ABSTRACT
Objective To investigate the clinical feature and antibiotic resistance profile of K.pneumoniae isolates from patients for better management of K.pneumoniae infections.Methods Nonduplicate K.pneumoniae strains were collected from January to December in 2015.K.pneumoniae strains were identified by VITEK 2-Compact 60 and tested for antimicrobial susceptibility by KirbyBauer method.Results A total of 753 strains ofK.pneumoniae were included,most (40.9％,308/753) of which were isolated from sputum,followed by urine (18.2％,137/753).Most of the strains were from old patients at least 60 years of age (40.8％,307/753),and primarily from intensive care units (16.7％,126/753) and Department of Respiratory Medicine (13.7％,103/753).Respiratory tract infection was found in 144 patients,of which 71.5％ (103/144) were due to K.pneumoniae.More than half of the K.pneumoniae strains were resistant to piperacillin (66.3 ％),cefazolin (60.8 ％) and cefitroxime (59.4 ％).Only a few strain were resistant to imipenem (2.4 ％) and meropenem (2.0).ESBLs were produced in 410 (54.4 ％) of the 753 strains,and 29 (3.9 ％) strains were carbapenem-resistant,492 (65.3 ％) strains were resistant to multiple antimicrobial agents.Conclusions Clinical K.pneumoniae isolates are highly resistant to most of the antimicrobial agents tested.The strains were mostly isolated from sputum and urine,and positive for ESBLs.MDR K.pneumoniae sWains are emerging.K.pneumoniae isolates are still very susceptible to carbapenems in vitro.
ABSTRACT
Objective To investigate the expression and resistant gene of integron in multidrug-resistant Acinetobacter baumannii (MDR-Ab).Methods 51 strains of MDR-Ab isolated from a hospital in August-October 2012 were collected, antimicrobial susceptibility testing was performed.Class I(Int I),II (Int II)and III (Int III)of integrase genes and inte-gron variable region gene cassettes were detected by polymerase chain reaction (PCR),and the homology of integron varia-ble region was analyzed by detection results of restriction fragment length polymorphism (RFLP)and DNA sequencing. Results Positive rate of integrase gene in MDR-Ab was 78.43%(40/51).All genes belonged to Int I,while IntⅡand IntⅢ were not found.Variable region cassettes were detected in 97.50% (n=39)of Int I,there were 5 types of integron gene cassettes:aacA4 in 14 strains,aacA4+catB8 in 22 strains,arr-3 +aacA4 in 1 strain,dfrA15 in 1 strain and arr-3 in 1 strain.Conclusion MDR-Ab isolated from this hospital may be related with Int I expression.Int I carried gene cassettes as follows:aacA4,aacA4+catB8,arr-3+aacA4,dfrA15 and arr-3.
ABSTRACT
Objective To explore the efficacy of low-dose aripiprazole combining with citalopram on the depression. Methods A total 57 patients with depression were randomly assigned to the study group and the control group. Either group was treated with a fixed dose 20 mg citalopram per day, and the study group was simultaneously titrated to low dose (5～10mg/d) of aripiprazole at initiating dose 2.5 mg per day within two weeks. They were evaluated with Hamilton Depression Scale (HAMD).Clinical Global Impression (CGI-SI) and Treatment Emergent Symptom Scale(TESS) before treatment and at the end of 1st, 2nd, 4th and 6th week after treatment. The study lasted for 6 weeks. Results HAMD total score of either group were 11.54 ± 5.58 and 16.59 ± 6.67 respectively, which had statistically significant difference between two groups(t = 2.961, P<0.05) at the end of the study. CGI-SI score of either group was 2.12 ± 1.47 vs 3.17 ± 1.63 at treatment termination, which also had statistically significant difference (t = 2.439, P<0.05). There were mild side effects rate and no statistically significant difference between two groups (χ~2 =0.625, P>0.05). TESS scores were not statistically significant difference between two groups at each point of measure. Conclusion The results suggest low dose of aripiprazole augmentation of citalopram may be effective and safe in the treatment of depression.
ABSTRACT
OBJECTIVE To investigate in vitro activities of 12 antimicrobial agents including cefmetazole against extended-spectrum beta-lactamases-producing Escherichia coli(528 strains),Klebsiella pneumoniae(311 strains) and Proteus mirabilis(15 strains).METHODS They all collected from 15 teaching hospitals in China during 2005 and 2006 and included in the study.The levels of minimal inhibitory concentration(MIC) of 12 antimicrobial agents were determined by agar dilution method.WHONET 5.4 Software was used to analyze the data.RESULTS Against ESBLs-producing E.coli and ESBLs-producing K.pneumoniae,carbapenems were the most active antimicrobial agents(all 100.0% susceptible),followed by cephamycins(80.1-97.3%).Piperacillin/tazobactam(78.5-95.1%)showed a higher activity than cefoperazone/sulbactam(44.1-56.2%).The susceptible rate to ceftazidime against ESBLs-producing E.coli was remarkably higher than the other three cephalosporins,however the differences did not happen to ESBL-producing K.pneumoniae obviously.The susceptible rate to cefuroxime was below 1.6%.ESBLs-producing K.pneumoniae showed high sensitivity to carbapenems,cephamycins and ?-lactam/lactamase inhibitor combinations(all 100% susceptible),however the susceptible rates to cephalosporins were relatively lower.CONCLUSIONS Carbapenems and cephamycins remain the relatively high activity against ESBLs-producing Enterobacteriaceae.
ABSTRACT
OBJECTIVE To investigate the drug-resistance rate of strains isolated from nosocomial infection patients with Acinetobacter spp.METHODS A total of 198 patients with Acinetobacter spp nosocomial infection were studied retrospectively from 2003 to 2005.The antibiotic resistance profiles were specifically analyzed.RESULTS The strains of Acinetobacter spp were mainly isolated from sputum(74.75%) and wound secretion(11.61%) specimens.There were no significant differences in the resistance of Acinetobacter spp against antibiotics in 3 years except piperacillin/tazobactam and meropenem.The resistance rate of all 198 strains to 13 kinds of antibiotics were as following:imipenem/cilastatin 2.53%,meropenem 2.02%,cefoperazone/sulbactam 30.81%,piperacillin/tazobactam 38.38%,amikacin 53.54%,cefepime 61.11%,levofloxacin 66.67%,ceftazidime 66.16%,ciprofloxacin 68.69%,gentamicin 67.68%,sulfamethoxazole/trimethoprim 63.64%,piperacillin 70.72%,and aztreonam 85.35%.CONCLUSIONS It is indicated that Acinetobacter spp are highly resistant to the common antibiotics,but still sensitive to imipenem/cilastatin and meropenem.