OBJECTIVE To evaluate the distribution and drug resistance of pathogens in patients of liver cirrhosis combined with spontaneous bacterial peritonitis(SBP),and provide the credible evidence with the clinic diagnosis and the treatment of SBP.METHODS Totally 113 cases of hospitalized cirrhotic patients with SBP were admitted to our hospital between Mar,2000 and Dec,2005.Ascitic fluids of all cases were cultured.The total 114 strains of pathogens were identified and the drug resistance was analyzed.RESULTS Escherichia coli among the pathogens infected the ascitic fluids rated the top(39.5%),the next were Klebsiella pneumoniae,Enterobacter cloacae and Acinetobacter baumannii.The drug resistance of E.coli to imipenem was the lowest,about 2.2%.CONCLUSIONS The diagnosis of SBP with cirrhosis mainly depended on both of ascites results and clinical symptoms.The clinic should reasonably choose the antibiotics according to the test results of the pathogens sensitivity to drugs.

OBJECTIVE To investigate the ?-lactamase genes and virulence gene in Escherichia coli isolated from the old patients.METHODS Twenty strains of E. coli were selected to test 15 kinds of ?-lactamase genes (TEM,SHV,CTX-M-1 group,CTX-M-2 group,CTX-M-9 group,OXA-1 group,OXA-2 group,OXA-10 group,PER,GES,VEB/CEF,CARB,DHA,ACT/MIR and LAT/CMY) and two virulence genes (CNF-1 and CNF-2).RESULTS Six ?-lactamase genes and one virulence gene have been found out from these 20 strains of E. coli. The results showed that there were 14,3,1,5,2,2 and 1 strain which carried TEM,SHV,CTX-M-1 group,OXA-1 group,DHA,ACT/MIR and CNF-1,respectively. These 20 E. coli strains contained at least 1 ?-lactamase gene and 7 E. coli strains were found containing more than 2 kinds of ?-lactamase at the same time.CONCLUSIONS The resistance of these 20 E. coli strains to ?-lactam antibiotics is closely relative to ?-lactamase.

OBJECTIVE To explore the clinical features of Acinetobacter baumannii lung infection and drug resistance situation.METHODS An analysis was conducted on clinical features and risk factors of 79 cases of A.baumannii lung infection in elderly patients from Jan 2005 to Jun 2008.Drug resistance of A.baumannii to 12 kinds of antimicrobial drugs such as ciprofloxacin,ceftazidime,ceftriaxone,imipenem and amikacin was tested.RESULTS An onset of A.baumannii infections in the lungs of elderly patients usually appeared during the critical period of some underlying diseases.More clinical manifestations as fever,lung and wet La-hypoxemia existed.Accepting antibiotic therapy,pulmonary diseases,mechanical ventilation,ICU wards,etc were the risk factors.There was a high mortality rate with multi-drug resistant(MDR) A.baumannii.Bacterial resistance to cefoperazone/sulbactam,piperacillin/tazobactam was lower while its resistance to other antibiotics was higher.The detection rate of MDR was 37.97%.CONCLUSIONS Elderly patients with A.baumannii infection have a high incidence of lung infection,but lacking characteristic clinical signs and symptoms.There is an increasing trend in the detection rate of MDR.It is of great significance to reduce the incidence rate of A.baumannii lung infection and prevent the spread of multi-drug resistant strains by strengthening the monitoring of pathogens and their resistance and choosing antibiotics according to susceptibility testing.

OBJECTIVE To understand the pathogens spectrum of tuberculosis patients with lower respiratory tract infection in hospital and the drug resistance,so as to provide guidance of rational drug use.METHODS 576 pathogens isolated from the sputum samples of TB patients with lower respiratory tract infection in hospital from 2005 to 2007 and the drug resistance were analyzed.ESBLs test was conducted on the Gram-negative bacill.RESULTS Gram-negative bacilli accounted for 73.6 percent.The first six ones were: Pseudomonas aeruginosa(19.4%),Acinetobacter baumannii(12.0%),Klebsiella pneumoniae(11.1%),E.coli(9.9%),Staphylococcus aureus(9.2%),Candida albicans(8.2%).They were highly sensitive to impinem,Cefoperazone-sulbactam.The drug resistance rates of ESBLs produceing P.aeruginosa and A.baumannii were respectively 2.7%-30.3% and 8.7%-30.4%.The resistance of MRSA to B-lactamase,Fluoroquinolone and Aminoglycoside was 64.7%-100.0%.ESBLs produceing E.coli and K.pneumoniae strains accounted for 52.6% and 45.3%.CONCLUSIONS Lower respiratory tract infection of tuberculosis patients was mainly caused by Gram-negative bacilli,most of which was portunistic pathogens.The pathogens resistance to antibiotics are increasing E.coli and K.pneumoniae produce a higher proportion of EBSLs.To delay the formation of pathogen resistance and control the hospital infection,it is important to enhance drug monitoring and rational use of antibiotics.

OBJECTIVE To investigate the existance of class Ⅰ gene integron and transposon(merA and tnpA) gene marker in Escherichia coli isolated from the elderly patients.METHODS Antibiotic sensitivity was performed by microdilution test.Integron gene IntⅠ1 and transposon marker genes were detected by polymerase chain reaction(PCR).The PCR products were purified and sequenced.RESULTS E.coli resistant to amikacin accounted for 60%,to sulfamethoxazole 95%,and to third-generation cephalosporin 100%(all ESBLs-producing strains).The resistance was related closely to the class Ⅰ integron.The positive rate of integron intⅠ1 was 80%(16/20),whereas the positive rate of gene merA was only 10%(2/20).Gene tnpA was not tested out.CONCLUSIONS The drug resistance of E.coli has close relation with transmission of integron and transposon.The transposons of Tn21/Tn501 are all firstly reported in China.

OBJECTIVE To investigate the genes of disinfectant-sulfadiazine and antibiotic resistance of Escherichia coli strains in elderly wards.METHODS Polymerase chain reaction and dilution test were used to detect and analyze the disinfectant-sulfadizane drug resistance gene and drug resistance of the E.coli.RESULTS From 30 E.coli strains isolated from elderly patients,21 were detected carrying disinfectant-sulfadizine drug resistance genes,and the positive rate of qacE△1-sulⅠ was 70.0%.CONCLUSIONS The detection rate of disinfectant-sulfadiazine drug resistance gene from E.coli strains isolated from elderly patients,the bacteria detection rates are relatively high.Most of the isolates were resistant to commonly used antibiotics.It suggests that clinical drug-resistant strains may be resistant to disinfectants.This condition should be paid much attention by disinfection wotkers of our country.

OBJECTIVE To investigate the ?-lactamases in Klebsiella pneumoniae strains isolated from the elderly patients.METHODS We had an observation on 20 strains of Klebsiella pneumoniae about 15 kinds of ?-lactamase gene test(blaTEM,blaSHV,blaLEN,laOKP,blaCTX-M-1 group,blaCTX-M-2 group,blaCTX-M-9 group,blaOXA-1 group,blaOXA-2 group,blaOXA-10 group,blaGES,blaPER,blaVEB,blaDHA,and blaACT-1).RESULTS Six kinds of ?-lactamase genes had been found out from these 20 strains of K.pneumoniae,namely,blaTEM,blaSHV,blaCTX-M-1 group,blaCTX-M-9 group,blaOXA-1 group,and blaDHA.Their positives were 95%,30%,50%,5%,5% and 15%.Among these 20 strains of K.pneumoniae,there were 19 ones of K.pneumoniae which at least contained 1 kind of ?-lactamase genes.Fifteen strains of K.pneumoniae were found containing more than 2 kinds of ?-lactamase genes,at the same time.Some were even tested out having 4 kinds of ?-lactamase genes.CONCLUSIONS The resistance of ?-lactamase antibiotics of these 20 strains of K.pneumoniae has a close relative to the number of ?-lactamase.

OBJECTIVE To investigate the chloramphenicol-resistant gene in Escherichia coli strains isolated from the old patients.METHODS Twenty strains of E.coli were clinically isolated.The resistance genes were analyzed by polymerase chain reaction(PCR) and verified by DNA sequencing.RESULTS The positive rates of catB and cmlA were 20% and 20%,respectively.Two strains of E.coli were found containing catB gene and cmlA gene.CONCLUSIONS The resistance to chloramphenicol in these 20 strains of E.coli has a close relation to antimicrobial-resistance gene existed,and the genes of catB and cmlA in E.coli are all firstly found and reported in China.

OBJECTIVE To find out the status about detection and drug resistance of Ureaplasma urealyticum(Uu) and Mycoplasma hominis(Mh) of urogenital tract infection in Shaoxing area of Zhejiang Province.METHODS The detections and drug sensitive tests of Uu and Mh adopting the reagent boxes produced by bioMerieux Company in France were made.RESULTS In 2678 samples of suspicious urogenital tract infection patients,980 samples cultured of mycoplasma were positive,and the positive rate was 36.6%.Among these cases,763 samples(28.5%) were Uu positive;116 samples(4.3%) were Mh positive.In the drug sensitive test,Uu and Mh were most sensitive to PRI,JOS,DOX and TET.To CFLX,OFL,ERY,CM and AM,they had the highest level of drug resistance.CONCLUSIONS The clinical therapy of mycoplasma infection ought to choose the appropriate antibiotics based on the results of the drug sensitive test of the laboratory.

OBJECTIVE To investigate the prevalence of sulfamethoxazole/trimethoprim(SXT)-resistance genes and drug resistance in Escherichia coli isolates from the old patients.METHODS Drug resistance of 20 E.coli strains were analyzed.The SXT-resistance genes(sul1,dfrA1,dfrA12 and dfrA17)were detected by polymerase chain reaction(PCR).The PCR products were purified and sequenced.RESULTS In 20 E.coli strains,95.0% were SXT resistant.The positive rate of genes of sul1,dfrA12 and dfrA17 were 80.0%,20.0% and 65.0%.Gene of dfrA1 was not detected out,17 strains of E.coli were found dfrA gene.The SXT-resistance gene dfrA or sul1 was detected in 18 of the 20 strains.CONCLUSIONS The SXT resistance of E.coli can be caused mainly by gene expression of dfrA and sul1,and the genes of sul1,dfrA12 and dfrA17 are all firstly found and reported in China.