Objective To explore the in vitro activities of antimicrobial agents including fosfomycin tromethamine against Enter-obacteriaceae isolates from urine samples and provide evidence for reasonable use of antibiotics.Methods A total of 1 185 Enter-obacteriaceae isolates from midstream urine samples were identified by ATB system.Antimicrobial susceptibility and ESBLs production were tested by Kirby-Bauer method.The results were analyzed according to the breakpoints of CLSI 2012.WHO-NET 5.6 software was used to retrospectively analyze the distribution and antibiotic susceptibility of pathogenic bacteria.Re-sults Overall,about 90.8% of the 1 185 isolates tested were susceptible to fosfomycin tromethamine.The top three species of bacteria showing the highest suceptibility rate to fosfomycin tromethamine were Escherichia coli (93.1%),Klebsiella pneu-moniae (88.7%),and Proteus spp.(79.7%).The Enterobacteriaceae isolates from urine samples of inpatients were less sus-ceptibe to the antimicrobial agents tested compared to the isolates from outpatients (87.0% versus 92.7% susceptible).ESBLs were identified in 54.4% of Escherichia coli ,38.7% of Klebsiella pneumoniae and 23.2% of Proteus strains.The ESBL-pro-ducing E.coli (89.5%)and K.pneumoniae (87.5%)were highly susceptible to fosfomycin tromethamine.Conclusions Esch-erichia coli is the most popular Enterobacteriaceae isolated from urine samples.Fosfomycin tromethamine has good in vitro an-tibacterial activity against Enterobacteriaceae strains,including ESBLs-producing E.coli and K.pneumoniae.Fosfomycin tromethamine is a valuable therapeutic option for urinary tract infections.

Objective To verify if the multidrug resistant stains of P.aeruginosa isolated from different patients in burn ward have the same origin. Methods The susceptibility testing was performed with Etest,and the strains were typed by rep PCR with the primer ERIC2 and M13 following electrophoresis in agarose gel. Results There were multidrug resistant P.aeruginosa strains in burn ward,and analysis of the PCR productions indicated that all these multidrug resistant strains have an identical band pattern different from the sensitive strains. Conclusions The multidrug resistant strains of P. aeruginosa derive from a common origin.

OBJECTIVE To investigate the epidemic characteristics and drug resistance profile of clinical bacteria in hematology ward of our hospital. METHODS The susceptibility testing of clinical isolates from hematology ward was performed and the ESBLs producing strains were detected using K-B method.The results were analyzed by WHONET5. RESULTS Out of the 397 clinical isolates, 65.2% were Gram-negative bacilli and 34.8% were Gram-positive cocci.In Gram-negative bacilli,55% were Enterobacteriaceae and 44% were nonfermenting Gram-negative bacilli.In Gram-positive cocci,60.8% were Staphylococcus spp and 38.4% were Enterococcus spp.The ESBLs producing strains in Escherichia coli and Klebsiella spp were 55.8% and 19.2%,respectively.The MRSA in S.aureus and MRCNS in coagulase negative Staphylococcus were 40.9% and 95.2%,respectively.No resistance to carbapenem was detected in Enterobacteriaceae and no resistance to vancomycin was detected in Gram-positive cocci.The resistance rate of nonfermenting Gram-negative bacilli to cefoperazone/sulbactam was less than 2.1%. CONCLUSIONS The data will be useful for the early empiric administration of antimicrobial agent in hematology ward.

OBJECTIVE To evaluate the effect of delayed entry(0-24 h) into BacT/Alert 3D and BACTEC 9120 and the effect of 2 incubation temperatures(22 ℃ vs 35 ℃) on culture positivity.METHODS We utilized the BacT/Alert system with FA bottles and the BACTEC 9120 system with Plus(Aerobic) bottles.Four clinical bacterial species,Staphylococcus aureus,Escherichia coli,Streptococus pneumoniae,Candida albicans,were used as the test strains.and 5 ml of blood were added to each bottle.Each species was inoculated into the bottles 3 times at an inoculum size of 10 CFU/ml,102 CFU/ml and 108 CFU/ml,respectively.The inoculated bottles were cultured using the respective instruments after they were allowed to stand at room temperature(22 ℃)and 35 ℃ for 0,8,16 and 24 h.Time-to-detection and culture positivity were evaluated.RESULTS The delay in transportation of blood culture bottles stored at room temperature(22 ℃) or 35 ℃ had no effect on the recovery rate for BACTEC 3D at less than 24 h preincubation time and for BacT/Alert 9120 at less than 16h preincubation time.The positivity rate decreased significantly for BacT/Alert 9120 for 24 h of delay.Culture positivity of BacT/Alert 3D was higher than BACTEC 9120 for 24 h of delay.CONCLUSIONS The delayed entry for BacT/Alert 3D should be within 24 h,but the delayed entry for BACTEC 9120 should be within 16 h.

Objective: To establish a RP-HPLC method for the determination of icariin in Bushenning Capsules. Methods: The sample was prepared by water extraction-purfication through polyamide column. The determination was carried out on C 18 ODS column with mobile phase of acetonirile-water (23∶77), and detection wavelength at 270nm according to the external standard method.Results: The icariin sample size showed a good linear relationship at the range of 0.12-1.91ug and correlation coefficient was 0.9999. The average recovery of the added sample was 99.21%(n=5) and RSD was 1.79%. The RSD in a duplicate test was 2.18%.Conclusion: The method is simple, accurate, reproducibe and can be used for content determination of icariin of icariin of Bushenning Capsules.

Objective: To establish a new method and limit of detection for Flavonoids content in Fructus Crataegi. Methods: Flavonoids in Fructus Crataegi in 10 regions was determined by colorimetry. Results: Content of Flavonoids in samples selected from 10 regions ranged 0.84%～3.62%. Content of hyperoside by colorimetry is correlative to that by HPLC. Conclusion: The method is simple, quick and reproducible. Flavonoid content in Fructus Crataegi was designed no less than 1.0%, extraction must be performed under 60?C and dried to constant weight for 6 hours.

Objecive To investigate the prevalence of NDM-type carbapenemases in the carbapenem-resistant Escherichia coli strains collected from Ruijin Hospital, Shanghai Jiaotong University School of Medicine. The epidemiological characteristics of NDM-type carbapenemase-producing isolates were analyzed.Methods Eighteen strains were collected from November 2013 to January 2015 in the clinical microbiology laboratory of Ruijin Hospital. All of them were resistant to imipenem or meropenem (inhibition zone diameter≤19 mm). The blaNDM gene was detected by PCR. The amplified products were subjected to sequencing analysis. Conjugation experiment was carried out to verify the transferability of plasmids. Multilocus sequence typing (MLST) and pulsed field gel electrophoresis (PFGE) were performed to analyze the molecular epidemiology.Results The blaNDM gene was identified in 6 strains, 4 of which had blaNDM-1-type and 2 had blaNDM-5-type carbapenemase gene. Three strains were positive in the conjugation experiment. MLST analysis showed that 6 NDM carbapenemase-producing isolates belonged to ifve sequence types, corresponding to five PFGE-DNA patterns (A-E). Two of these isolates shared the identical sequence type (ST5018) and nearly the same PFGE-DNA patterns (A1, A2).Conclusions NDM-type carbapenemase-producing E. coli is identified in this study. Most blaNDM-positive cases were sporadic. Plasmid might play an important role in the spread of blaNDM inE. coli. The blaNDM-5 type carbapenemase gene was first identified in Shanghai, to which more attention should be paid.

Objective To analyze the distribution and antimicrobial resistance of pathogenic bacteria in urinary tract infection (UTI)so as to provide evidence for appropriate selection of antimicrobial agents in clinical practice. Methods From January 2001 to December 2008 in Shanghai Ruijin Hospital,4683 strains of pathogenic bacteria isolated from urine samples were detected by ATB system;drug susceptibility test was performed with disk diffusion method and pathogenic bacteria distribution and drug resistance was analyzed with WHO NET 5.3 software. Results Among 4683 strains of pathogenic bacteria,most was gramnegative bacilli,accounting for about 77.8%,of which predominant strain was Escherichia coli (68.7%,3217/4683).The predominant strain of gram-positive bacteria was Enterococcus faecalis,accounting for 10.0%(468/4683).Escherichia coli showed hish resistance rotes to ampicillin,piperacillin and compound snlfamethoxazole(SMZ-TMP),which were 76.6%,61.7%and 57.4%respectively,while a low resistance to imipenem,cefoperazone-sulbactam,piperacillin-tazobactam,Enterococcus faecalis showed high resistance rates to erythromycin,gentamicin and levofloxacin,which were 65.8%,43.2%and 31.1%respectively,and were most susceptive to vancomycin and teicoplanin, both with resistance rates of 0. The susceptibility rate of Enterobacteriaceae to imipenem was 100%. From 2006 to 2008, the detection rate of extend-spectrum β-lactamases ESBLs -producing Escherichia coil in outpatient increased year by year, from 28.7% to 43.3% (P＜0.05), whereas no significant change was found in inpatients. The detection rate of (ESBLs)-producing Escherichia coil in inpatients was significantly higher than that in outpatients (P＜0.05).The detection rate of ESBLs-producing Escherichia coil was 23.6%. The antimicrobial resistance rate in elderly patients was significantly higher than that in overall antimicrobial resistance rote (P＜0.05). Conclusions The predominant bacteria of UTI are still gram-negative bacteria, main of which is Escherichia col. Bacteria are resistant to a variety of antibiotics. Approximate selection of antibiotics in clinical practice should be made on the basis of susceptibility test results.

Objective To investigate the prevalence and main genotypes of carbapenemases in carbepenem‐resistant Enterobacteriaceae (CRE) .Methods A total of 114 strains of CRE were isolated in Shanghai Ruijin Hospital from May 2011 to June 2013 .The diameter of inhibition zone of imipemen or meropenem for these strains was not larger than 22 mm .PCR method was used to screen for the main carbapenemase genes (blaKPC ,blaIMP ,blaVIM ,blaOXA‐48 and blaNDM ) with previously described primers followed by nucleotide sequencing analysis . Conjugation experiments were performed to examine the transferability of plasmids .Pulsed‐field gel electrophoresis (PFGE) was used to show the relatedness of KPC‐2‐producing Enterobacteriaceae .Results Most of the 114 isolates were K lebsiella pneumoniae and Escherichia coli .Of the 114 isolates ,98 was positive for carbapenemases ,specifically ,78 blaKPC‐2‐positive ,15 blaIMP‐4‐positive ,2 blaIMP‐8‐positive ,1 positive for both blaKPC‐2 and blaIMP‐4 and 4 blaNDM‐1‐positive .None of the strains was positive for blaOXA‐48 or blaVIM .About 21 .4% (21/98) of the isolates were conjugated successfully .The 49 blaKPC‐2‐positive K .pneumoniae isolates were grouped into 12 types according to PFGE patterns .Majority (34/49) of these isolates belonged to the same type A .Conclusions BlaKPC‐2 was the primary epidemic genotype of Enterobacteriaceae in Ruijin Hospital ,followed by blaIMP‐4 .NDM‐1 carbapenemase was produced in 4 strains of CRE . Meanwhile , clonal spread of KPC‐2‐producing K . pneumoniae was observed in some departments of our hospital , such as surgical ICU , respiratory medicine and thoracic surgery . Appropriate measures should be taken timely and effectively to prevent the in‐hospital spread of resistant genes .

Object To look for the proprietary constituent and the constituents with blood lipid regulating effect from the dried fruit of Crataegus pinnatifida Bge var major N E Br Methods Various column chromatographic techniques were employed for isolation and purification of the constituents UV, IR, EI MS, FAB MS, 1HNMR, 13 CNMR, HMBC, HMQC and 13 CGATE were used to identify the structure of the isolated constituents Results Six compounds were isolated from the fruit of C pinnatifida They were identified as 5, 7, 4′ trihydroxy flavone 8 C ? L rhamnopyranosyl (1→2) ? D glucopyranoside, i e vitexin rhamnoside (Ⅰ), hyperoside (Ⅱ), citric acid (Ⅲ), vitexin (Ⅳ), quercetin (Ⅴ), ursolic acid (Ⅵ) Conclusion Compound Ⅰ is a proprietary constituent in the fruit of C pinnalifida, which was obtained from this plant for the first time Compound Ⅱ is a main constituent with blood lipid reducing effect in flavonoids