Evidence-Based Analysis Of Carbapenem-resistant Enterobacteriaceae

Objectives:By using the method of system analysis of Meta related to the evaluation of drug resistance mechanism of our country Enterobacteriaceae of carbapenem; reliability using the existing various detection methods of evidence-based medicine study on the principle of carbapenem resistant Enterobacteriaceae. The advantages and disadvantages of sensitivity and specificity; and evidence-based analysis of nosocomial infection in surgery department of National Hospital, comprehensive understanding of the epidemic and infection associated diseases in China of carbapenem resistant Enterobacteriaceae detection control status.Methods:Using computer retrieval PubMed, wanFang Data, VIP, CNKI, The cochrane Library, EMbase and CBM database and setting the timelines which is starting from 1994 until December 2014, retrieving and finding the required documents. Formulating the correspond standard to exclude and include the literatures. after screening the literature, we started to input the datum, statistic them and do the Meta analysis.Results:By retrieving and after exclusion and inclusion criteria screening, There are 37 articles which write about the Resistance mechanisms of Penicillium carbon alkene resistant enterobacteriaceae bacteria, including 14 provinces and 1081 strains of CRE in China. Results statistical analysis showed that:Klebsiella pneumoniae, e. coli, sewer e. coli are The most common bacteria. Compared to the south of huaihe river and north of the huaihe river found that: The main resistance mechanism is produce carbon alkene enzyme in China, most of the articles have record Genotype analysis found that:the CRE mainly produce KPC enzyme, The second is losing Outer membrane protein, At the same time with the high level expression of Beta lactamase. According to statistics, about 40% of south of huaihe river,32% of north of huaihe river. Other resistance mechanisms, for enterobacteriaceae is uncommon and even rare, so no much research literature.Screening for relevant literature which about Diagnosis method research of CRE,There are 16 articles(10 papers in Chinese,6 papers in english). From this system evaluation result shows that:(1) The modified Hodge test to test for the CRE strain as preliminary screening test is quite appropriate. (2) CHROMagarTM KPC petri dish method:detection of the specific degree (0.90) and the combining sensitivity (0.84) are not too high, but its the biggest advantage for the detection of the method is simple. (3) meropenem and APBA joint detection KPC phenotype:The trial operation is relatively simple, and provides a relatively objective criterion, the results are clear and easy to read, and the existing research shows that the sensitivity of the test KPC and specific degrees is 100%. At the same time compared the other several detection methods and discussed them.According to the standard requirements, Included domestic hospital surgical infection related with 87 references of the present study. The statistical analysis of evidence-based medicine (ebm), Comparing the domestic each big general hospital patients nosocomial infection rate accounted for the internal and external departments found that:Infection rate of Surgical system is higher; The usage of antibiotics yet to be improved; On the basis of month Statistical analysis, The hospital infection rate is higher during September to November. On the basis of infection site analysis showed that:Respiratory tract, urinary tract and blood are three vulnerable parts; Analysis of the Hospital infection detection of pathogenic bacteria classification and proportion found that: G- bacillus still has a detection rate of more than half; At the same time also found that the total number of fungal infection of pathogenic bacteria ratio has a tendency to rise year by year; The statistics of the literature of reported, Non-response rates of hospital infection reduced year by year, But because of the statistical sample data is small, and non-response rates statistics itself will have a variety of factors make its produce error in every hospital, therefore non-response rates value may be small.