BACKGROUND Antibiotic resistance has become a global threat for human health,calling for rational use of antibiotics.AIM To analyze the distribution and drug resistance of the bacteria,providing the prerequisite for u...BACKGROUND Antibiotic resistance has become a global threat for human health,calling for rational use of antibiotics.AIM To analyze the distribution and drug resistance of the bacteria,providing the prerequisite for use of antibiotics in emergency patients.METHODS A total of 2048 emergency patients from 2013 to 2017 were enrolled.Their clinical examination specimens were collected,followed by isolation of bacteria.The bacterial identification and drug susceptibility testing were carried out.RESULTS A total of 3387 pathogens were isolated.The top six pathogens were Acinetobacter baumannii(660 strains),Staphylococcus aureus(436 strains),Klebsiella pneumoniae(347 strains),Pseudomonas aeruginosa(338 strains),Escherichia coli(237 strains),and Candida albicans(207 strains).The isolation rates of these pathogens decreased year by year except Klebsiella pneumoniae,which increased from 7.1%to 12.1%.Acinetobacter baumannii is a widely-resistant strain,with multiple resistances to imipenem,ciprofloxacin,minocycline and tigecycline.The Staphylococcus aureus had high resistance rates to levofloxacin,penicillin G,and tetracycline.But the susceptibility of it to vancomycin and tigecycline were 100%.Klebsiella pneumoniae had high resistance rates to imipenem,cefoperazone/sulbactam,amikacin,and ciprofloxacin,with the lowest resistance rate to tigecycline.The resistance rates of Pseudomonas aeruginosa to cefoperazone/sulbactam and imipenem were higher,with the resistance rate to amikacin below 10%.Besides,Escherichia coli had high resistance rates to ciprofloxacin and cefoperazone/sulbactam and low resistance rates to imipenem,amikacin,and tigecycline.CONCLUSION The pathogenic bacteria isolated from the emergency patients were mainly Acinetobacter baumannii,Staphylococcus aureus,Klebsiella pneumoniae,Pseudomonas aeruginosa,Escherichia coli,and Candida albicans.The detection rates of drugresistant bacteria were high,with different bacteria having multiple drug resistances to commonly used antimicrobial agents,guiding the rational use of drugs and reducing the production of multidrug-resistant bacteria.展开更多
Objective： To understand distribution and drug resistance of pathogenic bacteria from a specialized cancer hospital in 2013 in order to provide a basis for rational clinical antimicrobial agents. Methods： Pathogenic...Objective： To understand distribution and drug resistance of pathogenic bacteria from a specialized cancer hospital in 2013 in order to provide a basis for rational clinical antimicrobial agents. Methods： Pathogenic bacteria identification and drug sensitivity tests were performed with a VITEK 2 compact automatic identification system and data were analyzed using WHONET5.6 software.Results： Of the 1,378 strains tested, 980 were Gram-negative bacilli, accounting for 71.1%, in which Klebsiella pneumonia, Escherichia coli and Pseudomonas aeruginosa were the dominant strains. We found 328 Gram-positive coccus, accounting for 23.8%, in which the amount of Staphylococcus aureus was the highest. We identified 46 fungi, accounting for 4.1%. According to the departmental distribution within the hospital, the surgical departments isolated the major strains, accounting for 49.7%. According to disease types, lung cancer, intestinal cancer and esophagus cancer were the top three, accounting for 20.9%, 17.3% and 14.2%, respectively. No strains were resistant to imipenem, ertapenem or vancomycin.Conclusions： Pathogenic bacteria isolated from the specialized cancer hospital have different resistance rates compared to commonly used antimicrobial agents; therefore antimicrobial agents to reduce the morbidity and mortality of infections should be used.展开更多
Objective:To understand the pathogenic bacteria isolated from patients and their drug resistance changes in general ICU of the Affiliated Hospital of Hebei University,so as to provide reference for appropriate selecti...Objective:To understand the pathogenic bacteria isolated from patients and their drug resistance changes in general ICU of the Affiliated Hospital of Hebei University,so as to provide reference for appropriate selection of antibiotics in clinical practice.Methods:A retrospective investigation was conducted to analyze the bacteriological distribution and drug resistance of nosocomial pathogens isolated from the specimens of hospitalized patients in the comprehensive ICU of the hospital from 2019 to 2021.The US technology BD Phoenix 100 automatic bacterial identification analyzer was used for bacterial identification of the pathogen samples,disk diffusion method was used for drug susceptibility test,and SPSS 22.0 software was used to analyze the trend of drug resistance.Results:A total of 970 strains of nosocomial pathogens were detected in the three years.The main pathogens were Acinetobacter baumannii(133 strains,13.71%),Klebsiella pneumoniae(106 strains,10.93%),Pseudomonas aeruginosa(83 strains,8.56%),Escherichia coli(76 strains,7.84%)and Enterococcus faecium(69 strains,7.11%).The resistance rate of Acinetobacter baumannii to antibiotics was high.Klebsiella pneumoniae,Pseudomonas aeruginosa and Escherichia coli had low resistance rates to carbapenems.The situation of bacterial drug resistance is still serious.Conclusion:The drug resistance of pathogenic bacteria collected from Class III Grade A Hospital’s patients to antibiotics was generally high.Therefore,clinical departments should strengthen the inspection of specimens of infection and drug sensitivity test in order to grasp the resistance mechanisms and drug resistance of pathogenic bacteria changes,and select appropriate antimicrobial agents according to the test results.Besides,the formation of drug-resistant strains also needs to be prevented,and the treatment of patients with severe infection needs to be improved.展开更多
BACKGROUND Diabetic foot ulceration(DFU)is the prime health concern globally.It accounts for the major burden related to disease mortality and morbidity and economic cost.The timely and early recognition of the DFU ca...BACKGROUND Diabetic foot ulceration(DFU)is the prime health concern globally.It accounts for the major burden related to disease mortality and morbidity and economic cost.The timely and early recognition of the DFU can help present its occurrence and improve clinical outcomes.AIM To evaluate interrelationships between foot ulcers,risk factors,and antibiotic resistance among diabetic patients having ulcers in their foot.METHODS The databases such as PubMed,ERIC,Medline,and Google Scholar were extensively used for the extraction of studies.The selected studies were published within the time-period of 2014-2018.Ten studies were selected,which were found to be completely relevant to the current study.RESULTS The prevalence of diabetic foot ulcers among the population was evaluated,and the associated risk factors with its prevalence.Moreover,few studies also reported on the bacteria that are found to be most prevailing among diabetic patients.A narrative discussion was drawn through this analysis,which was used to highlight the specific area of research through selected studies,extraction of the significant information that matched with the topic of research,and analysis of problem through the findings of the selected articles.The results helped in assessing significant knowledge regarding the risk factors of diabetic foot ulcers and the role of antimicrobial resistant in its treatment.CONCLUSION The gram-negative bacteria were found to be the most common reason for diabetic foot ulcers.The study only included 10 studies that are not sufficient to produce generalized results,and no information was reported on the tests required to analyze antimicrobial susceptibility that can guide clinicians to propose better and sound treatment plans.It is evident that most study results depicted that the most common risk factors were found to be hypertension and neuropathy.展开更多
Background： Aerosolized amikacin （AA） is a current option for the management of ventilator-associated pneumonia （VAP） caused by multidrug-resistant Gram-negative bacteria （MDR-GNB）, as it is reported that AA co...Background： Aerosolized amikacin （AA） is a current option for the management of ventilator-associated pneumonia （VAP） caused by multidrug-resistant Gram-negative bacteria （MDR-GNB）, as it is reported that AA could increase the alveolar level of the drug without increasing systemic toxicity. This study aimed to evaluate the efficacy and safety of AA as an adjunctive therapy for VAP caused by MDR-GNB. Methods： In this single-center, double-blind study conducted in a 36-bed general Intensive Care Unit （ICU） in a tertiary hospital from June 2014 to June 2016, 52 ICU patients with confirmed MDR-GNB VAP were randomized to two groups （AA group, n - 27 and placebo group, n = 25）. Amikacin （400 rag, q8h） or saline placebo （4 ml, q8h） was aerosolized for 7 days. The attending physician determined the administration of systemic antibiotics for VAP. Patients were tbllowed up for 28 days. Bacteriological eradication, clinical pulmonary infection score （CP1S）, and serum creatinine were assessed on day 7 of therapy. New resistance to amikacin, cure rate of VAP, weaning rate, and mortality were assessed on day 28. Results： The baseline characteristics of patients in both groups were similar. At the end of the treatment, 13 of the 32 initially detected bacterial isolates were eradicated in AA group, compared to 4 of 28 in placebo group （41% vs. 14%, P - 0.024）. As for patients, 11 of 27 patients treated with AA and 4 of 25 patients treated with placebo have eradication （41% vs. 16%, P = 0.049）. The adjunction of AA reduced CPIS （4.2 ± 1.6 vs. 5.8 ± 2.1, P = 0.007）. New drug resistance to amikacin and the change in serum creatinine were not detected in AA group. No significant differences in the clinical cure rate in survivors （48% vs. 35%, P = 0.444）, weaning rate （48% vs. 32%, P = 0.236）, and mortality （22% vs. 32%, P = 0.427） were detected between the two groups on day 28. Conclusions： As an adjunctive therapy of MDR-GNB VAP, AA successfully eradicated existing MDR organisms without inducing new resistance to amikacin or change in serum creatinine. However, the improvement of mortality was not found.展开更多
文摘BACKGROUND Antibiotic resistance has become a global threat for human health,calling for rational use of antibiotics.AIM To analyze the distribution and drug resistance of the bacteria,providing the prerequisite for use of antibiotics in emergency patients.METHODS A total of 2048 emergency patients from 2013 to 2017 were enrolled.Their clinical examination specimens were collected,followed by isolation of bacteria.The bacterial identification and drug susceptibility testing were carried out.RESULTS A total of 3387 pathogens were isolated.The top six pathogens were Acinetobacter baumannii(660 strains),Staphylococcus aureus(436 strains),Klebsiella pneumoniae(347 strains),Pseudomonas aeruginosa(338 strains),Escherichia coli(237 strains),and Candida albicans(207 strains).The isolation rates of these pathogens decreased year by year except Klebsiella pneumoniae,which increased from 7.1%to 12.1%.Acinetobacter baumannii is a widely-resistant strain,with multiple resistances to imipenem,ciprofloxacin,minocycline and tigecycline.The Staphylococcus aureus had high resistance rates to levofloxacin,penicillin G,and tetracycline.But the susceptibility of it to vancomycin and tigecycline were 100%.Klebsiella pneumoniae had high resistance rates to imipenem,cefoperazone/sulbactam,amikacin,and ciprofloxacin,with the lowest resistance rate to tigecycline.The resistance rates of Pseudomonas aeruginosa to cefoperazone/sulbactam and imipenem were higher,with the resistance rate to amikacin below 10%.Besides,Escherichia coli had high resistance rates to ciprofloxacin and cefoperazone/sulbactam and low resistance rates to imipenem,amikacin,and tigecycline.CONCLUSION The pathogenic bacteria isolated from the emergency patients were mainly Acinetobacter baumannii,Staphylococcus aureus,Klebsiella pneumoniae,Pseudomonas aeruginosa,Escherichia coli,and Candida albicans.The detection rates of drugresistant bacteria were high,with different bacteria having multiple drug resistances to commonly used antimicrobial agents,guiding the rational use of drugs and reducing the production of multidrug-resistant bacteria.
文摘Objective： To understand distribution and drug resistance of pathogenic bacteria from a specialized cancer hospital in 2013 in order to provide a basis for rational clinical antimicrobial agents. Methods： Pathogenic bacteria identification and drug sensitivity tests were performed with a VITEK 2 compact automatic identification system and data were analyzed using WHONET5.6 software.Results： Of the 1,378 strains tested, 980 were Gram-negative bacilli, accounting for 71.1%, in which Klebsiella pneumonia, Escherichia coli and Pseudomonas aeruginosa were the dominant strains. We found 328 Gram-positive coccus, accounting for 23.8%, in which the amount of Staphylococcus aureus was the highest. We identified 46 fungi, accounting for 4.1%. According to the departmental distribution within the hospital, the surgical departments isolated the major strains, accounting for 49.7%. According to disease types, lung cancer, intestinal cancer and esophagus cancer were the top three, accounting for 20.9%, 17.3% and 14.2%, respectively. No strains were resistant to imipenem, ertapenem or vancomycin.Conclusions： Pathogenic bacteria isolated from the specialized cancer hospital have different resistance rates compared to commonly used antimicrobial agents; therefore antimicrobial agents to reduce the morbidity and mortality of infections should be used.
基金In-Hospital Fund Project of Affiliated Hospital of Hebei University:Analysis of Nosocomial Infection in Intensive Care Unit(2019Q030)。
文摘Objective:To understand the pathogenic bacteria isolated from patients and their drug resistance changes in general ICU of the Affiliated Hospital of Hebei University,so as to provide reference for appropriate selection of antibiotics in clinical practice.Methods:A retrospective investigation was conducted to analyze the bacteriological distribution and drug resistance of nosocomial pathogens isolated from the specimens of hospitalized patients in the comprehensive ICU of the hospital from 2019 to 2021.The US technology BD Phoenix 100 automatic bacterial identification analyzer was used for bacterial identification of the pathogen samples,disk diffusion method was used for drug susceptibility test,and SPSS 22.0 software was used to analyze the trend of drug resistance.Results:A total of 970 strains of nosocomial pathogens were detected in the three years.The main pathogens were Acinetobacter baumannii(133 strains,13.71%),Klebsiella pneumoniae(106 strains,10.93%),Pseudomonas aeruginosa(83 strains,8.56%),Escherichia coli(76 strains,7.84%)and Enterococcus faecium(69 strains,7.11%).The resistance rate of Acinetobacter baumannii to antibiotics was high.Klebsiella pneumoniae,Pseudomonas aeruginosa and Escherichia coli had low resistance rates to carbapenems.The situation of bacterial drug resistance is still serious.Conclusion:The drug resistance of pathogenic bacteria collected from Class III Grade A Hospital’s patients to antibiotics was generally high.Therefore,clinical departments should strengthen the inspection of specimens of infection and drug sensitivity test in order to grasp the resistance mechanisms and drug resistance of pathogenic bacteria changes,and select appropriate antimicrobial agents according to the test results.Besides,the formation of drug-resistant strains also needs to be prevented,and the treatment of patients with severe infection needs to be improved.
文摘BACKGROUND Diabetic foot ulceration(DFU)is the prime health concern globally.It accounts for the major burden related to disease mortality and morbidity and economic cost.The timely and early recognition of the DFU can help present its occurrence and improve clinical outcomes.AIM To evaluate interrelationships between foot ulcers,risk factors,and antibiotic resistance among diabetic patients having ulcers in their foot.METHODS The databases such as PubMed,ERIC,Medline,and Google Scholar were extensively used for the extraction of studies.The selected studies were published within the time-period of 2014-2018.Ten studies were selected,which were found to be completely relevant to the current study.RESULTS The prevalence of diabetic foot ulcers among the population was evaluated,and the associated risk factors with its prevalence.Moreover,few studies also reported on the bacteria that are found to be most prevailing among diabetic patients.A narrative discussion was drawn through this analysis,which was used to highlight the specific area of research through selected studies,extraction of the significant information that matched with the topic of research,and analysis of problem through the findings of the selected articles.The results helped in assessing significant knowledge regarding the risk factors of diabetic foot ulcers and the role of antimicrobial resistant in its treatment.CONCLUSION The gram-negative bacteria were found to be the most common reason for diabetic foot ulcers.The study only included 10 studies that are not sufficient to produce generalized results,and no information was reported on the tests required to analyze antimicrobial susceptibility that can guide clinicians to propose better and sound treatment plans.It is evident that most study results depicted that the most common risk factors were found to be hypertension and neuropathy.
文摘Background： Aerosolized amikacin （AA） is a current option for the management of ventilator-associated pneumonia （VAP） caused by multidrug-resistant Gram-negative bacteria （MDR-GNB）, as it is reported that AA could increase the alveolar level of the drug without increasing systemic toxicity. This study aimed to evaluate the efficacy and safety of AA as an adjunctive therapy for VAP caused by MDR-GNB. Methods： In this single-center, double-blind study conducted in a 36-bed general Intensive Care Unit （ICU） in a tertiary hospital from June 2014 to June 2016, 52 ICU patients with confirmed MDR-GNB VAP were randomized to two groups （AA group, n - 27 and placebo group, n = 25）. Amikacin （400 rag, q8h） or saline placebo （4 ml, q8h） was aerosolized for 7 days. The attending physician determined the administration of systemic antibiotics for VAP. Patients were tbllowed up for 28 days. Bacteriological eradication, clinical pulmonary infection score （CP1S）, and serum creatinine were assessed on day 7 of therapy. New resistance to amikacin, cure rate of VAP, weaning rate, and mortality were assessed on day 28. Results： The baseline characteristics of patients in both groups were similar. At the end of the treatment, 13 of the 32 initially detected bacterial isolates were eradicated in AA group, compared to 4 of 28 in placebo group （41% vs. 14%, P - 0.024）. As for patients, 11 of 27 patients treated with AA and 4 of 25 patients treated with placebo have eradication （41% vs. 16%, P = 0.049）. The adjunction of AA reduced CPIS （4.2 ± 1.6 vs. 5.8 ± 2.1, P = 0.007）. New drug resistance to amikacin and the change in serum creatinine were not detected in AA group. No significant differences in the clinical cure rate in survivors （48% vs. 35%, P = 0.444）, weaning rate （48% vs. 32%, P = 0.236）, and mortality （22% vs. 32%, P = 0.427） were detected between the two groups on day 28. Conclusions： As an adjunctive therapy of MDR-GNB VAP, AA successfully eradicated existing MDR organisms without inducing new resistance to amikacin or change in serum creatinine. However, the improvement of mortality was not found.
