Objective To investigate antimicrobial resistance of Escherichia coli (E.coli)and Klebsiella pneumoniae (K.pneumoniae),antimicrobial use density(AUD),as well as relation between antimicrobial resistance and AUD in a ter-tiary first-class hospital.Methods Antimicrobial resistance rates of clinically-isolated E.coli and K.pneumoniae,AUD of carbapenems and quinolones,as well as relation between resistance and AUD in 2013-2015 were statistically analyzed. Results Correlation analysis of antimicrobial resistance of bacteria and AUD showed that the decrease in resistance rate of E.coli to levofloxacin was related to the decrease in the use density of quinolones(r=0.61,P=0.03);increase in resist-ance rate of K.pneumoniae to imipenem was related to the increase in the use density of carbapenems(r=0.78,P<0.01). Conclusion Antimicrobial use is one of the causes of bacterial resistance,management on antimicrobial use needs to be strengthened to reduce the threat of bacterial resistance to human health.

To explore the association between hyperfibrinogenemia and prognosis in patients with acute ischemic stroke （AIS） receiving intravenous thrombolysis.Methods Patients with acute ischemic stroke who received recombinant tissue plasminogen activator （rt PA） intravenous thrombolysis within 4.5 h of onset from August 2018 to December 2021 in the Department of Neurology of Zhejiang Provincial People's Hospital were retrospectively collected.Hyperfibrinogenemia were diagnosed according to the fibrinogen （FIB） level before thrombolysis.The prognosis of these patients were evaluated according to the modified Rankin Scale （mRS） scores 90 d after discharge.Multivariate logistic regression analysis was performed to determine the independent risk factors for prognoses of acute ischemic stroke patients after rt PA intravenous thrombolysis.Results Among the 327 patients，52 patients（15.90%） in the hyperfibrinogenemia group and 275（84.10%） in the non hyperfibrinogenemia group；63 patients （19.27%） had a poor prognosis and 264 （80.73%） had a good prognosis.As compared with the patients in nonhyperfibrinogenemia group，the patients in hyperfibrinogenemia group had significantly higher levels of the baseline FIB，proportion of drinking history and a poor prognosis （P<0.05）.Compared with the good prognosis group，the poor prognosis group had significantly advanced age，significantly longer door to needle time （DNT），significantly higher level of the baseline FIB，significantly lower proportion of small artery occlusion type and lower proportion of early neurological improvement，significantly higher the proportion of use anticoagulants，significantly higher of large atherosclerotic type，significantly higher of cardioembolic type，significantly higher of PH hemorrhagic transformation，significantly higher of symptomatic intracranial hemorrhage and significantly higher of severe cerebral edema （P<0.05）.Multivariate Logistic regression showed that the levels of the baseline FIB（OR=0.566，95%CI 0.368-0.872，P<0.05），and the 7 d NIHSS scores （OR=0.638，95%CI 0.490-0.831，P<0.05） were independent risk factors for poor prognosis.Conclusion Hyperfibrinogenemia is associated with poor prognosis after intravenous thrombolysis in patients with acute ischemic stroke.Acute ischemic stroke patients with higher baseline FIB levels and higher 7 d NIHSS scores are prone to have poor prognosis.