Objective To realize detection,antimicrobial resistance,and ward distribution of imipenem-resistant Acinetobacter baumannii (IRAB )from sputum.Methods AB strains isolated from sputum specimens in a hospital between January 1 ,2009 and September 30,2013 were analyzed retrospectively.Ward distribution,antimicrobial resistance,and isolation rates between IRAB and non-IRAB strains were compared.Results 711 AB strains were isolated from sputum,442 of which were IRAB,269 were non-IRAB.AB were mainly distributed in intensive care unit(ICU,39.10%)and neurology department (25.18%);detection rate of IRAB was significantly higher than non-IRAB in ICU (57.47%[n=254]vs 8.92%[n=24],χ2 =165.50,P <0.05),detection rate of IRAB in ICU was significantly higher than non-ICU (91 .37% vs 43.42%,χ2 =257.29,P <0.05).Detection rates of IRAB in 2009-2013 increased continuously (25.30%,36.36%,74.68%,65.56%,and 90.07%,respectively).The resistant rate of IRAB to amikacin was low (27.25%),resistant rates of non-IRAB to amikacin and piperacillin/tazobactam were both low (7.31 % and 8.24% respectively);except compound sulfamethoxazole,resistant rates of IRAB to other antimicrobial agents were all significantly higher than non-IRAB strains (all P < 0.05 ).Conclusion The detection rate and drug resistant rate of IRAB from sputum are both high,early culture,early treatment,and early isolation should be carried out to reduce the emergence of multidrug-resistant organisms.

Objective To understand the distribution and drug resistance change trend of pseudomonas aeruginosa (PA) in hospital clinical infection in order to provide laboratory basis for rational clinical use of medications.Methods Statistical analyses was conducted retrospectively in 818 strains of PA separated in our hospital from January 2007 to December 2011.Results Of all the separation,PA number of the pathogen constituted a ratio of 15.2％ (818/5365) ; The main source of specimens was sputum,accounting for 82.6％ (676/818).There was good antimicrobial activity of Imipenem,Piperacillin/Tazobactam,Aztreonam,Ceftazidime,Levofloxacin and Ciprofloxacin to PA,with resistance rates of 14.9％ (97/653),25.0％ (179/716),26.8％ (179/667),26.9％ (208/773),28.6％ (211/738) and 29.1％ (220/757) respectively; The resistance of Ciprofloxacin and Levofloxacin did not change significantly during 2007-2010 year,but in 2011 year a significant decrease of resistance rates was found (ciprofloxacin:35.1％ (175/498) vs.17.4％ (45/259) ; Levofloxacin:38.0％ (181/476) vs.11.5％ (30/262)) ; During 2009-2011 year,the resistance of Imipenem and Amikacin increased year by year (Imipenem:7.4％ (9/121) vs.7.7％ (66/209) vs.19.5％ (51/262) ; Amikacin:13.0％ (2/23) vs.33.3％ (69/207) vs.36.2％ (94/260)).Conclusion PA detection rate and its resistance is rising from 2007 to 2011 year.We should make rational drug use clinically according to antimicrobial susceptibility test results.Laboratories shall strengthen the bacterial resistance monitoring.

Objective To compare distribution and drug resistance of Acinetobacter baumannii specimen in the intensive care unit(ICU) and the ICU.Methods Retrospective analysis ICU of 1 079 strains isolated and the 8 413 strains of bacteria isolated from ICU , Bacteria identification and drug sensitive test instrument using VITEK 2 Compact automatic bacterial culture identification .Results Most ICU Acinetobacter baumannii separation , form (29.2%) was significantly higher than the ICU (6.2%),the difference was statistically significant (χ2 =625.955, P<0.05).ICU imine resistant Acinetobacter baumannii from south (IRAB)detection rate(91.7%)was significantly higher(43.5%) than the ICU,difference was statistically significant (χ2 =193.541,P<0.05);Specimens of ICU and the ICU isolated bacteria were mainly comes from sputum ,constitute a ratio of 64.0%and 32.9%respectively. ICU and the separation of the ICU Acinetobacter baumannii to amikacin resistant rate was low (20.0%-21.6%),the separation of ICU Acinetobacter baumannii for three or four generation of cephalosporin , composite inhibitor drugs , penicillium carbon alkene ,quinolone antibacterial drugs ,significantly higher percentages of ICU ,difference was statis-tically significant(χ2 =146.124,104.407,253.171,195.646,186.580,all P<0.05).Conclusion Multiple drug resistance of Acinetobacter baumannii in ICU detection rate is high ,the bacteria monitoring should be strengthened , and the rational use of drugs ,reduce the drug resistance of bacteria .

Objective To understand the hospital intensive care unit(ICU) pathogenic bacteria distribution and drug resistance for providing the basis for rational drug use and hospital infection control and prevention.Methods The drug resistance of 749 strains of pathogenic bacteria the separated from ICU was analyzed from January 2009 to December 2012.VITEK 2 Compact automatic bacteria identification instrument was used to detect bacteria identification and drug sensitive test using.Results There were Acinetobacter baumannii(208 strains,27.8％),Pseudomonas aeruginosa(108 strains,14.4％),E.coli (96 strains,12.8 ％),Staphylococcus aureus (76 strains,10.1％),Klebsiella pneumoniae(62 strains,8.3％) mainly accupied in 749 strains of pathogenic bacteria.The species was mainly from sputum specimens sources (503 strains,67.2％) ; the separation rate of Methicillin-resistant staphylococcus aureus (MRSA) was 82.9％ (63/76) ; the separation rate of Imine resistance from South pseudomonas aeruginosa(IRPA) was 22.2％ (24/108) ; the separation rate of resistance to carbon penicillium alkene antimicrobial acinetobacter baumannii (CR-AB) was 88.0％ (183/208).The resistant rate of Acinetobacter baumannii to amikacin was from 28.6％ to 31.5％,the other 20 kinds of antimicrobial drug resistant rate was as high as 81.6％-100.0％ ; Pseudomonas aeruginosa to ciprofloxacin,ofloxacin,aztreonam and piperacillin/tazobactam resistant rate of 11.6％-25.0％.Conclusion Detection of pathogens in ICU,multi-drug resistance is serious,the hospital should strengthen the bacterial drug resistance monitoring,rational use of antimicrobial drugs,reduce the nosocomial infection.

Objective To retrospectively analyze the drug resistance evolution of Staphylococcus aureus and MRSA,to provide the basis for prevention and control measures.Methods 576 strains of clinical isolated Staphylococcus aureus from 2009 to 2012 were analyzed.The bacteria identification and drug sensitivity test were detected by VITEK 2 Compact automatic bacteria identification instrument.Results The separation rate of MRSA from 2009 to 2012 was 59.5％,but the separation rate was gradually decreased per year.The antibacterial activity of MRSA was better to vancomycin,linezolid,quinupristin/Dalfopristin,teicoplanin,nitrofurantoin (resistance rate ＜ 2.4％).The resistance rate and sensitive rate of MRSA to tigecycline was 0.0％,intermediary rate was 100.0％.The resistance of MRSA to gentamicin,ciprofloxacin,moxifloxacin,clindamycin,tetracycline and erythromycin was gradually decreased.From 2010 to 2012,The resistance of MRSA to cotrimoxazole decreased significantly,from 65.3％ in 2010 to 28.2％ in 2011 and 4.7％ in 2012 (P ＜ 0.05).Conclusion Separation of MRSA and drug resistance is reduced year by year,we should continue to strengthen the administration of antimicrobial agents,scientific and reasonable application of antibacterial drugs,reduce the incidence of multiresistant bacteria and drug resistance.

Objective To investigate the distribution of the Bauman acinetobacter baumannii (IRAB) resisted to imipenem and character of drug resistance.Methods Retrospective analyzed 517 strains of IRAB and 319 strains of imipenem drug resistance of acinetobacter baumannii from South Africa (not IRAB) by VITEK 2 compact automatic bacterial culture identification.Results IRAB positive rate was 61.8％ (517/836).The main source of IRAB was from sputum(85.5％ (442/517)).The constitute ratio of main areas in IRAB was ICU ward (55.9％) and only 7.8％ in non-IRAB.The resistant rate of IRAB to amikacin was 27.2％.The resistant rate of non-IRAB to Amikacin and piperacillin/tazobactam were 8.0％ (21/262),8.2％ (26/317),suggesting the good antibacterial activity.In terms of rate of resistance drug,apart from Cefazolin,Cefotetan,Cotrimoxazole,Nitrofurantoin,the sort of antibacterial drugs against IRAB was obviously higher than that of non-IRAB,and difference was statistically significant (P ＜ 0.05).Conclusion Drug resistance surveillance should be strengthened because of high detection rate and drug resistance in ICU in terms of IRAB.Combination therapy and related intervention measures might effective control of infection and IRAB.

Objective To understand the antibacterial activity of nitrofurantoin from gram negative bacilli,provide the basis for clinical rational use of furan appropriate for drugs.Methods Gram negative bacilli 5 589 strains isolated from clinical were monitored between January 2009 and December 2009.VITEK 2 Compact automatic bacteria identification instrument was used for bacteria identification and drug sensitive test.Whonet 5.6 software was used for data analysis.Results E.coli and klebsiella bacteria produced acid with nitrofurantoin had good antibacterial activity (resistance to ＜ 4.3%),E.coli and klebsiella pneumoniae to with nitrofurantoin for antimicrobial activity was good (the percentages of 25.6% ～ 25.6%),pseudomonas aeruginosa,acinetobacter baumannii,singular deformation bacteria and glue abdulrahman al saleh,bacterium antibacterial activity of furan appropriate for poorer(ni 93.7% ～ 98.9%).Imine resistance from south pseudomonas aeruginosa (IRPA),resistant to carbon penicillium alkene antimicrobial acinetobacter baumannii(CR-AB) and penicillium carbon alkene antimicrobial drug resistant enterobacteriaceae bacteria(CRE) with nitrofurantoin because of the percentages were 100.0% (108/108),100.0% (335/335) and 96.1% (74/77).Conclusion Urine,blood,pus,and secretion of primary separation of E.coli with nitrofurantoin has better antimicrobial activity; Sputum specimens of primary separation of pseudomonas aeruginosa and acinetobacter baumannii with nitrofurantoin has the high prevalence of resistance.

Objective To analyze clinical distribution and change in drug resistance of Acinetobacter baumannii (A.baumannii)in 2009-2013,guide clinical rational antimicrobial use,and reduce healthcare-associated infection rate.Methods 919 A.baumannii isolates were isolated from inpatients and outpatients in a hospital between Janu-ary 2009 and December 2013,specimen and department sources,as well as change in drug resistance of A.bauman-nii were analyzed.Results A total of 10 273 pathogens were isolated from 2009 to 2013,the constituent ratio of A.baumannii in each year was 7.98%(n=93),11.31%(n=155),10.22%(n=185),7.73%(n=217),and 8.62%(n=269)respectively;the constituent ratio of imipenem-resistant A.baumannii was 24.73%,38.06%,71.89%, 64.52%,and 86.99% respectively;the main specimen source was sputum (83.68%);the major department sources were intensive care unit(ICU,39.28%),department of neurology (20.78%),and department of respiratory medi-cine(8.60%).The resistant rate of A.baumannii to most antimicrobial agents increased,the resistant rates to imi-penem and piperacillin/tazobactam increased from 24.73% and 4.44% in 2009 to 86.99% and 86.25% in 2013 re-spectively;resistant rate to sulphamethoxazole/trimethoprim decreased from 91.30% in 2009 to 27.14% in 2013;in 2013,except resistant rates to amikacin and sulphamethoxazole/trimethoprim were low (20.82% and 27.14%respectively),resistant rates to the other 11 kinds of antimicrobial agents were all >83.64%.Conclusion The iso-lation rate of A.baumannii is high in this hospital,the main specimen source is sputum,the main department source is ICU;antimicrobial resistant rate of A.baumannii is high,prevention and control of infection and trans-mission of A.baumannii should be strengthened.

The paper described the building of a nursing team in a newly built hospital.The process consists of setting up the nursing department in advance and developing rules and regulations;enhancing nurse rotations and training to enhance their professionalism; building a seamless communication to make a supportive environment and sense of belongings; enhancing education of professional spirit to train the nurses to respect their career.All these provide the hospital with solid support of nursing team building.

Objective To study the safety,efficiency and feasibility of increase the aminotic fluid volume by transabdominal amnioinfusion(AI). Methods Thirty-three patients were selected according to the following criteria: oligohydramnios or borderline oligohydramnios found by B ultrasound ,indications of vaginal delivery and with cephalic presentation,and who is ready to receive AI. After located by puncture bougie,at most 380 ml saline solution at 37℃ were infused into the amniotic cavity. Results AI was accomplished in 32 of 33 cases (96.97%). Premature rupture of membrane occurred in one case (3 03%). No placental abruption and infection or other complications happened. Twety-five patients (75.76%)successed in vaginal delivery. Cesarean sections were performed in 8 cases (24 24%) because of encephalopelvic disproportion,cord prolapse and fetal distress. No neonatal asphyxia happened. Conclusion Amnioinfusion can effectively increase amniotic fluid volume,create favorable conditions of vaginal delivevy for oligohydramnios and decrease the incidence of cesarean section as well as improve perinatal outcome.