摘要
Objective To explore the drug resistance mechanism and characteristics of carbopenem-resistant pseudo-monas aeruginosa(CRPA)in our hospital.Methods BD phoenix 100 automatic bacterial identification and drug sensitivity an-alyzer was used to identify and detect the drug sensitivity of the strains.The minimum inhibitory concentration(MIC)of ceftazi-dime/acibactam was detected by micro broth dilution method.The modified carbapenem inactivation method(mCIM)and colloi-dal gold immunochromatography were used to detect the carbapenemase phenotype of the strains.The whole genome sequencing was used to detect the carbapenemase resistance gene and ST typing of the screened positive strains.Results A total of 22 strains of clinically isolated CRPA were collected,of which the antibacterial drugs with the lowest resistance rate were ceftidine/avibatan(22.7% ),followed by gentamicin and amikacin(27.3% ),pyracillin/tazobactam(59.09% ),cefuroxime(63.6% ).Ceftazide and aminotransferrane(77.27% ),ciprofloxacin(86.36% ),levofloxacin(95.45% ).There are a total of 5 strains(22.7% )of carbapenems in 22 CRPA by phenotypic detection.The whole genome sequencing results show that 4 strains of ST549 CRPA carry metal β-lactamase IMP-45 and serine β-lactamase OXA-1,OXA-50,one strain is ST245 CRPA carries metal β-lactamase NDM-1,that is,all five CRPA strains produce metal β-lactamase.Conclusion The resistance rate of CRPA to ceftazidime/avibactam is low in our hospital.Carbapenemase-producing is not the main mechanism of CRPA resistance to car-bapenems,while metal β-Lactamase-producing is the main mechanism of CRPA resistance to ceftazidime avibactam.
摘要
Objective To compare the distribution and drug resistance of isolates between sterile body fluid and non‐sterile body fluid in the hospital in 2014 .Methods By adopting the retrospective analysis method ,we used BD phoenixTM 100 to conduct bacteria identification and drug susceptibility testing ,the Whonet5 .6 software and SPSS19 .0 software to statistically analysize the drug re‐sistance of the bacteria .Results E .coli ranked the top in sterile body fluid isolates(43% ) while the highest rate in non‐sterile body fluid was P .aeruginosa .E .coli(21% ) .Isolates from sterile body fluid had lower drug resistance rate to 11 kinds of antibacterials such as ampicillin ,chloramphenicol ,ciprofloxacin and aztreonam than the strains isolated from non‐sterile body fluid(P<0 .05) .S . aureus ,isolated from sterile body fluid ,had lower drug resistance rate to 6 kinds of antibacterials such as amikacin ,amoxicillin/cla‐vulanicacid ,ciprofloxacin than the strains isolated from non‐sterile body fluid .P .aeruginosa ,isolated from sterile body fluid ,had lower drug resistance rate to aztreonam than the srains isolated from non‐sterile body fluid .K .pneumoniae ,isolated from sterile body fluid ,had lower drug resistance rate to 6 kinds of antibacterials such as ampicillin/sulbactam ,sulfamethoxazole ,chlorampheni‐col than the strains isolated from non‐sterile body fluid(P<0 .05) .Conclusion There is significant difference between sterile body fluid and sterile body fluid in strain distribution and drug resistance ,so it is vital to enhance the bacterial resistance surveillance of sterile body fluid .
摘要
Objective To explore the inhibitory effect of 24 pseudomonas aeruginosa(PA) on pathogenic fungi ,such as candida albicans ,candida tropicalis ,candida glabrata ,candida parapsilosis ,candida krusei ,mucous spore bacterium (MSB) etc .Methods 24 PA isolates were collected from clinical specimens and identified by Gram′s stain ,oxidase production and the API 20NE system(bi-oMerieux ,France) .Cross-streaking method and sterilizing filter paper-disk method and co-cultured method were applied to observe the inhibitory effect of PA .Sodium dodecyl sulfate-polyacrylamide gel electrophoresis(SDS-PAGE) analyzed the difference of bacte-rial proteins of PA .Results The results showed that some strains of 24 PA had strong inhibitory effect against pathogenic fungi , some strain had partial effect and others had no effect .Co-cultured test showed that PA could inhibit the growth of fungal hyphae . SDS-PAGE displayed the significant difference in secretive proteins between the PA strains which had strong effect and no effect . Conclusion PA have inhibitory effect upon common pathogenic fungi and and this might be related to inhibit fungal hyphae forma-tion ,various protein secretion and inhibit the growth of fungi .
摘要
Objective To investigate the distribution and drug resistance of pathogens of ventilator-associated pneumonia(VAP) in general intensive care unit(ICU).Methods Statistical methods were used to analyze retrospectively the data of pathogens and drug resistance of VAP in general ICU from 2004 to 2006.Results Totally 347 pathogens were isolated from deep-part secretion of lower respiratory tracts of 302 VAP in general ICU.The main pathogens included Pseudomonas aeruginosa(32.3%),Acinetobacter baumanii(31.1%),Staphylococcus aurous(16.7%),Klebsiella(7.5%) and Coagulase-negative Staphylococci(6.1%).Gram-negative bacillus showed a high resistance to piperacillin and Cefotaxime but high susceptibility to carbapenems and the enzyme inhibitor antibiotics.Gram-positive coccobacteria showed a high resistance to Penicillin,Clindamycin and Erythromycin but high susceptibility to Vancomycin and Quinolone.Conclusion Gram-negative bacillus was the main pathogen of VAP in general ICU,multidrug resistance was serious.The rate of methicillin-resistant staphylococcus aurous(MRSA) and methicillin-resistant coagulase-negative staphylococci(MRCNS) was high,with serious drug resistance.According to the data of the bacteria pathogen and antibiotics susceptibity,we can select antibiotics reasonably to control the infection and delay the emergency of new drug-resistant bacteria.