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Surveillance of antimicrobial resistance in the strains isolated from Chuzhou First People's Hospital in 2016

Chinese Journal of Infection and Chemotherapy.2017;17(5):562-567. doi:10.16718/j.1009-7708.2017.05.015

Objective To investigate the distribution and antimicrobial resistance profile of the bacterial strains isolated from Chuzhou First People's Hospital in 2016.Methods The bacterial isolates were identified and tested for antibiotic susceptibility using MicroScan WalkAway 96 PLUS bacterial identification system.All the data were analyzed with WHONET 5.6 software.Results A total of 1 441 clinical isolates were collected during 2016,of which gram-positive organisms accounted for 28.4％ and gram-negative organisms 71.6％.Prevalence of methicillin-resistant strains in S.aureus (MRSA) and coagulase negative Staphylococcus (MRCNS) was 37.5％ and 83.0％,respectively.All Staphylococcus isolates were susceptible to vancomycin,daptomycin and linezolid.All E.faecium isolates were susceptible to daptomycin,vancornycin and linezolid.One strain (2.6％) of E.faecalis was resistant to linezolid.All Streptococcus pneumoniae strains (mainly isolated from children) were susceptible to penicillin.The prevalence of extended-spectrum beta-lactamases (ESBLs) positive strains was 49.1％,24.2％ and 62.5％ in E.coli,Klebsiella (K.pneumoniae and K.oxytoca) and P mirabilis,respectively.The resistance rate of ESBLs-positive strains was higher than ESBLs-negative strains to most antibiotics.The percentage of the P.aeruginosa isolates resistant to meropenem and imipenem was all 10.4％.The percentage of Acinetobacter (A.baumannii accounted for 95.0％) strains resistant to imipenem and meropenem was 79.0％ and 78.2％.Conclusions The situation of antibiotic resistance is still very serious in 2016 in this hospital.The prevalence of carbapenemresistant K.pneumoniae and 4.baumannii is still increasing,which is of great concern.

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Distribution and antimicrobial resistance of the bacterial strains isolated from lower respiratory tract in children

Yi YUAN ; Wenbi CHEN ; Jinbo LIU ; Weiping FU

Chinese Journal of Infection and Chemotherapy.2017;17(5):552-557. doi:10.16718/j.1009-7708.2017.05.013

Objective To study the distribution and antimicrobial resistance of the bacterial strains isolated from lower respiratory tract in children,to provide evidence for better clinical management.Methods The medical data of children (0-5 years of age) with lower respiratory tract infection were retrospectively reviewed.The children were treated during the period from September 2014 to September 2016.Results Of the 4815 sputum samples collected from the lower respiratory tract of children,1582 (32.86％) had a positive bacterial culture.A total of 1614 strains of pathogens were identified.The most common bacterial pathogen was Haemophilus influenzae (9.66％),followed by Streptococcus pneumoniae (7.12％) and Moraxella catarrhalis (5.15％).The bacterial detection rate varied greatly with season and the age of children (P＜0.01).H.influenzae,M.catarrhalis and S.pneumoniae isolates showed lower resistance rate to cefotaxime,all ＜20.0％.Escherichia coli and Klebsiella pneumoniae isolates showed lower resistance rate to cefotetan,imipenem and piperacillin tazobactam,all ＜ 10％.Less than 20％ of the S.aureus strains were resistant to oxacillin.Conclusions H.influenzae is the most frequently isolated pathogen from lower respiratory tract in children aged 0 to 5 years in Neijiang Sichuan Province,followed by S.pneumoniae and M.catarrhalis.The detection rate of bacterial pathogens varies with season and the age of children.Antimicrobial agents should be selected rationally based on the results of antimicrobial susceptibility testing to reduce the occurrence of antibiotic resistance in clinical pathogens.

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Neuraminidase gene profiling of influenza B virus in Shangrao

Yanyan ZHANG ; Yu LAI ; Lin ZHU ; Ying XIONG ; Jianxiong LI ; Changhe CHENG

Chinese Journal of Infection and Chemotherapy.2017;17(5):538-540. doi:10.16718/j.1009-7708.2017.05.010

Objective To characterize the neuraminidase (NA) genes of influenza B virus in Shangrao.Methods The specimens of nasopharyngeal swabs were collected from patients with influenza-like symptoms in influenza sentinel hospital.Seven strains of influenza B virus were randomly selected for culture and isolation in Madin-Darby Canine Kidney Epithelial Cells (MDCK Line).Viral RNA was extracted.Fragments of NA genes were amplified by one-step RT-PCR and then were sequenced.The data obtained were analyzed with software DNAStar 6.0 and Mage 5.0.The deduced amino acid sequences were examined to explore the features ofNA gene.Results The NA gene showed high homology ofnucleotides between the 7 strains of influenza B virus.No amino acid substitution was found in catalytic or framework residues of the deduced amino acid sequences of NA gene.Conclusions All the 7 strains of influenza B virus were sensitive to neuraminidase inhibitors.However,ongoing resistance surveillance is necessary for control and prevention of influenza.

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Antimicrobial resistance profile and genotypes of Haemophilus influenzae isolates from respiratory tract in children

Huihong QIN ; Chun WANG ; Fen PAN ; Changqi LIU ; Kewen ZHAO ; Hong ZHANG

Chinese Journal of Infection and Chemotherapy.2017;17(5):532-537. doi:10.16718/j.1009-7708.2017.05.009

Objective To investigate the antibiotic resistance profile and ftsⅠ genotypes of Haemophilus influenzae isolates from respiratory tract in children.Methods A total of 141 consecutive nonduplicate clinical strains of H.influenzae were collected from January to March 2016.Antimicrobial susceptibility was determined using Kirby-Bauer method.Beta-lactamase production was detected by nitrocefin disk test.PCR technique was employed for ftsⅠ genotyping.Antimicrobial resistance was compared between differentfisⅠ genotypes.Results The prevalence of β-lactamases was 40.4％ (57/141) in H.influenzae isolates.More than half (53.2％,75/141) of the strains were resistant to ampicillin.Mutation offtsI gene was positive in 72.3％ (102/141) of the isolates.The dominant genotype of genomic beta-lactamase-negative ampicillin-resistant (gBLNAR) strains was type Ⅲ (72/102,70.6％).The gBLNAR strains showed higher resistance rate to ampicillin and cefuroxime than the genomic beta-lactamase-negative ampicillin susceptible (gBLNAS) strains (P＜0.05).Conclusions High prevalence offisⅠgene mutation is found in the strains ofH.influenzae isolated from respiratory tract in children.The dominant genotype of gBLNAR strains was type Ⅲ.Mutation offtsⅠ gene in H.influenzae is associated with higher resistance rate to ampicillin and cefuroxime.

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Clinical epidemiology and prognostic analysis of nosocomial candidemia

Haibo LIU ; Dong WEI ; Jinghong XIA ; Guangfa ZHU

Chinese Journal of Infection and Chemotherapy.2017;17(5):492-497. doi:10.16718/j.1009-7708.2017.05.002

Objective To analyze the clinical features,etiology and prognostic factors of nosocomial candidemia in Beijing Anzhen Hospital.Methods A total of 174 cases of nosocomial candidemia identified during the period from January 2003 to December 2013 in Anzhen Hospital were reviewed retrospectively.The underlying conditions,risk factors,clinical manifestations and outcome were described and analyzed.The prognostic factors were analyzed by both univariate analysis including t-test and Chisquare test,and multivariate regression analysis.Results The 174 patients included 108 (62.1％) males and 66 (37.9％) females.The mean age of patients was 53.9±27.3 years,specifically:＜18 years (31/174,17.8％),18-＜ 65 years (56/174,32.2％),and ≥ 65 years (87/174,50.0％).About one-third (59/174,33.9％) of the patients were treated in ICU,followed by cardiac surgery ward (58/174,33.3％),respiratory medicine ward (21 / 174,12.1％),general surgery ward (14/174,8.0％),neurology ward (7/174,4.0％),vascular surgery (6/174,3.4％),and orthopedic ward (3/174,1.7％).Fever was documented in all cases,including 37.5-37.9 ℃ in 3 (1.7％) cases,38.0-38.9 ℃ in 81 (46.6％) cases,39.0-39.9 ℃ in 85 (48.9％) cases,and ≥ 40.0 ℃ in 5 (2.9％) cases.Increased peripheral blood WBC (＞10×109/L) was reported in 162 (93.1％) cases.The percentage of neutrophils (＞75％) was reported in 166 (95.4％) cases.Thrombocytopenia (＜ 100 × 109/ L) was documented in 24 (13.8％) cases.The most frequently isolated pathogen was C.albicans (99/174,56.9％),followed by C.parapsilosis (37/174,21.3％),C.glabrata (20/174,11.5％),C.krusei (11/174,6.3％),C.tropicalis (4/174,2.3％),and other Candida spp.(3/174,1.7％).The death rate was 50.0％ (87/174).Univariate analysis showed that old age,thrombocytopenia,hypoalbuminemia,renal insufficiency,indwelling urinary catheter were associated with death of candidemia patients.Multivariate analysis showed that hypoalbuminemia,bacterial co-infection,and indwelling urinary catheter were independent risk factors of death in nosocomial candidemia.Conclusions Nosocomial candidemia is more common in the patients treated in ICU and surgery ward.The most common pathogen of nosocomial candidemia is C.albicans associated with high mortality.Old age,hypoalbuminemia,bacterial co-infection,and indwelling urinary catheter are associated with death in nosocomial candidemia.

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Surveillance of bacterial resistance in Tongling People's Hospital during 2016

Kai PAN ; Zhijun HU ; Xiaolong PAN ; Yuanming SONG ; Daowei WU

Chinese Journal of Infection and Chemotherapy.2017;17(5):584-592. doi:10.16718/j.1009-7708.2017.05.018

Objective To investigate the bacterial distribution and antibiotic resistance profile in Tongling People's Hospital during 2016.Methods All the clinically isolated bacterial strains in Tongling People's Hospital during 2016 were identified and tested for their susceptibility to antimicrobial agents.The results were analyzed with WHONET 5.6 software.Results A total of 2 949 strains of bacteria were collected,including 2 134 strains of gram-negative bacteria and 815 strains of gram-positive bacteria.The top five gram-negative bacteria were E.coli,4.baumannii,K.pneumoniae,P.aeruginosa and Enterobacter.The top five gram positive bacteria were coagulase-negative Staphylococcus,S.aureus,E.faecalis,E.faecium and Streptococcus.The prevalence of ESBLs-producing strains was 42.3％ in E.coli and 31.1％ in K.pneumoniae,The prevalence of carbapenem-resistant strains was 1.2％ (8/640) in E.coli isolates and 29.4％ (108/367) in K.pneumoniae isolates.Majority (94.3％) ofA.baumannii strains were susceptible to tigecycline.However,74.3％ and 74.9％ of these strains were resistant to imipenem and meropenem,respectively.Most P aeruginosa strains (78.2％) were resistant to piperacillin,but about 70％ were susceptible to carbapenem antibiotics.The prevalence of methicillin-resistant strains was 32.0％ (74/231) in S.aureus and 65.6％ (170/259) in coagulase-negative Staphylococcus.No staphylococcal strains were found resistant to teicoplanin or vancomycin.No enterococcal isolates were resistant to teicoplanin or linezolid.Conclusions The number of bacterial isolates in this hospital is increasing year by year.The prevalence of multidrug-resistant bacteria is also on rise,especially the pandrug-resistant Enterobacteriaceae and A.baumannii.It is urgently required to strengthen the control of hospital infections.

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Surveillance of antibiotic resistance of clinical isolates in Shandong Provincial Hospital during 2016

Yuzhen ZHANG ; Lin ZHANG ; Yan JIN ; Yueling WANG ; Chunhong SHAO

Chinese Journal of Infection and Chemotherapy.2017;17(5):576-583. doi:10.16718/j.1009-7708.2017.05.017

Objective To investigate the antibiotic resistance of clinical isolates in Shandong Provincial Hospital during 2016.Method The antimicrobial susceptibility of isolates was tested by using VITEK 2-Compact system or disk diffusion method.All the data were analyzed by WHONET 5.6 software according to CLSI 2016 breakpoints.Results A total of 4 810 non-duplicate clinical strains were collected during 2016,of which gram-negative bacilli and gram-positive cocci accounted for 70.2％ and 29.8％,respectively.The most common specimen source was respiratory tract (38.1％),followed by skin and soft tissue (21.1％) and urine (17.5％).Escherichia coli was the most frequently isolated bacteria,followed by Staphylococcus aureus,Pseudomonas aeruginosa,Klebsiella and Enterococcus,accounting for 24.3％,10.2％,9.9％,9.8％ and 9.6％,respectively.The prevalence of ESBLs-positive E.coli and K.pneumoniae was 55.0％ and 37.9％,respectively.Carbapenem-resistant E.coli and K.pneumoniae accounted for 1.6％ and 4.2％,respectively.The percentage of P aeruginosa resistant to imipenem and meropenem was 24.3％ and 21.9％,respectively.More than 40％ of the A.baumannii strains were resistant to all the antibiotics tested except minocycline (33.2％).The prevalence of beta-lactamase positive strains was 70.1％ in H.influenzae and 97.5％ in M.catarrhalis.The prevalence of methicillin-resistant S.aureus (MRSA) was 31.4％.No staphylococcal strains were found resistant to vancomycin,teicoplanin or linezolid.E.faecium strains showed higher resistance rate to most antibiotics tested than E.faecalis.One strain of E.faecium was resistant to both vancomycin and teicoplanin.A total of 191 strains of S.pneumoniae were isolated,of which 143 (74.9％) isolates were from pediatric wards.None of the non-meningitis strains was resistant to penicillin.Other hemolytic Streptococcus strains were sensitive to penicillin,cephalosporins and vancomycin.Conclusions Bacterial resistance is still on rise.We should pay more attention to strengthening antimicrobial resistance surveillance and improving rational use of antimicrobial agents.

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Report of bacterial resistance surveillance in Zhujiang Hospital in 2015

Liang FU ; Lingxiao JIANG ; Jun LONG ; Changhong JIANG ; Lijuan LIN ; Yanping FANG ; Nianyi ZENG ; Nan YU

Chinese Journal of Infection and Chemotherapy.2017;17(5):568-575. doi:10.16718/j.1009-7708.2017.05.016

Objective To investigate the susceptibility profile of clinical isolates in Zhujiang Hospital in 2015.Methods Susceptibility test was carried out using Kirby-Bauer method or automated systems.Results A total of 4 229 clinical isolates were isolated from January to December 2015,including 2 688 (63.6％) gram negative and 1 541 (36.4％) gram positive bacteria.Methicillin-resistant S.aureus (MRSA) and coagulase-negative Staphylococcus (MRCNS) accounted for 47.2％ and 76.4％,respectively.The methicillin-resistant strains have much higher resistance rates to beta-lactams and other antimicrobial agents than methicillin-susceptible strains.Majority (94.0％) of MRSA strains were susceptible to trimethoprim-sulfamethoxazole,and 83.1％ MRCNS strains were susceptible to rifampin.No staphylococcal isolates were found resistant to vancomycin,teicoplanin or linezolid.E.faecalis strains showed much lower resistance rate to most of the drugs tested (except chloramphenicol) than E.faecium.No enterococcal isolates were found resistant to vancomycin or teicoplanin.ESBLs were produced in 52.6％ of E.coli and 39.7％ of Klebsiella (K.pneumoniae and K.oxytoca) strains.ESBLs-producing Enterobacteriaceae strains had higher resistance rates to common antimicrobial agents than non-ESBLs-producing strain.Enterobacteriaceae isolates were highly susceptible to carbapenems,(＜4％ resistant).Acinetobacter spp.strains showed high resistance to imipenem (69.2％ resistant) and meropenem (71.2％ resistant).Conclusions The antibiotic resistance is still increasing in this hospital.The emerging multi-drug or pan-drug resistant strains pose a serious threat to clinical practice and implies the importance of strengthening infection control.

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Performance evaluation of the GP68 Antibiotic Susceptibility Testing card in testing the susceptibility of Streptococcuspneumoniae on VITEK 2-Compact system

Anying XIONG ; Li HUANG ; Li MA ; Mei HUANG

Chinese Journal of Infection and Chemotherapy.2017;17(5):558-561. doi:10.16718/j.1009-7708.2017.05.014

Objective To evaluate the performance of GP68 Antibiotic Susceptibility Testing card in testing the susceptibility of Streptococcus pneumoniae on VITEK 2-Compact system,taking E-test as reference.Methods A total of 98 strains of S.pneumoniae were collected and subjected to susceptibility testing using E-test and VITEK 2-Compact (AST-GP68) in Luzhou People's Hospital form January 1 to December 31,2015.Results According to the breakpoints of Clinical and Laboratory Standards Institute (CLSI),category agreement (CA) of penicillin was 80.6％.Very major error (VME) was 0.Major error (ME) was 12.2％,minor error (mE) was 7.1％.CA of ceffriaxone was 90.8％,VME 0,ME 4.1％,mE 5.1％.CA of cefotaxime was 91.8％,VME 0,mE 5.1％,mE 3.1％.CA of meropenem was 85.7％,VME 0,ME 2.0％,mE 12.2％.CA of other antibiotics (amoxicillin,ertapenem,erythromycin,tetracycline,chloramphenicol,telithromycin,linezolid,vancomycin,moxifloxacin,ofloxacin,levofloxacin) was 100％.Conclusions AST-GP68 on VITEK 2-Compact system may have false results of antimicrobial resistance to some antibiotics such as penicillin,ceftriaxone,cefepime,meropenem due to the defects of the underlying principle.Such false results should be verified by other methods in clinical practice.

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Performance assessment of MALDI SepsityperTM kit and serum separator tube as pretreatment methods for direct identification of microorganisms from blood cultures using MALDI-TOF mass spectrometry

Juanxiu QIN ; Qian HUANG ; Qianqian GAO ; Yihui XIE ; Min LI ; Haomin ZHANG

Chinese Journal of Infection and Chemotherapy.2017;17(5):546-551. doi:10.16718/j.1009-7708.2017.05.012

Objective The aim of this study was to evaluate the commercial SepsityperTM kit and serum separator tube coupled with matrix-assisted laser desorption/ionization time of flight (MALDI-TOF) mass spectrometry for direct identification of microorganisms in a blood culture system.Methods A total of 138 clinical blood samples from clinical laboratory in Renji hospital were tested with two methods respectively from April to June of 2016.Performance of the assays were compared against that of conventional bacterial culture as a reference.Results A total of 138 nonduplicate positive blood culture samples were collected,including 70 (53.03％) gram negative samples,57 (43.18％) gram positive samples,3 fungus samples,2 mixed samples,and 6 false positive samples which were excluded from further analysis.The accuracy rate of SepsityperTM kit and serum separator tube was 91.67％ and 84.09％ in rapid identification of pathogen from blood samples,83.33％ and 61.36％ in correct identification to species level.The accuracy rate of SepsityperTM kit and serum separator tube was 98.57％ and 95.71％ in identifying gram-negative bacteria,87.72％ and 78.59％ in identifying gram-positive bacteria,respectively.The turnaround time for identification of each sample was 40 min by the commercial SepsityperTM kit and 25 min by serum separator tube.Conclusions MALDI SepsityperTM kit has shown slightly higher accuracy rate in identification of pathogen from blood sample than serum separator tube,but the difference is not significant (91.67％ vs.84.09％,P＞0.05).Compared with MALDI SepsityperTM kit,serum separator tube is a rapid,easy,and cost-effective pretreatment method for direct identification of microorganisms from blood cultures using MALDI-TOF mass spectrometry.

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