Horizontal Distribution and Annual Variations of Fecal Coliform Bacteria in Luoyuan Bay

Fecal Coliform Bacteria （FCB） of marine waters was monitored in Luoyuan Bay from January, 2003 to December, 2005. The results showed that number of FCB in marine water samples ranged from no detection （ 〈2 cfu/100 mL） to 540 cfu/100 mL in Luoyuan Bay. Values of FCB during August to October were significantly higher than those during January to April during three year period. Monthly changes of FCB values at each year period were mainly due to monthly precipitation. In addition, compared with FCB values in difference sample sites, values of FCB in Bay-heed were significantly higher than those in middle of bay and Bay-mouth, Luoyuan Bay. However, values of FCB in Bay-mouth were significantly less than those in middle of bay. The ratios to the par of FCB in 2003, 2004, and 2005 years were 100%, 98.0%, and 97.9%, respectively. Therefore, we considered that the pollution of FCB of surface marine water in Luoyuan Bay was not serious.

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.

Distribution and drug resistance of pathogenic bacteria in emergency patients

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.

Particle size distribution and property of bacteria attached to carbon fines in drinking water treatment

The quantitative change and size distribution of particles in the effluents from a sand filter and a granular activated carbon （GAC） filter in a drinking water treatment plant were investigated. The average total concentration of particles in the sand filter effluent during a filter cycle was 148 particles/mL, 27 of which were larger than 2 μm in size. The concentration in the GAC effluent （561 particles/mL） was significantly greater than that in the sand filter effluent. The concentration of particles larger than 2 μm in the GAC filter effluent reached 201 particles/mL, with the amount of particles with sizes between 2 μm and 15 μm increasing. The most probable number （MPN） of carbon fines reached 43 unit/L after six hours and fines between 0.45 μm and 8.0 μm accounted for more than 50%. The total concentration of outflowing bacteria in the GAC filter effluent, 350 CFU （colony-forming units） /mL, was greater than that in the sand filter effluent, 210 CFU/mL. The desorbed bacteria concentration reached an average of 310 CFU/mg fines. The disinfection efficiency of desorbed bacteria was lower than 40% with 1.5 mg/L of chlorine. The disinfection effect showed that the inactivation rate with 2.0 mg/L of chloramine （90%） was higher than that with chlorine （70%）. Experimental results indicated that the high particle concentration in raw water and sedimentation effluent led to high levels of outflowing particles in the sand filter effluent. The activated carbon fines in the effluent accounted for a small proportion of the total particle amount, but the existing bacteria attached to carbon fines may influence the drinking water safety. The disinfection efficiency of desorbed bacteria was lower than that of free bacteria with chlorine, and the disinfection effect on bacteria attached to carbon fines with chloramine was better than that with only chlorine.

Distribution and drug resistance of pathogenic bacteria isolated from cancer hospital in 2013

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.

Geographical distribution of general aerobic heterotrophic bacteria in surficial sediments from the Chukchi Sea and Canadian Basin

This paper determined the abundance of General Aerobic heterotrophic Bacteria （GAB） in surficial sediments from the Chukchi Sea and the Canadian basin by using MPN and discussed their geographical distribution. The result shows that the determination percentages of the GAB were high, even till 100 percentage. The abundance range and averages of GAB for 4℃and 25℃ were from 4.00 × 10^2 to 2.40× 10^6 , 1.71×10^6 ind.·g^-1 （wet sample ） and from 2.40 ×10^5 to 2.40×10^7 , 1.10×10^7 ind. ·g^-1 （wet sample ） respectively. Not only the abundance range but also the averages of GAB in 25℃ were higher than that in 4℃. The abundance of GAB in sediments show a tendency that it is roughly greater in the lower latitudinal area than in the higher latitudinal area. The abundance of GAB increased from east to west as for the longitudinal distribution. With the water depth increasing, the abundance of GAB at 4℃ decreased, but GBA at 25℃ is not changed obviously with water depth. It seems that warmer circumstantial temperature is more suitable for some GAB.

Oil pollution experiment in marine-enclosed experimental ecosystem Ⅰ. Ecological distribution of hydrocarbon-degradation bacteria

On the basis of the investigation into ecological distribution degradation and the self-purification ability of hydrocarbons by microbes, this paper deals with the study of ecological distribution of hydrocarbon-degrading bacteria and its correlation with environmental factors in a marine-enclosed experimental ecosystem in the eastern part of the Xiamen Bay.

Ecological characteristics of the abundance and distribution of bacteria in the waters nearby the front of the Hangzhou Bay

Abundance of total bacteria, heterotrophic bacteria, coliform and oil degradable bacteria and their relations with salinity and suspended matter in the frontal waters in the Hangzhou Bay are described. The results obtained show that the highest abundances of total bacteria , heterotrophic bacteria are encountered around the front and near the northern shore of the Hangzhou Bay, where a positive correlation ( r =0. 70) between the total bacteria abundance and the total suspended matter (TSM) is persent. Moreover,the abundance of oil degradable bacteria being an indicator of oil pollution, is also high in that region.

Analysis on Distribution and Drug Resistance of Pathogenic Bacteria in ICU Patients with Nosocomial Infection from 2019 to 2021

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.

Seasonal Distribution of Bioaerosols in the Coastal Region of Qingdao

Bioaerosols were collected by using a six-stage bioaerosols sampler from September 2007 to August 2008 in the coastal region of Qingdao, China. The terrestrial and marine microbes(including bacteria and fungi) were analyzed in order to understand the distribution features of bioaerosols. The results show that the average monthly concentrations of terrestrial bacteria, marine bacteria, terrestrial fungi and marine fungi are in the ranges of 80–615 CFU m-3, 91–468 CFU m-3, 76–647 CFU m-3 and 231–1959 CFU m-3, respectively. The concentrations of terrestrial bacteria, marine bacteria, terrestrial fungi, marine fungi and total microbes are the highest in each microbial category during fall, high in spring, and the lowest in the summer and winter. The bacterial particles are coarse in spring, autumn and winter. The sizes of fungal particle present the log-normal distribution in all the seasons.

Spatial and temporal variation of picoplankton distribution in the Yellow Sea, China

Seven surveys were carried out in April, September, October, December 2006 and March, May, August 2007 in the Yellow Sea, China. Variations in the spatial and temporal distribution of Synechococcus, picoeukaryotes and heterotrophic bacteria are quantified using flow cytometry. Synechococcus and heterotrophic bacteria are most abundant from late spring to autumn, while picoeukaryotes concentration is high in spring. Synechococcus and heterotrophic bacteria concentrated high in the northwest part of the Yellow Sea in spring and autumn, while picoeukaryotes distributed evenly over the whole study area except for a small frontal zone in the coastal area on the west （in spring） and central Yellow Sea （in autumn）. Under mixing conditions, the vertical distribution of the three picoplankton groups showed a well-mixed pattern. Upon a well-established stratification, the maximum abundance of picoplankton occurred above the mixed layer depth （-30 m）. Cell sizes of Synechococcus and picoeukaryotes were estimated by converting forward scatter signals （FSC） from cytometry analysis to cell diameter, showing the results of 0.65-0.82 um for Synechococcus and 0.85-1.08 um for picoeukaryotes. The average integrated carbon biomasses ranged 15.26-312.62 mgC/m2 for Synechococcus, 18.54-51.57 mgC/m2 for picoeukaryotes, and 402.63-818.46 mgC/m2 for heterotrophic bacteria. The distribution of Synechococcus and heterotrophic bacteria was temperature dependent, and picoplankton presence was poor in the Yellow Sea Cold Water Mass.

Distribution Pattern and Geographical Division of Terrestrial Living Things in the World

After summary of the distribution data of 180,661 genera of terrestrial animals,plants,fungi,bacteria and viruses in the world,according to the ecological conditions such as topography and climate,the world land is divided into 67 BGUs(Basic Geographic Units),which are analyzed by four quantitative methods:Single linkage method,Average group linkage method,Sum of squares method and MSCA(Multivariate Similarity Clustering Analysis)method.The MSCA has stronger data mining ability than the first three traditional clustering methods,and can obtain more,more detailed,more accurate and more stable clustering results.According to the clustering results,the first world biogeographical regionalization system was established.This system not only affirms and supports the reasonable scientific core of the mammalian and flowering plant geographical division plan formulated by the predecessors of scholars in the 19th century,but also revises some imbalances in the division criteria and boundary determination caused by their qualitative methods,unifying various global geographical division plans emerging since the 21st century.

某三甲医院尿路感染患者病原菌分布及药敏分析

目的了解自贡市第三人民医院尿路感染患者病原菌分布及药敏耐药性特点,为临床医师合理选用抗菌素及控制院内感染、降低细菌耐药性提供帮助。方法收集2019年1月—2020年12月自贡市第三人民医院尿路感染就诊患者尿液标本3802份,采用MicroScan Walk/Away-40(美国SIEMENS公司)全自动微生物鉴定和药敏系统进行细菌鉴定和药敏试验。结果539株分离菌中革兰阴性菌411株,占比76.25%;革兰阳性菌128株,占比23.75%;其中前5位的菌株416株,依次为大肠埃希菌294株(54.55%)、粪肠球菌46株(8.53%)、肺炎克雷伯菌38株(7.05%)、屎肠球菌23株(4.27%)、奇异变形杆菌15株(2.78%)。前5位3种革兰阴性菌中,大肠埃希菌对复方新诺明、环丙沙星、头孢唑啉及左旋氧氟沙星耐药率均>50.00%,对头孢噻肟、头孢曲松、氨曲南和头孢吡肟耐药率均>40.00%,庆大霉素为35.71%,其余均在30.00%以内;肺炎克雷伯菌对复方新诺明耐药性最高为52.63%,其次是头孢唑林为42.11%、头孢噻肟为36.84%、环丙沙星和头孢曲松均为31.58%,其余均在30.00%以内;奇异变形杆菌,对复方新诺明耐药率最高为60.00%,其次环丙沙星为53.33%、妥布霉素为46.67%,头孢唑啉、庆大霉素和氨曲南均为33.33%,其余均在30.00%以内。前5位2种革兰阳性菌中,粪肠球菌,对四环素耐药性最高为86.96%,其次红霉素为76.09%、利福平为54.35%,环丙沙星为32.61%、左旋氧氟沙星和莫西沙星均为30.43%,其余均在30.00%以内;屎肠球菌,对红霉素、环丙沙星和左旋氧氟沙星耐药率均为100%,其次青霉素G为95.65%、莫西沙星为91.30%、利福平和阿莫西林/克拉维酸均为82.61%、四环素为65.22%,对大多数抗菌药物耐药率均较高,其中对万古霉素耐药率最低为4.35%,其次为利奈唑胺为5.26%、呋喃妥因为8.70%。结论临床医师在诊疗过程中,应加强与实验室合作,重视尿路感染的病原学检查,在选用抗菌药物治疗时应结合实验室病原学报告和药敏试验结果,合理使用抗菌药物,同时遏制细菌耐药性。

VSD治疗对胫骨骨折术后继发骨感染患者手术指标、炎性因子及功能恢复的影响

目的探讨负压封闭引流技术(VSD)治疗对胫骨骨折术后继发骨感染患者手术指标、炎性因子、功能恢复的影响。方法选取2020年12月至2022年6月河北医科大学第三医院收治的87例胫骨骨折内固定术后继发骨感染患者,均为胫骨干骨折;其中原开放骨折55例,一期均缝合伤口;32例在外伤发生时一期清创后行内固定手术;对患者采用手术清创、去除内固定物,行外固定架固定,经清创后局部均存在创面不能完全闭合,合并骨外露,随机选用VSD覆盖治疗(研究组,n=46)或骨水泥覆盖治疗(对照组,n=41),分析患者病原菌构成分布、比较两组手术指标、炎症因子[肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)、C反应蛋白(CRP)水平]、功能恢复情况[膝关节、踝关节功能以及肢体功能恢复情况]以及并发症情况。结果87例患者共87株病原菌,其中革兰阳性菌43株(49.42%),革兰阴性菌32株(36.78%),真菌12株(13.80%)。研究组换药次数少于对照组,控制感染时间、创面无菌时长、住院时间、行皮瓣转移手术时间均短于对照组,差异均有统计学意义(P<0.05);治疗后两组TNF-α、IL-6、CRP水平均下降,其中研究组变化最为显著,差异有统计学意义(P<0.05);治疗后两组HSS、Baird-Jackson评分均上升,其中研究组变化最为显著,差异有统计学意义(P<0.05)。研究组优良率为(95.65%)高于对照组优良率(80.49%),差异有统计学意义(P<0.05)。结论在创面不能闭合情况下,VSD治疗胫骨骨折内固定术后继发骨感染患者,可改善患者手术指标、炎性因子水平,促进患者肢体功能恢复,值得临床推广应用。

某院铜绿假单胞菌的临床分布及耐药性分析

目的统计大连市友谊医院近六年来铜绿假单胞菌感染的菌株来源与临床分布,分析11种临床常见抗菌药的耐药情况,为临床治疗铜绿假单胞菌感染及合理使用抗菌药物提供理论依据。方法回顾性分析我院2017年1月-2022年12月铜绿假单胞菌感染的临床送检标本1316株,进行细菌体外分离培养与药敏实验,应用Whonet 5.6软件分析药敏结果,Spss 23软件对6年内该菌耐药率的变化进行卡方检验。结果1316株铜绿假单胞菌中,主要来源于痰液907株(68.9%)和尿液167株(12.7%)。这些菌株主要分布于重症医学科513株(39.0%)和老年病科359株(27.3%)。在所统计的11种抗生素中,哌拉西林/他唑巴坦、头孢吡肟和氨曲南三种药物6年内耐药率变化显著,具有统计学意义(P<0.05);其间耐药率最高的是2021年左氧氟沙星(37.0%),耐药率最低的是2022年头孢吡肟(8.3%)。结论本院铜绿假单胞菌的碳青霉烯类和喹诺酮类耐药率较高,哌拉西林/他唑巴坦呈耐药率逐年上升;微生物室应加强耐药菌监测的同时,临床也要加强抗菌药物的管理。

血液病房产超广谱β-内酰胺酶菌分布情况及药物敏感性分析

目的分析2020年1月至2021年11月江西省九江市第一人民医院(以下简称“本院”)血液病房产超广谱β-内酰胺酶(ESBLs)菌分布情况及药物敏感性。方法选取2020年1月至2021年11月江西省九江市第一人民医院血液病房138例患者作为研究对象,收集患者的分泌物进行病原菌培养,并对产ESBLs菌分布情况和药物敏感性进行分析。结果革兰氏阴性菌居多,共分离出160株,占比80.00%,其次是真菌和革兰氏阳性菌,各分离出22株和18株。其中以铜绿假单胞菌、大肠埃希菌和肺炎克雷伯菌最为常见。本院血液病房病原菌共检出200株,检出情况主要以痰、中段尿、咽拭子居多,以肛拭子、大便检出较少;200株病原菌共检出产ESBLs菌56株,占比28.00%,以中段尿、咽拭子检出居多,脓液、肛拭子、大便中未检出。本院血液病房产ESBLs菌除对亚胺培南、美罗培南耐药率较低外,对大部分抗菌药物的耐药率均较高。结论本院血液病原菌以革兰氏阴性菌为主,且对抗菌药物的耐药率较高,临床应重点关注此类菌株感染,需引起重视,加强院感的防控,避免发生耐药菌的暴发和流行。

2019~2023年某中医院6种多重耐药菌临床分布与耐药性分析

目的了解本院6种多重耐药菌的分布及耐药情况。方法对北京中医药大学东方医院2019年1月至2023年12月分离的菌株进行分析,统计6种临床常见耐药菌的检出情况。结果耐碳青霉烯类大肠埃希菌(CRECO)、耐甲氧西林金黄色葡萄球菌(MRSA)检出率呈逐步上升趋势;耐碳青霉烯类肺炎克雷伯菌(CRKPN)、耐碳青霉烯类铜绿假单胞菌(CRPA)呈波浪形下降趋势;耐碳青霉烯类鲍曼不动杆菌(CRAB)起伏波动较大;万古霉素耐药肠球菌(VRE)总体检出率较低,变化趋势不大。6种多重耐药菌主要分布于脑病内科、脑病外科、呼吸热病科、急诊科、重症监护、肿瘤科等科室。标本来源中CRKPN、CRPA、CRAB、MRSA均以痰标本为首,CRECO、VRE均以尿标本为首。性别方面,CRKPN、CRPA、CRAB、MRSA男性多于女性,CRECO和VRE则反之;6种耐药菌年龄分布均以60岁以上老年患者为主;季节分布上,CRKPN、CRPA、VRE以冬季占比最高,CRAB以夏季占比最高,CRECO、MRSA则是以秋季占比最高。CRECO、CRKPN、CRAB对多种抗菌药物耐药率均较高。结论应加强对多重耐药菌的监控,延缓细菌耐药发生。

老年糖尿病合并肺部感染患者病原菌分布及血清HSP70、HMGB1水平与病情严重程度和预后的关系

目的探讨老年糖尿病合并肺部感染患者病原菌分布情况,分析血清热休克蛋白70(HSP70)、高迁移率族蛋白B1(HMGB1)水平与病情严重程度和预后的关系。方法选择2021年1月—2023年11月西安交通大学第一附属医院呼吸内科与危重症医学科收治的2型糖尿病(T2DM)合并肺部感染患者253例为研究对象,根据出院时预后情况分为预后良好组(n=191)和预后不良组(n=62)。鉴定患者痰液中病原菌并检测血清HSP70和HMGB1水平;采用多因素Logistic回归分析老年T2DM合并肺部感染预后的影响因素;受试者工作特征曲线(ROC)分析血清HSP70和HMGB1水平对老年T2DM合并肺部感染预后的预测价值。结果预后不良组患者年龄、空腹血糖(FPG)、高血压、慢性阻塞性肺疾病(COPD)及病情重度占比显著高于预后良好组(t/χ^(2)/P=6.251/<0.001、14.949/<0.001、4.666/0.031、5.827/0.016、16.530/<0.001)。253例患者痰标本中共检出病原菌株298株,其中革兰阴性菌占比65.10%(194/298)、革兰阳性菌占比28.86%(86/298)、真菌占比6.04%(18/298)。预后不良组血清HSP70和HMGB1水平明显高于预后良好组(t=11.672、13.069,P均<0.001)。血清HSP70和HMGB1水平比较,重度>中度>轻度患者(F=54.146、231.257,P均<0.001);多因素Logistic回归显示,年龄大、HSP70高、HMGB1高、FPG高、COPD及严重程度重均为老年T2DM合并肺部感染预后的危险因素[OR(95%CI)=1.322(1.015~1.722)、1.993(1.336~2.973)、1.754(1.302~2.363)、1.876(1.401~2.512)、3.016(1.798~5.060)、3.956(2.208~7.718)];血清HSP70、HMGB1及二者联合预测老年T2DM合并肺部感染预后的曲线下面积(AUC)分别为0.785、0.772、0.897,二者联合优于各自单独预测效能(Z=3.452、3.297,P均<0.001)。结论血清HSP70、HMGB1水平与老年T2DM合并肺部感染严重程度和预后密切相关,二者联合对其预后具有较高预测价值。

小儿呼吸机相关性肺炎病原菌分布及耐药性分析

目的分析小儿呼吸机相关性肺炎(VAP)病原菌分布情况及耐药性。方法回顾性分析2018年1月至2020年10月日照市中医医院收治的56例VAP患儿的临床资料,采集所有患儿气道分泌物进行病原菌培养及药敏试验,分析病原菌分布情况及耐药性。结果56例VAP患儿以晚发型为主,占比69.64%;共检出61株病原菌,其中革兰阴性菌47株(77.05%),以鲍曼不动杆菌(29.51%)、铜绿假单胞菌(22.95%)、肺炎克雷伯菌(14.75%)为主;革兰阳性菌12株(19.67%),以金黄色葡萄球菌(8.20%)、肺炎链球菌(6.56%)为主;真菌2株(3.28%)。主要革兰阴性菌鲍曼不动杆菌、铜绿假单胞菌、肺炎克雷伯菌对头孢噻肟、头孢曲松、头孢唑林耐药性均>50.00%,对亚胺培南、美罗培南未产生耐药性。革兰阳性菌金黄色葡萄球菌、肺炎链球菌对青霉素、氨苄西林、红霉素耐药性均≥75.00%,对替考拉宁、万古霉素未产生耐药性。结论小儿VAP以晚发型为主,革兰阴性菌为主要致病菌,且整体致病菌对常规抗菌药物呈广谱耐药现象,需依据药敏结果选用针对性药物治疗,促进感染消退。

ICU感染病原菌分布情况及耐药性分析

目的:分析重症监护室(ICU)感染病原菌分布情况及耐药性。方法:回顾性分析2019年12月—2022年12月阜宁县人民医院收治的120例ICU患者的病例资料。统计ICU患者院内感染发生情况及病原菌分布特征,分析ICU院内感染患者耐药情况。结果:120例ICU患者共有30例发生院内感染,院内感染的发生率为25.00%。120例ICU院内感染患者共检出菌株35株,其中20株为革兰阴性菌,占病原菌总株数的57.14%,12株为革兰阳性菌,占病原菌总株数的34.29%,3株为真菌,占病原菌总株数的8.57%。对肺炎克雷伯菌、大肠埃希菌两种主要革兰阴性菌进行耐药性分析:肺炎克雷伯菌对头孢唑啉、左旋氧氟沙星、头孢吡肟的耐药率均>50.00%;肺炎克雷伯菌对亚胺培南、红霉素的耐药率最低,均为20.00%,对头孢唑啉的耐药率最高,为100.00%。大肠埃希菌对氨苄西林、莫西沙星的耐药率均≥50.00%;大肠埃希菌对亚胺培南的耐药率最低,为0,对氨苄西林的耐药率最高,为75.00%。对金黄色葡萄球菌、表皮葡萄球菌两种主要革兰阳性菌进行耐药性分析;金黄色葡萄球菌对氨苄西林、左旋氧氟沙星、红霉素的耐药率均>50.00%;表皮葡萄球菌对氨苄西林、红霉素的耐药率均为100.00%;金黄色葡萄球菌对莫西沙星的耐药率为0;表皮葡萄球菌对利福平的耐药率为0。结论:ICU患者检出病原菌以革兰阴性菌为主,多数病原菌存在不同程度的耐药,在临床治疗中需根据药敏结果有针对性地进行合理用药。