.2001 ~ 2005 Jinzhong District Hospital Infection Pathogen Resistance Change And The Ampc Enzyme Detection

OBJECTIVE 1. To conclude the changing patterns of nosocomial infection pathogens and drug-resistance in Jinzhong from 2001 through 2005; 2. To investigate the correlation between the quantity of antibacterial drugs prescribed yearly from 2003 to 2005 and the resistance of pathogens to antibacterial drugs in Jinzhong ; 3. To explore the situation of nosocomial infection gram negative organisms producing AmpCβ-lactamase in Jinzhong.METHODS 1. The data of nosocomial infection patients were analyzed in Jinzhong hospitals from 2001 to 2005 retrospectively. 2. DDDs and the increasing rate of antibacterial drugs were investigated during 2003-2005 retrospectively and the correlation were studied between drug-resistance and DDDs of antibacterial drugs. 3. A total of 124 clinical isolates of nonrepetive gram negative bacteria were collected between September 2005 to February 2006 in Jinzhong hospitals and AmpCβ-lactamase producing isolates were identified by cefoxitin three–dimensional test .RESULTS 1. 1075 patients had nosocomial infection during 2001-2005, the incidence was 1.66%. Respiratory tract infection and urinary tract infection were the most frequent types of hospital-acquired infection. Among the various department of the hospitals ,department of oncoma and hematology ranked the highest , followed by departments of neurosurgery and neurology. 2. Of nosocomial infection pathogens , gram-negative organisms accounted for 58.32%, but gram-positive bacteria and fungi went up . The most common pathogens of nosocomial infection were Escherichia coli , followed by Klebsiella spp. , Proteus and Pseudomonas aeruginosa . But Acinetobacter and Enterobacter went up. 3. The resistance rates of cephalosporins and fluoroquinolones increased from 33.71% and 38.74% to 72.76% and 78.75%, respectively . 4. The growth rate of all kinds of antibacterial drugs'DDDs yearly was 96.94% and average growth rate was 14.52% from 2003 through 2005 in Jinzhong . The DDDs of cephalosporins , fluoroquinolones and fungistats increased rapidly , their average growth rates were 19.29%, 24.34% and 26.93%,respectively . 5. 21 isolates were positive in cefoxitin three–dimensional test in a total 124 clinical gram-negative isolates , which the positive rate was 16.94% . Most positive isolates were AmpCβ-lactamase producers only . Comparison of phenotype screening test and cefoxitin three–dimensional test , the coincidence rate was 91.3% .CONCLUSIONS 1.The incidence of nosocomial infection increased year by year .The departments of having higher infection rate should be monitored . 2. The drug resistance rates of cephalosporins and fluoroquinolones are highly prominent . Cephalosporins and fluoroquinolones should be strategically controlled. While the first choice for experimental treatment is ceftazidime and aminoglycoside . 3. The rate of AmpCβ-lactamase producing was higher , and the increment may be correlated to the resistance rates to antibacterial . Cefoxitin three–dimensional test can be used to identify gram-negative isolates whether they produce AmpCβ-lactamase. Phenotype screening test can be used as the routine screening method to detect AmpCβ-lactamases .