Community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) is one of the most important pathogen and can cause infection ranging from superficial skin infections to life-threatening disease. The prevalence of CA-MRSA is rising in children in these years. Therefore, the review will cover the research progress in the CA-MRSA prevalence, risk factors, clinical manifestation, treatment and preventions in children. The risk factors and disease patterns and antimicrobial resistant rates in different parts of China in the recent decade will be also discussed.

OBJECTIVE To explore the relationship between multidrug resistance of Acinetobacter baumannii(ABA) and its class Ⅰ integron.METHODS In this study,39 multidrug resistant strains and 41 non-multidrug resistant strains of ABA were collected.The improved Kirby-Bauer was employed to check the collected strains′ drug-resistant phenotype;PCR was administrated to detect the distribution of class Ⅰ integron.and their relationship was also analyzed.RESULTS Results showed that ABA′s drug-resistance rate to the most antibiotics was high.imipenem,cefoperazone-sulbactam,ABA was sensitive to ciprofloxacin,amikacin and Piperacillin-tazobactam,however,ABA′s drug resistance rates to other antibiotics were all over 40%.It revealed that ABA′s drug-resistance rate was high.The study indicated that the positive rate of Class Ⅰ integron in multidrug resistant ABA was as hight as 82.1%(32/39).The positive rate of non-multidrug resistant strains was 26.8%(11/41),and the differences were statistically significant(?2=24.6,P

Objective To study the antimicrobial resistance changes of common pathogenic bacterial isolates in Guangzhou. Methods Disc diffusion test was used to measure the antibiotic susceptibility of 5063 strains collected from 13 hospitals in Guangzhou from 1998 to 2000 (Fastidious bacteria were detected by E test). Results From 1998 to 2000, the percentage of methicillin resistant Staphylococcus aureus was 45.3%,53.0%, and 50.8%, respectively, and that of methicillin resistant coagulase negative Staphylococcus was 64.1%, 86.0%, and 79.0% accordingly. There was no resistance to vancomycin in the strains of Staphyloccocas and there were 40.7%, 31.8% and 36.4% in E.coli and 43.1%, 42.7%, and 31.5% in Klebsiella found to be extended spectrum lactamases producing in the 3 years. Resistant rates of Enterobacter spp against the third generation cephalosporins increased. Resistant rates of P.aeruginosa against cefoperazone/sulbactam, ceftazidime,amikacin were changed unmarkedly in recent years. Conclusions The antimicrobial resistance of common pathogenic bacteria is serious in Guangzhou area. The surveillance of antimicrobial susceptibility is of great significance.

Objective To investigate the effect of double lumen tube applied in the simple negative pressure drainage.Methods Forty cases were divided into two groups by a random table method,with 20 cases in each group. The double lumen tube was used in observation group while the normal gastric tube was used in control group,then the indexes on the drainage effect and wound healing were quantized and analyzed.Results In the observation group,one case suffered obstruction at 2 -4 days,1 case after 4 days of treatment,the obstruction rate was 10%.In the control group,two cases suffered obstruction at 2 -4 days,and 2 cases after 4 days of treatment,the obstruction rate was 25%.There was significant difference between two groups(χ2 =9.212,5.021,P =0.027,0.032).There were two cases of delayed healing and 17 cases with effective in the observation group,but 8 cases delayed healing and 11 cases with effective in the control group,there was statistically significant difference (χ2 =5.833,4.800,P =0.016, 0.028).Conclusion Double lumen tube can delay the occurrence time and reduce the occurrence rate of obstruction in simple negative pressure drainage,which promotes wound healing,and it is worth popularizing and using clinically.

OBJECTIVE To analyze the sequence of IMP-4 metallo-?-lactamases(MBLs) encoding gene from clinical isolates of multiple-drug-resistant Klebsiella oxytoca strains and attempt to know the integrons composing the drug resistance gene box.METHODS The antibiotic sensitivity test of multi-resistant K.oxytoca strains was done according to Kirby-Bauer method of CLSI 2005,and the double disk synergy test and Etest were for detecting their MBLs.The Class 1 integrons were detected by PCR.The purified amplicons of Class l integrons were sequenced.The type and order of gene cassettes in integrons were analyzed by searching GenBank.RESULTS The K.oxytoca was resistant to carbapenems,the third-generation cephalosporins,cefoxitin,quinolones,cefoperazone/sulbactam,sulfamethoxazole/trimethoprim,amoxicillin/clavulanate,ticacillin/clavulanate,piperacillin,cefepime,rifampicin and piperacillin/tazobatam,only susceptible to amikacin and polymyxin B.The IMP-4 metallo-?-lactamases,aadA1,AmpC,CTX-M-14,qacE△1-sull and intI1 were positive.CONCLUSIONS Integrons are important molecular mechanism in the development of multidrug resistance.There are resistance gene boxes in them.

OBJECTIVE To investigate the genotypes of aminoglycoside-modifying enzymes(AMEs)genes of Acinetobacter baumannii.METHODS Clinical isolates of A.baumannii were collected from 2003 to 2006,and their resistance to gentamicin,amikacin and tobramycin were tested by K-B method.Twenty-three isolates were chosen because of their resistance to aminoglycoside antibiotics(at least resistant to one kind of the drugs).Nine types of the AMEs were detected by PCR.RESULTS Drug resistant rates of 23 isolates of A.baumannii to gentamicin,amikacin and tobramycin,were 86.96%,56.5% and 69.56%,respectively.The detection rates of the 9 AMEs,including ant(3')-Ⅰ,aac(3)-Ⅰ、aac(6')-Ⅰ,aph(3')-Ⅵ,aac(3)-Ⅱ,aac(6')-Ⅱ and ant(2″)-Ⅰ were 69.56%,60.87%,56.52%,47.82%,30.4%,26.09% and 21.73%,respectively.CONCLUSIONS The resistance to aminoglycoside antibiotics of A.baumannii is mainly caused by AMEs.

Objective To investigate the clinical effect of amiodarone combined with psychological intervention in the treatment of senile rapid arrhythmia.Methods 120 cases of elderly patients with rapid arrhythmia diagnosed and treated in our hospital from January 2015 to January 2017 were divided into two groups: the control group was treated with the system, the observation group was treated with the system combined with amiodarone+The clinical data of amiodarone combined with psychological intervention in the treatment of senile rapid arrhythmia were discussed and compared with the data obtained from the two groups.Results The clinical effect of the observation group (system synthesis+amiodarone+psychological intervention) in the treatment of elderly patients with tachyarrhythmia was better than that of the control group (systematic synthesis).The clinical symptoms improved significantly and the adverse reactions were few Statistically significant (P<0.05).Conclusion The clinical effect of prescription system combined with amiodarone+psychological intervention in patients with rapid arrhythmia is significant, which can effectively improve the clinical symptoms and less adverse reactions.It is widely used in the treatment of elderly patients with rapid arrhythmia.

Objective To explore the effect of ca se-teaching applied to the classes of practical training of parasitology. Methods The case-teaching was tentatively performed in a part of the undergraduates in our school during their parasitology practical training classe s.Results The effect of case-teaching was obviously superior t o the traditional one. The total scores,the theory examination and the specimen recognition scores were all higher in the class which employed the case-teachin g than in the control ones (P

Objective To study the prevalence and sequence homology of virulence genes exoU and exoS in 53 strains of pan-drug-resistant Pseudomonas aeruginosa .Methods The virulence genes exoU and exoS were detected by PCR.Sequence homo-logy was analyzed by BOX-PCR.Results Of the 53 clinical isolates of pandrug-resistant Pseudomonas aeruginosa ,the exoS+/exoU- genotype was identified in 40 strains,exoU+/exoS - genotype in 10 strains,exoS +/exoU+ genotype in 1 strain, and exoS-/exoU- genotype in 2 strains.BOX-PCR results showed that 41 exoS+ isolates belonged to 24 genotypes,and 11 exoU+ strains could be grouped into 7 genotypes.Conclusions The prevalence of virulence genes is high in clinical isolates of pandrug-resistant Pseudomonas aeruginosa .BOX-PCR fingerprint analysis combined with sequence homology analysis is help-ful for effective monitoring and control of hospital pandrug-resistant pseudomonas aeruginosa infection.