Epidemiologic Survey Of Major Pathogenic Bacteria On Patients Of Nosocomial Infection And Initial Approach On Drug Resistance Of These Bacteria

Nosocomial infection had been highly thought by people inmorden hospitals. The result of investigation shew that the percentof different country's nosocomial infection was between 6% to 10%.The data acquired from china was between 6% to 9%. The data of XiangYa hospital of Zhong Nan University was 7.04%. The reson ofnosocomial infection include objection and subjective factors. Theirrational using of antibiotic was the major one among those factors.For this reason, the study to the drug resistance rationale ofbacteria is very important. There are two parts in this study: oneis epidemiological study of nosocomial infection in the firsthospital of Ji Lin University; the other is the study of drugresistance rationale of bacteria.I consulted all of the medical records(TMR)of ordinarysurgery, urinary surgery, bone surgery, internal medicine ofrespiratory and internal medicine of blood from Octobor, 2003 toOctobor, 2004 in the first hospital of Ji Lin University. The resultshew that: the prevalence rate of nosocomial of the first hospitalof Ji Lin University was 5.6%. The distribution of bacteria therewas: the primary pathogenic bacteria of the internal medicinesystem was: E.coli, SP and SA; the primary pathogenic bacteria ofthe surgery system was: E.coli, PA and SA. The distribution ofbacteria in the different speciments was: the primary bateriaaround the wounds was: SA, SP and E.coli; the primarey bacterialin the urine was: E.coli; the primary bacteria in the secretion ofrespiratory tract was: SP. The quantity of all of the nosocomialinfectons, wound infection was the first, abdomen infection was thesecond. The occurrence and application of Penicillin started new epochof chemistry therapy. The antibiotics close behind it were:Streptomycin, Alficetin, Oxytetracycline, Abomacetin andEconomycin etal. They played important role of the therapy ofinfectious diseases and made the people's mean life extend fifteenyears. But with the abuse of the antibiotics, the occurrence speedof the drug resistance of bacteria was fast and fast. With theassistance of the doctors in the chmical examination division, Iproceed the dretrospective survey of drug resistance of bacteriaand gathered all the results to statistic. I collected 120 strainsof pathogenic bacteria from the patients in the first hospital ofJilin University from 2003 to Octobor, 2004. The more common strainswere Staphylococcus aureus,Escherichi ecoli and Pseudomonasaeruginosa ,respectively.The main sites of infection werepostoperative cuts,abdominal infection and skin around thedrain.These bacteria were tested against 17 kinds of antibioticsby means of Kirby-Bauer disc agar diffusion on Mueller-Hintonmedia.(AUTO) The result of antibiotic susceptibility showed thatalmost all the strains were resistant to Penicillin and Ampicillinwith a resistant rate of more than 80%,but a part of gram-positiveand gram-negative strains,as well as Leptospira are still sensitive吉林大学硕士学位论文to the two kinds of antibiotic.They are in the first place to treatgas gangrene,anthrax and syphilis.The resistant rate of E.coli toGentamicin was over 75% and that of other gram-negative strains wasbetween 40% and 75%.Only a small part of Staphylococcus aureus aresensitive to the first generation cephalosporin,so theiranti-bacteria spectrums are getting more and more narrow.Most ofgram-negative bacteria are sensitive to the second generationcephalosporin,cefuroxime sodium,but Pseudomonas aeruginosa wasless sensitive.It can be used to prevent infection or treat minorinfection.Among the third generation cephalosporin,the sensitiverate of Pseudomonas aeruginosa and Escherichia coli to ceftazidimeand cefoperazone were over 97%,but to cefotaxime andcefoperazone/sulbactam,the sensitive rate was lower than that tothe two kinds of antibiotic above concerned.They can treat mediumand a part of serious infections.The fourth generationcephalosporin,cefepime,has a wide spectrumof anti-bacteria,notonly can they kill gram-negative bacteria,such as Pseudomonasaeruginosa and Enterobacter ,but also they can kill mostgram-positive bacteria。It is the firstly selected antibiotic totreat serious and mixed infections in clinic.Imipenem also has awide spectrum of anti-bacteria.Vancomyin is a glycopeptideantibiotic that prevents the formation of peptidolgycan by bindingto cell wall peptide precursors. I also studied the resistance plasmid by pasmidfingerprinting,the elimination,conjugation and transformation.