OBJECTIVE To investigate the antibacterial activity of cefoperazone/sulbactam to Gram-negative bacilli in vitro.METHODS Gram-negative bacilli were isolated from various clinical specimens in our hospital from Jan 2004 to Dec 2007,screened by Gram-staining and oxidase test.The strain identification and the antimicrobial susceptibility test were determined by VITEK-60 Full Automated Microbiology Analyzer and slip diffusion method,respectively.The results of the survey were retrospectively reviewed.RESULTS The resistance rates of Enterobacteriaceae to cefoperazone / sulbactam were very low,the rates of Escherichia coli,Klebsiella pneumoniae and Enterobacter cloacae were 6.9%,9.2%and 12.9%,respectively;and the rates of Acinetobacter baumannii,Chryseobacterium meningosepticum,Pseudomonas aeruginosa,Stenotrophomonas maltophilia and Burkholderia cepacia were 7.7%,8.1%,20.4%,21.5% and 34.1%,respectively.CONCLUSIONS The antimicrobial activity of cefoperazone/sulbactam to Enterobacteriaceae and non-fermentation bacteria(A.baumannii,Ch.meningosepticum) is strong.The resistant rate of other Gram-negative bacteria to cefoperazone/sulbactam is less than 40 percent.In the treatment of infection caused by Gram-negative bacilli,cefoperazone/sulbactam has a very good prospect.

OBJECTIVE To investigate the antimicrobial resistance profile of Burkholderia cepacia isolated from clinical specimens in past 3 years.METHODS The B.cepacia strains were isolated from various clinical specimens by routine method from Jan 2004 to Dec 2006.In our hosptial the identification and antimicrobiol susceptibility test were determined by VITEK-32 Full Automated Microbiology Analyzer.RESULTS A total of 126 strains of B.cepacia were isolated.From them 75.14% and 15.08% of isolates were from lower respiatory tract and blood.All isolates were resistant to aminoglycosides,ampicillin,ampicillin/sulbactam,amoxicillin/CLAB,cefazolin,nitrofurantoin,and imipenem.The antibiotic resistant rates of the isolates to SMZ+TMP,cefepime,cefoperazone/sulbactam,meropenem,ceftazidime and piperacillin/tazobactam were 5.10%,16.99%,39.18%,39.61,39.65% and 48.12%,respectively.CONCLUSIONS The detection and antimicrobial resistance of the isolates of B.cepacia are increasing gradually.Multidrug resistance in the isolates of B.cepacia is serious.

OBJECTIVETo evaluate the clinical application of microsurgical fascia latae flaps combined with rib and skin graft for reconstruction of the distal phalanx defect.

METHODSThe phalanx wounds were sutured together like syndactyly. The autologous rib was revised to repair the bone defect of distal phalanx. The fascia latae flap was used to cover the bone exposure with microvascular anastomoses and resurfaced by a meshed split-thickness skin graft.

RESULTS5 cases were treated successfully. The fascia latae flaps were all survived with only skin graft necrosis at the distal end in one case. It was healed spontaneously.

CONCLUSIONSThe fascia latae flap is nourished by the descending branch of the lateral circumflex femoral artery. The flaps has a good blood supply and can be easily obtained with a long vascular pedicle. The flap is ideal for the reconstruction of distal phalanx defect when combined with autologous rib implant and skin graft.

Adolescent ; Adult ; Fascia Lata ; transplantation ; Female ; Finger Injuries ; surgery ; Hand Injuries ; surgery ; Humans ; Male ; Reconstructive Surgical Procedures ; methods ; Ribs ; transplantation ; Skin Transplantation ; methods ; Surgical Flaps ; blood supply ; Young Adult