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Objective:To explore the efficacy and safety of sofosbuvir-based direct-acting antiviral treatment in children and adolescent patients with chronic hepatitis C (CHC).Methods:A total of 52 children and adolescent patients who admitted to The Third People′s Hospital of Kunming City and The People′s Hospital of Fuyuan County aged from three to 17 years old with CHC from January 2018 to August 2022 were enrolled, and their basic information was collected. Patients were treated with sofosbuvir/velpatasvir (SOF/VEL) or ledipasvir/sofosbuvir (LDV/SOF) with or without ribavirin for 12 weeks. The biochemical and virological indexes were followed up before and after treatment and 12 weeks after withdrawal. The primary endpoint was the sustained virological response (SVR) at week 12 of follow-up after treatment, and the occurrence of adverse events (AE) during treatment. Statistical analysis was used by nonparametric test.Results:A total of 52 patients with CHC including 38 children and 14 adolescents were enrolled. Thirty-one were male and 21 were female. The age was 9(7, 12) years old. Among 52 patients, seven patients were type 1b, 11 were type 2a, three were type 2, five were type 3a, 18 were type 3b, one was type 6a, three were type 6k, four were type 6n and one was type 6v. Twelve (23.1%) patients were vertical transmission, 21(40.4%) patients had horizontal transmission among family members, two (3.8%) patients were blood fluid transmission, and 17(32.7%) were unknown transmission route. Compared with the baseline levels, Total bilirubin, alanine aminotransferase and aspartate aminotransferase were all significantly decreased after 12 weeks of treatment and 12 weeks after withdrawal, and the differences were statistically significant ( F=12.71, 30.23 and 42.52, respectively, all P<0.05). Up to September 30, 2022, 100.0%(52/52) of patients achieved SVR at the end of treatment. For patients who completed follow-up for 12 weeks after treatment, 95.8%(46/48) achieved SVR. Common AEs during treatment were fatigue (11.5%(6/52)), headache (5.8%(3/52)), dizziness (1.9%(1/52)), abdominal pain (3.8%(2/52)), diarrhea (1.9%(1/52)), rash (1.9%(1/52)) and skin pruritus (1.9%(1/52)). No patients discontinued treatment because of AE. Conclusions:Sofosbuvir-based direct-acting antiviral treatment is efficient and well-tolerated in children and adolescent patients with CHC. No patients discontinued treatment due to AE.
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Objective:To explore the competence characters of hospital young scientists and build a competency model.Methods:The model characters were screened by literature review, behavioral event interview, expert consultation and questionnaire survey. The competency characters were extracted by exploratory factor analysis.Results:The competency characters model includes 5 factors and 34 characters: comprehensive accomplishment, practical ability, personal trait, professional skill and knowledge quality. The Cronbach's α coefficient of the model was 0.980 and the Cronbach's α coefficient of the 5 factors ranged from 0.832 to 0.964, with a split-half reliability of 0.922. The content validity index of the scale was 0.977, and the content validity index of each entry ranged from 0.857 to 1.000. The value of KMO was 0.944.Conclusions:The competency model of hospital young scientists has high stability, and provides reference for young scientists' ability and quality, which will provide the basis for optimizing the training system and training strategy of hospital scientists.
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Objective To evaluate the degree of liver injury and liver fibrosis in patients in the immune-tolerant phase of chronic HBV infection, and to provide a basis for judging the condition of patients in the immune-tolerant phase. Methods A total of 300 patients with HBV DNA ≥10 7 IU/mL, alanine aminotransferase (ALT) ≤40 U/L, and complete data who were treated in The Third People's Hospital of Kunming from January 2015 to December 2019 were enrolled as subjects, and related data were collected, including age, sex, duration of HBV infection, blood biochemistry, hepatitis B surface antigen (HBsAg) level, and HBV DNA. Liver pathological examination was performed for all patients, and the patients were divided into G < 2 and G ≥2 groups according to inflammation grade and S < 2 and S ≥2 groups according to the degree of fibrosis. The t -test was used for comparison of continuous data between two groups, and univariate and multivariate unconditional logistic regression analyses were used to investigate the influencing factors for G ≥2 liver inflammation and S ≥2 liver fibrosis. Results Among the 300 patients, 213 (71%) had G ≥2 liver inflammation and 120 (40%) had S ≥2 liver fibrosis, with a baseline age of 26.06±9.01 years; male patients accounted for 48%, and the duration of infection was 5.62±5.09 years. The univariate analysis showed that there were significant differences between the G < 2 and G ≥2 groups in ALT, alkaline phosphatase (ALP), albumin (Alb), platelet count (PLT), diameter of the portal vein, and spleen thickness ( t =-26.677, -11.612, 2.149, 5.410, -6.092, and -2.911, all P < 0.05), and there were significant differences between the S < 2 and S ≥2 groups in duration of infection, ALT, ALP, Alb, HBV DNA, PLT, diameter of the portal vein, and spleen thickness ( t =-6.320, -6.694, -7.880, 2.349, 4.552, 19.160, -5.782, and -5.622, all P < 0.05). The multivariate analysis showed that ALT (odds ratio [ OR ]=10.270, 95% confidence interval [ CI ]: 2.212-47.672, P =0.003) and ALP ( OR =1.097, 95% CI : 1.013-1.188, P =0.023) were independent risk factors for G ≥2 liver inflammation in patients in the immune-tolerant phase, and ALP ( OR =1.034, 95% CI : 1.015-1.054, P < 0.001), PLT ( OR =0.913, 95% CI : 0.886-0.938, P < 0.001), HBV DNA ( OR =0.198, 95% CI : 0.062-0.636, P =0.007), and duration of infection ( OR =1.176, 95% CI : 1.033-1.340, P =0.015) were independent influencing factors for S ≥2 liver fibrosis in patients in the immune-tolerant phase. Conclusion Most patients in the immune-tolerant phase have significant liver histological changes. ALT and ALP are the influencing factors for significant liver inflammation, and ALP, HBV-DNA, PLT, and infection time are the influencing factors for significant liver fibrosis in patients in the immune-tolerant phase.
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Objective:To analyze the current situation of scientific research in hospitals in China based on the indicators and results of Science and Technology Evaluation Metrics in Chinese hospitals, and propose possible countermeasures for scientific research development.Methods:The external and internal environment of scientific research in a Grade-A tertiary obstetrics and gynecology hospital was discussed through the results of Science and Technology Evaluation Metrics and situation analysis.Results:The external opportunity of the hospital is that the national and municipal government lead the development direction of science and technology, the hospital leaders attach great importance to the development direction of the hospital and have a clear direction for the development of the hospital; the challenge is that the new generation of information technology puts forward the requirements of cross integration of scientific research work, the flow of high-level talents is accelerated, and there is a significant gap with the similar hospitals in the field of obstetrics and gynecology. The internal advantages are embodied in the following points: the advantages of specialties are obvious, the output of scientific research results has increased year by year after the implementation of the scientific research management of hospital departments, the training and introduction of talents are equally important; the disadvantages are reflected in the following points: lack of basic research and scientific research platforms, lack of high-end scientific and clinical research talents, insufficient academic influence, lack of national-level scientific research projects, insufficient high-level scientific research results, and low achievement conversion rate.Conclusions:The hospital should improve performance assessment, build research platform and achievement transformation platform, strengthen interdisciplinary integration and personnel training, and promote the fine management of high-level achievements, so as to improve the scientific and technological output, academic influence and scientific and technological conditions of the hospital.
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Objective:This article aims to sort out the current situation and problems of horizontal scientific research projects in a tertiary hospital, so as to improve the management of horizontal scientific research projects, and to mobilize the enthusiasm of researchers to undertake horizontal scientific research projects, and give full play to their characteristics of interdisciplinary integration, transfer and transformation of scientific and technological achievements.Methods:A total number of 129 horizontal projects undertaken by Beijing Obstetrics and Gynecology Hospital, Capital Medical University from 2010 to 2019 were reviewed.The comparison of management policies and risk prevention of horizontal scientific research projects before and after 2017 was also analyzed.The existing problems were analyzed and relevant management suggestions were put forward.Results:From 2017 to 2019 the hospital undertook 18.7 horizontal research projects per year, which was 1.8 times of that 2010 to 2016.The hospital strengthened the cooperation with foundations, companies and foreign countries, carried out substantive scientific research, standardized the budget, leased or borrowed equipment, and built the joint laboratories by medical research and enterprise, and carried out risk prevention in human genetic resources and biological security.At present, there are still some problems, such as the lack of relevant policy basis for management, the management of project approval and conclusion is not in place, the conversion rate of achievements is low, and the horizontal scientific research projects of platform construction are need to be constructed.Conclusions:Our hospital will improve the relevant system of horizontal scientific research projects management, incorporate the horizontal scientific research projects into the position title evaluation, performance evaluation and reward, build various platforms through multiple channels, promote the interdisciplinary integration, and give full play to the characteristics of horizontal scientific research projects in promoting the transfer and transformation of scientific and technological achievements, so as to promote the discipline construction and scientific and technological innovation of the hospital, and accelerate the transformation of the hospital into innovative and research-oriented hospital.
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Objective:To understand the cognition of scientific research integrity of applicants of the National Natural Science Foundation of China (NSFC) and the necessity of developing scientific research integrity construction.Methods:Questionnaire survey was used to collect information from 121 applicants who had applied for the NSFC from 2016 to 2020, collected data were statistically analyzed.Results:The cognitive average score of scientific research integrity knowledge of NSFC applicants was (287.03±49.45) points, and the overall awareness rate was 80.44%. The average score of the necessity of scientific research integrity construction work was (20.71±3.59) points, and the overall necessity rate 87.27%; educational background, position title, and experience as principle investigator are factors that affect the perception of integrity, while educational background, position, job category, and research management experience of a project are factors that affect the necessity of scientific research integrity construction. Behaviors with less than 70% of scientific research integrity behaviors include stem cell ethical issues, genetic technology ethical issues, human genetic resources issues, conditions for secondary publication, and use of official cards for settlement.Conclusions:The hospital should strengthen the scientific research integrity knowledge training of NSFC and other project applicants. On the basis of giving full play to the supervision role of relying units, the hospital will improve the relevant system of scientific research integrity, improve the construction of scientific research integrity at the same time, carry out classified evaluation, and put an end to scientific research misconduct from the source.
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Objective To develop the management system of science and technology awards through understanding dynamically the trend of awards in Beijing Obstetrics and Gynecology Hospital,Capital Medical University.Methods The data from the department of science and technology in Beijing Obstetrics and Gynecology Hospital,Capital Medical University were used to learn about some informations of science and technology awards including the winner's age,education,title and department,the proportion of rank and level,the trend of awards from 1998 to 2017,the number of social association awards from 2013 to 2017.Results The kinds of science and technology awards were up to 11.The 23 awards were obtained from 1998 to 2017,which were mainly composed of social association awards (65％) and gave priority to the second rank (48％).The age of the first winners were from 51 to 55 years.There were 9 departments obtained awards,accounting for 45％ of all the hospital clinical medical department.The increasing trend in the number of awards were observed from 1998 to 2017,and in nearly five years,the number showed the fast rising trend.Conclusions The less number of awards were obtained in Beijing Obstetrics and Gynecology Hospital,Capital Medical University.Whereas the most of awards were supported by social association.We were lack of the high rank and high level awards.The higher age showed that there were not enough youth scientific research and talent reserves.The situation need to be further strengthened the management and promoted the development in science and technology awards.
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Objective Along with the fast increasing of scientific research capacity,more and more financial funding were available at hospital level,at the same time,the kinds and quantities of the reagents and consumables for scientific research uses are also increased.As a result,procurement risks become a gig concern in hospitals.Thus,how to increase the cost-effectiveness of their financial funds while lowering the risks and hidden troubles are the key issues need addressing urgently.Methods This paper took Beijing Obstetrics and Gynecology Hospital,Capital Medical University as an example,summarized its service conditions of reagents and consumables for scientific research uses in past three years (2014-2016),according to the comparison and analysis of their actual prices with the guiding prices on the same as indicated on the informational procurement platform,to discuss the existing issues and risks.Results Under the current procurement management system of reagents and consumables for scientific research uses,the purchasing price for some items are relatively high.Conclusions This paper specifically proposed some measures and advices on risk prevention and control during the period of transition with the intention to reduce the purchasing cost,increasing the costeffectiveness of the financial funds,and lowering the risks and hidden troubles in procurements.
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Objective Objective To find out the existed problems and suggest for possible countermeasures for the patents management through keep track of the trend of patents in Beijing Obstetrics and Gynecology Hospital,Capital Medical University.Methods The data of patents from the department of science and technology in Beijing Obstetrics and Gynecology Hospital,Capital Medical University during 2002-2017 were extracted,to analyze the number of application and grants of patents,type,the authorized inventors'department,project and funding.The method of the stage of technological development was used to deduce the development stage of the technology innovation ability.Results The number of patents application and grants was small in Beijing Obstetrics and Gynecology Hospital from 2002 to 2017.The wave-like increasing trend was observed in the number of patent application,while the stable change in the number of grants of patents.The Compound Annual Growth Rate of the number of application and grants of patents were 14.9％ and 8.2％,respectively.In terms of patent types,most patents (69.2 ％) were utility models patents.The proportion of service invention was 50％.The grants of patents were not affected by research funding.The technology innovation ability of patent is developing,and there will be a rising trend in the future.Conclusions The hospital should strengthen the patent management,improve the management of patent policy,cultivate full-time professional staff,strengthen the cooperation with the patent agency and enterprise,and the construction of patent conversion platform to promote development of patent quality.
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Objective To improve scientific research capacity and disciplines development,we performed grading system to specialize and quantize the management in Beijing Obstetrics and Gynecology Hospital,Capital Medical University.Methods With assistance of forum survey related to 20 clinical and technical departments in hospital,we assessed the status of disciplines development,designed assessment criteria,and revised relevant regulations in grading system.Results The implementation of grading system promoted scientific achievements,academic communications and human resource development in hospital as relative to their pre-implemental controls.Conclusions The implementation of grading system facilitates scientific research and improves disciplines development.
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Objective To summarize the minimally invasive transthoracic ventricular septal defect (VSD) occlusion operation experience in the clinical application. Methods 142 VSD patients (admitted from August, 2013 to October, 2014) were chosen. All patients were treated with minimally invasive transthoracic device closure under the monitoring of transoesophageal echocardiogram. Results 136 cases received successful closure, and 6 cases still need CPB conventional extracorporeal circulation operation. After follow-up for 3 ~ 12 months for 102 patients, 16 cases remain residual shunt. Conclusion The short-term therapeutic effect of minimally invasive transthoracic device closure of VSD is satisfying. However , the long-term follow-up remains to be studied.
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Objective To compare the efficacy and safety of levofloxacin 750 mg for 5 days versus 500 mg for 7‐14 days intravenous (IV ) infusion in the treatment of community‐acquired pneumonia (CAP ) . Methods This study was a multi‐center , randomized , open‐label , non‐inferiority , controlled clinical trial .The CAP patients were randomized to receive levofloxacin 750 mg IV daily for 5 days or levofloxacin 500 mg IV daily for 7‐14 days .The clinical symptoms , laboratory tests , imaging results and microbiology data were collected and compared between the two treatment groups in terms of efficacy and safety .Results A total of 241 patients were enrolled in this clinical trial from 10 study centers .Among these patients ,223 were eligible for full analysis set (FAS) analysis ,including 111 in 750 mg group and 112 in 500 mg group .Of the 223 patients in FAS ,211 were eligible for per‐protocol set (PPS) analysis ,including 107 in 750 mg group and 104 in 500 mg group .Two hundred and forty‐one patients were included in safety set (SS) ,including 121 patients in 750 mg group and 120 in 500 mg group .The median treatment duration was 5 .0 days in 750 mg and 9 .0 days in 500 mg group .The median total dose was 3 750 mg in 750 mg group and 4 500 mg in 500 mg group .The overall efficacy rate was 86 .2% in 750 mg group and 84 .7% in 500 mg group in terms of FAS at visit 4 ,which suggested that the efficacy of 750 mg group was non‐inferior to 500 mg group .Of the 111 FAS patients in 750 mg group ,40 were bacteriological evaluable ,and 41 strains of pathogens were isolated .Forty‐nine of the 112 FAS patients in 500 mg group were bacteriological evaluable ,and 51 bacterial strains were obtained .The bacterial eradication rate was 100% in both groups .The clinical treatment efficacy rate for atypical pathogens was 100% in both groups .In 750 mg group ,the most common clinical adverse drug reactions (ADRs) were injection site adverse reactions including injection site pruritus ,pain and hyperemia .The other common ADRs were insomnia ,nausea ,skin rash .The most common drug‐related laboratory abnormalities were neutrophil percentage decreased , decreased white blood cell (WBC ) count , alanine aminotransferase (ALT) and aspartate aminotransferase (AST) elevation .Most of the ADRs were mild in severity and well‐tolerated .The safety profile of the two treatments was comparable in terms of the drug‐related treatment discontinuation and the incidence of ADRs .Conclusions The short‐course regimen of levofloxacin 750 mg IV for 5 days is at least as effective and well tolerated as the long‐course regimen of 500 mg IV for 7‐14 days in treatment of CAP .
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Objective This study was designed to evaluate the safety ,tolerability and efficacy of intravenous caspofungin for treatment of invasive candidiasis and esophageal candidiasis in Chinese adults .Methods This was a non-controlled ,multicenter ,candidiasis .All the 63 patients were included in the safety set (SS) and the full analysis set (FAS) .In the SS ,19 SAEs occurred in 14 patients .All these SAEs were unrelated to caspofungin .There were 73 caspofungin-related non-serious AEs in 31 patients (49 .2% ) .Five patients (7 .9% ) had both clinical AEs and laboratory abnormalities .Eight patients (12 .7% ) had clinical AEs (mainly rashes) ,and 27 patients (42 .9% ) had laboratory abnormalities ,mainly increases in liver enzymes alanine transaminase and aspartate transaminase and reduction in blood potassium .About 91 .7% of the clinical AEs were mild to moderate .Treatment was discontinued in 1 patient (1 .6% ,1/63) due to AEs .The overall efficacy was 58 .1% (36/62) in the FAS and 70 .0% (35/70) in the per-protocol set (PPS) .In the FAS ,the therapeutic efficacy was 57 .6% (34/59) for invasive candidiasis and 66 .7% (2/3) for esophageal candidiasis .In the PPS , the therapeutic efficacy was 68 .8% (33/48 ) for invasive candidiasis and 100% (3/3 ) for esophageal candidiasis .Conclusions The AEs of caspofungin were mostly mild to moderate in the treatment of invasive candidiasis and esophageal candidiasis in Chinese adults .Only one patient terminated therapy due to drug-related AE .Caspofungin is safe and effective for the treatment of invasive candidiasis and esophageal candidiasis in Chinese adults .
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Objective To determine the in vitro antibacterial activity of levornidazole against 375 anaerobic isolates.Methods Agar dilution method was used to determine the minimum inhibitory concentrations (MICs)of levornidazole,3 comparators (metronidazole,ornidazole and dextrornidazole)against 375 anaerobic isolates.Results For anaerobic gram-negative and gram-positive bacilli,and anaerobic gram-positive cocci,levornidazole displayed activity similar to or slightly higher than that of met-ronidazole,ornidazole and dextrornidazole.Levornidazole showed good activity against B.fragilis,Bacteroides thetaiotaomi-cron ,Clostridium difficile ,Clostridium perfringens ,and Peptostreptococcus magnus .The MIC90 value of levornidazole a-gainst the above-mentioned anaerobes was 0.5,1,0.25,2 and 1 mg/L,respectively.However,levornidazole and the compa-rators had poor antibacterial activity against Veillonella spp.among anaerobic gram-negative cocci.Conclusions The in vitro anti-anaerobic activity of levornidazole is similar to or slightly higher than that of metronidazole, ornidazole and dex-trornidazole.Levornidazole has good activity against both gram-negative and gram-positive anaerobic bacilli,and gram-positive anaerobic cocci,suggesting its promising clinical use.
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ObjectiveTo investigate the clinical pharmacokinetics (PK) and pharmacodynamics (PD) of gemifloxacin tablet in healthy Chinese volunteers and to provide evidences for optimal clinical dosing.MethodsTwenty volunteers were enrolled in the randomized (1∶1) double-blind study,and divided into administration group and control group.Each group received multiple oral doses of 320 mg of gemifloxacin tablet or placebo.The plasma and urine samples for gemifloxacin were analyzed by igh-performance liquid chromatogram(HPLC)-fluorometricmethod. Theminimuminhibition concentrations (MIC)of gemifloxacin against190clinical isolateswere determinedby broth microdilution method.The fAUC0～24 h/MIC and fCmax/MIC,with target value of 25 and 5,were used as the indices to evaluate PK and PD characteristics of gemifloxacin. The cumulative fraction of response (CFR) of gemifloxacin against each bacterium and the probability of target attainment (PTA) under various MIC level were evaluated using Monte Carlo simulation following multiple administration at steady state.ResultsThe Cmax of gemifloxacin after once-daily oral doses for 7 days were (1.55 ±0.32) μg/mL and (1.57±0.31) μg/mL for the first and last dose,while the AUC0～24 h were (7.91±1.52) and (8.91±1.15) h · μg · mL-1,respectively.The accumulation factor was 1.13±0.05.The time-profile of gemifloxacin could be described using two-compartment model and the half-life of distribution and elimination phase were (0.64 ± 0.17) and (7.10 ± 2.10) h,respectively. The cumulative urinary excretion rates within 24 h of gemifloxacin were 34.83 ％ and 38.95 ％ for the first and the last dose,respectively.PD study showed that the MIC90 of gemifloxacin were 0.25 mg/L and 0.125 mg/L against Streptococcus pneumoniae and Moraxelle catarrhalis,respectively,while the MIC90 was 2 mg/L against Hemophilus influenza. However,most of Klebsiella pneumoniae and methicillin-resistant Staphylococcus aureus (MRSA) were resistant to gemifloxacin ( MIC90 ＞ 32mg/L).The PTA values of fAUC0～24 h/MIC and fCmax/MIC of gemifloxacin 320 mg daily for 7 days were close to 100％ when MIC was ≤0.06 mg/L.ConclusionsGemifloxacin is rapidly absorbed after oral administration of single doses in healthy Chinese volunteers,and the plasma concentration could reach steady state at the third day,while a minimal accumulation is shown after consecutive 7 days dosing.The PK/PD analysis suggests that the favorable clinical and bacteriological efficacy could be obtained when using thisregimen in treatment of sensitive patients with community-acquired pneumonia and acute exacerbation of chronic obstructive pulmonary disease.
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Objective To investigate the mechanism of the different levels of ciprofloxacin resistance in qnrA-containing transconjugants.Methods E. coli J53AzR as the recipient,4 qnrA-containing transconiugants were constructed by conjugation from 4 qnrA-carrying clinical isolates.MICs of the transconjugants were measured by E test.aac(6')-Ib-cr was detected by PCR,and qnrA mRNA expression level was determined by real-time RT-PCR.The promoter sequences of qnrA were amplified by PCR from qnrA-bearing plasmids and cloned into plasmid pKK232-8,then transformed into HB101.All promoter fragments were sequenced.Resuits The MICs of ciprofloxacin against 4 transconjugants demonstrated a 10-fold difference from 0.094 μg/ml to 1.000 μg/m1.Of 4 qnrA-bearing plasmids in E.coli J53,ciprofloxacin MICs of pHS4 and pHS5 were 0.094 μg/ml and 0.125 μg/ml,respectively;pHS3,which contained the aac(6')-Ib-cr gene as well,MIC was 0.25μg/ml;and pHS5,which had a high expression level of qnrA and the aac(6')-Ib-cr gene,MIC was 1.00μg/ml.The relative expression levels of qnrA mRNA in J53 pHS6 was 32.5,much higher than the other 3 transconjugants(from 1.0 to 2.5).The promoter in plasmid pHS6 was 12-fold stronger than that in the other 3 plasmids.Compared with pHS3,there was 7 bp(GTTAGCA)deletion between the transcription initiation site and the start of qnrA in pHS6.Conclusion Co-existence of qnrA and aac(6')-Ib-cr in a single plasmid and high level of qnrA expression can account for the different levels of ciprofloxacin resistance in transconjugants.
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Objective To characterize clinical feature, frequency of isolation and antimicrobial susceptibility of pathogens isolated from patients with nosocomial bloodstream infections in Huashan Hospital, Fudan University from 1995 to 2004. Methods The clinical data of all patients who were diagnosed with nosocomial bloodstream infections based on national diagnostic criteria of nosocomial bloodstream infections were retrospectively analyzed. The pathogens were routinely isolated and identified. Susceptibilities against antimicrobial agents were determined by Kirby-Bauer methods and analyzed by WHONET 5.0 software. Results During the 10-year study period, a total of 395 patients were diagnosed with nosocomid bloodstream infection with 435 strains isolated from blood specimen.Gram positive bacteria, Gram negative bacilli and fungi, accounted for 47.4%, 45.1 % and 7.6%,respectively. Coagulase-negative Staphylococci (21.4%), S. aures (17.9%), E.coli (13.6%), K. pneumoniae (10.8%), Candidaspp (7.4%), Enterococci (6.0%), Pseudomonasspp (6.0%) and Acinetobacter spp (3.7%) were frequently identified isolates. S. aures and coagulase-negative Staphylococci resistant to methicillin were 62.8% and 87.1%, respectively. The susceptibilities of cefotaxime and ceftazidime against E. coli and K. preumonine were 46%-78% and 27.7%-40.4%, respectively. Conclusions The Gram positive cocci are slightly more prevalent than Gram negative bacilli in nosocomial bloodstream infections and resistance to the first line antibiotics is common among all pathogens isolated. Candida spp is the fifth leading cause of nosocomial bloodstream infections.
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OBJECTIVE To characterize clinical feature,frequency of isolation and antimicrobial susceptibility of bacterial pathogens isolated from patients with healthcare-associated bacterial meningitis(HABM).METHODS We review the charts of all patients in whom the diagnosis was based on(national) diagnostic criteria of healthcare-(associated) infections at Huashan Hospital from 1995 through 2004.The pathogens were routinely isolated,(identified) and susceptibilities against antimicrobial agents were determined by Kirby-Bauer methods.RESULTS During the 10-year study period,109 patients were treated for 120 episodes of HABM.Most of patients had a(history) of recent and remote neurosurgery.Fever was present in all patients,while nuchal rigidity and decrease consciousness were present in less than half of all patients.CSF opening(pressure,) white blood cell count and(protein) were elevated with predominance of neutrophils.A total of 120 strains were isolated from CSF specimen,Gram-positive bacteria and Gram-negative bacilli were accounted for 35.8% and(64.2%) of all isolates,respectively.Acinetobacter spp(24.2%),coagulase-negative staphylococci(22.5%),Klebsiella pneumoniae(12.5%),Pseudomonas aeruginosa(10%),Enterobacter cloacae(8.3%) and Staphylococcus aureas(7.5%) were the 6 most frequent isolates and resistance to the first line antibiotics was common among all pathogens isolated.(CONCLUSIONS) The most common risk factor for HABM is neurosurgery.Gram-negative bacilli and staphylococci are important causes of HABM,resistance to the first line antibiotics is common among all pathogens isolated.
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20 antimicrobial agents were determined by Kirby-Bauer methods by the participating institutions.RESULTS A total of 428 strains were isolated,Gram-positive cocci and Gram-negative bacilli accounted for 49.8% and 50.2%,respectively.The Gram-positive bacteria increased from 44.6% to 51.2% from 1995-1996 through 2003-2004 and Gram negative bacteria decreased from 55.4% to 48.2% in the meantime.The most frequent Gram-positive isolates were coagulase negative staphylococci,Staphylococcus aureus,Enterococcus spp and Streptococcus pneumoniae;the most frequent Gram-negative isolates were Acinetobacter spp,Klebsiella spp,Escherichia coli,Pseudomonas aeruginosa and Enterobacter spp;Neisseria meningitidis,Haemophilus influenzae,Flavobacterium spp and Citrobacter spp were relative less common.No strains resistant to vancomycin were found in staphylococci and enterococci.Gram-negative bacilli were highly susceptible to carbapenem.CONCLUSIONS Gram-positive cocci play an increasing role in central nervous sysytem infections,especilly coagulase negative staphylococci,and Gram-positive cocci have been increasing from 1995-1996 through 2003-2004,resistance to the first line antibiotics is common among all cerebrospinal fluids isolates.
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Objective To detect the clinical pathogenic bacteria and antimicrobial-resistant genes quickly and sensitively using DNA chip.Methods Based on the analysis of 23S rRNA gene se- quences and other genes sequences associated with antimicrobial resistance(SHV＜CTX_M),oligo nucleotide microarray was designed according to different bacteria and antimicrobial-resistant genes. The DNA fragments were amplified by labeling Cy5 fluorescence and detect clinical pathogenic bacte- rias and antimicrobial-resistant genes by hybridization.Results The result of detection(10~3-10~6 bac- teria/ml)was consistent with that of some documents in domestic and overseas under ideal circum- stances of detecting bacteria genomic DNA by the Reagent Box.And it was specific and reproducible when the detection system were evaluated with some clinical isolates and drug-resistant standard strain.DNA chip could identify 16 species and 7 generics including common diverse clinical pathogenic bacteria,and could detect the drug-resistant of extended spectrum?lactamase gene simultaneously. Conclusions The methods that we have established DNA chip is a sensitive,specific and reproducable tool for supplying routine methods.