Objective　To study the antimicrobial resistance of isolated pathogens from surgical infections in Hubei area.Methods　The diameters of the inhibition zones of surgical isolates around antibiotic susceptibility test discs in 15 hospitals were computerfiled and analysed by the software of “WHONET-4” according to NCCLS published in 1999.Results　A total of 1314 surgical isolates were collected between October 1998 and September 1999.S.aureus,P.aeruginosa,E.coli,Enterobacter sp.and CNS were the main microorganisms.44.6% of staphylococcus was resistant to oxacillin.Imipenem,amikacin,ceftazidime and ciprofloxacin were most active against Gram-negative bacilli with the sensitities (in descending order) of 84.4% to 57.2%.Conclusion　Antimicrobial resistance should be seriously considered during surgical therapy and prohylaxis with antimicrobial agents.The tendency to antimicrobial resistance of clinical isolates should be followed up continuously.

Objective To investigate the resistance of Salmonella enterica serotype Typhimurium (STM) to quinolone. Methods A total of 33 salmonella typhimurium resistant to Ciprofloxacin in stool of outpatients from July 1st. 2004 to Oct 31st was isolated. in four hospitals in Wuhan. Antimicrobial susceptibility test was conducted by the Agar Dilution method. All of the strains were studied for the occurrence of mutations in the genes coding for QRDR by PCR and REP-PCR. Results The sequencing of QRDR of these genes in highly quinolone-resistant mutants (MICs of 4 to 16?g/ml) of the 25 STM revealed the presence of gyrA mutation, and inserted base in the gyrB and parE genes were found only in 5 STM. With aid of REP-PCR, the 32 strains were divided into 9 profiles which were correlated to the antibiotic susceptibility spectrums. Conclusions The resistance of STM from community acquired infection in WuHan is very severe. The resistance mechanism was associated with mutations of the quinolone resistance-determining regions. It suggests an outbreak in the community.

Objective To study the antimicrobial resistance of isolated pathogens from surgical infections in Hubei area.Methods The diameters of the inhibition zones of surgical isolates around antibiotic susceptibility test discs in 15 hospitals were computerfiled and analysed by the software of “WHONET 4” according to NCCLS published in 1999.Results] A total of 1314 surgical isolates were collected between October 1998 and September 1999. S.aureus, P.aeruginosa, E.coli, Enterobacter sp. and CNS were the main microorganisms. 44 6% of staphylococcus was resistant to oxacillin. Imipenem, amikacin, ceftazidime and ciprofloxacin were most active against Gram negative bacilli with the sensitities (in descending order) of 84 4% to 57 2%.[WT5”HZ] Conclusion Antimicrobial resistance should be seriously considered during surgical therapy and prohylaxis with antimicrobial agents . The tendency to antimicrobial resistance of clinical isolates should be followed up continuously.

The bile was collected from fro patients with biliary infections, with the bacterium isolated to study the sensitivity of each kind of the bacterium to several antibiotics in common use. Except G- bacterium, we also found some kinds of G+ bacterium in infection bile. G- bacterium were not sensitive to Clindamycin, G+ bacterium were sensitive to Ciprofloxacin. Escherichia coli, Xanthomonas maltophilia, Enterobacter cloacae, Pseudomonas aeruginosa were sensitive to Ampicillin. G+ bacterium were not sensitive to Azactam. Enterococcus faecalis, Enterococcus faecium, Enterobacter cloacae were not sensitive to Ceftazidime. Enterococcus faecalis, Staphylococcus coagulase negative, Staphylococcus epidermidis, Pseudomonas aeruginosa were not sensitive to Ceftriaxone Sodium. We didn't found any bacterium resistance Imipenem. The possibility of the existence of G+ bacterium as well as drug resistance should be considered n patients with biliary infections. The value of susceptibility test should be respected to avoid drug abuse of antibiotics.
Anti-Bacterial Agents/*pharmacology ; Anti-Bacterial Agents/therapeutic use ; Cholecystitis/drug therapy ; Cholecystitis/*microbiology ; Drug Resistance, Bacterial ; Enterobacter aerogenes/drug effects ; Enterococcus faecalis/*drug effects ; Escherichia coli Infections/*drug therapy ; Gram-Positive Bacterial Infections/*drug therapy ; Klebsiella Infections/drug therapy ; Klebsiella pneumoniae/drug effects ; Microbial Sensitivity Tests

Objective To investigate the relationship of icaA,aap ,atlE,sarA gene with biofilm phenotype in Staphyloccus epi-dermidis .Methods Tissue culture plates assays were used to assess biofilm-forming ability of 78 Staphyloccus epidermidis strains.The presence of icaA,atlE,aap ,sarA gene was amplified with PCR method,the relationship between these genes and bio-film phenotype was evaluated by χ2 test and the difference of the biofilm OD′s value in TSB and TSB+3% NaCl by icaA + strains and icaA - strains was evaluated by Wilcoxon sign test,respectively.Results The positive rates of icaA,atlE,aap ,sarA gene were 24.4%(19/78),79.5%(62/78),73.8%(57/78),82.1%(64/78),respectively.40 biofilm-positive strains were detected(51.3%), among which 16 strains carried icaA gene,24 strains showed weak biofilm-forming ability.Those genes above with biofilm forma-tion were statistically correlated.Moreover,there was a relation between the icaA gene and the high biofilm-producing phenotype. There was a significant difference between the biofilm OD values in TSB and TSB+3% NaCl by icaA + strains and icaA - strains, respectively.Conclusion Multiple genes are involved in Staphylococcus epidermidis biofilm-positive phenotype,but the icaA gene contributes to the high biofilm-forming phenotype.Biofilm phenotype is also influenced by environmental factors.

Objective To determine whether anticoagulation markers can improve mortality prediction in patients of surgical intensive care unit (ICU).Methods A case-control study was adopted,252 patients from Tongji hospital's surgical ICU and 30 healthy control individuals were investigated.The protein C,antithrombin,thrombomodulin,and other coagulation/ inflammatory markers were detected.The Acute Physiology and Chronic Health Evaluation Ⅱ (APACHE Ⅱ) score were obtained.Markers level comparison among survivors,non-survivors and controls were conducted with single factor variance analysis,Kruskal-Wallis test or Mann-Whitney U test.Results Between survivors and non-survivors after 28-day hospitalization,there were significant difference on protein C levels[(70.2 ±22.7)％ vs (48.6 ±29.8)％,t=2.84,P＜0.01],APACHE Ⅱ scores[(21.0±8.2) vs (29.5 ±10.9),t =-2.51,P＜0.05] and prothrombin times[(12.9-± 3.5) s vs (18.8 ± 10.2) s,t =-2.13,P ＜ 0.05].Combining protein C levels with APACHE Ⅱ score could obtain a higher mortality prediction efficiency in patients of surgical ICU than any single marker (AUC =0.806).That protein C concentration less than 47.5％ [OR =6.40,95％confidence interval(CI) 2.526-16.216,P ＜0.001] and APACHE Ⅱ score (OR =1.123,95％ CI 1.012 -1.250,P ＜ 0.05) were the independent risk factors for surgical ICU death.Conclusion Decrease of protein C levels predict increase of mortality risk in patients of surgical ICU,combining protein C with APACHE Ⅱ score can improve the prognostic accuracy for patients of surgical ICU.(Chin J Lab Med,2013,36:339-342)

OBJECTIVE To investigate antibiotic resistance and the prevalence of serotype of Streptococcus pneumoniae in Wuhan.METHODS Totally 152 strains of S.pneumoniae were collected to test the MICs of various antibiotics by agar dilution method according to the approved standard of NCCLS.Serotyping of S.pneumoniae was performed by using quelling reaction.RESULTS Among 152 strains of S.pneumoniae,65(42.76%) strains were resistant to penicillin(MIC≥0.12mg/L).94.08%,50.66%,41.45% and 11.18% of S.pneumoniae were resistant against the first(cefalexin),second(cefaclor) and third(cefaxime and ceftriaxone) generation of cephalosporins respectively.The resistance rates to other antibiotic agents,such as erythromycin,tetracycline,trimethoprim/sulfamethoxazole and chloramphenicol,were 84.21%,88.82%,89.47% and 18.42%,respectively.Strains that were resistant to levofloxacin and moxifloxacin were found both for 1.32%.Twenty serotypes were involved in 152 strains. The prevalent serotypes were 19(25.66%),23(19.08%),6(13.82%),15(7.24%)and 14(4.61%).Eight strains were remained for unable to serotype.All penicillin-resistant S.pneumoniae was included in serotypes 6,19 and 23.CONCLUSIONS The antibiotic resistance of S.pneumoniae is serious in Wuhan.Most of them are multi-resistant strains.Except for fluoroquinolones,ceftriaxone and chloramphenicol, most antibiotic agents have lost there activities against S.pneumoniae.The prevalent serotypes,especially of the multi-resistant strains,were 19,23 and 6.Pneumococcal polyvalent vaccine can well cover these serotypes.

Objective To explore the distribution and antimicrobial resistance of pathogens causing lower respiratory tract infection in patients, and provide basis for rational choice of antimicrobial agents in clinic.Methods All bronchoalveolar lavage fluid specimens in a hospital from January 1, 2013 to December 31, 2014 were performed culture, antimicrobial susceptibility testing of isolated strains was performed with Kirby-Bauer method.Results A total of 999 strains were isolated from 7 702 bronchoalveolar lavage fluid specimens, 398 (5.17%), 326 (4.23%), and 275(3.57%) strains were bacteria, fungus, and Mycobacterium respectively.The main bacteria were Pseudomonas aeruginosa(P.aeruginosa, n=97), Acinetobacter baumannii(A.baumannii, n=87), Klebsiella pneumoniae(K.pneumoniae, n=62), Staphylococcus aureus(S.aureus, n=44), and Haemophilus influenzae (n=28);the main fungi were Candida albicans (n=161), Aspergillus fumigatus (n=41), and Aspergillus flavus(n=38);the main Mycobacterium were Mycobacterium tuberculosis(n=271).Antimicrobial susceptibility testing results showed that resistance rates of P.aeruginosa to the commonly used antimicrobial agents (except ticarcillin/clavulanic acid and levofloxacin) were all<30.00%.Resistance rates of A.baumannii to ampicillin/sulbactam, imipenem, amikacin, gentamicin, and tobramycin were all >80.00%, but to the other commonly used antimicrobial agents were 36.84%-60.53%.Among 62 strains of K.pneumoniae, 20 were extended-spectrum β-lactamases(ESBLs)-producing strains.Antimicrobial resistance rates of ESBLs-producing strains were obviously higher than non-ESBLs-producing strains.Among 44 S.aureus strains, 26 were methicillin-resistant S.aureus (MRSA), resistance rate of S.aureus to penicillin was 97.73%, to vancomycin, teicoplanin, and linezolid were all 0, to the other antimicrobial agents were 9.09%-61.36%.Conclusion Bacteria is the major pathogen causing lower respiratory tract infection in hospitalized patients, but fungus and Mycobacterium can not be ignored.Resistance rates of P.aeruginosa to commonly used antimicrobial agents is relatively low, but resistance of A.baumannii is more serious.

Objective To explore the inhibitory effect of 24 pseudomonas aeruginosa(PA) on pathogenic fungi ,such as candida albicans ,candida tropicalis ,candida glabrata ,candida parapsilosis ,candida krusei ,mucous spore bacterium (MSB) etc .Methods 24 PA isolates were collected from clinical specimens and identified by Gram′s stain ,oxidase production and the API 20NE system(bi-oMerieux ,France) .Cross-streaking method and sterilizing filter paper-disk method and co-cultured method were applied to observe the inhibitory effect of PA .Sodium dodecyl sulfate-polyacrylamide gel electrophoresis(SDS-PAGE) analyzed the difference of bacte-rial proteins of PA .Results The results showed that some strains of 24 PA had strong inhibitory effect against pathogenic fungi , some strain had partial effect and others had no effect .Co-cultured test showed that PA could inhibit the growth of fungal hyphae . SDS-PAGE displayed the significant difference in secretive proteins between the PA strains which had strong effect and no effect . Conclusion PA have inhibitory effect upon common pathogenic fungi and and this might be related to inhibit fungal hyphae forma-tion ,various protein secretion and inhibit the growth of fungi .

Objective To investigate the distribution,variability and antibiotic resistance of the pathogen sisolated from bloodstream infections.Methods The bacterial strains were routinely isolated from blood samples and identified.Brucella trains were identified by PCR and gene sequencing.Antimicrobial susceptibility were routinely tested for these isolates.Results A total of 2 152 strains,excluding coagulase negative Staphylococcus,were isolated from blood specimens during the 5-year period from 2009 through 2013.Gram-positive cocci,gram-negative bacilli and fungi accounted for 35.3% (761/2 152), 57.7% (1 242/2 152)and 6.9% (149/2 152),respectively.The top three gram-positive bacteria were S.aureus,E.faecium and E.faecalis.E.coli,K.pneumoniae,P .aeruginosa,A.baumannii,and Brucella were the most frequently isolated gram-negative bacteria.In 2009,only one Brucella melitensis was isolated,but increased to 50 in 2013 (7.1%),including one strain of Brucella suis .The prevalence of MRSA was 54.1% in S.aureus.No staphylococcal isolate was found resistant to vancomycin or linezolid.More than 60% of the E.faecalis isolates still showed low resistance (< 30%)to ampicillin and levofloxacin.But E.faecium strains were highly resistant to most antibiotics (>70%)except glycopeptides and linezolid.E. coli and K.pneumoniae isolates displayed low resistance rate (< 15%)to piperacillin-tazobactam,amikacin,cefoxitin and
were still the most common pathogens in blood stream infections.Attention should be paid to the increasing prevalence of Brucella in blood stream infections.Various levels of antibiotic resistance are found in the pathogens of blood stream infections.Antibiotics should be prescribed reasonably according to local susceptibility testing data.