Epidemiological study of methicillin-resistant Staphylococcus aureus isolated from the urology ward in 2003--nosocomial infection and community-acquired infection

Methicillin-Resistant Staphylococcus aureus (MRSA) strains with the exception of urinary strains were isolated from the inpatients in urology ward hospitalized in 2003 and medical workers. Biotype according to the production of coagulase, enterotoxin and mupirocin sensitivity, and genotype by pulsed field gel electrophoresis (PFGE), and clinical background were determined for the MRSA strains to analyze the transmission route of the infection. In 34 medical workers in urology ward, MRSA were isolated in 6 (17.6%) workers from the nasal cavity, and the rate of colonization in doctors was higher than in nurses. Furthermore, mupirocin-resistant strains were isolated from two medical workers. 18 MRSA strains were isolated in 2003 and the accounting was 8 strains from wounds, 6 strains from sputum or nasal cavity, 3 strains from blood, and 2 strains from urinary tract. Most of the patients with MRSA had operations under general anesthesia or were under severe conditions with malignant tumors. No MRSA was detected at the same time from the same rooms. There were some rooms in which the MRSA detected rate was high, however no MRSA was isolated from hospital environments and dumping bacteria. These results suggest that the involvement of the medical workers and the spread of MRSA in the society might be important as infection source and for transmission of MRSA in hospital.     

糖尿病患者医院感染病原菌分布与影响因素分析

目的调查医院感染糖尿病患者病原菌类型及分布情况,分析患者感染相关影响因素。方法收集2019年本院收治的1059例糖尿病患者临床资料,调查患者感染部位。收集患者空腹血糖、血脂、血压等临床指标,经统计学分析影响患者各部位感染发生的相关因素。收集感染患者的标本,采用全自动微生物鉴定仪鉴定病原菌类型。挑取白色念珠菌的单菌落,经PCR验证分型。结果1059例糖尿病患者中,感染患者数407例,感染率为38.43%。其中男性患者感染190例,女性患者感染217例。患者主要发生呼吸、泌尿、皮肤软组织以及消化系统感染。各部位感染的糖尿病患者临床指标(空腹血糖、血脂、血压)不稳定者较多。性别、空腹血糖、血脂、血压是糖尿病患者发生泌尿系统、呼吸系统、皮肤软组织以及消化系统感染的影响因素(P<0.05)。从泌尿系统、皮肤软组织、消化系统感染者中分离的病原菌主要为革兰阴性菌,呼吸系统感染者中主要为革兰阳性菌。共分离147株病原菌。75株革兰阴性菌中,以大肠埃希菌为主(31株);46株革兰阳性菌中,以表皮葡萄球菌为主(26株);26株真菌中,白色念珠菌18株。白色念珠菌中,10株(55.56%)为A型,5株(27.78%)为B型,3株(16.67%)为C型,未检出D型和E型白色念珠菌。结论女性糖尿病患者发生泌尿系统感染者居多,呼吸系统感染患者数次之。临床中应注意预防女性患者发生泌尿系统感染。A型白色念珠菌检出率较高,应给予重视。     

住院期间老年泌尿系统感染患者的病原菌分布及其耐药性特征分析

目的 分析老年泌尿系统感染住院患者的病原菌分布特点和耐药情况,为老年性泌尿系统感染的诊疗提供参考依据.方法 选取2018年1月-2018年12月期间在复旦大学附属华东医院接受治疗、年龄≥60岁、且尿培养阳性的住院患者465例,对泌尿系统感染病原体的分布特点和耐药性进行分析.结果 465例中段尿培养阳性的老年住院患者共检...     

耐碳青霉烯肺炎克雷伯菌感染的危险因素及耐药机制的研究

目的探讨耐碳青霉烯肺炎克雷伯菌感染的危险因素及耐药机制。方法对我院2018年6月1日-2019年5月31日57例耐碳青霉烯肺炎克雷伯菌(CRKP)感染患者和70例碳青霉烯敏感肺炎克雷伯菌(CSKP)感染患者进行回顾性分析。结果CRKP感染患者主要分布在呼吸科31.6%(18/57)、神经内科21.1%(12/57)、神经外科14%(8/57)和ICU 10.5%(6/57),感染部位以下呼吸道感染78.9%(45/57)和泌尿道感染17.8%(8/57)为主;相比CSKP感染组,使用两种或三种抗生素患者的比例在CRKP感染组中显著增加。多元Logistic回归分析显示,1月内使用三代头孢/酶抑制剂、1月内使用碳青霉烯类以及留置尿管为CRKP感染的独立危险因素。57株CRKP菌株中,有39株(68.4%)携带blaKPC基因,6株(10.5%)携带blaIMP基因。结论CRKP菌株日见增多,规范化使用碳青霉烯类抗生素,减少或缩短侵入性医疗操作有利于降低CRKP感染的发生率;产KPC型碳青霉烯酶是CRKP菌株对碳青酶烯类耐药的最主要耐药机制。     

Antimicrobial resistance among Gram-negative bacteria isolated from intensive care units in a Cardiology Institute in Istanbul, Turkey

Antibiotic resistance among Gram-negative rods (GNRs) causing hospital-acquired infections poses a threat, particularly to intensive care unit (ICU) patients. This study was undertaken in order to achieve the following: to detect the frequency of GNRs isolated from coronary and surgical ICUs at the Institute of Cardiology, Istanbul University, between January 2000-December 2002; to compare the resistance of these GNRs to selected antibiotics; and to determine the prevalence of extended-spectrum beta-lactamases (ESBLs). A total of 367 isolates were obtained from 171 patients. Susceptibility testing and detection of ESBLs were performed using the E-test method. Ceftazidime-clavulanate was used for the detection of ESBLs. The majority of microorganisms were isolated from the respiratory tract (45.5%) and blood (36.7%). Acinetobacter baumannii was the most frequently isolated GNR (24.5%), followed by Pseudomonas aeruginosa (22%). ESBL positivity was found to be 21.1%. High rates of the ESBLs of Escherichia coli and Klebsiella pneumoniae were observed, i.e., 27.7 and 57.5%, respectively. High rates of resistance to all antibiotics studied were observed. The most active agent against the majority of the isolates was imipenem (79.2%), followed by levofloxacin (77%) and ciprofloxacin (71%).     

幽门螺杆菌感染个体中菌株基因多态性的研究

幽门螺杆菌(H.pylori)感染的临床结局与宿主易感性、环境因素和菌株的基因多态性相关。了解感染个体中菌株的基因多态性，有助于阐明H.pylori感染的影响因素、致病机制和治疗后复发等问题。目的：研究同-H.pylori感染个体中的菌株是否存在基因多态性。方法：分别从14例临床H.pylori感染者的胃窦活检标本中分离、培养H.pylori,从每例菌株中分离出10个单克隆菌株。从分离自另7例患者胃窦和胃体活检标本的配对菌株中各分离出1个单克隆菌株。采用随机扩增多态性DNA(RAPD)指纹分析方法检测H.pylori菌株的基因多态性。结果：分离自不同感染个体的H.pylori菌株的RAPD指纹图有显著差异。大多数来自同一胃活检部位或同一感染个体的单克隆菌株的RAPD指纹图相同或十分相似，仅少数单克隆菌株的指纹图存在差异。结论：不同H.pylori感染个体所携带菌株的基因型存在显著多态性，同一个体携带的H.pylori菌株基因型相对均一。     

Detection methods and changes in metallo-beta-lactamase-producing Gram-negative rod isolates at Nagasaki University Hospital from 1991 to 2005

Since plasmid-mediated metallo-beta-lactamase (MBL)-producing Pseudimonas aeruginosa was reported in Japan, MBL-producing Gram-negative rods (GNRs) have emerged worldwide. We developed a way to detect MBL-producing GNRs in routine examination using broth microdilution with the MBL inhibitor sodium mercaptoacetate (SMA) in frozen plates. Between 1996 and 2005, we evaluated this and other methods, including broth microdilution with another MBL inhibitor dipicolinic acid (DPA) in dry plates, conventional PCR, and a combined simple DNA preparation and enzymatic PCR product detection. The combined method is suitable for detecting IMP-type MBL-producing GNRs from numerous isolates. Broth microdilution with SMA at a concentration of 400 microg/mL had high performance and detected most PCR-positive MBL-producing GNRs in routine antimicrobial susceptibility testing. DPA in dry plates at 400 microg/mL yielded false positive results in 11.4% of isolates but worked satisfactorily at 175 microg/mL and 400 microg/mL of SMA in frozen plates. Until 1996, MBL had been detected from only 6 bacterial species, i.e., Pseudomonas aeruginosa, Pseudomonas putida, Pseudomonas stutzeri, Achromobacter xylosoxidans, Serratia marcescens, and Citrobacter freundii, MBL-producing GNRs were later found in other glucose nonfermenting GNRs such as Acinetobacter baumanii, Acinetobacter lwoffii, and Burkholderia cepacia complex and Enterobacteriaceae. Most MBL-producing bacteria were multidrug resistant and no antimicrobial agents exist that are active against such isolates in monotherapy, making their rapid detection very important in controlling infection control.     

Expression of P, type-1, and type-1C fimbriae of Escherichia coli in the urine of patients with acute urinary tract infection

In vivo expression, in human urine, of P, type-1, and type-1C fimbriae by Escherichia coli was analyzed by indirect immunofluorescence. Urine samples from 20 patients with acute urinary tract infection, as well as cultures of the corresponding E. coli isolates, were immunostained with three polyclonal antisera to P fimbriae, antiserum to type-1 fimbriae, monoclonal antibody specific for type-1C fimbriae, and fluorochrome-conjugated second antibodies. P fimbriae were found in 17 urine samples and in 18 of the isolated strains. Type-1-fimbriate bacteria were detected in only nine urine samples, although 18 of the isolated strains expressed type-1 fimbriae after growth in vitro. Four strains possessed type-1C fimbriae; only two expressed type-1C fimbriae in urine. The bacterial populations in urine were heterogeneous, and in each positive staining, only a fraction of the bacterial cells were reactive. The results show that E. coli P fimbriae are expressed and are subject to phase variation in vivo during acute urinary tract infection.     

Occult hepatitis B virus after acute self-limited infection persisting for 30 years without sequence variation

BACKGROUND/AIMS: After acute self-limited hepatitis B virus (HBV) infection, serological loss of viral antigens and appearance of anti-HBs is generally believed to signify viral clearance. Latent and occult HBV infection appearing decades after self-limited hepatitis B has not been reported, nor has the evolutionary rate of HBV DNA over the same observation period. METHODS: DNA from serum and leukocytes from 16 patients with acute self-limited hepatitis B 30 years earlier was tested by polymerase chain reaction and positive samples were sequenced. Liver tissue from four patients was also tested. Additionally, another 10 HBV strains isolated from acute HBV cases in 1969-72 were compared to 11 strains isolated from acute cases in 1998-99 in the same community. RESULTS: HBV DNA was detected in liver from two patients, but not in serum or leukocytes. The HBV strains detected in liver showed complete homology, in the sequences analyzed, to the strains originally infecting these patients. Ten strains from 1998-99 were identical in pre-S and core promoter/precore regions to strains from the same community isolated 30 years earlier. CONCLUSIONS: HBV can persist as an occult infection three decades after acute, apparently self-limited hepatitis B, and both the mutation and evolutionary rates of HBV DNA are low.     

Catheter associated urinary tract infections in neurology and neurosurgical units

OBJECTIVE: Catheter associated bacteriuria is the most common infection acquired in hospitals. The objective of the study was (1) to study the incidence of bacteriuria following indwelling urethral catheterization in patients with short-term vs long-term catheterization (2) to define the antibiotic resistance pattern among these isolates so that the study can provide guidelines for choosing an effective antibiotic against infections in catheterized patients. METHODS: This is a prospective study carried out over a period of 18 months in Neurology/Neurosurgical patients who had indwelling catheters for > or =48 h. RESULTS: In this study, 68 out of 800 (8.5%) adult inpatients acquired urinary tract infection following indwelling bladder catheterizations. The risk was significantly higher for female, elderly patients, critically ill and patients on prolonged catheterization. Among the bacterial pathogens, Escherichia coli was the commonest organism isolated (32.9%) followed by Pseudomonas sp. (15.1%) and Staphylococcus aureus (12.3%). Candida sp. comprised 13.7% of all isolates. Among Gram negative bacterial pathogens maximum number of isolates were sensitive to Amikacin (sensitivity of 42%). All Gram positive organisms were however sensitive to Vancomycin. CONCLUSIONS: Our results provide guidelines for choosing salvage therapy against hospital resistant strains causing infection in catheterized patients. However, antibiotics seem to prevent urinary tract infections but primarily in patients catherized for short duration, i.e. 3-14 days and not in patients with long-term catheterization.     

Clinical, microbiologic, and epidemiologic characteristics of Pseudomonas aeruginosa infections in a University Hospital, Malatya, Turkey

BACKGROUND: Pseudomonas aeruginosa strains are generally resistant to many antibiotics, and nosocomial infections because of this species are one of the major problems in many hospitals. Molecular typing provides very useful information about origin and transmission of the strains. The aims of the present study were to investigate clinical and microbiologic characteristics of the nosocomial infections caused by P aeruginosa strains in a medical center and to bring up the cross-transmission level of this opportunistic pathogen in a university hospital by analyzing the clonal relationship among the isolates. METHODS: A total of 105 P aeruginosa strains had been identified among the 80 inpatients in a 1-year period from August 2003 to August 2004. Demographic, clinical, and epidemiologic data of the patients were prospectively recorded. The standardized disk-diffusion method was used to determine resistance of the strains to imipenem, ceftazidime, aztreonam, amikacin, gentamicin, mezlocillin, cefepime, tobramycin, meropenem, ceftriaxone, and ciprofloxacin. Clonal relatedness of the strains was investigated by pulsed-field gel electrophoresis (PFGE). RESULTS: Of the 105 P aeruginosa strains identified, 45 (43%) were isolated from the patients hospitalized in intensive care units. Thirteen patients had repeated pseudomonas infection (total 38 infections/13 patients); 26 of these repeated infections in 9 patients showed the same localization. Half of the patients had at least 1 underlying disease such as burn (48%), chronic illness (32%), and malignancy (20%). Fifty-seven patients (71%) had urinary and/or other catheterization. Urinary tract infection (35%) was the most frequent infection encountered, followed by respiratory tract infection (34%) and sepsis (13%). Resistance to the antibiotics tested was in the 12% to 88% range; amikacin was the most effective and ceftriaxone was the least effective antibiotic. The PFGE typing method showed that 28 of the 80 patients' isolates were clonally related, including 23 indistinguishable or closely related strains (29%), and 5 possibly related strains (6%). Epidemiologic data of the 16 patients (20% of the patients) confirmed a clonal relationship among the strains. Of the 26 isolates of the 9 patients having repeated infection in the same location, 18 (69%) were in the clonally related groups, whereas 11 of the 12 strains isolated from repeated infections on different body sites were clonally different. CONCLUSION: Our results indicated that P aeruginosa infections in our hospital mainly affected the patients hospitalized in intensive care units and those having catheterization, burn, and/or chronic illness. Amikacin was the best antibiotic as far as bacterial resistance was considered. Although lack of major PFGE type confirmed no P aeruginosa outbreak, typing results showed that cross transmission and treatment failure are the 2 main problems, which should be consider together to prevent this bacterial infection in medical centers.     

尿路感染患者产超广谱β-内酰胺酶大肠埃希菌的耐药性分析

目的了解尿路感染患者中产超广谱β-内酰胺酶(extended-spectrumβ-lactamase,ESBLs)大肠埃希菌的耐药现状,指导临床合理用药。方法从我院2015年1月—2016年1月间尿路感染患者的尿液中分离出大肠埃希菌株。所有菌株采用法国梅里埃公司VITEK2 Compact分析仪进行细菌鉴定,纸片扩散法检测大肠埃希菌产ESBLs的产生情况及耐药特点。结果从尿路感染患者中共检出大肠埃希菌432株,其中有226株产ESBLs,检出率为52.31%,药物敏感性试验结果显示产ESBLs菌株对亚胺培南耐药率仅为0.88%;其次为呋喃妥因,耐药率为19.91%;耐药率最高的为氨苄西林,为98.23%;对含酶抑制剂的药物其耐药率也明显增加。与非产ESBLs菌株耐药性相比,产ESBLs株的耐药率显著增高。结论尿路感染患者中分离得到产ESBLs大肠埃希菌的比例较高,积极检测和监测产ESBLs大肠埃希菌及其耐药情况对于临床合理用药、院内感染控制及流行病学调查极为重要。     

Indwelling urinary catheters in the elderly. Relation of "catheter life" to formation of encrustations in patients with and without blocked catheters

In order to define the natural history of indwelling urinary catheters in the elderly, 50 patients aged 65 years or older were followed. Their catheters had been in place for a mean of 33.2 days. When removed, 40.4 percent were blocked or showed poor flow. After the catheters were changed, the 14-day "catheter life" was 78 percent. About half the population had blocked catheters. They had a 14-day "catheter life" of only 31.8 percent (p = less than 0.01). Patients with blocked catheters ("blockers") excreted more alkaline urine, calcium, protein, and mucin than patients without blocked catheters ("nonblockers"), but urea-splitting bacteria were no more frequent. The mortality was not significantly different. Flow of water through catheters was closely related to extent of encrustations. Encrustations formed uniformly throughout the catheter lumen except when the tip was obstructed. The distribution and number of species of microorganisms (three and a half per specimen) were virtually identical in catheter and bladder urine, but the counts in the catheter urine were more frequently greater than 100,000 cfu/ml (p = less than 0.01). Patients with blocked catheters appear to be metabolically different from patients without blocked catheters and should have their catheters changed at seven to 10 days to avoid obstruction.     

呼吸重症监护病房多重耐药鲍曼不动杆菌耐药基因研究

目的 观察我院呼吸重症监护病房(RICU)临床分离多重耐药鲍曼不动杆菌β-内酰胺酶基因和消毒剂耐药基因qacE△1-sul1存在状况.方法 收集RICU分离多重耐药鲍曼不动杆菌16株,采用PCR方法检测8种β-内酰胺酶基因(TEM、SHV、PER、DHA、IMP、VIM、OXA-23、OXA-24)和消毒剂耐药基因(qacE△1-sul1)共9种基因.采用多基因聚类分析方法进行多重耐药菌株亲缘性分析.结果 16株多重耐药鲍曼不动杆菌中blaOXA-23阳性5株(31.25%),blaTEM阳性2株(12.50%),blaDHA 2株(12.50%),blaOXA-24 1株(6.25%),blaPER 1株(6.25%).blaSHV、blaIMP、blaVIM均未检出,消毒剂耐药基因检测qacE△1-sull阳性16株(100.00%).多基因聚类分析发现存在克隆传播现象.结论 我院RICU多重耐药鲍曼不动杆菌携带多种β-内酰胺酶基因,消毒剂耐药基因携带率高,聚类分析显示存在克隆传播现象,应引起临床重视.     

Patient factors contributing to the emergence of gentamicin-resistant Serratia marcescens.

One hundred forty nosocomial Serratia marcescens infections (including 76 cases of bacteremia) were identified by prospective surveillance from 1975 through 1977 and retrospective chart review from 1968 through 1974. Thirty-four cases (24 per cent) involved gentamicin-resistant strains. All gentamicin-resistant strains appeared after 1974. Ninety per cent of the patients had undergone surgery, and 88 per cent had received prior antimicrobial therapy. The emergence of gentamicin-resistant S. marcescens paralleled the increase in usage of gentamicin. Prior use of gentamicin for more than two days in an individual patient was a significant risk factor (P = 0.0002) for being infected with a Serratia that was gentamicin-resistant. Other factors which separated gentamicin-resistant Serratia infections from gentamicin-sensitive Serratia infections were (1) urinary site of infection (P = 0.0005), (2) urinary catheter (P = 0.002), (3) endotracheal tube or tracheotomy (P = 0.03) and (4) increasing duration of hospitalization (P less than 0.05). Thirty-three of 34 (97 per cent) patients with gentamicin-resistant strains had urinary catheters. Specific measures to control infection were effective in decreasing the incidence of infections caused by gentamicin-resistant Serratia.     

A study of methicillin-resistant Staphylococcus aureus (MRSA) infection in the urological field

Clinical backgrounds of 35 patients with urogenital infection, from whom methicillin-resistant Staphylococcus aureus (MRSA) was isolated, were analyzed. Susceptibilities of these MRSA strains to various antimicrobial agents were also measured. Out of 35 MRSA strains, 29, 4 and 2 were isolated from urine, pus and sputum specimens, respectively, showing a definitely high isolation rate from urine. As for underlying diseases, 22 patients (62.8%), 11 (31.4%) and one each had a malignant tumor of the urinary tract or genital organ, prostatic hypertrophy, urolithiasis and vesicoureteral reflux, respectively. Patients aged at over 60 years numbered 20 (57%), and 32 patients (91.4%) were treated with some antimicrobial agent at the time of MRSA isolation. Out of 35 strains, 17 were isolated after total cystectomy with urinary diversion or transurethral surgery. As for the state of MRSA infection, 9 and 26 patients had single and polymicrobial infections, respectively, but none of patients had serious symptoms definitely thought to be caused by MRSA. On evaluation of susceptibilities of MRSA to various antimicrobial agents, the MRSA strains were found to be sensitive to minocycline, netilmicin and ofloxacin. From these results, MRSA strains isolated from patients treated in the field of urology were thought to rarely cause serious infectious symptoms, especially true for those isolated from the urine.     

Preventing hospital-acquired urinary tract infection in the United States: a national study.

BACKGROUND: Although urinary tract infection (UTI) is the most common hospital-acquired infection in the United States, to our knowledge, no national data exist describing what hospitals in the United States are doing to prevent this patient safety problem. We conducted a national study to examine the current practices used by hospitals to prevent hospital-acquired UTI. METHODS: We mailed written surveys to infection control coordinators at a national random sample of nonfederal US hospitals with an intensive care unit and >or=50 hospital beds (n=600) and to all Veterans Affairs (VA) hospitals (n=119). The survey asked about practices to prevent hospital-acquired UTI and other device-associated infections. RESULTS: The response rate was 72%. Overall, 56% of hospitals did not have a system for monitoring which patients had urinary catheters placed, and 74% did not monitor catheter duration. Thirty percent of hospitals reported regularly using antimicrobial urinary catheters and portable bladder scanners; 14% used condom catheters, and 9% used catheter reminders. VA hospitals were more likely than non-VA hospitals to use portable bladder scanners (49% vs. 29%; P=.001), condom catheters (46% vs. 12%; P=.001), and suprapubic catheters (22% vs. 9%; P=.001); non-VA hospitals were more likely to use antimicrobial urinary catheters (30% vs. 14%; P=.001). CONCLUSIONS: Despite the strong link between urinary catheters and subsequent UTI, we found no strategy that appeared to be widely used to prevent hospital-acquired UTI. The most commonly used practices--bladder ultrasound and antimicrobial catheters--were each used in fewer than one-third of hospitals, and urinary catheter reminders, which have proven benefits, were used in <10% of US hospitals.     

A clinical study on patients with urinary tract infection due to coagulase-negative staphylococci.

To assess the clinical significance of coagulase-negative staphylococci (CNS) in patients with urinary tract infection (UTI), the clinical characteristics of a total of 117 patients (106 complicated UTI patients, 11 uncomplicated UTI patients) from whom CNS were isolated at urinary colony counts of 10(5) or more per ml were studied. Of the complicated UTI patients, 95 patients (89.6%) suffered from no symptoms while 11 (10.4%) had fever of 38 degrees C or greater, which was strongly suspected to be due to genitourinary tract infections. Six of these patients were managed by indwelling urinary catheters. On the other hand, all of the patients with uncomplicated UTI were young women and had typical symptoms of acute cystitis. These results suggest that CNS, which hitherto have been considered mere contaminants or benign colonization rather than true pathogens, can also cause complicated UTI requiring chemotherapy under certain conditions such as indwelling urinary catheterization and acute cystitis in sexually active women.     

Clinical significance of Mycobacterium fortuitum isolated from respiratory specimens

BACKGROUND: Although Mycobacterium fortuitum is not an uncommon organism among the non-tuberculous mycobacteria isolated from respiratory specimens, its clinical significance had not been well studied. METHODS: We identified all patients whose respiratory specimens were positive for M. fortuitum between January 2003 and December 2005. Among 182 patients whose specimens were positive for M. fortuitum, 26 were positive at least twice. We retrospectively reviewed their characteristics, and clinical courses. RESULTS: Of the 26 patients, 15 had two positive culture results for M. fortuitum; the other 11 had three or more. Sixteen patients were male and the median age was 61.5 years. Major presenting symptoms were cough (65%) and sputum (58%). Most patients had known underlying lung diseases, including prior tuberculosis (54%), lung cancer (15%), idiopathic pulmonary fibrosis (15%), and other mycobacterial lung disease (15%). The most common CT findings were bronchiectasis (80%). Only one patient received specific prolonged antibiotic therapy against M. fortuitum infection; the other 25 did not. No patients showed clinical aggravation during the follow-up period, although in five patients their underlying lung diseases continued to progress. The median follow-up duration was 12.5 months and none of the patients whose sputum specimens were available had persistent positive cultures for M. fortuitum. CONCLUSION: M. fortuitum usually causes colonization or transient infection in patients with underlying lung disease, such as prior tuberculosis or bronchiectasis. The majority of patients may not need to receive prolonged antibiotic therapy for M. fortuitum isolates.     

我院儿科感染病原菌分布及耐药性分析

目的了解我院近3年儿科患者感染的病原菌构成及耐药率。方法对我院儿科住院患儿感染的病原菌及耐药进行分析。结果共分离1037株细菌,其中革兰阳性菌407株(39.24%),革兰阴性菌630株(60.75%);病原学分类为肺炎克雷伯菌200株(19.29%),大肠埃希菌198株(19.09%),凝固酶阴性的葡萄球菌139株(13.4%),肺炎链球菌123株(11.86%),金黄色葡萄球菌81株(7.81%);在病区分布上,新生儿530株(51.11%),普儿病区507株(48.89%)。革兰阴性杆菌主要对碳青霉烯类抗菌药物敏感,对常用药物如第三代头孢菌素、氨曲南等耐药率较高,革兰阳性葡萄球菌主要对万古霉素、利奈唑胺和奎奴普丁/达福普汀敏感。结论我院儿科患者感染的病原体以革兰阴性菌占优势,新生儿病区较普通儿科病区的病原菌耐药程度高。