Microbial growth patterns in a total parenteral nutrition formulation containing lipid emulsion

Microbial growth of Staphylococcus aureus, Escherichia coli, Pseudomonas aeruginosa and Candida albicans was evaluated in a standard amino acid-dextrose-based total parenteral nutrition (TPN) solution, 10% lipid emulsion, and a combined TPN formulation containing amino acids, dextrose, and lipid emulsion. At an initial inoculum of 10(4) CFU/ml, all three bacterial organisms grew well in 10% lipid emulsion, died in the standard solution and grew only minimally or died in the combined formulation. C. albicans grew in all three formulations at an initial inoculum of 10(4) CFU/ml; however, at an initial inoculum of 10(2) CFU/ml, which approximates touch contamination, growth of Candida in the standard and combined formulations was less than 1 log at 24 hr in contrast to the 10% lipid emulsion which showed significant growth greater than 2 log at 24 hr. It is concluded that a 24-hr infusion time is safe for the combined TPN formulation used in this study. This should result in significant cost savings compared to the previously recommended 12-hr infusion time.     

Sterility testing of home and inpatient parenteral nutrition solutions

The microbial contamination rate was compared for parenteral nutrition solutions prepared by patients for home use and by pharmacy personnel for inpatient use. Phase I validated the Ivex 0.22-micron inline filter as a tool for microbiological testing by inoculating small numbers of organisms in 5% dextrose injection and testing for recovery. Phase II validated the same method for determining microbial contamination of total parenteral nutrition (TPN) solutions. Phase III compared inpatient and home TPN microbial contamination rates using the methodology validated in phase II. Test organism inocula used in phase I and II were Candida albicans, Escherichia coli, Enterobacter cloacae, Klebsiella pneumoniae, Proteus vulgaris, Pseudomonas aeruginosa, Staphylococcus aureus, Staphylococcus epidermidis, and Streptococcus pyogenes. All contaminated solutions in phase I showed visual turbidity within 48 hr, and all test organisms were recovered and identified. All phase II-contaminated TPN solutions showed visual turbidity after 96 hr, and all test organisms were recovered and identified. One hundred postinfusion TPN samples were collected randomly during phase III from inpatient parenteral nutrition patients. Six patients and two hospitals participated in the study. None of the 44 home parenteral nutrition samples and none of the 56 inpatient TPN samples developed visible turbidity. Subcultures of each sample on blood agar were negative for microbial growth. This described methodology offers an effective means to establish contamination rates of parenteral nutrition solutions after administration.     

The stability of amikacin, gentamicin, and tobramycin in total nutrient admixtures

Amikacin (A), gentamicin (G), and tobramycin (T) were added to eight different total nutrient admixtures (TNA) with varying concentrations of dextrose, amino acid, and fat emulsion to determine drug and emulsion stability. All TNA were prepared aseptically and stored at room temperature under normal room lighting for 12 hr before drug addition. One volume of each drug was added to an equal volume of each of the eight TNAs to simulate 1:1 piggyback contact volumes. Samples were left at room temperature for 6 hr. Drug concentrations were analyzed by fluorescence polarization immunoassay. TNA/drug admixtures were pH tested and visually inspected before and after centrifugation in microhematocrit tubes, noting signs of emulsion stability at 1 and 6 hr. Emulsion particle size was determined at 1 and 6 hr using interference contrast microscopy. All three drugs retained their immunoreactivity in all TNAs for at least 6 hr. G and T were stable in all eight TNAs for at least 6 hr with no significant effect on emulsion particle size or stability after centrifugation. A was incompatible with all eight TNAs, resulting in visual breaking of all emulsions within 1 hr. Therefore, G and T, but not A, can be administered via piggyback method with the eight TNAs tested if the infusion is completed within 6 hr.     

Synthesis, biological evaluation and 2D-QSAR analysis of benzoxazoles as antimicrobial agents

A new series of 5(or 6)-nitro/amino-2-(substituted phenyl/benzyl)benzoxazole derivatives were synthesized and evaluated for antibacterial and antifungal activities against Staphylococcus aureus, Bacillus subtilis, Klebsiella pneumoniae, Pseudomonas aeruginosa, Escherichia coli, Candida albicans and their drug-resistant isolate. Microbiological results indicated that the synthesized compounds possessed a broad spectrum of activity against the tested microorganisms at MIC values between > 400 and 12.5 microg/ml. The results against B. subtilis, P. aeruginosa, drug-resistant B. subtilis, drug-resistant E. coli, and C. albicans isolate for these kinds of structures are quite encouraging. The 2D-QSAR analysis of a set of newly and previously synthesized benzoxazoles tested for growth inhibitory activity against B. subtilis ATCC 6633 was performed by using the multivariable regression analysis. The activity contributions for substituent effects of these compounds were determined from the correlation equation for predictions of the lead optimization.     

Bacterial/fungal growth in a combined parenteral nutrition solution

Appropriately mixed, compatible solutions of glucose, amino acids and lipid have recently become available for clinical use. While a single hyperalimentation solution has several advantages over the conventional two-bottle technique, its effect on infusion-related septicemia is unknown. An in vitro, mock infusion system identical to that used in our new-born intensive care unit was set up to assess the relative growth rates of three microorganisms in several parenteral nutrition mixtures. Growth of Staphylococcus epidermidis, Escherichia coli and Candida albicans was measured in seven different alimentation solutions, including two combined solutions. Generally, microbial growth was the same or decreased in combined solutions as compared to fat alone although considerably greater than that observed in nonlipid containing solutions. In addition, the ability of these organisms to pass in-line terminal filters of pore size 0.22 and 1.2 microns was assessed.     

Tetrasodium EDTA as a novel central venous catheter lock solution against biofilm.

BACKGROUND: Central venous catheter (CVC)-related bloodstream infections (BSIs) are known to increase rates of morbidity and mortality in both inpatients and outpatients, including hematology-oncology patients and those undergoing hemodialysis or home infusion therapy. Biofilm-associated organisms on the lumens of these catheters have reduced susceptibility to antimicrobial chemotherapy. This study tested the efficacy of tetrasodium EDTA as a catheter lock solution on biofilms of several clinically relevant microorganisms. METHODS: Biofilms of Staphylococcus epidermidis, methicillin-resistant S. aureus, Pseudomonas aeruginosa, Escherichia coli, Klebsiella pneumoniae, and Candida albicans were grown to levels of approximately 1 x 10(5) colony-forming units (CFU)/cm(-1) on CVC segments in a model system, then subjected to the tetrasodium EDTA lock treatment. RESULTS: Comparisons of biofilms before and after exposure to the 40-mg/mL(-1) tetrasodium EDTA lock for 21 hours showed that the biofilm viable cell counts of all organisms tested were significantly reduced (P < .05) after exposure to the treatment. CONCLUSION: Antimicrobial lock treatment using 40 mg/mL(-1) of tetrasodium EDTA for at least 21 hours could significantly reduce or potentially eradicate CVC-associated biofilms of clinically relevant microorganisms.     

Answering the fat emulsion contamination question: three in one admixture vs conventional total parenteral nutrition in a clinical setting

Fat emulsions (FE) support microbial growth when inoculated in vitro; dextrose/amino acid solutions (D/AA) do not. Can FE be safely added to D/AA when delivered over 24 hrs? We attempted to answer this question by culturing both conventional (C) total parenteral nutrition (TPN), in which the FE and D/AA are given separately, and the 3-in-1 admixture TPN, in which all components are delivered in one bag. Two-hundred TPN fluid cultures were obtained serially by collecting 1 ml of fluid from the distal-most connection when the TPN was changed every 24 hrs. Quantiative and qualitative cultures were obtained. One hundred sixty-six (83%) were negative. Of the 34 (17%) positive cultures, 15 (17% of 88) were from the conventional system whereas 19 (17% of 112) were from the 3-in-1 system. Six clinically septic patients furnished 11 TPN fluid specimens which grew greater than 400 colonies/ml. Seven (8% of 88) of these were from the conventional system whereas four (3.6% of 112) were from the 3-in-1 system. All had distant sites of sepsis. The 23 remaining positive TPN fluid cultures grew less than 25 colonies/ml, with 20 growing Staphylococcus epidermidis. All of these patients were clinically well and there was no significant difference in the distribution of positive cultures between the conventional system (9%) and the 3-in-1 system (13%).(ABSTRACT TRUNCATED AT 250 WORDS)     

心内科住院患者感染的影响因素、易感部位及病原学分析

目的对心内科住院患者感染的影响因素、易感部位及病原学分析进行研究为治疗提供依据。方法回顾性研究2873例心内科住院患者的有关资料。结果患者中发生感染345例,影响因素为心功能的级别、伴有并发症、住院的时间、年龄的差异等;最常见易感部位是上、下呼吸道系统、泌尿系统感染、消化系统感染等;检出病原菌411株;常见致病菌主要是革兰阴性杆菌250株(占60.8%)(以肺炎克雷伯杆菌、铜绿假单胞菌、鲍氏不动杆菌、大肠埃希菌为主),其次是革兰阳性球菌130株(占31.6%)(以金黄色葡萄球菌、表皮葡萄球菌、肠球菌属为主),真菌31株(占7.6%)(白色假丝酵母菌为主);耐药性普遍较高,其中肺炎克雷伯杆菌对美罗培南、亚胺培南,表皮葡萄球菌、金黄色葡萄球菌对万古霉素的敏感程度均达到100.0%。结论要根据药敏试验结果进行合理用药。     

Total nutrient admixture: a review

The TNA system of nutritional support has become very popular and offers some unique advantages over the traditional method of administering TPN to hospitalized and home patients. However, these advantages as outlined in this review, must be carefully weighed against potential disadvantages before the TNA system is employed as a nutritional support modality. It should also be noted that the stability of TNA systems is not well established since many stability studies do not provide specific information regarding formulations tested. In addition, many studies do not utilize methods to determine the entire spectrum of particle size and distribution. Droplet size in TNA systems attain a diameter several times larger than the 0.2 to 0.4 micron of manufacturer's lipid emulsions and naturally occurring chylomicrons. Although the administration of the TNA system has not been associated with any acute toxicity, the long-term consequences of infusing droplets larger than 0.4 micron is not definitely known. In addition, the biological implications of using the TNA system need to be elucidated. Subtle differences in the properties of the lipid emulsion can affect the way it is metabolized by the body. Wretlind has mentioned that two apparently similar soybean oil emulsions, Intralipid, and Lipofundin are handled differently by the body. Minor differences in the phospholipid layer of the droplets were postulated as a cause. Certainly the nature of the emulsifying layer of phospholipid on TNA system droplets is modified and therefore may be metabolized differently. The recent report of enhanced growth of microorganisms in TNA systems is also worrisome.(ABSTRACT TRUNCATED AT 250 WORDS)     

Hepatic Indicators of Oxidative Stress and Tissue Damage Accompanied by Systemic Inflammation in Rats Following a 24‐Hour Infusion of an Unstable Lipid Emulsion Admixture

Background: Use of lipid emulsions in parenteral nutrition therapy is an important source of daily energy in substitution of potentially harmful glucose calories when given in excess in the intensive care unit. When added to parenteral nutrition (PN) admixtures as a total nutrient admixture (TNA), the stability and safety of the emulsion may be compromised. Development of a rat model of a stable vs unstable lipid infusion would enable a study of the potential risk. Design: Prospective, randomized, controlled study. Methods: Surgical placement of a jugular venous catheter for the administration of TNAs was performed. Two groups were studied: a stable or s‐TNA (n = 16) and an unstable or u‐TNA (n = 17) as a 24‐hour continuous infusion. Stability of TNAs was determined immediately before and after infusion using a laser‐based method approved by the United States Pharmacopeia. Results: Blood levels of aspartate aminotransferase, glutathione‐S‐transferase, and C‐reactive protein were significantly elevated in u‐TNA vs s‐TNA (P < .05). Also, liver tissue concentrations of malondialdehyde were significantly higher in the u‐TNA group (P < .05), and triglyceride tissue levels were also higher in u‐TNA and approached statistical significance (P = .077). Conclusions: Unstable lipid infusions over 24 hours produce evidence of hepatic accumulation of fat associated with oxidative stress, liver injury, and a low‐level systemic inflammatory response.     

The growth of micro-organisms in intravenous fluids

The growth of four micro-organisms in 12 different intravenous fluids at room temperature was studied. Gram-negative organisms grew better than Gram-positive, and lipid solutions were most favourable to microbial growth. Microbial growth was inhibited in solutions with osmolalities over 500 mosmol/l; Staphylococcus epidermidis was inhibited by inocula with Gram-negative bacilli, while the growth of Gram-negative bacilli generally was not affected. Candida albicans was inhibited by Gram-negative bacilli in lipid and 5% dextrose solutions.     

Synthesis, characterization and antimicrobial activity of Co(II), Zn(II) and Cd(II) complexes with N-benzyloxycarbonyl-S-phenylalanine

In this paper the first complexes of M(2+) ions (M(2+) = Zn(2+), Cd(2+) and Co(2+)) with N-benzyloxycarbonyl-S-phenylalaninato ligand (1-3) are described. The new complexes were characterized by means of elemental analysis, IR and UV-vis spectroscopy, molar conductivity measurements and (1)H, (13)C and (15)N NMR spectroscopy (1D and 2D). The Co(II) complex adopts an octahedral geometry, and the Zn(II) and Cd(II) complexes adopt a tetrahedral one. For the first time, the antimicrobial activity of N-benzyloxycarbonyl-S-phenylalaninato ligand (N-Boc-S-phe) and the complexes 1-3 was investigated against gram-positive: Micrococcus luteus, Staphylococcus aureus, Staphylococcus epidermidis, Enterococcus faecalis and Bacillus subtilis and gram-negative bacteria: Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa and two strains of the yeast Candida albicans. It was shown that the complexes were effective against most strains. The best activity was detected against the yeast C. albicans.     

重症监护病房脓毒症患者病原菌的流行病学特征

目的了解重症监护病房中脓毒症患者常见的病原菌种类、分布及耐药情况,为脓毒症患者抗菌药物合理应用提供参考依据。方法回顾性收集2015年1月—2016年6月入住某院重症监护病房的脓毒症患者的临床资料、送检培养标本的病原菌检出及药敏试验结果,对资料进行分析。结果共选取175例脓毒症患者,检出241株病原菌,129株多重耐药菌;其中革兰阴性菌139株(57.68%)、革兰阳性菌68株(28.22%),真菌29株(12.03%);分离率居前5位的病原菌分别为大肠埃希菌(20.75%),肺炎克雷伯菌(14.11%),鲍曼不动杆菌(13.28%),白假丝酵母菌(12.03%),铜绿假单胞菌(9.54%)。检出率居前5位的多重耐药菌分别为鲍曼不动杆菌(29/32,90.63%)、屎肠球菌(16/20,80.00%)、肺炎克雷伯菌(24/34,70.59%)、葡萄球菌属(14/21,66.67%)、铜绿假单胞菌(14/23,60.87%)。大肠埃希菌和肺炎克雷伯菌中产超广谱β-内酰胺酶(ESBLs)菌株分离率分别为68.00%(34/50)和17.65%(6/34),大肠埃希菌对碳青霉烯类及β-内酰胺酶抑制剂耐药率低,肺炎克雷伯菌仅对替加环素敏感;鲍曼不动杆菌对抗菌药物呈普遍耐药,铜绿假单胞菌仅对多粘菌素敏感;肠球菌及葡萄球菌对糖肽类、利奈唑胺及替加环素敏感;白假丝酵母菌对抗真菌药物普遍敏感。结论该院重症监护病房脓毒症患者所分离的病原菌耐药率高,尤以鲍曼不动杆菌显著,酶抑制剂类、碳青霉烯类和糖肽类抗菌药物仍然是经验性抗感染治疗的有效药物。     

2016-2017年医院病原菌的分布及耐药性分析

目的 了解临沂市人民医院2016-2017年病原菌的分布及耐药情况,为临床合理使用抗菌药物提供参考依据。方法 根据CLSI 2016年版、2017年版标准,用WHONET 5.6软件,回顾性分析了2016-2017年该院临床分离菌株的分布及耐药性。结果 2年间全院共分离出病原菌19940株,其中革兰阴性杆菌占64.7%,主要以大肠埃希菌(17.3%)、肺炎克雷伯菌(13.2%)、铜绿假单胞菌(9.2%)、鲍曼不动杆菌(7.3%)为主;革兰阳性球菌占30.8%,主要以金黄色葡萄球菌(8.4%)、肺炎链球菌(6.4%)和表皮葡萄球菌(4.1%)为主。大肠埃希菌、肺炎克雷伯菌对替加环素、多粘菌素、碳青霉烯类、酶抑制剂复合剂的耐药率多低于5%;铜绿假单胞菌、鲍曼不动杆菌未发现对多粘菌素B耐药的菌株,对替加环素敏感,对其他抗菌药物大都耐药。金黄色葡萄球菌和表皮葡萄球菌多产β-内酰胺酶,对β-内酰胺类抗菌药物、红霉素、克林霉素耐药严重,目前未检出对万古霉素、利奈唑胺耐药的菌株;肺炎链球菌对红霉素、克林霉素、复方新诺明耐药,而对其他抗菌药物大都敏感。结论 近2年该院病原菌感染以革兰阴性菌为主,其中大肠埃希菌、肺炎克雷伯菌、铜绿假单胞菌的检出率增长迅速,鲍曼不动杆菌的耐药性极为严重。多重耐药性细菌仍然是临床面临的重要问题,医院应加强对细菌的监测,以减少耐药菌株的产生,控制医院感染。     

中心静脉导管病原菌污染调查

目的探讨中心静脉导管（CVC）的病原学特征。方法回顾分析近5年临床各科送检的CVC病原学结果及细菌耐药性。结果3189份CVC标本中471份（14.77%）检出致病菌514株,G＋球菌、G-杆菌和真菌分别占42.41%、40.66%和16.93%;最常见的致病菌分别为表皮葡萄球菌（15.56%）、金黄色葡萄球菌（13.81%）、铜绿假单胞菌（13.23%）、肺炎克雷伯菌（7.59%）和鲍氏不动杆菌（6.23%）;91.18%为耐甲氧西林金黄色葡萄球菌（MRSA）,88.57%为耐甲氧西林凝固酶阴性葡萄球菌（MRCNS）,12.00%肠杆菌科产超广谱β-内酰胺酶（ESBLs）;44.12%铜绿假单胞菌和34.38%鲍氏不动杆菌全部耐药。结论CVC检出病原菌以耐药菌为主,应加强病原学监测及导管护理,是控制导管相关性感染的关键。     

Synthesis and antimicrobial activity of some novel derivatives of benzofuran: part 1. Synthesis and antimicrobial activity of (benzofuran-2-yl)(3-phenyl-3-methylcyclobutyl) ketoxime derivatives

The reaction of salicylaldehyde with 1-phenyl-1-methyl-3-(2-chloro-1-oxoethyl) cyclobutane (1) and potassium carbonate was used to prepare (benzofuran-2-yl)(3-methyl-3-phenylcyclobutyl) methanone (2) for the starting reagent purposes. (benzofuran-2-yl)(3-phenyl-3-methyl cyclobutyl) ketoxime (3) was synthesized from the reaction of the compound (2) with hidroxylamine. New derivatives of (benzofuran-2-yl)(3-phenyl-3-methyl cyclobutyl) ketoxime (3) such as, O-glycidylketoxime (4) and O-phenylacylketoxime (5a-c) were obtained very high yields. Alkyl, allyl and aryl substituted N-oxime ethers (6a-e) were obtained from the reaction compound 3 and various halogen contained compounds. The syntheses of the compounds (7a-f) were carried out from the reaction of the compound (4) and different amines such as, isopropyl amine, natrium azide, morpholine and piperazine. All of the synthesized compounds were tested for antimicrobial activity against Staphylococcus aureus ATCC 6538, Staphylococcus epidermidis ATCC 12228, Escherichia coli ATCC 8739, Klebsiella pneumoniae ATCC 4352, Pseudomonas aeruginosa ATCC 1539, Salmonella typhi, Shigella flexneri, Proteus mirabilis ATCC 14153 and Candida albicans ATCC 10231. Among the synthesized compounds (benzofuran-2-yl)(3-phenyl-3-methyl cyclobutyl)-O-[2-hydroxy-3-(N-methylpiperazino)] propylketoxime (7d) was found the most active derivative against S. aureus ATCC 6538. The compounds 2, 5b, 6b, 6c, 7b and 7f showed very strong and the same antimicrobial effect against C. albicans ATCC 10231. Similarly (benzofuran-2-yl)(3-phenyl-3-methylcyclobutyl)-O-benzylketoxime 6a showed good antimicrobial effect against C. albicans ATCC 10231. None of the other compounds exhibited activity against the other test microorganisms.     

Management of catheter-related infections in pediatric patients

Broviac catheters are commonly used to provide parenteral nutrition and access for infusion of blood products and drugs to pediatric patients. Sepsis is the most common serious complication of continued catheter use. Although removal of the catheter is generally recommended when it becomes contaminated, it may not be feasible to do so without compromising patient care. We evaluated the management of catheter-related infections in pediatric patients with and without removal of catheter. Seventy-seven episodes of catheter sepsis were evaluated in 61 pediatric patients; 24 were neonates and 37 were older children. The catheters were used for multiple purposes in 75% of cases. The most common microorganisms isolated were Staphylococcus epidermidis in 26%, Klebsiella pneumoniae in 9%, and Streptococcus viridans in 8% of cases; other pathogens included group D Enterococcus, Staphylococcus aureus, and Escherichia coli. Pseudomonas aeruginosa was isolated in four older children. Thirty-five patients were treated with antibiotics without catheter removal. Thirty patients received appropriate antibiotic therapy based on the susceptibility data. Twenty-six of these 30 patients responded within 5 days of therapy whereas the others required 15-39 days of treatment. Lack of response was mainly associated with the presence of abscess, immunocompromised status, and organisms P. aeruginosa and Candida albicans. Based on the sensitivity and minimum inhibitory concentration data, a combined regimen of gentamicin and vancomycin would be an effective initial therapy. These findings suggest that (1) catheter sepsis can be managed with appropriate antibiotics, and (2) when continued use of Broviac catheter is desired, a trial of antibiotic therapy should be attempted before catheter removal.     

尿液pH对常见泌尿系感染细菌抗生素敏感性的影响

目的 探讨尿液pH对常见泌尿系感染细菌抗生素敏感性的影响。方法 配制不同pH的人工尿液,以大肠杆菌、表皮葡萄球菌、金黄色葡萄球菌、产超广谱β-内酰胺酶(extended-spectrum β-lactamases,ESBL)的肺炎克雷伯菌和产ESBL的铜绿假单胞菌为研究菌种,环丙沙星、左氧氟沙星、磷霉素氨丁三醇和头孢呋辛为研究药物,采用药敏试验中的微量肉汤稀释法比较不同抗生素在不同pH的人工尿液培养基中的抗菌效力。结果 环丙沙星对大肠杆菌、表皮葡萄球菌和产ESBL的肺炎克雷伯菌的抗菌效果随着pH升高而升高;左氧氟沙星对大肠杆菌和表皮葡萄球菌的抗菌效果亦随着pH升高而升高;磷霉素对大肠杆菌、表皮葡萄球菌和金黄色葡萄球菌的抗菌效果随着pH的升高而降低;头孢呋辛对大肠杆菌和金黄色葡萄球菌的抗菌效果亦随着pH的升高而降低。结论 通过调节尿液pH能够改变致病菌对抗生素的敏感性,以期在临床上提高抗生素对泌尿系感染的治疗效果。     

24141份血培养病原菌的分布及耐药性分析

目的 了解医院2009年1月-2011年12月血培养阳性标本检出的病原菌分布及耐药性,为临床血流感染的诊断、治疗提供依据.方法 采用BacT/Alert 3D全自动血培养仪进行血培养,VITEK-2 Compact全自动微生物分析系统进行鉴定,用K-B纸片法进行体外药敏试验,应用WHONET 5.4软件对结果进行统计分析.结果 从24141份血液标本中培养分离病原菌1289株,检出阳性率为5.3％,革兰阴性菌667株,占51.7％,包括大肠埃希菌、肺炎克雷伯菌、鲍氏不动杆菌、铜绿假单胞菌等,分别占15.2％、7.4％、6.9％、5.5％,革兰阳性菌447株,占34.7％,包括表皮葡萄球菌、金黄色葡萄球菌、人葡萄球菌、溶血性葡萄球菌等,分别占7.7％、5.6％、3.5％、3.2％,真菌133株,占10.3％,包括白色假丝酵母菌、热带假丝酵母菌,分别占3.2％、2.3％;大肠埃希菌、肺炎克雷伯菌对亚胺培南、阿米卡星高度敏感;铜绿假单胞菌、鲍氏不动杆菌对各类抗菌药物的敏感率普遍较低;革兰阳性球菌对万古霉素、替考拉林和喹奴普汀/达福普汀高度敏感;真菌对伏立康唑、两性霉素B、氟康唑高度敏感.结论 引起血流感染的病原菌的菌种复杂、耐药率高,临床应加强血流感染病原菌耐药性监测,合理使用抗菌药物.     

外科手术部位感染病原菌分布

目的了解外科患者手术部位感染的病原菌分布. 方法总结分析全国医院感染监控网资料中的手术部位感染病原学资料. 结果金黄色葡萄球菌、表皮葡萄球菌、肠球菌属分别占分离病原体的12.69%、8.08%、6.49%;大肠埃希菌、铜绿假单胞菌、肠杆菌属、克雷伯菌属分别占19.32%、9.69%、7.88%、5.65%;白色念珠菌和非白色念珠菌分别占1.51%和2.19%;由表浅切口到器官腔隙感染,G 菌和真菌的比例逐渐增加. 结论常见的手术部位感染病原体为大肠埃希菌、金黄色葡萄球菌、铜绿假单胞菌、表皮葡萄球菌、肠杆菌属、肠球菌属、克雷伯菌属,需加强对手术部位感染及其病原菌和耐药性的监测.