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Future perspective of focal therapy for localized prostate cancer

Asian Journal of Urology 2021年第4期8卷 354-361页

作者： Luke P.O’Connor Shayann Ramedani Michael Daneshvar Arvin K.George andre luis abreu Giovanni E.Cacciamani Amir H.Lebastchi Urologic Oncology Branch National Cancer InstituteNational Institutes of HealthBethesdaMDUSA College of Medicine The Pennsylvania State UniversityHersheyPAUSA Department of Urology University of MichiganAnn ArborMIUSA Center for Image-Guided and Focal Therapy for Prostate Cancer Institute of Urology and Catherine and Joseph Aresty Department of UrologyKeck School of MedicineUniversity of Southern CaliforniaLos AngelesCAUSA Institute of Urology and Catherine and Joseph Aresty Department of Urology Keck School of MedicineUniversity of Southern CaliforniaLos AngelesCAUSA

Objective:To summarize the recent literature discussing focal therapy for localized prostate cancer.Methods:A thorough literature review was performed using PubMed to identify recent studies involving focal therapy for the treatment of localized prostate cancer.Results:In an effort to decrease the morbidity associated with prostate cancer treatment,many urologists are turning to focal therapy as an alternative treatment option.With this approach,the cancer bearing portion of the prostate is targeted while leaving the benign tissue untouched.Multiparametric magnetic resonance imaging remains the gold standard for visualization during focal therapy,but new imaging modalities such as prostate specific membrane antigen/positron emission tomography and contrast enhanced ultrasound are being investigated.Furthermore,several biomarkers,such as prostate cancer antigen 3 and prostate health index,are used in conjunction with imaging to improve risk stratification prior to focal therapy.Lastly,there are several novel technologies such as nanoparticles and transurethral devices that are under investigation for use in focal therapy.Conclusion:Focal therapy is proving to be a promising option for the treatment of localized prostate cancer.However,further study is needed to determine the true efficacy of these exciting new technologies.

关键词： Focal therapy Prostate cancer Multiparametric magnetic resonance imaging Imaging Innovation Technology

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The Weight of Environment Aspect in the Choice of Vinasse Processing with New Technology through Economic Assessment

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Journal of Environmental Science and Engineering(A) 2019年第3期8卷 113-129页

作者： Fábio Viana de abreu Marco Antonio Gaya de Figueiredo andre luis Alberton Pos graduation of Department of Chemical Engineering State University of Rio de JaneiroSao Francisco Xavier StreetRio de Janeiro 20541-330Brazil Department of Chemical Engineering State University of Rio de JaneiroSao Francisco Xavier StreetRio de Janeiro 20541-330Brazil

Vinasse improper disposal can cause damages to the environment.Fertigation,concentration and digestion aerobic or anaerobic generating fuel gas are the main technologies for vinasse use.Such alternatives present different impact on the environment;however,the weight of environment aspect in the decision remains under discussion.In this paper,authors present a discussion and valuations of environmental aspects about the main technologies of vinasse treatments.First,authors elaborated questionnaires,consulting specialists about the environmental and economical aspect of decision for changing to more environmentally friend technologies.The answers strongly suggest that the decisions of companies are mainly motivates by economics issue,and changing the current technology would be possible only if IRR(Internal Rate of Return)remains around 25%-30%.Then,authors proposed and performed calculations for inserting environmental aspects in the economical evaluation of technologies.The environmental resources performed considering carbon credit,economy with mineral fertilizers and the cost avoided with environmental fines.Scenarios and sensitivity cases performed,presenting discussions about the weight of environmental aspect in technology choice.It is possible to propose government policies that can economically value environmental benefits,such as tax reductions for people using vehicles to RGN(Renewable Gas Natural)or the implementation of a green label for companies that use biogas or RGN in their production processes(green label can be a differential or an extra score for company in future public bids,for example).The results showed that environmental aspect impacts directly the NPV(Net Present Value)of each technology,which can lead even to positive financial returns to companies;however,depending on valuation of environmental resources.Considering the environmental feature in economic impacts,the best option is the use of anaerobic digestion to produce energy that reduces carbon dioxide emissions or anaerobic digestio

关键词： Vinasse sugarcane and biogas

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Application of a biochemical and clinical model to predict individual survival in patients with end-stage liver disease

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World Journal of Gastroenterology 2009年第22期15卷 2768-2777页

作者： Eduardo Vilar Gomez luis Calzadilla Bertot Bienvenido Gra Oramas Enrique Arus Soler Raimundo Llanio Navarro Javier Diaz Elias Oscar Villa Jiménez Maria del Rosario abreu Vazquez Department of Hepatology National Institute of Gastroenterology Department of Pathology National Institute of Gastroenterology Department of Gastroenterology National Institute of Gastroenterology Deparment of Gastroenterology The"Calixto Garcia"Hospital Department of Biostatistics National Institute of Gastroenterology

AIM:To investigate the capability of a biochemical and clinical model,BioCliM,in predicting the survival of cirrhotic patients.METHODS:We prospectively evaluated the survival of 172 cirrhotic patients.The model was constructed using clinical(ascites,encephalopathy and variceal bleeding) and biochemical(serum creatinine and serum total bilirubin) variables that were selected from a Cox proportional hazards model.It was applied to estimate 12-,52-and 104-wk survival.The model's calibration using the Hosmer-Lemeshow statistic was computed at 104 wk in a validation dataset.Finally,the model's validity was tested among an independent set of 85 patients who were stratified into 2 risk groups(low risk≤8 and high risk>8).RESULTS:In the validation cohort,all measures of fi t,discrimination and calibration were improved when the biochemical and clinical model was used.The proposed model had better predictive values(c-statistic:0.90,0.91,0.91) than the Model for End-stage Liver Disease(MELD) and Child-Pugh(CP) scores for 12-,52-and 104-wk mortality,respectively.In addition,the Hosmer-Lemeshow(H-L) statistic revealed that the biochemical and clinical model(H-L,4.69) is better calibrated than MELD(H-L,17.06) and CP(H-L,14.23).There were no significant differences between the observed and expected survival curves in the stratified risk groups(low risk,P=0.61;high risk,P=0.77).CONCLUSION:Our data suggest that the proposed model is able to accurately predict survival in cirrhotic patients.

关键词：模型预测肝病末期患者临床生化应用

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Antioxidant and immunomodulatory effects of Viusid in patients with chronic hepatitis C

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World Journal of Gastroenterology 2010年第21期16卷 2638-2647页

作者： Eduardo Vilar Gomez Yadina Martinez Perez Hector Vega Sanchez Gretel Riveron Forment Enrique Arus Soler luis Calzadilla Bertot Ali Yasells Garcia Maria del Rosario abreu Vazquez Licet Gonzalez Fabian Department of Hepatology National Institute of GastroenterologyHavana 10400Cuba Department of Gastroenterology National Institute of GastroenterologyHavana 10400Cuba Department of Immunology National Institute of GastroenterologyHavana 10400Cuba Department of Oxidative Stress National Genetic CenterHavana 10400Cuba Department of Biostatistics National Institute of GastroenterologyHavana 10400Cuba Department of Pathology Institute of GastroenterologyHavana 10400Cuba

AIM:To investigate the efficacy of Viusid,a nutritional supplement,as an antioxidant and an immunomodulator in patients with chronic hepatitis C.METHODS:Sixty patients with chronic hepatitis C who were non-responders to standard antiviral treatment were randomly assigned to receive Viusid(3 sachets daily,n=30) or placebo(n=30) for 24 wk.The primary outcome was the change in serum malondialdehyde and 4-hydroxyalkenals(lipid peroxidation products).Secondary outcomes were changes in serum tumor necrosis factor-α(TNF-α),interferon-γ(IFN-γ) and interleukin-10(IL-10).RESULTS:Statistically significant reductions in serum 4-hydroxyalkenals and malondialdehyde levels were observed in both groups in comparison with pretreatment values,but the patients who received Viusid showed a more marked reduction as compared with the control group(P=0.001).TNF-α levels significantly increased from 6.9 to 16.2 pg/mL(P< 0.01) in the patients who received placebo in comparison with almost unchanged levels,from 6.6 to 7.1 pg/mL(P=0.26),in the patients treated with Viusid(P=0.001).In addition,IL-10 levels were markedly increased in the patients treated with Viusid(from 2.6 to 8.3 pg/mL,P=0.04) in contrast to the patients assigned to placebo(from 2.8 to 4.1 pg/mL,P=0.09)(P=0.01).Likewise,the administration of Viusid markedly increased mean IFN-γ levels from 1.92 to 2.89 pg/mL(P< 0.001) in comparison with a reduction in mean levels from 1.80 to 1.68 pg/mL(P=0.70) in the placebo group(P< 0.0001).Viusid administration was well tolerated.CONCLUSION:Our results indicate that treatment with Viusid leads to a notable improvement of oxidative stress and immunological parameters in patients with chronic hepatitis C.

关键词： Antioxidant therapy Chronic hepatitis C Cytokines Immunomodulatory therapy Nutritional supplement Oxidative stress

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I.31, a new combination of probiotics, improves irritable bowel syndrome-related quality of life

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World Journal of Gastroenterology 2014年第26期20卷 8709-8716页

作者： Vicente Lorenzo-Zú?iga Elba Llop Cristina Suárez Beatriz álvarez luis abreu Jordi Espadaler Jordi Serra Gastroenterology Motility and Functional Gut Disorders UnitHospital Universitari Germans Trias i Pujol/CIBERehd Gstroenterology Hospital Puerta de Hierro AB-Biotics

AIM:To determine the dose-related effects of a novel probiotic combination,I.31,on irritable bowel syndrome(IBS)-related quality of life(IBS-QoL).METHODS:A multicenter,randomized,double-blind,placebo-controlled intervention clinical trial with three parallel arms was designed.A total of 84 patients(53female,31 male;age range 20-70 years)with IBS and diarrhea according to Rome-Ⅲcriteria were randomly allocated to receive one capsule a day for 6 wk containing:(1)I.31 high dose(n=28);(2)I.31 low dose(n=27);and(3)placebo(n=29).At baseline,and 3and 6 wk of treatment,patients filled the IBSQoL,Visceral Sensitivity Index(VSI),and global symptom relief questionnaires.RESULTS:During treatment,IBS-QoL increased in all groups,but this increment was significantly larger in patients treated with I.31 than in those receiving placebo(P=0.008).After 6 wk of treatment,IBS-QoL increased by 18±3 and 22±4 points in the high and the low dose groups,respectively(P=0.041 and P=0.023vs placebo),but only 9±3 in the placebo group.Gutspecific anxiety,as measured with VSI,also showed a significantly greater improvement after 6 wk of treatment in patients treated with probiotics(by 10±2 and14±2 points,high and low dose respectively,P<0.05for both vs 7±1 score increment in placebo).Symptom relief showed no significant changes between groups.No adverse drug reactions were reported following the consumption of probiotic or placebo capsules.CONCLUSION:A new combination of three different probiotic bacteria was superior to placebo in improving IBS-related quality of life in patients with IBS and diarrhea.

关键词： Irritable bowel syndrome Probiotic combination Qua

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Severe splenic rupture after colorectal endoscopic submucosal dissection

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World Journal of Gastroenterology 2014年第28期20卷 9618-9620页

作者： Alberto Herreros de Tejada luis Giménez-Alvira Enrique Van den Brule Rosario Sánchez-Yuste Pilar Matallanos Esther Blázquez Jose L Calleja luis E abreu Department of Gastroenterology IDIPHIMPuerta de Hierro University Hospital Department of Surgery IDIPHIMPuerta de Hierro University Hospital Department of Radiology IDIPHIMPuerta de Hierro University Hospital Department of Pathology IDIPHIMPuerta de Hierro University Hospital

Splenic rupture(SR)after colonoscopy is a very rare but potentially serious complication.Delayed diagnosis is common,and may increase morbidity and mortality associated.There is no clear relation between SR and difficult diagnostic or therapeutic procedures,but it has been suggested that loop formation and excessive torquing might be risk factors.This is a case of a65-year-old woman who underwent endoscopic submucosal dissection(ESD)for lateral spreading tumor in the descending colon,and 36 h afterwards presented symptoms and signs of severe hypotension due to SR.Standard splenectomy was completed and the patient recovered uneventfully.Colorectal ESD is usually a long and position-demanding technique,implying torquing and loop formation.To our knowledge this is the first case of SR after colorectal ESD reported in the literature.Endoscopists performing colorectal ESD in the left colon must be aware of this potential complication.

关键词： Splenic rupture Endoscopic submucosal dissection C

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Discovery of unique African Helicobacter pylori CagAmultimerization motif in the Dominican Republic

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World Journal of Gastroenterology 2020年第45期26卷 7118-7130页

作者： Takaaki Ono Modesto Cruz Hiroyuki Nagashima Phawinee Subsomwong Junko Akada Takashi Matsumoto Tomohisa Uchida Rumiko Suzuki Celso Hosking Jose A Jimenez abreu Yoshio Yamaoka Department of Environmental and Preventive Medicine Oita University Faculty of MedicineYufu 879-5593Japan Criminal Investigation Laboratory Oita Prefectural Police HeadquartersOita 870-1117Japan Institute of Microbiology and Parasitology IMPAFaculty of ScienceAutonomous University of Santo DomingoSanto Domingo 10103Dominican Republic Department of Biomedical Research National Institute of Medicine and Diagnostic ImagingSanto Domingo 10107Dominican Republic Department of Gastroenterology Hokkaido Cancer CenterSapporo 003-0804Japan Department of Molecular Pathology Oita University Faculty of MedicineYufu 879-5593Japan Dominican-Japanese Digestive Disease Center Dr Luis E.Aybar Health and Hygiene CitySanto Domingo 10302Dominican Republic Department of Medicine Gastroenterology and Hepatology SectionBaylor College of MedicineHoustonTX 77030United States

BACKGROUND Helicobacter pylori(H.pylori)colonizes the human stomach and is a major cause of peptic ulcer disease and gastric cancer.However,although the prevalence of H.pylori is high in Africa,the incidence of gastric cancer is low,and this phenomenon is called to be African enigma.The CagA protein produced by H.pylori is the most studied virulence factor.The carcinogenic potential of CagA is associated with the Glu-Pro-Ile-Tyr-Ala(EPIYA)patterns and CagAmultimerization(CM)motifs.AIM To better understand the EPIYA patterns and CM motifs of the cagA gene.METHODS Gastric mucosal biopsy specimens were obtained from 258 patients with dyspepsia living in the Dominican Republic,from which 120 H.pylori strains were cultured.After the bacterial DNA extraction,the EPIYA pattern and CM motif genotypes were determined using a polymerase chain reaction-based sequencing.The population structure of the Dominican Republic strains was analyzed using multilocus sequence typing(MLST).Peptic ulcer disease and gastric cancer were identified via endoscopy,and gastric cancer was confirmed by histopathology.Histological scores of the gastric mucosa were evaluated using the updated Sydney system.RESULTS All CagA-positive strains carried the Western-type CagA according to the identified EPIYA patterns.Twenty-seven kinds of CM motifs were observed.Although the typical Western CM motif(FPLKRHDKVDDLSKVG)was observed most frequently,the typical East Asian CM motif(FPLRRSAAVNDLSKVG)was not observed.However,“FPLRRSAKVEDLSKVG”,similar to the typical East Asian CM motif,was found in 21 strains.Since this type was significantly more frequent in strains classified as hpAfrica1 using MLST analysis(P=0.034),we termed it Africa1-CM(Af1-CM).A few hpEurope strains carried the Af1-CM motif,but they had a significantly higher ancestral Africa1 component than that of those without the Af1-CM motif(P=0.030).In 30 cagA-positive strains,the"GKDKGPE"motif was observed immediately upstream of the EPIYA motif in the EPIYA-A segment,and there was a significant

关键词： Helicobacter pylori CagA CagA 3'region CagA-multimerization motif Glu-Pro-Ile-Tyr-Ala motif Dominican Republic

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帕博利珠单抗联合以铂类为基础的化疗治疗非小细胞肺癌合并稳定性脑转移患者的结局:KEYNOTE-021、-189和-407研究的汇总分析

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中国肺癌杂志 2022年第1期25卷 I0007-I0018页

作者：周清(翻译校对) Steven F Powell Delvys Rodríguez-abreu Corey J Langer Ali Tafreshi luis Paz-Ares Hans-Georg Kopp Jeronimo Rodríguez-Cid Dariusz M Kowalski Ying Cheng Takayasu Kurata Mark M Awad Jinaxin Lin Bin Zhao M Catherine Pietanza Bilal Piperdi Marina C Garassino 广东省人民医院肺三科广东省医学科学院广东省肺癌研究所广州510080 Sanford Health Sioux FallsSouth Dakota Complejo Hospitalario Universitario Insular-Materno Infantil Universidad de Las Palmas de Gran CanariaGran CanariaSpainospital Universitario Insular de Gran CanariaLas Palmas de Gran CanariaLas Palmas de Gran CanariaSpain Abramson Cancer Center University of PennsylvanialadelphiaPennsylvania Wollongong Private Hospital University of WollongongWollongongAustralia Hospital Universitario 12 de Octubre CNIOUniversidad Complutense and CiberoncMadridSpain Robert Bosch Centrum für Tumorerkrankungen Robert Bosch Cancer CenterKlinik SchillerhoheGerlingenGermany Oncology Center Médica Sur Hospital-Instituto Nacional de Enfermedades RespiratoriasMexico CityMexico Maria Sklodowska-Curie National Research Institute of Oncology WarsawPoland Jilin Cancer Hospital ChangchunJilinPeople's Republic of China Department of Thoracic Oncology Kansai Medical University HospitalHirakataOsakaJapan Massachusetts General Hospital Cancer Center and Harvard Medical School BostonMassachusetts Merck Sharp&Dohme Corp. a subsidiary of Merck&Co.Inc.KenilworthNew Jersey Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale dei Tumori MilanItaly

背景与目的此项探索性分析回顾评价了晚期非小细胞肺癌(non-small cell lung cancer,NSCLC)患者的结局,旨在确定基线时合并脑转移是否会影响一线应用帕博利珠单抗联合化疗(pembrolizumab plus chemotherapy,PC)比对单用化疗的疗效。患... 详细信息

背景与目的此项探索性分析回顾评价了晚期非小细胞肺癌(non-small cell lung cancer,NSCLC)患者的结局,旨在确定基线时合并脑转移是否会影响一线应用帕博利珠单抗联合化疗(pembrolizumab plus chemotherapy,PC)比对单用化疗的疗效。患者和方法对KEYNOTE-021队列G(非鳞癌)、KEYNOTE-189(非鳞癌)和KEYNOTE-407(鳞癌)三项研究晚期NSCLC患者的数据进行汇总分析。患者接受含铂两药化疗和/或35个周期帕博利珠单抗治疗(每3周200 mg)。所有研究均纳入了经治或初治的稳定性脑转移患者(KEYNOTE-189与KEYNOTE-407研究纳入初治脑转移患者)。经治的脑转移患者已处于病情稳定的状态≥2周(KEYNOTE-021队列G患者≥4周),无新发或脑转移病灶扩大的证据且入组前至少3天以上未使用激素。初治的无症状脑转移患者需定期接受脑部影像学检查。结果共纳入1298例患者,其中171例有基线脑转移,1127例无脑转移。两组的中位随访时间(范围)在数据截止时分别为10.9(0.1-35.1)个月和11.0(0.1-34.9)个月。合并脑转移和无脑转移患者的总生存期[0.48(95%CI:0.32-0.70)和0.63(95%CI:0.53-0.75)]和无进展生存期[0.44(95%CI:0.31-0.62)和0.55(95%CI:0.48-0.63)]的风险比(PC/化疗)相似。合并脑转移的患者中,PC组和单用化疗组患者的中位总生存期分别为18.8个月和7.6个月,中位无进展生存期分别为6.9个月和4.1个月。无论是否合并脑转移,PC组患者的客观缓解率都高于单用化疗组,且缓解持续时间有显著延长。合并脑转移的患者中,PC组与单用化疗组的治疗相关不良事件发生率分别为88.2%和82.8%;而无脑转移的患者中,两组治疗相关不良事件的发生率分别为94.5%和90.6%。结论无论是否合并脑转移,与单用化疗相比,帕博利珠单抗联合以铂类为基础的组织学特异性化疗可改善所有PD-L1亚组的临床结局,其中包括PD-L1肿瘤比例评分<1%的患者,并且在晚期NSCLC患者中安全性良好。该方案是晚期NSCLC初治患者的标准方案,并可用于合并稳定性脑转移的患者。

关键词：帕博利珠单抗脑转移化疗非小细胞肺癌 PD-L1

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您控制网络还是网络控制您?看看网络监控

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现代传输 2018年第3期 14-16页

作者： RUSSELL KIRKLAND luis abreu 马继涛康宁光通信

如果您投资了数千万美元,建立了一个可靠、健壮、高效的网络系统,您现在就需要问自己一些严肃的问题：为了确保更高的性能、更好的可靠性和更好地利用网络,您将做些什么？您会积极主动想办法,还是当您的系统开始滞后,利用率过度、应用... 详细信息

如果您投资了数千万美元,建立了一个可靠、健壮、高效的网络系统,您现在就需要问自己一些严肃的问题：为了确保更高的性能、更好的可靠性和更好地利用网络,您将做些什么？您会积极主动想办法,还是当您的系统开始滞后,利用率过度、应用程序开始崩溃的关键时刻,您会做出什么反应？您会用您、您的客户、您的信誉、系统的代价做赌注吗？所有这些问题的最好解决方案都是网络监控。许多人在听到网络监控这个词时立刻想到了安全应用程序。

关键词：网络监控网络控制控制网络网络系统应用程序利用率可靠性健壮

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Antimicrobial Resistance of Microorganisms Causing Pneumonia in Patients of a Public Hospital in Brazilian Pre-Amazon Region

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Journal of Pharmacy and Pharmacology 2019年第1期7卷 15-21页

作者： Raissa G.Assuncao Wellison A.Pereira Francisco J.R.Nogueira Itaynara L.Dutra Tania M.G.Novais Afonso G.abreu Programa de Po-Graduacao Universidade CEUMASao Luis 65075-120Brazil Programa de Pos-Graduacao em Ciencias da Saude Universidade Federal do MaranhaoSao Luis 65080-805Brazil

Nosocomial infections have been common in health services in Brazil.Among them,pneumonia is very highlighted due to the comorbidity that usually affects intensive treatment unit(ITU)patients,and due to the need for endotracheal intubation.The aim of this study was to determine the resistance profile of bacteria isolated from ITU patients with pneumonia in a public hospital in S?o luis,an important city in the Brazilian pre-Amazon region.Bacteria strains were obtained from tracheal aspiration and collected for diagnosis as well for phenotypic characterization.Standards culture media,such as blood and MacConkey agar,were used to isolate clinical strains.Automatized Vitek 2 method was used to identify strains and disc diffusion method(Kirby-Bauer)was performed to determine the antimicrobial susceptibility profile.During study,eighty-eight patients were diagnosed with pneumonia,caused by more than 20 different bacteria.Among them,P.aeruginosa(28%),Acinetobacter baumannii(20%),Coagulase-negative Staphylococci(19%),Staphylococcus aureus(8%)and Klebsiella pneumoniae(7%)were the most prevalent microorganisms.Regarding to the resistance,antimicrobial susceptibility test showed that majority of Gram-negative bacteria presented resistance to ampicillin.In Gram-positive bacteria there was a high resistance to ampicillin,penicillin,ciprofloxacin,clindamycin and erythromycin.This study showed a high prevalence of bacteria resistance in ITU patients in a public hospital.Although P.aeruginosa was the most frequent pathogen,it was possible to find other pathogens that were not recurrent,such as Enterobacter spp.,Proteus mirabilis and Providencia stuartii.Regarding antimicrobials,the results showed a high resistance to several antimicrobials.

关键词： Pneumonia infection bacteria resistance

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