Objective:To investigate the distribution and antimicrobial resistance profile of clinical bacteria isolated from blood culture in China.Methods:The clinical bacterial strains isolated from blood culture from member hospitals of Blood Bacterial Resistant Investigation Collaborative System (BRICS) were collected during January 2018 to December 2019. Antibiotic susceptibility tests were conducted with agar dilution or broth dilution methods recommended by US Clinical and Laboratory Standards Institute (CLSI). WHONET 5.6 was used to analyze data.Results:During the study period, 14 778 bacterial strains were collected from 50 hospitals, of which 4 117 (27.9%) were Gram-positive bacteria and 10 661(72.1%) were Gram-negative bacteria. The top 10 bacterial species were Escherichia coli (37.2%), Klebsiella pneumoniae (17.0%), Staphylococcus aureus (9.7%), coagulase-negative Staphylococci (8.7%), Pseudomonas aeruginosa (3.7%), Enterococcus faecium (3.4%), Acinetobacter baumannii(3.4%), Enterobacter cloacae (2.9%), Streptococci(2.8%) and Enterococcus faecalis (2.3%). The the prevalence of methicillin-resistant S. aureus (MRSA) and methicillin-resistant coagulase-negative Staphylococcus were 27.4% (394/1 438) and 70.4% (905/1 285), respectively. No glycopeptide-resistant Staphylococcus was detected. More than 95% of S. aureus were sensitive to amikacin, rifampicin and SMZco. The resistance rate of E. faecium to vancomycin was 0.4% (2/504), and no vancomycin-resistant E. faecalis was detected. The ESBLs-producing rates in no carbapenem-resistance E. coli, carbapenem sensitive K. pneumoniae and Proteus were 50.4% (2 731/5 415), 24.6% (493/2001) and 35.2% (31/88), respectively. The prevalence of carbapenem-resistance in E. coli and K. pneumoniae were 1.5% (85/5 500), 20.6% (518/2 519), respectively. 8.3% (27/325) of carbapenem-resistance K. pneumoniae was resistant to ceftazidime/avibactam combination. The resistance rates of A. baumannii to polymyxin and tigecycline were 2.8% (14/501) and 3.4% (17/501) respectively, and that of P. aeruginosa to carbapenem were 18.9% (103/546). Conclusions:The surveillance results from 2018 to 2019 showed that the main pathogens of bloodstream infection in China were gram-negative bacteria, while E. coli was the most common pathogen, and ESBLs-producing strains were in majority; the MRSA incidence is getting lower in China; carbapenem-resistant E. coli keeps at a low level, while carbapenem-resistant K. pneumoniae is on the rise obviously.

Background: Escherichia coli is the most common pathogens in patients with community-onset blood stream infections (COBSI). Knowledge of the epidemiology of this disease is crucial to improve allocation of health resources, formulate isolation strategies that prevent transmission, and guide empirical antibiotic therapy. Methods: This retrospective observational study examined patients with E. coli COBSI (EC-COBSI) at a non-tertiary hospital in China. Whole-genome sequencing and analysis of the isolates was performed. The relationships of clinical variables with antimicrobial resistance and the genetic background of the isolates were examined. Results: There were 148 isolates in patients with EC-COBSI. All isolates were susceptible to ceftazidime/avibactam, carbapenems, and tigecycline; 35.1% were positive for extended spectrum β-lactamase (ESBL+); and blaCTX–M–14 was the most common ESBL gene. Patients with ESBL- isolates were more likely to receive appropriate empiric treatment than those with ESBL+ isolates (61.5% vs. 91.4%, p < 0.001), but these two groups had similar mortality rates. The overall 30-day mortality rate was 9.5%. Phylogenetic analysis showed that the isolates were diverse, and that the main sequence types (STs) were ST95, ST131, and ST69. Intra-abdominal infection was the primary source of disease, and isolates from these patients had lower frequencies of virulence genes. Conclusion: The mortality rate of patients with EC-COBSI was unrelated to ESBL status of the isolates. Most isolates had low resistance to most of the tested antimicrobial agents. The isolates were diverse, and multiple strains were related. Prevention and control of EC-COBSI should target prevention of patient colonization and the living environment.

Objective:To investigate the bacterial composition and antimicrobial resistance profile of clinical isolates from bloodstream infections in China.Methods:The clinical bacterial strains isolated from blood culture were collected during January 2020 to December 2020 in member hospitals of Blood Bacterial Resistant Investigation Collaborative System (BRICS). Antibiotic susceptibility tests were conducted by agar dilution or broth dilution methods recommended by Clinical Laboratory Standards Institute(CLSI, USA). WHONET 5.6 was used to analyze data.Results:During the study period, 10 043 bacterial strains were collected from 54 hospitals, of which 2 664 (26.5%) were Gram-positive bacteria and 7 379 (73.5%) were Gram-negative bacteria. The top 10 bacterial species were Escherichia coli (38.6%), Klebsiella pneumoniae (18.4%), Staphylococcus aureus (9.9%), coagulase-negative Staphylococci (7.5%), Pseudomonas aeruginosa (3.9%), Enterococcus faecium (3.3%), Enterobacter cloacae (2.8%), Enterococcus faecalis (2.6%), Acinetobacter baumannii (2.4%) and Klebsiella spp (1.8%). The prevalence of methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-resistant coagulase-negative Staphylococcus aureus were 27.6% and 74.4%, respectively. No glycopeptide- and daptomycin-resistant Staphylococci were detected. More than 95% of Staphylococcus aureus were sensitive to rifampicin and SMZco. No vancomycin-resistant Enterococci strains were detected. Extended spectrum β-lactamase (ESBL) producing Escherichia coli, Klebsiella pneumoniae and Proteus mirabilis were 48.4%, 23.6% and 36.1%, respectively. The prevalence rates of carbapenem-resistance in Escherichia coli and Klebsiella pneumoniae were 2.3% and 16.1%, respectively; 9.6% of carbapenem-resistant Klebsiella pneumoniae strains were resistant to ceftazidime/avibactam combination. The prevalence rate of carbapenem-resistance in Acinetobacter baumannii was 60.0%, while polymyxin and tigecycline showed good activity against Acinetobacter baumannii. The prevalence rate of carbapenem-resistance of Pseudomonas aeruginosa was 23.2%. Conclusions:The surveillance results in 2020 showed that the main pathogens of bloodstream infection in China were gram-negative bacteria, while Escherichia coli was the most common pathogen, and ESBL-producing strains declined while carbapenem-resistant Klebsiella pneumoniae kept on high level. The proportion and the prevalence of carbapenem-resistant Pseudomonas aeruginosa were on the rise slowly. On the other side, the MRSA incidence got lower in China, while the overall prevalence of vancomycin-resistant Enterococci was low.

目的 分析老年肺炎继发抗生素相关性腹泻(AAD)患者的粪便病原学特点及腹泻发生的危险因素. 方法 选取2019年1月-2019年12月本院收治的60例老年肺炎继发AAD患者为观察组,另选取同期收治的78例老年肺炎未继发AAD患者作为对照组.检测60例AAD患者的粪便病原菌分布以及耐药情况;通过Logistic回归分析法分析老年肺炎患者继发AAD的危险因素. 结果 60例AAD患者的粪便中共分离出病原菌89株,其中革兰阴性菌58株(65.17％),以大肠埃希菌为主;革兰阳性菌26株(29.21％),以难辨梭状芽孢杆菌为主;真菌5株(5.62％),以白色念珠菌为主.58株革兰阴性菌对青霉素类、喹诺酮类、头孢菌素类药物均产生了不同程度的耐药性;白色念珠菌对两性霉素B和制霉菌素敏感率均为100％;难辨梭状芽孢杆菌对甲硝唑和万古霉素敏感率均为100％.多因素Logistic回归分析显示,重症肺炎、应用机械通气、抗生素持续应用超过7d、联合应用抗生素以及禁食均是老年肺炎患者继发AAD的独立危险因素(P＜0.05). 结论 老年肺炎继发AAD患者的粪便病原菌以大肠埃希菌和难辨梭状芽孢杆菌为主,临床应严格掌握抗生素的应用指征,合理应用抗生素,减少AAD的发生.

目的:了解近3 a临床主要G-杆菌分布及耐药性变迁,为合理使用抗生素提供帮助。方法:VATEK32鉴定仪对临床分离菌进行鉴定及药敏实验。结果:检出的G-杆菌以大肠埃希菌、肺炎克雷伯菌、鲍氏不动杆菌、铜绿假单胞菌为主,鲍氏不动杆菌呈上升趋势,抗生素的耐药率逐年升高。结论:G-杆菌耐药性非常严重,鲍氏不动杆菌出现广泛耐药,应加强病原菌耐药性监测,防止医院感染暴发。

自2004年1月至2006年8月对我院神经外科颅脑外伤气管切开术后93例病人的痰液共451份标本进行细菌培养及对抗生素耐药性的测定,为临床气管切开术后病人的预防和治疗提供参考资料.现将分析结果报告如下.

Objective To investigate the distribution and drug resistance of the pathogenic floras isolated from the clinical specimen in Putian.Methods.Flora cultivation and isolation were operated based on the National Clinical Laboratory Operational Regulations.Flora was identified with VITEK-32 automatic identifier,and bacteriostatic test was operated with KIRby-baucer method.Results.A total of 3230 strains were isolate between 2003 and 2004.The proportions of gram-negative bacilli,gram-positive cocci and fugus were 51.1%(1652 strains,most of them were nonfermenters),31.3%(1012 strains) and 15.1%(486 strains) respectively.Most of these pathogens showed multiple drug resistance.The detective rate of E.coli(ESBLs),K.pneumoniae(ESBLs) and oxacillin resistant S.aureus(MRSA) were 38.3%,55.9% and 68.4% respectively.Conclusion. Now the most serious problems are fugus infection and multiple drug resistance.It is important to take note of reasonable application of antibacterials and strengthen surveillance of the vicissitudes trends and resistance of bacteria.

本文对我院3 a来ICU患者革兰阴性杆菌感染的耐药性进行动态监测分析,观察耐药菌株的变迁特点如下. 1 材料和方法 1.1 材料本院2002-05～2005-04 ICU患者首次分离株.

新生儿缺氧缺血性脑病(HIE)是围生期窒息的严重并发症、病死率高,可合并多器官损害[1],并可产生永久性神经功能障碍,当前缺乏具有高度敏感性和特异性诊断新生儿窒息和HIE的指标,国际上普遍强调采用多项指标进行综合评价[2],以减少误诊.本文对40例HIE患儿、25例窒息新生儿及30例无窒息史新生儿进行心肌酶检测,以探讨HIE患儿血清心肌酶活性的变化.

目的探讨留置导尿病人更换一次性集尿袋的最佳时间.方法将169例留置导尿管后当天尿培养无细菌生长的留置导尿者随机分为三组,即每天更换集尿袋(A组),3 d更换1次(B组),7 d更换1次(C组),并每天采集三组病人集尿袋中的尿液进行细菌培养.结果尿培养细菌阳性率A组与C组比较,差异无显著性意义(P＞0.05);B组与A、C组比较,差异有显著性意义(均P＜0.05).B组尿培养细菌阳性率明显低于A、C两组.结论留置导尿的病人3 d更换集尿袋1次为宜.

为了解临床近年来泌尿系感染的病原菌分布和耐药性的情况,给临床治疗和合理用药提供依据,我们对近2年来临床拟诊为"泌尿系感染"患者的中段尿细菌检出率、菌群分布及耐药状况进行分析.