1.Distribution, drug resistance and drug sensitivity of pathogens in patients with intra-abdominal infection
Jianfei PAN ; Hong ZHANG ; Chengcai DAI
Acta Universitatis Medicinalis Anhui 2018;53(3):453-457
Objective To investigate the distribution of pathogens and the results of drug sensitivity test in patients with intra-abdominal infection, and to provide theoretical basis for the rational selection of anti-infective programs. Methods The pathogenic bacteria culture and drug sensitivity test results of peritoneal fluid or drainage fluid in hospitalized patients with intra-abdominal infection were retrospectively analyzed. Results 405 cases of positive culture results were obtained in 3 509 cases of intra-abdominal infection specimens. A total of 436 strains of pathogens, including 268 strains of Gram-negative bacteria (61.47%), 151 strains of Gram-positive bacteria(34. 63%), 17 strains of Fungi (3. 90%). The top five were Escherichia coli (22. 25%), Acinetobacter baumannii (10. 09%), Klebsiella pneumoniae (9. 86%), Enterococcus faecium (7. 80%), Staphylococcus aureus(4. 13%). The extended spectrum β-lactamas rates of Escherichia coli and Klebsiella pneumoniae were 58. 76% and 16. 28%, respectively. The multi-drug resistant strains of Acinetobacter baumannii were 79. 55%. Vancomycin resistant strains were detected in Enterococcus faecium (8. 82%), the detection rate of methicillin-resistant Staphylococcus aureus (MRSA) in Staphylococcus aureus was 72. 22%, and the detection rate of methicillin-resistant Staphylococcus aureus (MRCNS) in coagulase-negative Staphylococci was 51. 92%. Conclusion The main pathogens of intra-abdominal infection is Escherichia coli, followed by Acinetobacter baumannii, Klebsiella pneumoniae, Enterococcus faecium and Staphylococcus aureus, the detection rate of MRSA and MRCNS is high. The overall drug resistance of intra-abdominal infection is serious.
2.The prognostic value of serum cystatin C combined with bedside renal ultrasound in patients with sepsis-induced acute kidney injury
Chengcai DAI ; Zhenxing CHENG ; Qianqian TU
The Journal of Practical Medicine 2024;40(22):3226-3231
Objective To assess the prognostic significance of serum cystatin C(CysC)in combination with bedside renal ultrasound for patients diagnosed with sepsis-induced acute kidney injury(AKI).Methods The study cohort comprised 134 patients with sepsis-induced AKI who were admitted to our hospital between October 2019 and October 2023.Based on the 30 day prognosis,the patients were categorized into a survival group(n=93)and a death group(n=41).Collected clinical data included gender,age,heart rate,underlying diseases,treat-ment modalities,duration of hospital stay,basic biochemical indicators,and Acute Physiology and Chronic Health Evaluation Ⅱ(APACHEⅡ)scores.Renal function markers such as serum creatinine(SCr),blood urea nitrogen(BUN),and cystatin C levels were measured;renal blood flow resistance index(RI)was assessed using bedside routine ultrasound.Cox regression analysis was employed to evaluate factors influencing poor prognosis in patients with sepsis-induced AKI while analyzing the prognostic assessment value of combining cystatin C with bedside renal ultrasound through ROC curves.Results The death group exhibited significantly higher APACHEⅡ scores,SCr,BUN,CysC levels,and RI(all P<0.05)compared to the survival group.Cox regression analysis revealed that both CysC levels and RI were significant prognostic indicators(P<0.05).ROC curve analysis demonstrated that the combined assessment of CysC levels and RI yielded a high diagnostic accuracy of 97.5%in predicting outcomes for patients with sepsis-induced AKI.Conclusion CysC levels and bedside renal ultrasound can serve as prognostic indicators for patients with sepsis-induced acute kidney injury(AKI),thereby guiding clinical treatment.