Double J Tube Biofilm Related Infections Clinical Features And Drug Susceptibility Test Analysis

Objective:Screening of double J tube biofilm positive, of the biofilm bacteria resistance and sensitivity gap analysis, at the same time monitoring multiple drug-resistant bacteria, understand the clinical distribution characteristics of the bacteria, explore resistant to antibiotics, features to guide the clinical reasonable application of antibiotics.Methods:1. Screening and identification of double J tube biofilm bacteria infection and clinical distribution:collection of Kunming medical university first affiliated hospital uropoiesis surgical department on June6,2012-September2013specimens of500cases of double J tube. Screening of bacterial biofilm positive; Learn to bacterial urinary tract infections bacteria biofilm clinical distribution characteristics.2. The difference of clinical drug susceptibility research:through the bacterium of positive of biofilm in ordinary casein hydrolysate (MH) medium and mooring los gresham (Poloxamer) difference in sensitivity and resistance to research on the culture medium.3. Monitoring multiple drug-resistant bacteria:screening special resistant strain detection of the pathogen. Results:1.500cases were double J tube specimens, by Congo red biofilm positive screening out the strain of181cases, biofilm bacteria samples the positive rate is36%. The bacteria identification,54gram-positive bacteria strains, accounting for30%; Gram-negative bacteria118strains, accounting for65%. Most gram-negative bacteria accounted for, including e. coli, klebsiella pneumoniae and pseudomonas aeruginosa. And the constitution of gram positive bacteria to bowel aureus and coagulase negative staphylococcus, such as dung enterococcus, urine enterococcus and staphylococcusaureus.2.(1) Biofilm bacteria in normal and Poloxamer MH medium medium, in addition to the cefoxitin, gentamycin (10μg), and compound new Ming, amikacin, ni culture south of the differences in the two groups has no statistical significance (P>0.05), the rest of the drug resistant rate in two kinds of culture differences were statistically significant (P<0.05). There was no statistically significant difference analysis of five kinds of antimicrobial drug resistance to known:cefoxitin, gentamycin (10g), and compound new Ming, amikacin, have higher percentages of on two kinds of culture medium; Imine culture south high sensitivity on the two kinds of culture medium. The drug in the two kinds of culture medium on the difference is not big, does not affect the whole situation of two kinds of culture medium on antimicrobial drug resistance analysis. Through the analysis of the data, the biofilm bacteria in ordinary MH medium and Poloxamer medium resistance difference was statistically significant (P<0.05), and the bacteria biofilm on the Poloxamer medium resistance is stronger;(2) From181strains of bacterium of positive of biofilm in vitro susceptibility test results show that cause urinary tract infection of gram-negative bacteria such as e. coli the fungus and bacteria pneumonia klebsiella appeared high resistance, and on carbon penicillin kind sensitive; At the same time cause urinary tract infections gram-positive bacteria such as urine enterococcus apparent resistance, is very sensitive to sugar peptide antibiotics. E. coli bacterium of three generation cephalosporin, promise of tetracycline and compound new quinolone, Ming resistant rate higher than that of klebsiella pneumoniae; Enterococcus in urine resistance of enterococcus was obviously higher than that of dung enterococcus.3. The hospital drug resistance monitoring in e.coli bacterium ESBLs positive rate is61%, pneumonia klebsiella bacteria ESBLs positive rate was23%, positive rate40.9%of MRSA, MRCONS positive rate was65.7%. MRD is mainly klebsiella pneumoniae, the proportion of27.4%. CRE is the main strains klebsiella pneumoniae, at33%.Conclusions:1. Indwelling double J tube infection rate was36%, with most gram-negative bacteria accounted for, and easier to form biofilms.2. Biofilm bacteria in the drug resistance of two kinds of culture medium on most of the difference was statistically significant (P<0.05), than the average in the Poloxamer medium MH stronger resistance on the medium; In vitro medicine sensitive experiment suggests e. coli and enterococcus bacteria and urine, higher percentages.3. E. coli bacterium and pneumonia klebsiella bacteria were the main multi-resistant bacteria.