OBJECTIVETo investigate the correlation between Shigella flexneri multi-drug resistance and drug resistance gene cassette of integrons.

METHODAll 79 strains of Shigella flexneri were isolated from the feces of children ranged in age from 6 months to 14 years in some hospitals of Jinan, between May 2009 and April 2012.The resistance was detected by Kirby Bauer agar diffusion method, 1, 2 and 3 integron gene was amplified by PCR, the variable region of positive strains treated with enzyme digestion and determined by Series Analysis.

RESULTAmong 79 Shigella flexneri strains, the resistance rate was 91% (72/79) to ampicillin, chloramphenicol, tetracycline, streptomycin, 70% (55/79) to sulfamethoxazole/trimethoprim, 30% (24/79), 23% (18/79), 33% (26/79) and 32% (25/79) to cefotaxime, ceftazidime, ciprofloxacin and levofloxacin.All 79 strains were susceptible to cefoxitin, imipenem, cefoperazone/sulbactam. The common drug resistance pattern is ampicillin tetracycline-chloramphenicol-streptomycin, accounted for 91% (72/79); 91% (72/79) strains carried integrons of class 1, 86% (68/79) strains carried integrons of class 2, No intI3 was detected. The resistance to ampicillin, streptomycin, tetracycline, chloramphenicol of atypical class 1 integron positive strains was significantly higher than the negative strains (χ² = 35.96, P<0.01). The sequencing results:dfrV was detected in class 1 integron variable regions of 9 strains, dfrA17-aadA5 in 2 strains, blaOXA-30-aadA1 in 70 strains, 2 strains were not detected resistance gene cassette, all resistance gene cassettes were dfrA1-sat1-aadA1 in class 2 integron variable regions.

CONCLUSIONThe muti-drug resistance of Shigella flexneri in Jinan was closely associated with integrons.

Adolescent ; Anti-Bacterial Agents ; pharmacology ; Child ; Child, Preschool ; Drug Resistance, Multiple, Bacterial ; genetics ; Dysentery, Bacillary ; microbiology ; Feces ; microbiology ; Humans ; Infant ; Integrons ; Polymerase Chain Reaction ; Shigella flexneri ; drug effects ; genetics

Objective:To establish a total normalized productive maintenance(TnPM)model for medical equipment,and to explore its application value in the management of multi-source treatment equipment.Methods:In accordance with the principles of self-management,economic efficiency and dynamic improvement,the TnPM management mode of the medical equipment lifecycle management system was developed.22 multi-source treatment equipment in clinical use in the of department of burn and plastic surgery of The Second Affiliated Hospital of Air Force Medical University were selected and divided into a control group(16 units)and an observation group(18 units,including 12 of control group and 6 newly added units)according to different management modes.The control group implemented the traditional management mode,and the observation group adopted TnPM management mode.The operation quality,comprehensive efficiency and team management capabilities of the two groups were compared.Results:The equipment failure rate of the observation group was(4.82±0.21)%,which was lower than that of traditional group,the self-repair rate,maintenance rate and operating standard rate were(91.63±3.59)%,(96.60±2.47)%and(97.31±1.54)%,respectively,which were higher than those of the control group,the difference was statistically significant(t=2.434,5.246,4.525,5.311,P<0.05).The equipment availability rate,performance index and quality index of the observation group were(90.82±2.78)%,(97.03±2.24)%and(97.85±1.26)%,respectively,which were higher than those of control group,the difference was statistically significant(t=6.231,4.671,5.997,P<0.05).The assessment scores of the personnel involved in the equipment on job responsibilities,basic equipment theory,usage assurance level and management performance of observation group were(93.95±2.81)points,(91.45±2.47)points,(90.75±2.54)points and(93.08±3.34)%,respectively,which higher than those of the control group,the difference was statistically significant(t=2.831,3.979,6.472,4.001,P<0.05).Conclusion:The TnPM management mode can improve the operation quality of equipment in the treatment of clinical patients,reduce the incidence of failure,enhance the comprehensive efficiency of equipment and clinical service level,and promote the construction of a management team.