Objective To evaluate the clinical performance of the BACTEC Plus aerobic,BACTEC Lytic anaerobic,BacT/Alert aerobic and anaerobic blood culture media in detection of bloodstream infections.Methods Retrospective study was conducted.A total of four blood culture bottles from each inpatient with suspected bloodstream infections were collected and analyzed from June 2013 to September 2015 in Peking University People's Hospital.The four bottles,including BACTEC Plus aerobic,BACTEC Lytic anaerobic,BacT/Alert FA aerobic and BacT/Alert FN anaerobic media,and was incubated for 5 days in the BacT/Alert 3D and BACTEC FX instruments,respectively.Time to detection (TTD) and positive rate in detecting bacteria of the two systems were evaluated by Wilcoxon test and Chi-square test.Results Among 2 189 total cultures collected,20 were excluded because of blood shortage and 201 (9.27％) were positive for pathogens.The positive rates of BACTEC Plus aerobic media and BacT/Alert FA aerobic media were 75.3％ (140/186) and 69.4％ (129/186) (x2 =1.625,P=0.202),respectively.While,the positive rates of BacT/Alert FN anaerobic media and BACTEC Lytic anaerobic media were 81.8％ (99/121) and 63.6％ (77/121) for total organisms,respectively (x2 =10.083,P =0.001).A significant difference in TTD was detected in BACTEC Plus aerobic media[11.0 (8.0-16.0) h] and BacT/Alert FA aerobic media[13.9 (10.4-18.7) h] (Z =-5.240,P ＜ 0.001).BACTEC Lyric anaerobic media[8.0(7.0-10.0) h] had a shorter TTD (Z =-4.299,P ＜ 0.001) than BacT/Alert FN anaerobic media[11.3(9.3-12.7) h].The positive rates of BACTEC and BacT/Alert system were 74.13％ (149/201) and 74.63％ (150/201),respectively,compared with taking one set from each system.Conclusions BACTEC media has a shorter TTD and almost the same bacterial recovery,and lower false positive rate than the BacT/ Alert media.

To investigate the resistance mechanisms of tigecycline-non-susceptible Acinetobacter baumannii and for providing the evidence of the control of nosocomial infection and rational use of antibiotics. The minimum inhibitory concentrations (MICs) of 94 non repetitive tigecycline-non-susceptible A. baumannii from 20 hospitals in 12 cities of China were determined by agar dilution method and broth microdilution method. The molecular epidemiology was studied by Multilocus sequence typing (MLST) and eBURST software. PCR and sequencing techniques were used to analyze the resistance genes (blaOXA-40-like, blaOXA-58-like, blaOXA-23-like, blaOXA-51-like, blaNDM-1), ISAba1, and the mutation sites of adeR, adeS, and trm. The activity of polymyxin B and minocyclinem against tigecycline-non-susceptible A. baumannii were 100% and 25.5%, respectively. The sensitivities of other antibiotics were less than 3.5%, and the sensitivities of imipenem and meropenem totigecycline-nonsusceptible A. baumannii were only 1.1%. A total of 12 ST types were identified, including ST195 (45, 47.9%), ST208 (19, 20.2%) and ST457 (10, 10.6%). EBURST analysis found that 8 of the ST types belonged to the clone complex 92 (Clonal Complex 92, CC92). The blaOXA-23-like type carbapenem gene was identiefied in 93 strains (99% positive); and none of the strains contained the blaNDM-1 gene. The detection rates of adeR and adeS were 73.4% and 91.5% respectively and high frequency mutation sites were located in adeR (Asp26Asn) and adeS (Ala97Glu); The ISAba1 located upstream of the adeS gene was detected in 12 strains of A. baumannii, mainly from the northern region of China. The 240 nucleotide deletion of the trm gene caused a frameshift leading to a premature stop. So the tigecycline-non-susceptible A. baumannii showed high resistance against most antibiotics except polymyxin B. The deletion and mutation of adeR, adeS and trm were the main resistant mechanisms in tigecycline-non-susceptible A. baumannii in China.

Vacuum sealing drainage (VSD) is frequently used in abdominal surgeries. However, relevant guidelines are rare. Chinese Trauma Surgeon Association organized a committee composed of 28 experts across China in July 2017, aiming to provide an evidence-based recommendation for the application of VSD in abdominal surgeries. Eleven questions regarding the use of VSD in abdominal surgeries were addressed: (1) which type of materials should be respectively chosen for the intraperitoneal cavity, retroperitoneal cavity and superficial incisions? (2) Can VSD be preventively used for a high-risk abdominal incision with primary suture? (3) Can VSD be used in severely contaminated/infected abdominal surgical sites? (4) Can VSD be used for temporary abdominal cavity closure under some special conditions such as severe abdominal trauma, infection, liver transplantation and intra-abdominal volume increment in abdominal compartment syndrome? (5) Can VSD be used in abdominal organ inflammation, injury, or postoperative drainage? (6) Can VSD be used in the treatment of intestinal fistula and pancreatic fistula? (7) Can VSD be used in the treatment of intra-abdominal and extra-peritoneal abscess? (8) Can VSD be used in the treatment of abdominal wall wounds, wound cavity, and defects? (9) Does VSD increase the risk of bleeding? (10) Does VSD increase the risk of intestinal wall injury? (11) Does VSD increase the risk of peritoneal adhesion? Focusing on these questions, evidence-based recommendations were given accordingly. VSD was strongly recommended regarding the questions 2-4. Weak recommendations were made regarding questions 1 and 5-11. Proper use of VSD in abdominal surgeries can lower the risk of infection in abdominal incisions with primary suture, treat severely contaminated/infected surgical sites and facilitate temporary abdominal cavity closure.
Abdomen ; surgery ; China ; Drainage ; methods ; Evidence-Based Medicine ; Humans ; Practice Guidelines as Topic ; Societies, Medical ; organization & administration ; Surgical Wound Infection ; prevention & control ; Traumatology ; organization & administration ; Vacuum