Since COVID-19 might have a lasting impact on global public health, it is crucial to analyze its effect on drug-resistant bacterial infections in the respiratory system for the prevention and control of hospital infections. This work aimed to investigate the impact of the COVID-19 outbreak on the clinical distribution and antibiotic resistance of bacterial infection among hospitalized patients in the respiratory unit in order to establish strategies to control antibiotic-resistant infections. Electronic clinical data registry records from 2018 to 2022 were retrospectively analyzed. A total of 36,829 clinical specimens, including sputum, bronchoalveolar lavage fluid, blood, and urine, were collected from 16,073 patients admitted to the Guangzhou First People’s Hospital from January 2018 to December 2022. Among them, 2209 samples were culture-positive. The bacterial isolation rates of different types of samples showed a similar trend from 2019 to 2022, with an increase in 2020 and 2022 and a decrease in 2021. Different bacterial species were separated from different types of samples. The most reported pathogens were identified in sputum samples. Gram-positive isolates were prevalent in urine samples, while Gram-negative bacilli were the predominant pathogenic bacteria isolated from respiratory tract and blood samples. Pseudomonas aeruginosa (P. aeruginosa), Acinetobacter baumannii (A. baumannii) complex, and Klebsiella pneumoniae (K. pneumoniae) were the most abundant Gram-negative bacteria in sputum samples, of which A. baumannii complex had the highest resistance to all tested antibiotics except colistin. Notably, there has been a substantial prevalence of carbapenem-resistant P. aeruginosa, A. baumannii, and K. pneumoniae in the past five years. This alarming situation calls for greater attention and precaution with prescribed antibiotics to limit the generation and spread of new multidrug-resistant bacteria and improve therapeutic management.

目的 本研究对广州地区5家教学医院的鲍曼不动杆菌进行分子流行病学分析.方法 5家教学医院共采集138株鲍曼不动杆菌,利用多位点序列分型(multilocus sequence typing,MLST)及eBURST算法评价菌株之间的遗传关系.结果 MLST将138株鲍曼不动杆菌分为8个已有序列类型(STs),分别为ST195、ST208、ST457、ST136、ST254、ST548、ST445和ST53,还发现17个新STs.其中ST195的数量最多,占所有分离株的35.5％(49/138),其次为ST208,占所有分离株的21.0％(29/138).eBURST算法分析显示以ST195为预测祖先型的克隆复合体(clonal complex,CC)195在医院环境中广泛传播.结论 鲍曼不动杆菌CC195是广州地区的流行克隆,各家医疗机构应根据其自身实际制定感染防控策略.

目的 探讨骨髓炎患者致病菌分布特点及耐药情况,为临床治疗提供合理指导.方法 回顾性分析该院2015—2017年收治的118例骨髓炎患者的临床资料,统计分析骨髓炎患者临床标本细菌培养及药敏试验结果 .结果 骨髓炎患者临床标本中分离出16种61株致病菌,临床标本细菌培养阳性率72.62％,革兰阳性菌39例(63.93％),革兰阴性菌22例(36.07％).结论 骨髓炎患者治疗应根据该病流行病学特点,制订合理的抗感染治疗方案,保证足够的抗菌药物使用疗程,以巩固抗感染效果,防止骨髓炎复发.

Objectives The clonal spread of Acinetobacter baumannii (A. baumannii) is an emerging problem. We analyzed the molecular epidemiology of A. baumannii isolated from 5 teaching hospitals in Guangzhou, China. Methods 138 A. baumannii isolates were collected. Multilocus sequence typing (MLST) was used to assess the genetic relationships among the isolates. The blaOXA-51-like gene was amplified and then sequenced. Results Most of the isolates (55.8%, 77/138) were obtained from intensive care units (ICUs). The respiratory system was the most common site where A. baumannii was found (72.5%, 100/138). A. baumannii remained susceptible to polymyxin and tigecycline, but the susceptibility to other antimicrobial agents was below 30%. We used MLST to group the A. baumannii isolates into 8 existing sequence types (STs) and 17 new STs. With the predicted founder ST195 (accounted for 35.5% of all isolates, 49/138), Clonal complex (CC) 195 was the most prevalent and widely spread STs in the hospital environment. All ST195 isolates harbored OXA-66 according to the blaOXA-51-like gene sequencing. But each hospital had its unique epidemiological feature. Conclusions OXA-66 gene harboring CC195 was the most epidemic STs in Guangzhou, China. Health care facilities should develop their own management strategy.

Background Extremely drug-resistant （XDR） Acinetobacter baumannii （ A. baumannii ）has been of a great concern. The relationship between XDR and patient outcomes remains unclear. We investigated the clinical features, risk factors, and outcomes of Hospital-acquired pneumonia (HAP)caused by XDR A. baumannii. Methods A multicenter retrospective case-control study was performed to determine factors associated with XDR A. baumannii pneumonia from 5 teaching hospitals in Guangzhou, China. Results 76 patients were enrolled in the study. XDR A. baumannii pneumonia patients were tend to be smoker (11.9% vs 3.9%, P = 0.130) and older (76.5±11.2 vs 70.3±16.4, P = 0.007) and had more comorbid diseases including chronic obstructive pulmonary disease (COPD) (48.7% vs 21.1%, P = 0.001) and renal failure (21.1% vs 3.9%, P = 0.002) and had higher APACHE II score (65.8% vs 47.4%, P = 0.033). Invasive procedures including insertion of urinary catheter, nasogastric tube, central venous/arterial catheter, bronchoscopy and mechanical ventilation along with using β-lactam/β-lactamase inhibitor and carbapenem were also risk factors for XDR A. baumannii pneumonia. Multivariate analysis showed the APACHE II score >=20 (OR, 2.1; 95% CI: 1.1–4.1, P = 0.023), COPD (OR, 9.6; 95% CI: 2.0–45.5, P = 0.004), central venous/arterial catheter placement (OR,11.5; 95% CI: 1.1-117.8, P = 0.040), low albumin levels (OR, 1.2; 95% CI: 1.1-1.4, P = 0.001) and using β-lactam/β-lactamase inhibitor (OR,15.9; 95% CI: 2.7-94.2, P = 0.002) were independent risk factors for XDR A. baumannii pneumonia. Compared with the non-XDR A. baumannii patients, the XDR A. baumannii pneumonia increased length of mechanical ventilation (11.1±12.3 vs 5.1±5.6, P = 0.000), hospital stay (42.2±24.3 vs 34.8±18.0, P = 0.036) and ICU (Intensive Care Unit) stay (27.5±19.0 vs 20.0±20.5, P = 0.020), but it did not increase in-hospital mortality (47.4% vs 32.9%, P = 0.137). Conclusions XDR A. baumannii pneumonia was strongly related to systemic illnesses, invasive procedure, low albumin levels and the APACHE II score and increasing the length of mechanical ventilation and hospital stay. But it did not increase in-hospital mortality.

OBJECTIVE To review the application of TCM injections in a tertiary a hospital to promote rational clinical use of TCM injections.METHODS Medical records for inpatients admitted from February 2014 to October 2016 were reviewed by accessing the Hospital Information System (HIS).Medical records for inpatients were randomly selected from1 inpatient area for each month for statistical analysis of the application of TCM injections.The utilization rate and rational use rate were calculated for each department.The irrationalities were analyzed,and were presented at the monthly general assembly of physicians. RESULTS Upon special review and analysis,it was noted that in the internal medicine departments,senior cadres wards,cardiology departmentⅠand cardiology departmentⅡhad the highest(100％)utilization rates of TCM injections,and the rational use rate was 100％in the Pediatrics Department.Of the surgery departments,the osteology department had the highest(96％) utilization rate of TCM injections,while TCM injection was not used in the gynecology department or ophthalmology department. Irrationalities in the use of TCM injections mainly included absence of indication,inappropriate dosage or method of administration, irrational vehicle selection and inappropriate drug combinations.The most commonly used TCM injections were those for promoting blood circulation and removing blood stasis.CONCLUSION Certain problems are present in the use of TCM injections,which needs further corrective measures.

Objective To evaluate the quantitative analysis value of gemstone spectral CT for diagnosing urate deposition in the first metatarsophalangeal joint and periarticular soft tissue of patients with hyperuricemia.Methods This work involved 84 patients with hyperuricemia who underwent foot gemstone spectral CT from October 2016 to June 2017.The patients were divided into three groups:36 patients (group A) with normal imaging,23 patients(group B) with bone destruction,and 25 patients(group C) with bone destruction and uric acid crystallization.The basal concentrations of uric acid(calcium) in the first metatarsophalangeal joint cortical bone,cancellous bone and periarticular soft tissue were measured using gemstone spectral CT scanning.The age,serum uric acid value,and basal concentration of uric acid(calcium) were compared by univariate ANOVA among the three groups.In intra-group comparison,LSD method was used for the data with equal variance,and Tamhane's T2 test was used for the data with unequal variance.Correlation of serum uric acid value with the uric acid(calcium) level of the first metatarsophalangeal joint cortical bone,cancellous bone,and periarticular soft tissue in all hyperuricemia patients was analyzed by linear regression.Results Significant differences in age,serum uric acid value,and uric acid (calcium) concentration were found for periarticular soft tissues of the first metatarsophalangeal joints(P＜0.05).No differences were observed between the uric acid(calcium) concentration in the first metatarsophalangeal joint cortical bone and cancellous bone.The following values were obtained for age:group A(39.1 ±11.1) years old,group B (48.5±13.9) years old,and group C (43.2±12.5) years old (LSD,P=0.019);for serum uric acid value:group A(489.5±90.6) μmol/L,group B(494.7±77.2) μmol/L,and group C(581.3 ±69.2) μmol/L(LSD,P＜0.001);for the uric acid (calcium) concentration in the periarticular soft tissues of the first metatarsophalangeal joints:group A (1169.58±7.88) mg/cm3,group B (1193.13±16.35) mg/cm3,and group C (1308.20±85.89) mg/cm3 (x2=-61.698,P＜0.001);for the uric acid(calcium) concentration in the first metatarsophalangeal joints:group A (1324.8±31.4) mg/cm3,group B (1335.6±37.3) mg/cm3,and group C (1320.4±43.5) (LSD,P=0.346);for the uric acid(calcium) concentration in the cancellous bone of the first metatarsophalangeal joints:group A (1134.3±13.3) mg/cm3,group B (1145.8 ± 23.3) mg/cm3,and group C (1145.8± 30.9) mg/cm3 (x2=3.464,P=0.177).The serum uric acid value was linearly positively correlated with the uric acid(calcium) concentration in periarticular soft tissues of the first metatarsophalangeal joints,but not with the uric acid(calcium) concentration in cortical bone and cancellous bone of the first metatarsophalangeal joints.Conclusion Gemstone spectral CT can measure quantitatively the internal and external base material concentrations of joints and define the crystallization of uric acid salt,which can provide a basis for clinical judgment.

INTRODUCTION:Multidrug-resistant Acinetobacter baumannii (A. baumannii) has become one of the greatest threats worldwide to the therapeutic management of infections. Our previous research confirmed an in vitro synergistic effect of amlodipine and imipenem against A. baumannii, and this study is designed to understand its mechanism. METHODS:Sixty-four non-duplicate A. baumannii isolates were collected and tested for antimicrobial susceptibility by the disk diffusion method. PCR amplification and sequencing were used to identify the presence of the adeB, adeE, adeH, adeJ, abeM and abeS efflux pump genes. The minimal inhibitory concentrations of imipenem, imipenem+amlodipine and imipenem+carbonyl cyanide m-chlorophenyl-hydrazone against these isolates were also determined by the broth microdilution method before and after siRNA silencing of the expression of the adeABC efflux pump. RESULTS:In this study, the combination of amlodipine with imipenem showed synergistic antimicrobial activity against sixty-four A. baumannii isolates when compared with the activity of imipenem alone (p<0.025). In the multidrug-resistant group, AML was more effective than carbonyl cyanide m-chlorophenyl-hydrazone (p<0.001). The efflux pump genes adeB, adeE, adeH, adeJ, abeM and abeS were detected in 100% (4/64), 75% (48/64), 0% (0/64), 100% (64/64), 96.9% (62/64) and 96.9% (62/64) of the sixty-four A. baumannii isolates, respectively. The expression of the adeABC efflux pump genes in the multidrug-resistant group (5.05±19.25) is clearly higher than in the non-multidrug-resistant group (0.17±0.20), (p = 0.01). A gene silencing test verified that the mRNA expression levels of adeABC were decreased at 12 h and increased at 24 h, while the reversal of imipenem resistance by amlodipine disappeared at 12 h and reappeared at 24 h. CONCLUSIONS:The combination of amlodipine with imipenem exhibits an in vitro synergistic antimicrobial effect on multidrug-resistant A. baumannii, which may be due to the inhibition of the AdeABC efflux pump.

目的 分析2011—2016年间铜绿假单胞菌分离株的耐药性及变迁情况,为临床合理用药提供科学依据.方法 对2011年1月—2016年12月广州市第一人民院患者各类标本中分离到的铜绿假单胞菌2257株进行细菌鉴定及药敏试验,并对耐药性变迁进行统计分析.结果 铜绿假单胞菌在痰液标本中的检出率最高为56.9％;6年铜绿假单胞菌平均耐药率以妥布霉素最低,为9.9％,对哌拉西林/他唑巴坦、头孢吡肟、头孢他啶、左氧氟沙星、环丙沙星、亚胺培南、庆大霉素等药物的耐药率均<20％,在2013年耐药率最低,此后三年逐年上升.结论 铜绿假单胞菌对广州市第一人民院常用抗生素的耐药率在近3年呈逐年上升趋势,临床医师应根据药敏结果合理选择抗菌药物,以提高疗效和减缓耐药菌的产生.

目的:充分了解影响农村地区老年高血压患者用药依从性的因素,为提高高血压患者用药依从性提供参考.方法:对甘肃省兰州市榆中县夏官营镇912名65岁以上居民进行健康体检,对所筛选出的高血压患者的用药依从性问题进行现场问卷调查.结果:老年高血压患者用药依从性好、尚可、差所占比例分别为36.12％、28.49％和35.04％;用药依从性不佳的主要原因为记忆力减退和家属督促不力;对药物疗效完全了解、部分了解、不了解者分别占50.52％、31.87％和17.61％.结论:甘肃省兰州市榆中县夏官营镇老年高血压患者用药依从性较差,对药物疗效等相关知识了解程度不高,不按时服药的老年高血压患者较多.提示医、药、护人员要深入社区,加强对老年高血压患者的健康教育,对患者家属加强督促,使患者认识到药物治疗对控制血压的重要性,提高用药依从性.

Background: The clonal spread of multiple drug-resistant Acinetobacter baumannii is an emerging problem in China. We analysed the molecular epidemiology of Acinetobacter baumanni isolates at three teaching hospitals and investigated the risk factors, clinical features, and outcomes of hospital-acquired pneumonia caused by extensive drug-resistant Acinetobacter baumannii (XDRAB) infection in Guangzhou, China.Methods: Fifty-two A. baumannii isolates were collected. Multilocus sequence typing (MLST) was used to assess the genetic relationships among the isolates. The blaOXA-51-like gene was amplified using polymerase chain reaction (PCR) and sequencing. The resistance phenotypes were determined using the disc diffusion method. A retrospective case-control study was performed to determine factors associated with XDRAB pneumonia.Results: Most of the 52 A. baumannii isolates (N = 37, 71.2%) were collected from intensive care units (ICUs). The respiratory system was the most common bodily site from which A. baumannii was recovered (N = 45, 86.5%). Disc diffusion classified the isolates into 17 multidrug-resistant (MDR) and 35 extensively drug-resistant (XDR) strains. MLST grouped the A. baumannii isolates into 5 existing sequence types (STs) and 7 new STs. ST195 and ST208 accounted for 69.2% (36/52) of the isolates. The clonal relationship analysis showed that ST195 and ST208 belonged to clonal complex (CC) 92. According to the sequence-based typing (SBT) of the blaOXA-51-like gene, 51 A. baumannii isolates carried OXA-66 and the rest carried OXA-199. There were no significant differences with respect to the resistance phenotype between the CC92 and non-CC92 strains (P = 0.767). The multivariate analysis showed that the APACHE II score, chronic obstructive pulmonary disease (COPD) and cardiac disease were independent risk factors for XDRAB pneumonia (P < 0.05). The mortality rate of XDRAB pneumonia was high (up to 42.8%), but pneumonia caused by XDRAB was not associated with in-hospital mortality (P = 0.582).Conclusions: ST195 may be the most common ST in Guangzhou, China, and may serve as a severe epidemic marker. SBT of blaOXA-51-like gene variants may not result in sufficient dissimilarities to type isolates in a small-scale, geographically restricted study of a single region. XDRAB pneumonia was strongly related to systemic illnesses and the APACHE II score but was not associated with in-hospital mortality.

Objective To investigate the carriage status of virulence factors of carbapenem-resistant Acinetobacter baumannii,and to evaluate its levels of pathogenicity. Methods Ninety-three strains of multi-drug resistant Acinetobacter baumanni were isolated from the specimens of infected patients , who were hospitalized in Guangzhou First Municipal People's Hospital between January 2016 and December 2016,including 75 carbapenem-resistant strains and 18 carbapenem-susceptible strains. The switching motility was examined by plate method. The gelatinase activity in the strains was determined by test tube method. The biofilm formation was determined by quantitative analysis of crystal violet staining method. The D-mannose-resistant hemagglutination was determined by micromethod. Results The biofilm formation rate of carbapenem-resistant Acinetobacter baumannii was 70.7％(60/93),while the biofilm formation rate of the susceptible strains was 38.9％(7/18)(P<0.05). The average diameter of switching motility of multi-drug resistant Acinetobacter baumanni was (5.82 ± 2.67) mm. The average diameter of switching motility of carbapenem-resistant Acinetobacter baumannii was(5.32±1.65)mm,and the average diameter of switching motility of carbapenem-susceptible strains was(7.89 ± 4.75)mm(P<0.05). The examination showed that there was gelatinase activity in 3 carbapenem-resistant Acinetobacter baumannii strains,and the others were all negative. The findings of the hemagglutination-inhibition test showed that 90 Acinetobacter baumannii strains were agglutinated with AB-type erythrocytes,and 89 strains were agglutinated with O-type erythrocytes under the absence of D-mannose;83 strains were agglutinated with AB-type erythrocytes,and 84 strains were agglutinated with O-type erythrocytes under the presence of D-mannose. There was no statistically significant difference in the hemagglutination-inhibition test between carbapenem-resistant strains and susceptible strains. Conclusion Multi-drug resistant Acinetobacter baumannii shows certain virulence. Carbapenem-susceptible strains show more virulence but less environmental adaptability than carbapenem-resistant strains,which are more likely to form biofilm. These etiologic features may be an important basis for the clinical infection of multi-drug resistant Acinetobacter baumannii.

Objective:To investigate the clinical characteristics of extensive drug-resistant Acinetobacter baumannii (XDRAB) epidemic strains and hospital-acquired pneumonia (HAP).Methods:Thirty-one non-repeated XDRAB strains,which were clinically isolated from Guangzhou First Municipal People's Hospital,were included and analyzed for molecular epidemiologic typing.The characteristics of XDRAB pneumonia were retrospectively analyzed.Results:Thirty-one strains of XDRAB were divided into 8 ST types,of which ST195 was the most common,accounting for 45.2% (14/31).APACHE Ⅱscore (P=0.034),chronic obstructive pulmonary disease(COPD)(P=0.012) and heart disease (P=0.016) were independent risk factors for XDRAB pneumonia.The mortality rate of XDRAB pneumonia reached to 42.8%,but there was no statistically significant difference in hospital mortality (P=0.582) compared with non-XDRAB pneumonia.Conclusion:Acinetobacter baumannii ST195 exists widely.XDRAB pneumonia is associated with COPD,heart disease and APACHE Ⅱscore,but does not increase the risk of death.

目的 探讨医院感染假丝酵母菌病的毒力因素,为研究医院感染假丝酵母菌病的致病性提供依据.方法 收集2010年3月1日-2013年6月30日医院感染假丝酵母菌病共98例患者,依照EORTC/MSG专家共识中对假丝酵母菌病的分类标准,将白色假丝酵母菌感染病例分为深部器官感染组及皮肤黏膜感染组;通过分析磷脂酶活性及溶血性对不同种类假丝酵母菌作毒力因子比较,并进一步比较深部器官感染及皮肤黏膜感染白色假丝酵母菌的毒力;采用SPSS17.0系统对数据进行统计分析.结果 98例假丝酵母菌病构成以白色假丝酵母菌病72例为主,占73.5％,不同种类假丝酵母菌的Pz指数及溶血指数比较差异无统计学意义;72例白色假丝酵母菌病标本中深部器官感染组52例占72.2％,皮肤黏膜感染组20例占27.8％;深部器官感染组白色假丝酵母菌的Pz值及溶血指数均高于皮肤黏膜感染组,差异有统计学意义(P＜0.05).结论 不同种类假丝酵母菌的磷脂酶及溶血性毒力无差异,白色假丝酵母菌感染侵袭的部位与其磷脂酶及溶血性毒力相关.

目的 对比三甲综合医院非发酵菌的临床分布特点及耐药性,为临床诊治非发酵菌感染及政府制定卫生方针提供依据.方法 回顾性收集2013年1月-2015年9月广东省两所三甲医院(A医院、B医院)检出非发酵菌送检标本,对常见的非发酵菌临床分布、组成和耐药性进行对比分析.结果 近3年两所三甲医院标本来源第一位均为痰,铜绿假单胞菌来源第一位科室均为呼吸科,鲍曼不动杆菌、嗜麦芽窄食单胞菌、洋葱伯克霍尔德菌均来源于重症监护病房;分离细菌各11 610、6 889株,A医院较B医院的常见非发酵菌检出率高(22.0％ vs 16.4％,P＜0.0l);铜绿假单胞菌均对第三、四代头孢菌素类及氨基糖苷类、第三代喹诺酮类、亚胺培南耐药率低(≤26％),但A医院亚胺培南耐药率是B医院的两倍(26％ vs 13％,P＜0.01);鲍曼不动杆菌耐药率均较高(≥44％),A医院与B医院比较,除对阿米卡星耐药率低(7％ vs 45％,P＜0.01)、嗜麦芽窄食单胞菌对第三代喹诺酮类耐药率低(15％～31％)外,余耐药率均较高(≥77％).对第三、四代头孢菌素类及左氧氟沙星、亚胺培南耐药率洋葱伯克霍尔德菌A医院耐药率高(≥71％),而B医院低(≤26％).结论 近年我区三甲综合医院分离的铜绿假单胞菌耐药率较低,鲍曼不动杆菌、嗜麦芽窄食单胞菌耐药率高,应加强各级医院院内非发酵菌耐药性监测,制定合理的临床用药策略.

ObjectiveTo evaluate the accuracy of VITEK 2 Compact automated microorganism analysis system for the determination of imipenem-resistantAcinetobacter baumannii to amikacin,and to investigate the existence of 16S rRNA methylase gene.Methods The drug susceptibilities of 72 isolates of imipenem-resistantAcinetobacter baumannii and 15 isolates of imipenem-sensitiveAcinetobacter baumannii to amikacin were determined by VITEK 2 Compact, Kirby-Bauer method and E-test. 16S rRNA methylasearmA gene was determined by polymerase chain reaction(PCR). Results Among the 72 isolates of imipenem-resistantAcinetobacter baumannii,the drug susceptibility results were consistent between Kirby-Bauer method and E-test. The minimal inhibitory concentration(MIC)of 69 isolates was 4-≥64μg/mL by VITEK 2 Compact,while the results of Kirby-Bauer method and E-test showed being resistant. The MIC of 3 isolates were≤2μg/mL by VITEK 2 Compact,while there were 2 isolates being sensitive by Kirby-Bauer method and E-test. The resistant double-ring phenomenon was found in 59 isolates. The positive rate of carryingarmA gene was 92.9%(65/70)by Kirby-Bauer method and E-test. Among the 15 isolates of imipenem-sensitiveAcinetobacter baumannii, the MIC to amikacin was≤2μg/mL,and the results were in accordance with those of Kirby-Bauer method and E-test. ConclusionsVITEK 2 Compact is not reliable for the determination of imipenem-resistantAcinetobacter baumannii to amikacin. The resistant double-ring phenomenon might be related with carryingarmA gene.

目的：对鲍曼不动杆菌菌株进行分子流行病学分型及耐药性分析，为临床防控提供指导。方法收集非重复鲍曼不动杆菌42株，采用多位点序列分型（ MLST）进行分子流行病学分型，eBURST分析菌株亲缘性，纸片扩散法进行药敏试验。结果42株鲍曼不动杆菌被分为10个ST型，其中ST195及ST208最常见，占总数的69.0％，eBURST分析提示主要流行克隆为CC92。根据纸片药敏结果，菌株对多黏菌素B的敏感性最高为100％，其余抗生素的敏感率均小于30％，42株菌株可分为多重耐药（ MDR）菌株11株，广泛耐药（ XDR）菌株31株。优势克隆CC92与非CC92的MDR、XDR菌株的比例差异无统计学意义（P＝0.676）。结论鲍曼不动杆菌CC92广泛流行，CC92与非CC92菌株的耐药性无差别，CC92的成功流行可能更依赖于对医院环境的高度适应性。

Objective To study the susceptibility of Acinetobacter baumannii to common disinfectants and to pro-vide more practical measures for hospital disinfection.Methods The susceptibilities of multidrug-resistant Acinetobacter baumannii to three common disinfectants in hospital were evaluated by determination of minimum bactericidal concentration ( MBC) and minimum inhibitory concentration ( MIC) .Disinfectant resistance gene qacEΔ1-sull was detected by PCR. Results The MBCs of formaldehyde disinfectant, glutaraldehyde disinfectant and 2%strengthening glutaraldehyde disin-fectant against multidrug-resistant Acinetobacter baumannii were 500, 20 000 and 2 500 mg/L, respectively, while the MICs were 250, 5 000 and 315 mg/L, respectively.The MBCs of formaldehyde disinfectant, glutaraldehyde disinfectant and 2%strengthening glutaraldehyde disinfectant against sensitive Acinetobacter baumannii and standard strains were 250, 10 000 and 1 250 mg/L, respectively, while the MICs were 125, 2 500 and 78 mg/L, respectively.The qacEΔ1-sull gene was detected in 7 multiple drug resistant Acinetobacter baumannii strains, while not in 5 strains of sensitive strains of Acinetobacter baumannii and quality controls.Conclusion The MBC and the MIC of multidrug-resistant Acinetobacter baumannii to disinfectants are significantly increased.Multiple drug resistant Acinetobacter baumannii resistance to disin-fectant is associated with disinfectant resistance genes qacEΔ1-sull.

OBJECTIVE To explore the results of isolation of Staphylococcus aureus strains in different years and analyze the drug resistance so as to provide guidance for reasonable clinical use of antibiotics .METHODS The sub‐mitted specimens that were obtained from the patients who were hospitalized from Jan 2007 to Dec 2012 were cul‐tured ,the strains were identified by using VITEK bacterial identification system ,and the drug susceptibility tes‐ting was performed with the use of drug susceptibility analysis system .RESULTS A total of 3 601 strains of S .au‐reus have been isolated ,most of the strains were isolated from the sputum specimens ;the integrated ward for eld‐erly cadres ranked the first place of department where the strains distributed ,followed by the critically intensive care unit and the respiratory internal medicine department .The drug resistance rate of the S .aureus to penicillin was the highest (98 .6% ) ,the drug resistance rates to oxacillin ,ciprofloxacin ,levofloxacin ,and moxifloxacin were 72 .3% ,69 .5% ,65 .3% ,and 62 .1% ,respectively ,the drug resistance rate to gentamicin ,clindamycin ,or erythromycin ranged from 56 .1% to 70 .1% ,and the drug resistance rate to vancomycin ,linezolid ,or teicoplanin was the lowest .CONCLUSION The clinical isolation rate of the S .aureus strains is increased year by year ,and the strains are resistant to multiple commonly used antibiotics .It is necessary to strengthen the monitoring and formu‐late the reasonable strategies for clinical medication .