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find Keyword "埃希菌" 6 results
  • Risk Factors and Genotyping of Nosocomial Pneumonia Due to Extended Spectrum β-Lactamase Producing EscherichiaColi and KlebsiellaPneumoniae

    Objective To analyze the current drug resistance and risk factors of hospital acquired pneumonia( HAP) due to extended spectrumβ-lactamase ( ESBLs) producing Escherichia coli and Klebsiella pneumoniae, and to estimate the prevalence trend of ESBLs producing strains. Methods FromApril 2007 to January 2008, 140 patients of Xinhua Hospital with HAP due to E. coli and K. pnermoniae were enrolled.Among them, 88 patients were with ESBLs producing strains and 52 patients were with non-ESBLs producing strains. Risk factors were analyzed by comparing between these patients. The rate of drug resistance was determined by antibiotic sensitive test. Fifty-three ESBLs producing strains were genotyped by random amplified polymorphic DNA ( RAPD) . Results The rate of drug resistance of ESBLs producing strains washigher than that of non-ESBLs producing strains. ICU stay, use of third- and forth-generation cehpalosporin were found to be the independent risk factors by multivariate analysis with logistic regression. By RAPD, 37 ESBLs producing E. coli strains were divided into 27 types and 16 ESBLs producing K. pneumoniae strains were divided into 13 types. Conclusions ICU stay, use of third-generation and forth-generation cehpalosporin remain as major risk factors in the HAP due to ESBLs producing E. coli and K. pneumoniae.RAPD is an economic, quick and credible method for epidemic analysis

    Release date:2016-08-30 11:53 Export PDF Favorites Scan
  • 儿童大肠埃希菌药敏分析及药物选择

    【摘要】目的 大肠埃希菌是临床上最常分离到的致病菌之一,居分离菌中首位。当机体免疫力低下时,能引起各种感染。 方法 对2007年1月1日-2008年3月31日住院患儿分离出的大肠埃希菌278株进行ESBLs检测,分析其药敏试验报告,并对ESBLs菌株耐药情况进行分析比较。 结果 278株大肠埃希菌中,产ESBLs菌142株,占51.08%。药敏试验显示,所有大肠埃希菌对亚胺培南均敏感,其次敏感的是头孢西丁和呋喃妥因。产ESBLs大肠埃希菌对其他药物均显示不同程度的耐药。 结论 大肠埃希菌是儿童感染的主要致病菌,以β内酰胺类抗生素的广泛应用,使产ESBLs菌株明显增加,相应的治疗难度也随之增大。

    Release date:2016-09-08 09:31 Export PDF Favorites Scan
  • 双歧杆菌、保加利亚乳杆菌、嗜热链球菌三联活菌去除肠道产超广谱β-内酰胺酶大肠埃希菌的研究

    目的研究双歧杆菌、保加利亚乳杆菌、嗜热链球菌三联活菌对肠道产超广谱β-内酰胺酶(ESBL)大肠埃希菌的除菌作用,为临床辅助治疗大肠埃希菌感染提供依据。 方法对2013年1月-9月5个病区1 358例入院患者采集肛拭子标本进行产ESBL大肠埃希菌定植筛查,选取产ESBL大肠埃希菌阳性患者306例,随机分为试验组与对照组。试验组140例在常规消毒隔离措施基础上口服双歧杆菌、保加利亚乳杆菌、嗜热链球菌三联活菌去除肠道产ESBL大肠埃希菌,对照组166例仅采取常规消毒隔离措施。3~7 d后,两组再次取肛拭子进行筛查。 结果试验组87例未再检出产ESBL大肠埃希菌,双歧杆菌、保加利亚乳杆菌、嗜热链球菌三联活菌去除肠道产ESBL大肠埃希菌有效率为62.14%;对照组125例再次检出产ESBL大肠埃希菌,肠道自行清除率为24.70%,两组差异有统计学意义(χ2=43.761,P<0.001)。 结论双歧杆菌、保加利亚乳杆菌、嗜热链球菌三联活菌具有清除肠道产ESBL大肠埃希菌的作用,清除率与使用时间长短、使用抗菌物有关。

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  • 2011年-2013年宜宾市大肠埃希菌临床分布及耐药趋势分析

    目的分析宜宾市2011年-2013年大肠埃希茵的临床分布特点及对常用抗茵药物的耐药趋势,为临床预防和控制大肠埃希茵感染提供依据。 方法对2011年-2013年从宜宾市第一人民医院和宜宾市第二人民医院住院患者的各种标本中分离出的4 372 株大肠埃希菌进行回顾性分析,比较大肠埃希菌感染部位、耐药变迁及其对12 种抗菌药物的耐药趋势。 结果大肠埃希菌的检出率呈逐年上升趋势,其耐药菌株检出率为44.81%;在尿液标本中检出最多,占40.44%;痰液标本耐药菌检出最多,占47.47%;呼吸内科大肠埃希菌检出最多,重症监护病房分离出的耐药大肠埃希菌最多;亚胺培南耐药率最低,哌拉西林/他唑巴坦、阿米卡星耐药率较低。 结论宜宾市大肠埃希菌的检出率和耐药率呈逐年上升趋势,其主要感染部位是泌尿道,呼吸道易发生耐药菌感染,重症监护病房、呼吸内科为高危科室;可经验性选择亚胺培南可哌拉西林/他唑巴坦、阿米卡星治疗大肠埃希菌感染,尽量减少使用氟喹诺酮类。

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  • Risk Factors Analysis of Community-acquired Urinary Tract Infections Caused by Extended-spectrum β-lactamase-producing Escherichia coli

    ObjectiveTo explore the risk factors of community-acquired urinary tract infections caused by extended-spectrum β-lactamase-producing Escherichia coli (ESBLs-producing Escherichia coli). MethodsProspective and retrospective investigation methods were combined, to investigate the hospitalized patients diagnosed with community-acquired urinary tract infections caused by ESBLs-producing Escherichia coli in the Second Affiliated Hospital of Fujian Medical University during July 2012 to December 2014. Statistical analysis was performed using SPSS 19.0 software. The potential risk factors were analyzed by chi-square test or Fisher exact probability method, then, factors with statistical significance identified by single factor analysis were further analyzed by non-conditional logistic regression. ResultsA total of 106 patients were included and divided into a ESBLs group (68 cases) and a control group (38 cases) according to the drug sensitivity test results. The results of single factor analysis indicated: there were significant differences between the ESBLs group and the control group in the use of antibiotics within three months before admission (χ2=11.292, P=0.001), the use of third generation cephalosporin (χ2=11.033, P=0.001), more than three kinds of diseases that could cause urinary tract obstruction (χ2=16.464, P=0.000), anemia (χ2=5.956, P=0.015), indwelling catheter (χ2=6.695, P=0.010), urinary system operations (χ2=9.730, P=0.002). The results of further non-conditional logistic regression analysis showed that more than three kinds of diseases that could cause urinary tract obstruction (OR=14.675, 95%CI 2.699 to 79.796, P=0.002), anemia (OR=7.976, 95%CI 1.785 to 35.632, P=0.007), the use of antibiotics within three months before admission (OR=7.057, 95%CI 1.597 to 31.175, P=0.010), the use of third generation cephalosporin (OR=6.344, 95%CI 1.145 to 35.146, P=0.034) and indwelling catheter (OR=3.844, 95%CI 1.058 to 13.967, P=0.041) were independent risk factors of community-acquired urinary tract infections caused by ESBLs-producing Escherichia coli. ConclusionThe risk factors of community-acquired urinary tract infections caused by ESBLs-producing Escherichia coli include more than three kinds of diseases that could cause urinary tract obstruction, anemia, the use of antibiotics within three months before admission, the use of third generation cephalosporin, and indwelling catheter. The use of antibiotics, especially the third generation cephalosporin, should be strictly controlled, the time of indwelling catheter should be reduced, and the anemia should be corrected, in order to reduce the incidence of community-acquired urinary tract infections caused by ESBLsproducing Escherichia coli.

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  • A multicenter investigation of two types of carbapenem-resistant Enterobacteriaceae in pediatric patients in Jiangxi Province for three consecutive years

    ObjectiveTo evaluate the burden of carbapenem-resistant Klebsiella pneumoniae (CRKPN) and carbapenem-resistant Escherichia coli (CRECO), two types of carbapenem-resistant Enterobacteriaceae (CRE), in pediatric patients in Jiangxi Province.MethodsA retrospective investigation was carried out for the distribution of CRKPN/CRECO in pediatric (neonatal group and non-neonatal group) and adult patients in 30 hospitals in Jiangxi Province from January 2016 to December 2018, and the changing trends and detection situations of different patients and types of hospitals were compared and analyzed.ResultsFrom 2016 to 2018, the annual resistance rates of Klebsiella pneumoniae and Escherichia coli to carbapenem in pediatric patients were 5.89%, 4.03%, and 4.24%, respectively, showed a downward trend (χ2trend=5.568, P=0.018). The resistance rate of Klebsiellae pneumoniae and Escherichia coli to carbapenem in neonatal group was higher than that in non-neonatal group (8.44% vs. 3.40%; χ2=63.155, P<0.001) and adult group (8.44% vs. 3.45%; χ2=97.633, P<0.001). In pediatric patients, the 3-year carbapenem resistance rate of Klebsiella pneumoniae was higher than that of Escherichia coli (9.10% vs. 2.48%; χ2=128.177, P<0.001). In non-neonatal pediatric patients, the 3-year resistance rate of Klebsiella pneumoniae and Escherichia coli to carbapenem in maternity and children hospitals was higher than that in general hospitals (4.35% vs. 1.36%; χ2=25.930, P<0.001). CRKPN/CRECO detected in pediatrics were mainly isolated from sputum (31.64%), blood (24.36%), urine (13.82%), and pus (8.36%).ConclusionAlthough the overall resistance rate of Klebsiella pneumoniae and Escherichia coli to carbapenem in pediatric patients showed a downward trend, that in neonatal patients was still high, and the monitoring and prevention and control measures of CRE should be strengthened in neonatal patients.

    Release date:2021-04-15 05:32 Export PDF Favorites Scan
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