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From 2004 to 2005 in our hospital clinical surveillance of antimicrobial resistance commonly_3030

By Maurice Moore,2014-10-30 18:06
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From 2004 to 2005 in our hospital clinical surveillance of antimicrobial resistance commonly_3030

    From 2004 to 2005 in our hospital clinical surveillance of antimicrobial resistance commonly

     Authors: Zhuo Chao Wen-Xiang Huang Zheng-line

    Chongzhi Xia Du Yu-ping-ping

     Abstract Objective To investigate the surveillance of

    antimicrobial resistance in China to help group (CHINET) Working Group in Chongqing in November 2004 ~ November 2005 on a variety of common clinical bacterial antimicrobial resistance status quo. Method of drug susceptibility testing using disc diffusion method, drug resistance data analysis software used WHONET5. The results of a year for the first time in our hospital were collected from patients with isolates 1380; Escherichia coli, Pseudomonas aeruginosa, Klebsiella pneumoniae, Acinetobacter baumannii, coagulase-

    negative staphylococcus, Staphylococcus aureus, Enterobacter Enterobacter, and Enterococcus faecalis were the most common bacteria, the respective proportions of 18.6%, 13.6%, 11.3%, 10.0%, 9.4%, 9.1%, 8.0% and 3.9%. Enterobacteriaceae resistant

    to imipenem and meropenem for the lowest rate, producing extended spectrum β lactamases (ESBLs) in Escherichia coli and Klebsiella pneumoniae strains detection rates were 37.5% and 31.4%; all strains produced ESBLs were sensitive to imipenem and meropenem, Pseudomonas aeruginosa to imipenem and meropenem resistance rates were 37.2% and 39.4%, to ceftazidime resistance rate of 48.9% , and the emergence of pan-resistance to all drug-resistant strains. Acinetobacter

    baumannii to imipenem and meropenem sensitive rates were 98.6%

    and 92.8% to cefoperazone / sulbactam sensitivity rate, intermediate rate, resistance rates were 34.8%, 27.5%, 37.7 %. Drug combination analysis showed that pairs of cefoperazone / sulbactam is not sensitive to strain has 58 for the same

    resistance patterns, PFGE analysis, these strains mainly from

two clone. In addition to carbapenem-sensitive, the other

    drugs are resistant, of which 46 come from the same ward. Conclusion hospital nearly six months of drug resistance of common bacteria monitoring results with previous similar, but in some intensive care unit because there is resistance to cefoperazone / sulbactam epidemic strain, so that Acinetobacter baumannii to cefoperazone / sulbactam The sensitivity was significantly lower than the early results of

    monitoring. To take effective measures to control the epidemic strain continues to spread is very important.

     Key words bacterial resistance to antimicrobial agents of Gram-positive cocci Gram-negative bacilli

     Surveillance of bacterial resistance from a hospital

     ABSTRACT Objective To investigate the antimicrobial resistance of clinical isolates from a hospital in Chongqing during 2004 to 2005 according to CHINET project. Methods Disc diffusion test (KB methods) was employed to study the

    antimicrobial resistance. WHONET5 was applied for analysis. Results In one year of study, 1380 strains were collected which were isolated firstly from each patient. E.coli, P.aeruginosa, K.pneumoniae, A.baumannii, coagulase negative

    staphylococci, S.aureus, Enterobacter cloacae and E.faecalis were the most common strains among isolates. The resistant rate of enterobacter to imipenem and meropenem were the lowest. The incidence of E.coli and K.pneumoniae producing ESBLs were 37.5% and 31.4%, respectively. All the ESBLs

    strains are susceptible to imipenem and meropenem. 37.2 %, 39.4% and 48.9% of P.aeruginosa were resistant to imipenem, meropenem and ceftazidime, respectively, and pandrug

    resistant (PDR) strains of P.aeruginosa have exhibited in our

    hospital. All strains of A.baumannii were susceptible to imipenem and meropenem, while only 34.8% of the strains were susceptible to cefoperazone / sulbactam. There are 58 strains shown the same resistant pattern among non susceptible

    strains of A.baumannii, and 46 of 58 isolated from the same ward. Conclusion The surveillance results in this year were similar with that in last year. There may be cloning strains of resistant to cefoperazone / sulbactam in some ICU, which resulted in the resistant rate of cefoperazone / sulbactam were higher than before. It is important to take measures to control the transmission of cloning strains in the hospital.

     KEY WORDS Bacterial resistance; Antimicrobial agents; Gram positive cocci; Gram negative bacilli

     Bacterial resistance emergence and spread of serious impact on human health. Bacterial resistance to antibiotics can lead to ineffective treatment, infection aggravated or even death. To curb the spread of bacterial resistance, the WHO established in 2000 to curb drug-resistant bacteria worldwide

    development strategy. Organization of the National Institute of Fudan University antibiotics east, west, south, north, 8 3 A-level hospitals in China was set up surveillance of antimicrobial resistance Assistance Team (CHINET), consecutive collected on a daily basis the clinical monitoring of drug-

    resistant bacteria to keep abreast of important pathogen resistance dynamics and change. In this study over the past year the CHONGQING workstation monitoring data analysis to

    understand the Chongqing area common clinical isolates to commonly used antimicrobial drug resistance status.

     1 Materials and methods

     1.2 bacterium from

     The First Affiliated Hospital of Chongqing Medical University, November 1, 2004 to November 30, 2005 clinical isolates collected in order to inpatients mainly a small amount of outpatients.

     1.2 Identification of bacteria

     Strains identified as conventional methods, or API, VITEK Identification System.

     1.3 Drug sensitivity test

     With KB (Kirby-Bauer) method. Paper, and MH

    susceptibility BD media products for the United States. Quality control strains of Staphylococcus aureus ATCC25923, Pseudomonas aeruginosa ATCC27853, E. coli ATCC25922 and β

    lactam / β lactamase inhibitor complex quality control from the control of Escherichia coli ATCC35218 Fudan University, Institute antibiotic. Test methods and determine the standard according to the U.S. Clinical Laboratory

    Standards Institute (CLSI) 2005 edition of the provisions of [1] (cefoperazone / sulbactam Pfizer pharmaceutical companies based on standards). Producing extended-spectrum β

    lactamases (ESBLs) strain confirmed double disk diffusion method, antimicrobial agents for the paper Cefotaxime /

    clavulanic acid (30μg/10μg) and ceftazidime / clavulanic

    acid (30μg/10μg ).

     1.4 Analysis Program

     Developed by CHINET sensitivity program implementation. Staphylococcus monitoring of drugs, including: ampicillin / sulbactam, oxacillin, I oxazole compound sulfamethoxazole, erythromycin, clindamycin, rifampicin, penicillin G, gentamicin, cefuroxime , cefazolin, cefoxitin (coagulase-

    negative staphylococci), vancomycin, levofloxacin; Enterococcus monitoring drugs: ampicillin, high unit gentamicin, erythromycin, ring C sand star, teicoplanin, vancomycin, nitrofurantoin. Enterobacteriaceae and Acinetobacter monitoring drugs: gentamicin, amikacin, ampicillin, ampicillin / sulbactam, piperacillin, imipenem, meropenem, cefazolin, the first spore furosemide Sim,

    cefoxitin, cefotaxime, ceftazidime, cefepime, cefoperazone / sulbactam, piperacillin / tazobactam, ciprofloxacin, sulfamethoxazole mouth oxazole compound . Pseudomonas monitoring of drug including: gentamicin, amikacin, piperacillin, imipenem, meropenem, ceftazidime, cefepime, aztreonam, cefoperazone, ceftazidime Piperazine ketone / sulbactam, pi