OBJECTIVE To analyze the resistance of Pseudomonas aeruginosa (PAE) isolated from clinical specimen and provide the guidance for the clinical treatment. METHODS The P. aeruginosas infection status from Jun 2005 to Dec 2007 was reviewed retrospectively,and the results of susceptibility test in 286 strains of PAE were analyzed. RESULTS The drug-resistance rates to gentamicin,cefotaxime,and ceftriaxone in PAE were all above 60.0%,and that to cefoperazone/sulbactam,piperacillin/tazobactam sodium,amikacin and levofloxacin showing all higher sensitivity. The resistance rates to meropenem and imipenem were 17.1% and 18.5%,respectively. CONCLUSIONS P. aeruginosa is one of the main pathogenic bacteria in nosocomial infection. It's very important to strengthen the monitoring of drug-resistance of PAE and rationally antibiotics usage.

OBJECTIVE To investigate the resistance of meticillin-resistant Staphylococcus aureus(MRSA) and the occurrence of gene erm.METHODS ATB Staph and microdilute tests were performed to detect the susceptibility to 15 kinds of antibiotics in 50 strains of the S.aureus(SAU).Gene erm of these strains was detected by polymerase chain reaction(PCR).RESULTS There were no strains resistant to vancomycin,teicoplanin,fusidic acid and quinupristin-dalfopristin in 42 strains of MRSA detected.There were no strains sensitive to penicillin,oxacillin,gentamicin,tetracycline,ciprofloxacin and levofloxacin.Thirty-five strains habored gene erm in 42 strains of MRSA.The positive rate of gene erm was 83.3%.CONCLUSIONS The multiple-resistance of the MRSA is a serious issue.The resistance to erythromycin in MRSA is mediated by gene erm which encodes the methylase and changes the target site of drug action.

ObjectiveThe clinical features, bacteria distribution and antibiotic resistance proifle of blood stream infection(BSI) were investigated in the patients with decompensated liver cirrhosis for better management of such infections.MethodsThe clinical data of BSI were collected in the patients with decompensated liver cirrhosis between January, 2012 and December, 2014, and reviewed retrospectively in terms of risk factors, diagnosis and treatment, pathogen distribution and prognosis.ResultsOf the 1 071 patients with decompensated liver cirrhosis and suspected bacterial infection, 154 (14.4%) were diagnosed as BSI evidenced by blood culture. Of these patients, the leukocyte count in the peripheral blood was higher than 10×109/L in only 48 (31.2%) patients; neutrophil proportion>0.75 in 133 patients (86.4%); serum procalcitonin level>0.5 ng/mL in 74 patients (68.5%). A total of 155 bacterial strains were isolated, including 115 strains of gram-negative bacilli and 40 strains of gram-positive cocci. Most patients (68.8%) recovered and 31.2% died or discharged from hospital voluntarily. All these BSI patients had Child-Pugh grade C liver function. Some patients also had other serious systemic diseases or repeated hospitalization.ConclusionThe prevalence of BSI is high in the decompensated liver cirrhosis patients with poor prognosis. Gram-negative bacilli are the major pathogens of such septicemia. Early diagnosis and proper use of antibiotics based on antimicrobial susceptibility testing are important to improve patient outcome.

OBJECTIVETo make a comparatively analysis of the effects of 10% KCl injection into the fatal cardiac area and yolk-sac aspiration on multifetal pregnancy reduction.

METHODSTwenty-three patients with multifetus were selected in the investigation. Eight of the patients accepted 10% KCl injection into the fatal cardiac area, and 15 of them received yolk-sac aspiration. The average number of punctures, average time of reduction operation, failure rate of operation, abortion rate, and infection rate were observed.

RESULTSThe average time of reduction operation[(2.8 +/- 0.7) min] of aspiration was significantly lower than that of 10% KCl injection [(5.11 +/- 1.35) min] (P < 0.05). The infection rate of yolk-sac aspiration was 6.7%, lower than that of 10% KCl injection (37.5%) (P > 0.05). Cardic area injection showed a higher infection rate, and no significant difference was observed in the average number of punctures, failure rate of operation and abortion rate(P > 0.05).

CONCLUSIONAlthough both yolk-sac aspiration and cardiac area injection were safe and reliable methods for multifetal pregnancy reduction, the former is worth recommending for its shorter operation time heeded and lower infection rate, especially for the multifetal patients within 60 gestation days.

Adult ; Female ; Humans ; Postoperative Complications ; etiology ; Potassium Chloride ; administration & dosage ; Pregnancy ; Pregnancy Reduction, Multifetal ; adverse effects ; methods ; Ultrasonography, Prenatal

Objective:To construct and implement an evidence-based practice protocol for the prevention of surgical site infections (SSI) in pediatric patients undergoing orthopedic implant surgery based on the best available evidence, and to evaluate its effectiveness in a clinical setting.Methods:Adhering to the standard procedures of a continuous quality improvement model based on evidence, evidence was transformed into clinical practice through four stages: evidence acquisition, current status review, evidence introduction, and effect evaluation. Totally 301 pediatric patients who underwent orthopedic implant surgery from March to December 2021 at Guangzhou Women and Children's Medical Center, along with 79 medical staff involved in the project implementation were selected by convenience sampling. Patients were divided into three groups according to the time of admission for baseline review (from March to May, n=106), first-round review post-implementation of the evidence-based protocol (from June to August, n=110), and second-round review (from September to December, n=85). Comparisons were made regarding the incidence of SSI in pediatric patients before and after the application of the evidence-based protocol, the knowledge level of medical staff concerning SSI associated with orthopedic implant surgeries in pediatric patients, and the execution of review indicators before and after the application of evidence. Results:Following the implementation of the evidence-based protocol, the incidence of SSI in pediatric patients undergoing orthopedic implant surgery reduced significantly from 8.49% in the baseline review to 0 in the second-round review ( P<0.05). Furthermore, there was a statistically significant increase ( P<0.01) in the scores denoting the knowledge level of medical staff on SSI associated with such surgeries, from (75.91±11.19) to (96.42±7.13). Comparison of the execution of review standards before and after evidence application revealed statistically significant differences ( P<0.05 in all cases) . Conclusions:The initiation of this evidence-based practice project can standardize perioperative diagnostic and nursing behaviors of orthopedic implant surgery in medical and nursing staff, effectively safeguard the safety of pediatric patients, and reduce the occurrence of SSI.