, 2014. All patients with SBP had polymorphonuclear cell count in ascitic fluid > 250/mm3. In patients with SB a thorough study did not reveal any other cause of bacteremia. The patients were followed-up for a 30-d period following diagnosis of the infection. The final outcome of the patients was recorded in the end of follow-up and comparison among 3 groups of patients according to the pattern of drug resistance was performed.RESULTS: Gram-positive-cocci (GPC) were found in half of the cases. The most prevalent organisms in a descending order were Escherichia coli (33), Enterococcus spp (30), Streptococcus spp (25), Klebsiella pneumonia (16), S. aureus (8), Pseudomanas aeruginosa (5), other Gram-negative-bacteria (GNB) (11) and anaerobes (2). Overall, 20.8% of isolates were multidrug-resistant (MDR) and 10% extensively drug-resistant (XDR). Health-care-associated (HCA) and/or nosocomial infections were present in 100% of MDR/XDR and in 65.5% of non-DR cases. Meropenem was the empirically prescribed antibiotic in HCA/nosocomial infections showing a drug-resistance rate of 30.7% while third generation cephalosporins of 43.8%. Meropenem was ineffective on both XDR bacteria and Enterococcus faecium (E. faecium). All but one XDR were susceptible to colistin while all GPC (including E. faecium) and the 86% of GNB to tigecycline. Overall 30-d mortality was 37.7% (69.2% for XDR and 34.2% for the rest of the patients) (log rank, P = 0.015). In multivariate analysis, factors adversely affecting outcome included XDR infection (HR = 2.263, 95%CI: 1.005-5.095, P = 0.049), creatinine (HR = 1.125, 95%CI: 1.024-1.236, P = 0.015) and INR (HR =1.553, 95%CI: 1.106-2.180, P = 0.011).CONCLUSION: XDR bacteria are an independent life-threatening factor in SBP/SB. Strategies aiming at restricting antibiotic overuse and rapid identification of the responsible bacteria could help improve survival.

2020—2022年自贡市第一人民医院细菌耐药性监测

目的了解自贡市第一人民医院临床分离菌对抗菌药物的耐药性,为临床合理使用抗菌药物提供依据。方法收集我院2020—2022年临床分离菌株,采用VITEK自动化鉴定及药敏系统、纸片扩散法及E-test方法进行细菌鉴定及药物敏感试验,以2022年美国临床和实验室标准化协会(CLSI)折点标准判断结果。结果共分离出临床菌株13324株,其中革兰阴性菌占69.6%,革兰阳性菌占30.4%。前五位分离菌为大肠埃希菌、肺炎克雷伯菌、金黄色葡萄球菌、铜绿假单胞菌和流感嗜血杆菌。耐甲氧西林金黄色葡萄球菌(MRSA)和耐甲氧西林凝固酶阴性葡萄球菌(MRCNS)的检出率分别为24.1%和73.0%。耐利奈唑胺屎肠球菌和粪肠球菌的检出率分别为2.1%和12.4%,分离出1株耐万古霉素的屎肠球菌。脑脊液中分离的4株肺炎链球菌均为青霉素非敏感菌株,未检出非脑脊液来源耐青霉素肺炎链球菌。耐碳青霉烯类阴沟肠杆菌的检出率为12.3%。而耐碳青霉烯类大肠埃希菌和肺炎克雷伯菌检出率低,分别为1.1%和2.9%。铜绿假单胞菌对哌拉西林/他唑巴坦、头孢吡肟和庆大霉素的耐药率逐年增加;鲍曼不动杆菌对常见抗菌药物耐药率明显高于铜绿假单胞菌,耐碳青霉烯类菌株检出率分别为41.9%和6.9%。未分离出耐头孢噻肟的流感嗜血杆菌和卡他莫拉菌。结论临床分离菌以革兰阴性菌为主,常见分离菌的耐药率呈现平稳或略有降低的特点。然而,耐利奈唑胺粪肠球菌和耐阿莫西林/克拉维酸流感嗜血杆菌检出率明显升高,应加强医院感染防控措施和抗菌药物的合理使用。

某医院近10年大肠埃希菌分离率和耐药率的变迁情况

目的总结近10年中国医科大学附属第一医院大肠埃希菌的分离率和耐药率,为临床抗感染经验治疗提供依据。方法数据来自2013年至2022年间从中国医科大学附属第一医院就诊患者中分离的大肠埃希菌,使用VITEK 2和VITEK MS进行菌种鉴定,使用VITEK2和KB法进行药物敏感性试验,采用WHONET 5.6软件进行分析。结果2013年至2022年共分离6845株菌株,其中80.5%来自住院患者,19.5%来自门诊和急诊患者。常见标本类型为尿液(57.8%)、血液(15.0%)、分泌物(9.2%)、引流液(8.1%)。大肠埃希菌超广谱β-内酰胺酶(ESBL)分离率为57.2%(54.3%~61.5%)。大肠埃希菌对碳青霉烯类抗菌药物的耐药率较低,仅为1.2%(0.2%~2.6%)。结论大肠埃希菌仍是临床感染的重要病原菌,对多种抗菌药物存在不同程度的耐药,且耐药率有上升趋势,临床医师应给予足够的关注。

《抗菌药物临床应用管理标准》制订与解析

抗菌药物临床应用管理是医疗机构药事管理和药学服务的重要组成部分。该标准以抗菌药物在医疗机构的生命全周期为主线,以国家政策法规为依据,以科学性、通用性、指导性和可操作性为编写原则,通过梳理问题、征集意见、专家论证审议而形成,是国内外首部对抗菌药物临床应用管理进行规范的团体标准。该文通过对该标准制订过程中的团队组成、问题梳理和编制流程以及标准各要素进行介绍与解析,为广大使用该标准的同行提供参考。

2022年北京航天总医院细菌耐药性监测

目的监测2022年北京航天总医院临床分离到的菌株对抗菌药物的耐药性。方法采用自动化鉴定及药敏仪器对从临床样本培养分离到的细菌菌株进行体外抗菌药物敏感性试验,参照2021年美国临床和实验室标准化协会(CLSI)推荐的药敏试验方法标准判读结果,用WHONET 5.6软件进行数据统计分析。结果2022年临床分离细菌共3261株,分离自呼吸道标本最多,占60.07%。其中革兰阳性菌982株,约占30.11%,葡萄球菌属544株,占革兰阳性菌的55.40%,肠球菌属338株,占革兰阳性菌34.42%,链球菌属31株。革兰阴性菌共2279株,占69.89%,其中肠杆菌属1222株,占革兰阴性菌的53.62%,非发酵菌1017株,占革兰阴性菌的44.62%。分离率前5名的菌株依次为肺炎克雷伯菌、铜绿假单胞菌、大肠埃希菌、鲍曼不动杆菌、屎肠球菌。耐甲氧西林金黄色葡萄球菌(MRSA)的检出率为22.86%,耐甲氧西林凝固酶阴性葡萄球菌(MRCNS)的检出率为75.07%,未发现万古霉素耐药的葡萄球菌。肺炎克雷伯菌对亚胺培南和美岁培南的耐药率分别为42.9%和67.0%,大肠埃希菌对亚胺培南和美罗培南的耐药率较低。铜绿假单胞菌对亚胺培南和美岁培南的耐药率分别为30.9%和28.0%,鲍曼不动杆菌对碳青霉烯类抗生素的耐药率高达60%以上。结论2022年北京航天总医院分离到的临床常见病原菌仍以革兰阴性细菌为主,碳青霉烯耐药的肺炎克雷伯菌和碳青霉烯耐药的鲍曼不动杆菌检出率较高。

2020—2022年济南市章丘区各级医疗机构消毒效果监测报告分析

目的了解济南市章丘区各级医疗机构消毒灭菌效果,为提高医疗机构消毒质量和管理水平提供科学依据。方法采用现场抽样法及细菌定量检验方法,对2020年1月—2022年12月济南市章丘区各级医疗机构的消毒灭菌效果进行评价。结果共采集2649份,其中合格2059份,总合格率为77.73%(2059/2649)。合格率呈逐年上升趋势(P<0.001);不同级别医疗机构比较,差异有统计学意义(P<0.001)。医护人员手、物体表面、使用中消毒液合格率在不同级别医疗机构间比较,差异有统计学意义(P<0.05)。结论2020—2022年济南市章丘区各级医疗机构消毒效果合格率逐年提高,压力蒸汽灭菌器、无菌器械消毒液合格率较高,医护人员手和物体表面合格率较低,市属医院的合格率高于乡镇(街道办事处)卫生院、村卫生室及个体诊所,要重点加强基层医疗机构消毒质量督导和技术性指导工作。

780株临床分离多重耐药菌分布及耐药性分析

目的分析某院临床分离多重耐药菌的分布及耐药情况,为临床医护人员对感染性疾病防治与控制提供依据。方法选取2019年1月至2023年12月临床送检微生物标本纳入数据,分析临床分离多重耐药菌的分布及耐药性,采用WHONET 5.6软件和SPSS22.0软件,根据美国临床和实验室标准化协会(CLSI)2020年更新标准,分析细菌体外药敏实验数据。结果2019年1月至2023年12月送检的各类临床标本3918份,分离出多重耐药菌菌株780株,其中革兰阴性菌519株,占66.54%;革兰阳性菌212株,占27.18%;真菌49株,占6.28%,以呼吸道和尿液分离出标本较多。常见多重耐药菌前5位依次是大肠埃希菌、肺炎克雷伯菌、鲍曼不动杆菌、金黄色葡萄球菌和铜绿假单胞菌。结论分离多重耐药菌耐药率高于内蒙古地区甚至全国水平,需从医院层面提高重视程度,建立适合的安全管理体系,多部门合作并进行精细化管理,全面提升医院感控管理水平。

Achieving broad-spectrum resistance against rice bacterial blight through targeted promoter editing and pathogen population monitoring

Plant diseases severely reduce crop yields and threaten global food security.Broad-spectrum resistance(BSR)is a desirable trait because it confers resistance against more than one pathogen species or the majority of races/strains of the same pathogen.To control plant diseases,breeders have selected BSR to reduce disease occurrence and prolong the life-span of newly released cultivars in the last several decades(Mundt,Phytopathology 108(7):792–802,2018).Although effective,breeding of BSR cultivars in crop plants is still time-consuming and technically challenging.Recently,new gene-editing technologies such as CRISPR/Cas9 have dramatically accelerated the process of plant breeding and provided an approach for rapidly creating new varieties with BSR and other beneficial traits(Borrelli et al.,Front Plant Sci 9:1245,2018).In addition,close surveillance of pathogen populations in the field can provide useful information for the deployment of appropriate resistance genes in the target regions.In this mini-review,we focus on the significance and application of the exciting results from two recent companion papers published in Nature Biotechnology that provide new strategies to develop crop plants with BSR against pathogens through targeted promoter editing of susceptibility genes in plants as well as pathogen population monitoring.

Epidemiological Characteristics, Resistance Patterns and Spread of Gram-Negative Bacteria Related to Colonization of Patients in Intensive Care Units

Our aim was to determine the epidemiological characteristics, the resistance patterns and the spread of Gram negative bacteria related to colonization of patients in adult Intensive Care Units. Methods: A prospective cohort of patients colonized and/or infected with Gram negative bacteria was conducted at two adult ICUs from hospitals in Brazil (April 2012 to February 2013). Nasal, groin and perineum swabs were performed. Samples were incubated on MacConkey and cetrimide agar (48 h at 37℃) and identification tests (Vitek-BioMérieux), antibiogram (Bauer-Kirby method), Carba NP test, Polymerase Chain Reaction (PCR) and sequencing were performed. The patterns of resistant microorganisms were compared by rep-PCR (Diversilab). Results: There were 53 cases of colonization. In these cases, we identified imipenem-resistant Acinetobacter baumannii (51%), Pseudomonas aeruginosa (32%), Klebsiella pneumoniae ESBL (38%) or imipenem resistant (5.6%). The use of antimicrobials and medical devices were related to colonization (p The resistance patterns expressed by Klebsiella pneumoniae were ESBL (CTX-M, SHV e TEM) and KPC2. A verified profile of Acinetobacter baumannii was related to OXA-23 and OXA-253 (OXA-143 variant). The profiles ESBL and KPC2 expressed by Klebsiella pneumoniae were distributed between the both ICUs. The distribution of OXA-23 and OXA-253 was verified only in one ICU. The similarity of strains ranged from 80% to 95%, highlighting the horizontal transference of these microorganisms.

Bacterial Sample Concentration and Culture Monitoring Using a PEG-Based Osmotic System with Inline Impedance and Voltammetry Measurements

Impedance measurements using graphite electrodes were used to detect the increase in culture medium conductivity due to bacteria growth in real time along with simultaneous voltammetric monitoring of pyocyanin concentration.Electrochemical methods were compared to conventional continuous monitoring of bacterial cultures using turbidity measurement at an optical density of 600 nm(OD600).A practical osmotic system was further designed for concentrating bacterial cultures during growth to enable earlier detection using the electrochemical methods.Bacterial cultures,starting from an initial culture density of 1×10^(8) cells/mL,were grown inside a sealed cellulose ester dialysis membrane,while polyethylene glycol in LB medium was used as the draw solution outside the membrane to gradually concentrate the growing cultures.0.7-mm-diameter graphite for mechanical pencils was utilized as working and counter electrodes with a platinum wire reference electrode for electrochemical measurements with and without the osmotic system.In the absence of forward osmosis,impedance meas-urements detected culture growth~1 h faster than conventional OD600.Integrating osmosis showed a twofold decrease in the time to detect pyocyanin production as an indicator for bacterial growth.For impedance monitoring,removal of water by osmosis was conflated with the impedance decrease due to cell growth;however,the results show a promising ability to detect bacteria growth via an observed shift in osmotic impedance profile when bacteria are present in a sample.By monitoring the deviation in the impedance profile,a threefold improvement in detection time was achieved when compared to conventional OD600 measurements.

中美欧食源性细菌耐药性监测系统比较研究及启示

抗微生物药物耐药性(antimicrobial resistance,AMR)涉及兽医、食品、环境、医学等多个领域,危及食品安全、国际贸易、经济发展和生命健康,已成为全球面临的重大公共卫生问题。我国是全球最大的抗微生物药物生产和消费国,其中约60%的抗微生物药物被用于养殖业。由于抗微生物药物在养殖业的广泛使用甚至滥用,导致大量耐药细菌的出现和迅速传播。遵循“One Health”策略,联合国鼓励各国建立跨部门间的AMR协调机制。研究比较了中美欧食源性细菌耐药性监测系统的发展、框架及部分监测结果,发现各国监测体系基本涵盖人群、食品动物和相关食品食源性细菌耐药性,同时也监测人医和食品动物抗微生物药物使用量。欧美国家和地区起步较早,通过近30多年的发展,基本掌握了食源性细菌耐药性的基线水平及药物使用水平。我国食源性细菌耐药性监测体系起步较晚,人群、食品动物和相关食品食源性细菌耐药性监测发展近20年,而食品动物抗生素药物使用量监测于2018年开始启动,各方面都需要进一步完善。欧盟监测体系实施跨部门协作机制,数据共享共用;目前,虽然我国已经建立了不同部门负责的食源性细菌耐药性监测体系,但尚未建立数据共享机制,存在数据“烟囱”和信息孤岛,无法最大化发挥现有数据资源的效用。欧美经验对我国食源性细菌耐药性监测系统有一定启发:我国应逐步完善耐药监测系统、建立多部门协同共治机制及加快新技术在数据挖掘中的运用,从而综合提升遏制细菌耐药性的能力,保障人民健康。

“四网一会”联动对某医院抗菌药物科学化管理及细菌耐药的影响分析

目的通过“四网”监测信息和对某医院现场情况调研,综合分析、评价抗菌药物临床应用与管理、细菌耐药及医院感染控制相关工作的开展情况。方法2021年7月“全国抗菌药物临床应用监测网”“全国细菌耐药监测网”“全国真菌病监测网”“全国医院感染监控网”“中华医学会细菌感染与耐药防治分会”(简称“四网一会”)专家组通过现场走访、分组调研、病历讨论、问卷调查等多种方式,深入了解某医院在抗菌药物临床应用综合管理、抗菌药物临床使用、感染性疾病科建设、细菌耐药、医院感染监测等方面的工作情况,对某院的抗菌药物目录、微生物标本送检、临床合理应用及干预、科学化管理等方面进行综合评价提出改进意见。该院针对专家提出问题采取一系列科学化管理方式进行整改,并利用全国首创的手机版细菌耐药监测查询系统(Hui-net)监测耐药变迁,预防感控事件,指导抗菌药物管理,另外还通过优化抗菌药物目录、提高血培养等无菌标本送检率、开展抗菌药物管理多学科协作(AMS-MDT)活动、加强院感细节管理等一系列措施。结果通过科学化管理措施,使得全院抗菌药物使用强度、替加环素及碳青霉烯类使用强度明显降低,降幅分别为19.94%(41.42/33.16)、58.0%(0.62/0.26)和18.57%(1.4/1.14)。细菌耐药率明显下降,MRSA、CRKPN和CRPAE联动前分别为53.28%(65/122)、56.13%(119/212)和46.67%(35/75),而联动后则分别下降到40.91%(54/132)、30.05%(55/183)和26.88%(25/93);替加环素及碳青霉烯类抗菌药物使用率下降;痰液送检率降低(P<0.05),科学化管理水平得以提升。结论“四网一会”联动活动对促进某医院进一步提高抗菌药物科学化管理水平,提高碳青霉烯类及替加环素等特殊抗菌药物的合理使用,减缓细菌耐药性产生积极影响,具有重要的指导意义。

药事服务干预重点监控药品和抗菌药物控费的效果评价

目的评价并探索对重点监控药品和抗菌药物的合理用药干预措施。方法2020年,山西省心血管病医院针对重点监控药品和抗菌药物的不合理情况实施了干预。采用回顾性研究方法,选取干预前(2019年)、干预后(2020年)我院重点监控目录内药品和抗菌药物的相关使用数据,以药物利用评价和药物使用合理性情况为评价指标,对比干预前后重点监控药品和抗菌药物的总体使用情况和合理性。结果与干预前比较,干预后我院重点监控药品的销售金额及其占药品总销售金额的比例、以及药占比均不同程度地降低;抗菌药物的销售金额和用药频度也均降低,用药频度降幅居于前3位的是注射用五水头孢唑林钠和注射用盐酸头孢甲肟、乳酸左氧氟沙星氯化钠注射液;抗菌药物的限定日费用变化较大的药品为注射用盐酸头孢甲肟和注射用盐酸万古霉素;注射用盐酸头孢甲肟的经济实用性和可接受程度最低。干预后(2020年),重点监控药品不合理使用率呈现降低趋势。结论通过药事管理和合理用药干预,我院重点监控药品和抗菌药物的销售金额明显降低,不合理使用情况明显改善,提示管控措施促进了重点监控药品和抗菌药物的临床合理应用。医院药事管理中强化药费控制措施,有助于控制药品在业务收入中的占比,促进临床用药合理化,整体降低医药费用。

细菌耐药性监测在临床微生物检验中的应用效果分析

目的 针对临床微生物检验中应用细菌耐药性监测的效果。方法 采用随机数表法选取2019年2月—2022年12月厦门市第五医院接受治疗的检出病原菌感染的180例患者为研究对象,探讨不同病原菌的耐药情况,统计不同科室微生物检验标本的耐药菌检出率。结果 在临床检出的病原菌中,大肠埃希菌占比最高为39.44%,其次为铜绿假单胞菌,占比20.00%。第3为肺炎克雷伯菌,占比18.89%;大肠埃希菌、铜绿假单胞菌、肺炎克雷伯菌进行药敏试验显示,头孢呋辛作为3种菌株耐药性最高的药物,占比分别为90.14%、100.0%、58.82%,其次为头孢噻肟,占比分别为67.61%、94.44%、41.18%,第3为氨曲南,占比分别39.44%、50.00%、20.59%。结论 在临床微生物检验中,应用细菌耐药性监测,可为患者的后续药物治疗提供可靠的依据,以此根据监测结果合理选择抗菌药物,避免耐药菌发展对临床治疗带来不利影响。

2016—2018年海军军医大学第三附属医院长海院区细菌分布及其耐药性分析

目的分析2016—2018年海军军医大学第三附属医院长海院区常见临床分离菌的分布及耐药性,为临床合理选用抗菌药物提供依据。方法回顾性分析2016—2018年该院区常见临床分离菌的分布及耐药性,依据CLSI 2018版折点对结果进行判读。结果2016—2018年该院区分离并检测临床菌株4094株,革兰阴性杆菌2784株(68.0%),革兰阳性球菌1310株(32.0%)。最常见细菌是大肠埃希菌、肺炎克雷伯菌、屎肠球菌、粪肠球菌、铜绿假单胞菌。大肠埃希菌和肺炎克雷伯菌对碳青霉烯类抗生素仍高度敏感,耐药率低于5%。铜绿假单胞菌对碳青霉烯类药物耐药率为10.7%~29.4%;鲍曼不动杆菌对碳青霉烯类耐药率为3.3%~16.0%。粪肠球菌对多数测试抗菌药物的耐药率均显著高于屎肠球菌。结论该院临床分离菌对常见抗菌药物的耐药性较低。做好细菌耐药监测工作,根据耐药监测数据合理使用抗生素,能达到良好的临床治疗疗效。

某院2022年细菌真菌耐药性监测及分析

目的 了解2022年1—12月广东省人民医院珠海医院(珠海市金湾中心医院)(本院)细菌耐药性监测及分析菌株分布和抗菌药物敏感性。方法 按照指南标准判断最低抑菌浓度(MIC)和抑菌圈直径结果,用办公软件EXCEL对本院分离出的致病菌分布及参与药敏监测的菌株进行敏感性分析。结果 经排除3 d内同一部位重复检出的同一种致病菌后共有1384株菌被纳入统计分析,其中有革兰氏阴性菌(G^(-)菌)776株,占56.1%;革兰氏阳性菌(G^(+)菌)241株,占17.4%;真菌367株,占26.5%。其中367株真菌中共分离出酵母样真菌325株,占88.6%,白色念珠菌236株,占72.6%。检出耐甲氧西林的凝固酶阴性葡萄球菌(MRCNS)和耐甲氧西林的金黄色葡萄球菌(MRSA)占比分别为76.4%和32.1%。产超广谱β内酰胺酶(ESBLs)的肺炎克雷伯菌和大肠埃希菌阳性率分别为20.5%和48.1%。检出耐碳青霉烯类抗菌药物的肠杆菌科(CRE)中大肠埃希菌和肺炎克雷伯菌占比分别为3.1%和5.9%,检出耐碳青霉烯类抗菌药物的铜绿假单胞菌和鲍曼不动杆菌占比分别为15%和20%。结论 与2022年全国细菌耐药监测数据相比较,本院细菌耐药率略低,应加强及重视细菌耐药监测,继续做好院内感染控制。

细菌耐药性监测结果分析——基于黔西南布依族苗族自治州人民医院临床数据

为探讨临床分离菌株常见菌对常用抗微生物药物的耐药率、患者年龄分布以及多重耐药菌发生率的影响,为临床医生经验性抗感染治疗提供依据,收集2018—2021年黔西南布依族苗族自治州人民医院检验科分离的非重复细菌样本,按照统一的方案进行菌株种属鉴定及药物敏感性检测,应用Whonet5.6软件对数据进行分析。研究表明,黔西南布依族苗族自治州人民医院临床分离的常见细菌对不同抗菌药物呈不同耐药率,患者以成人为主。临床应充分了解每季度细菌耐药监测结果,合理使用抗菌药物并加强医院感染管理。