Objective Titania and Ag containing nano-hydroxyapatite/polyamide 66 (TiO2-Ag-nHA/PA66) composite bone fill ing material has good biocompatibil ity and biological safety. To investigate the antibacterial effect and Ag+ release characteristics of TiO2-Ag-nHA/PA66 composite bone fill ing material containing different concentrations of Ag+ in vitro. Methods The n-HA/PA66 composite bone fill ing material A1 (material A1) was prepared by co-polymerization method, and TiO2-Ag-nHA/PA66 composite bone fill ing materials A2 and A3 (materials A2 and A3) were prepared by thesame way containing Ag+ of 0.22wt% and 0.64wt%, respectively, and the TiO2 content was 2.35wt%. The materials A2 and A3 were respectively immersed in 50 mL simulated body fluid (SBF), and Ag+ concentration was measured by atomic absorption spectrometry at 1, 3, 7, 14, 21, and 49 days. The inhibition ring test and colony count method were used to evaluate antibiotic effect against Staphylococcus aureus and Escherichia coli, the anti-adhesion capacity of Staphylococcus aureus and Escherichia coli was observed by scanning electron microscope (SEM). Results There was no significant difference in the Ag+ concentration between materials A2 and A3 at 1 day and 3 days (P gt; 0.05); and there were significant differences in the Ag+ concentration between materials A2 and A3 after 7 days (P lt; 0.05). The inhibition ring diameters of materials A2 and A3 to Staphylococcus aureus and Escherichia coli reached the maximum at 1 day, which were (13.40 ± 2.88), (9.40 ± 1.14) mm and (23.60 ± 1.14), (18.80 ± 0.84) mm, showing significant difference (P lt; 0.05) between materials A2 and A3 respectively; and then, the diameter of inhibition ring reduced with the time. The antibacterial effect of materials A2 and A3 against Staphylococcus aureus and Escherichia coli lasted 15, 33 days and 9, 24 days, respectively. No inhibition ring was observed around material A1 all the time. And the inhibitory rates of materials A2 and A3 were 89.74% ± 3.62%, 94.18% ± 2.05% and 78.65% ± 5.64%, 85.96% ± 2.50%; showing significant differences (P lt; 0.05) among materials A1, A2, and A3. SEM showed that bacterial adhesion of materials A2 and A3 was obviously fewer than that of material A1. Conclusion TiO2-Ag-nHA/PA66 composite bone fill ing material has antibacterial property against Staphylococcus aureus and Escherichia coli, and it has a good release effect in SBF.
Objective To investigate predictive value of procalcitonin (PCT) and C-reactive protein (CRP) levels for spontaneous bacterial peritonitis (SBP) in patients with liver cirrhosis ascites. Methods The clinical data of 140 patients with liver cirrhosis ascites treated in our hospital from January 2012 to January 2016 were retrospectively analyzed. According to the presence of SBP, these patients were divided into SBP group and non-SBP group. The clinical data were compared between these two groups. The receiver operating characteristic (ROC) curve was constructed to assess their sensitivities and specificities of PCT and CRP for diagnosis of SBP. Results The PCT and CRP levels of the SBP group were significantly higher than those of the non-SBP group (P<0.05). The differences of serum ALT, AST and white cell count between the SBP group and the non-SBP were not statistically significant (P>0.05). The ROC curve analysis showed that the area under the ROC curve of PCT and CRP were 0.895 and 0.926, their corresponding cut-off value 2.1 μg/L and 24.8 mg/L, the sensitivities were 86.9% and 89.5%, the specificities were 85.1% and 83.5%, respectively. Conclusion Abnormally elevated PCT and CRP levels might have an important detective value for SBP in patients with liver cirrhosis ascites.
摘要:目的：评价围手术期预防性应用抗菌药物现状及合理性。方法：采用回顾性调查的方法，随机抽查2009年度Ⅰ类切口手术围手术期病案500份，设计外科围手术期预防性应用抗生素调查表，对预防用药的适应证、用药种类、联合用药、给药时机及持续时间进行统计分析。结果：未使用抗生素5例，预防性使用抗生素495例，其中不合理80例（16.00％）。预防性使用抗生素总品规数为540，其中头孢菌素类453例（83.89%），青霉素类（包括加酶抑制剂）26例（4.81%），喹诺酮类44例（8.15%）。选用头孢唑啉钠178例（32.96%）居第一位，头孢替唑钠第二，151例（2796%）。结论：Ⅰ类切口手术患者围手术期预防性使用抗菌药物较为合理，但仍存在用药指征把握不严，抗菌药物的选择、抗菌药物使用时间较长等问题，有待进一步规范化管理。Abstract: Objective: To understand the current application of perioperative preventive antibiotics, and their rationality. Methods: Five hundred perioperative records of patients with incision Ⅰ were randomly chosen and surveyed in 2009. A questionnaire for prophylactic use of antimicrobial was designed. The indication of antimicrobial use, the species, combination, timing and drug duration were analyzed. Results: Our of 500, 495 used antimicrobial and 80 were unreasonable; 540 kinds of antimicrobial were used, included cephalosporin 453 cases (83.89%), penicillin class (including plus enzyme inhibitors) in 26 cases (4.81%), quinolone 44 cases (8.15%). Cefazolin sodium (178 patients, 32.96%) ranked first, second was cefazolin sodium (151, 27.96%). Conclusion: Perioperative use of antimicrobial prophylaxis in patients with incision Ⅰ is reasonable, but standardization management should be strengthened in the indication, species, and duration.
Objective To investigate the research progress of drug-loaded antibacterial coating of orthopedic metal implants in recent years. Methods The recent literature on the drug-loaded antibacterial coating of orthopedic metal implants were reviewed. The research status, classification, and development trend of drug-loaded antibacterial coating were summarized. Results The drug-loaded antibacterial coating of orthopedic metal implants can be divided into passive release type and active release type according to the mode of drug release. Passive drug release coating can release the drug continuously regardless of whether the presence of bacteria around the implants. Active drug release coating do not release the drug unless the presence of bacteria around the implants. Conclusion The sustained and stable release of drugs is a key problem to be solved in various antibacterial coatings research. The intelligent antibacterial coating which release antibiotics only in the presence of bacteria is the future direction of development.
ObjectiveTo explore application value of next-generation sequencing (NGS) technology in diagnosis of pathogenic microorganism infection through two cases report and literature review.MethodsThe NGS technology was used to make clear diagnosis of two cases of suspected pulmonary tuberculosis and pulmonary nontuberculous mycobacterial diseases. Bronchoalveolar lavage fluid of these two patients was collected for gene detection of pathogens using the NGS technology. A systematic literature review was performed for similar published cases in WanFang and CNKI database, using the keywords (next-generation sequencing) OR (NGS) AND (microorganism OR infection) from January 2000 to January 2018, using the PubMed database to retrieve the English literature before January 2018 with the " NGS, infectious diseases, China” as keywords.ResultsOne case of Mycobacterium tuberculosis and one case of non-tuberculous Mycobacteria were detected respectively. A total of 221 Chinese literatures and 3 English literatures were retrieved, excluding dissertations, conferences and newspapers. Finally, 10 articles were published in the infectious diseases and respiratory diseases subjects. The role of NGS technology in the diagnosis and study of related pathogens is proposed.ConclusionThe NGS method is expected to achieve precision medical purposes, such as early diagnosis of infectious diseases, transmission control, accurate treatment, good prognosis and so on.
Diabetic foot infection (DFI) is one of the main causes of hospitalized patients with diabetic foot. DFI should be diagnosed according to the clinical manifestations, and the severity of infection should be graded in time. Diabetic foot wounds are mostly chronic wounds, and there are many kinds of bacterial infections. The bacteria and antibiotics resistance will change with the progress of the disease. Bacterial biofilm is also one of the important causes of antibiotic resistance. Reasonable and timely surgical treatment combined with effective antibiotic treatment is an effective measure to deal with the challenge of DFI. On this basis, multidisciplinary cooperation will achieve the best clinical outcome.
PURPOSE: To investigate the treatment of severe bacterial endophthalmitis. METHODS:The curative effects of vitrectomy after intravitreal antibiotics and steroids (IVAS)for the treatment of 23 patients with bacterial endophthalmitis (group I)and vitrectomy and IVA at the same time for the treatment of 28 patients with bacterial endopbthalmitis (group I)were analyzed retrospectively. RESULTS: The rate of curative effects of two groups were similar,while the marked curative effects in group I (47.8% )was significantly higher than that of the group I (17.9%). The average period of eliminating infiamation of group I was longer than that of group I , and the incidence of postoperative retinal detachment of group Ⅱ was 3 times more than that of group I . CONCLUSION :It was indicated that vitrectomy after IVAS may increase the security of vitrectomy and the curative effects of severe bacterial ndophthalmitis.
Objective To clarify the bacterial spectrum and drug resistance of different biliary diseases through bile culture results. Methods Patients who underwent surgical treatment and retained bile for cultivation at the Chinese PLA General Hospital between January 2015 and December 2016 were retrospectively collected. Clinical data such as bile bacterial culture and antibiotic sensitivity results, surgical reasons, and perioperative complications were recorded. Results A total of 272 patients were included, including 142 males and 130 females, aged (53.4 ± 14.1) years old. Intrahepatic and extrahepatic bile duct stones were the most common surgical cause, accounting for 32.4%. The positive rate of bile culture in benign diseases was 78.7%, which was higher than that in malignant diseases (48.5%). The infection related complications (30.0% vs. 6.7%), bile leakage rate (20.8% vs. 6.7%), and poor wound healing rate (24.0% vs. 0.0%) in the bile culture positive group were higher than those in the bile bacteria culture negative group (P<0.05). Among 183 patients with positive bile bacterial culture, a total of 294 strains of pathogenic bacteria were detected. There were 96 patients with single bacterial infection, 66 patients with two bacterial infections simultaneously, 18 patients with three bacterial infections, and 3 patients with four or more bacterial infections. Escherichia coli was the most common bacterium, accounting for 17.0%. There were differences in the positive rate of bile culture among patients with different etiologies (P<0.05). There were significant differences in the sensitivity rate of Enterococcus faecalis and Enterococcus faecalis for many antibacterial drugs. Conclusions There are differences in the positive rate of bacterial culture in the biliary tract of patients with different etiologies, and there is a possibility of mixed infection. It is necessary to select appropriate antibiotics for empirical treatment based on different etiologies. The use of antibiotics should be changed in a timely manner based on the results of bile culture.
ObjectiveTo investigate the distribution and antimicrobial resistance of the clinical strains isolated from the First Affiliated Hospital of Xi’an Jiaotong University in 2019 and provide a basis for clinical rational use of antibiotics.MethodsAll the clinical samples which were collected from January 1st to December 31st in 2019 were employed to determine antimicrobial resistance retrospectively. Results were interpreted according to Clinical and Laboratory Standards Institute 2019 breakpoints and analyzed by WHONET 5.6 software.ResultsA total of 6 784 nonduplicate strains were isolated in 2019, including 2 865 (42.2%) strains of Gram-positive bacteria and 3 919 (57.8%) strains of Gram-negative bacteria. The top five pathogens with the highest detection rate were Escherichia coli, Klebsiella pneumoniae, Enterococcus faecium, Pseudomonas aeruginosa, and Staphylococcus aureus. Methicillin-resistant Staphylococcus aureus and methicillin-resistant coagulase negative Staphylococcus accounted for 33.0% and 72.0%, respectively. The detection rate of vancomycin-resistant Enterococcus faecium was 1.0% and the detection rates of linezolid-resistant Enterococcus faecium and Enterococcus faecalis were 0.3% and 2.9%, respectively. As for the non-meningitis Streptococcus pneumoniae, the prevalence of penicillin-susceptible Streptococcus pneumoniae was 100% in the isolates from adults. Extended-spectrum β-lactamases-producing strains accounted for 58.2%, 33.6%, and 33.3% in Escherichia coli, Klebsiella spp., and Proteus mirabilis, respectively. The total detection rate of carbapenem-resistant Enterobacteriaceae was 7.8%, among which the detection rates of carbapenem-resistant Escherichia coli and carbapenem-resistant Klebsiella pneumoniae were 1.5% and 17.2%, respectively. The percentages of Pseudomonas aeruginosa strains resistant to imipenem and meropenem were 25.0% and 21.6%, respectively, and those of Acinetobacter baumannii were 73.8% and 74.2%, respectively.ConclusionsBacterial resistance is still serious in this hospital. It is necessary to strengthen rational drug use. At the same time, effective prevention and control measures should be taken to avoid cross-infection.
Carbapenemase producing Enterobacteriaceae (CPE) has emerged as a significant global public health challenge and placing infected patients at risk of potentially untreatable infections. When resistance to carbapenems occurs, there are often few alternative treatments available. Numerous international guidelines have performed systematic and evidence review to identify new strategies to prevent the entry and spread of CPE in healthcare settings. Several key strategies have been shown to be highly effective. Firstly a new strategy that is proven to be effective is the early identification of the CPE carrier patients through active surveillance cultures. While waiting for the screening results, suspected CPE carriers will be put on preemptive isolation in single room and healthcare worker will at the same time practice contact precautions. The active surveillance culture and prompt preemptive isolation will limit the entry and spread of CPE from getting into hospital. Secondly, it is of utmost importance to incorporate enforcement of the basic infection prevention and control best practices in the hospital including, full compliance to hand hygiene, appropriate use of personal protective equipment, execute antibiotic stewardship program to control abuse of antibiotics, effective environmental cleaning and decontamination, staff education and feedback, as well as surveillance of healthcare-associated infections. Such a holistic approach has been shown to be effective in inhibiting CPE from gaining foothold in the hospital.