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Clinical experience of airway management and tracheal intubation under general anesthesia in patients with scar contracture of the neck

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Chinese Medical Journal 2008年第11期121卷 989-997页

作者： xue fu-shan liao xu li cheng-wen xu ya-chao yang quan-yong liu yi liu jian-hua luo mao-ping zhang yan-ming Department of Anesthesiology Plastic Surgery Hospital Chinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing i00041 China

Background Because patients with scar contracture of the neck are at a high risk of loss of the airway control after anesthesia induction, awake intubation is usually recommended. This retrospective clinical study was designed to evaluate the possibility, safety and efficacy of airway management and tracheal intubation under general anesthesia in such patients. Methods This retrospective study included 1683 patients from January 1994 to December 2006 with scar contracture of the neck, aged 1.5--67.0 years, who were scheduled for elective plastic surgery under general anesthesia in Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College. Based on the results of the preoperative airway assessment, the patients were classified into group 1 （including 1375 patients with the atlanto-occipital extension of 〉20° and the Mallampatti＇s grade I or II） and group 2 （containing 308 patients with the atlanto-occipital extension of 〈20° and the Mallampatti＇s grade III or IV. In group 1, the intravenous induction and maintenance of anesthesia and succinylcholine for muscle relaxation were used. The intubation was done using a modified Macintosh technique. In group 2, the total intravenous anesthesia （TIVA） or the sevoflurane inhalation anesthesia was chosen and the spontaneous breathing was reserved during anesthesia. The intubation was performed by a fiberoptic stylet laryngoscope （FOSL）. The number of intubation attempts, intubation time and relative complications were observed and recorded in all patients. Results In group 1, the intubation was accomplished during the first attempt in 1279 cases （93%） and the intubation time was 〈3 minutes in 1304 cases （95%）. In group 2, the intubation was completed by the first attempt in 114 patients （37%） and 123 patients had an intubation time of 〈3 minutes （40%）. Tracheal intubation was successful by the second or third attempt in 96 patients in group 1 and 156 patients in group 2. Thirty-eight pa

关键词： scar contracture of the neck limitation of head extension difficult intubation airway management general anesthesia

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Median effective dose of remifentanil for awake laryngoscopy and intubation

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Chinese Medical Journal 2009年第13期122卷 1507-1512页

作者： xu ya-chao xue fu-shan luo mao-ping yang quan-yong liao xu liu yi zhang yan-ming Department of Anesthesiology Plastic Surgery Hospital Chinese Academy of Medical Sciences and Peking Union Medical College Beijing 100144 China

Background Awake intubation requires an anesthetic management that provides sufficient patient safety and comfort, adequate intubating conditions, and stable hemodynamics. In this prospective clinical study, our aim was to determine the median effective dose （ED50） of remifentanil in combination with midazolam and airway topical anesthesia for awake laryngoscopy and intubation. Methods Thirty-six female adult patients, scheduled for elective plastic surgery under general anesthesia requiring orotracheal intubation were included in this study. Ten minutes after intravenous administration of midazolam 0.1 mg/kg, patients were assigned to receive remifentanil in bolus, followed by a continuous infusion. The bolus dose and infusion rate of remifentanil were adjusted by a modified Dixon＇s up-and-down method. Patient＇s reaction score at laryngoscopy and an Observer＇s Assessment of Alertness/Sedation Scale （OAA/S） were used to determine whether the remifentanil dosage regimen was accepted. During laryngoscopy, 2% lidocaine was sprayed into the airway to provide the topical anesthesia. ED50 of remifentanil was calculated by the modified Dixon up-and-down method, and the probit analysis was then used to confirm the results obtained from the modified Dixon＇s up-and-down method. In the patients who were scored as ＂accept＂, patient＇s OAA/S and reactJon scores at dJfferent observed points, JntubatJng conditJon score and patient＇s tolerance to the endotracheal tube after intubation were evaluated and recorded. Blood pressure and heart rate at different measuring points were also noted. Results ED50 of remifentanil for awake laryngoscopy and intubation obtained by the modified Dixon＇s up-and-down method was （0.62±0.02） μg/kg. Using probit analysis, ED50 and ED95 of remifentanil were 0.63 μg/kg （95% CI, 0.54-0.70） and 0.83 μg/kg （95% CI, 0.73-2.59）, respectively. Nineteen patients who were scored as ＂accept＂ had an OAA/S of 〉15 and tolerated well laryngoscopy without significant di

关键词： laryngoscopy awake intubation remifentanil median effective dose sedation and analgesia

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Comparison of bolus remifentanil versus bolus fentanyl for blunting cardiovascular intubation responses in children： a randomized, double-blind study

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Chinese Medical Journal 2009年第1期122卷 44-50页

作者： yang quan-yong xue fu-shan liao xu liu He-ping luo mao-ping xu ya-chao liu yi zhang yan-ming Department of Anesthesiology Plastic Surgery Hospital Chinese Academy of Medical Sciences and Peking Union Medical College Beijing 100144 China Department of Anesthesiology Xinxiang Medical College Xinxiang Henan 453003 China

Background The authors found no study to compare the efficacy of bolus dose fentanyl and remifentanil blunting the cardiovascular intubation response in children, so they designed this randomized, double-blind clinical study to assess the effects of remifentanil 2 μg/kg and fentanyl 2 μg/kg by bolus injection on the cardiovascular intubation response in healthy children.Methods One hundred and two children, the American Society of Anesthesiologists （ASA） physical status 1-2 and scheduled for elective plastic surgery under general anesthesia, were randomly divided into one of two groups to receive the following treatments in a double blind manner： remifentanil 2μg/kg （Group R） and fentanyl 2 μg/kg （Group F） when anesthesia was induced with propofol and vecuronium. The orotracheal intubation was performed using a direct laryngoscope. Blood pressure （BP） and heart rate （HR） were recorded before anesthesia induction （baseline values）, immediately before intubation, at intubation and every minute for 5 minutes after intubation. The percent changes of systolic blood pressure （SBP） and HR relative to baseline values and the rate pressure product （RPP） at every observing point were calculated. The incidences of SBP and HR percent changes 〉30% of baseline values and RPP 〉22 000 during the observation were recorded.Results There were no significant differences between groups in the demographic data, baseline values of BP and HR and the intubation time. As compared to baseline values, BP, HR and RPP at intubation and their maximum values during observation increased significantly in Group F, but they all decreased significantly in Group R. BP, HR and RPP at all observed points, and their maximum values during the observation, were significantly different between groups. There were also significant differences between groups in the percent change of SBP and HR relative to baseline values at all observed points and their maximum percent changes during the observation. The in

关键词： remifentanil fentanyl general anesthesia tracheal intubation cardiovascular responses children

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CEPC Technical Design Report

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Radiation Detection Technology and Methods 2024年第1期8卷 I0003-I0016,1-1091页

作者： Waleed Abdallah Tiago Carlos Adorno de Freitas Konstantin Afanaciev Shakeel Ahmad Ijaz Ahmed Xiaocong Ai Abid Aleem Wolfgang Altmannshofer Fabio Alves Weiming An Rui An Daniele Paolo Anderle Stefan Antusch yasuo Arai Andrej Arbuzov Abdesslam Arhrib Mustafa Ashry Sha Bai Yu Bai yang Bai Vipul Bairathi Csaba Balazs Philip Bambade yong Ban Tripamo Bandyopadhyay Shou-shan Bao Desmond P.Barber Ayse Bat Varvara Batozskaya Subash Chandra Behera Alexander Belyaev Michele Bertucci Xiao-Jun Bi Yuanjie Bi Tianjian Bian Fabrizio Bianchi Thomas Biekotter Michela Biglietti Shalva Bilanishvili Deng Binglin Denis Bodrov Anton Bogomyagkov Serge Bondarenko Stewart Boogert Maarten Boonekamp Marcello Borri Angelo Bosotti Vincent Boudry Mohammed Boukidi Igor Boyko Ivanka Bozovic Giuseppe Bozzi Jean-Claude Brient Anastasiia Budzinskaya Masroor Bukhari Vladimir Bytev Giacomo Cacciapaglia hua Cai wenyong Cai Wujun Cai yijian Cai yizhou Cai Yuchen Cai Haiying Cai huacheng Cai Lorenzo Calibbi Junsong Cang Guofu Cao jianshe Cao Antoine Chance xuejun Chang Yue Chang Zhe Chang Xinyuan Chang Wei chao Auttakit Chatrabhuti yimin Che Yuzhi Che Bin Chen Danping Chen fuqing Chen fusan Chen Gang Chen Guoming Chen hua-Xing Chen Huirun Chen Jinhui Chen Ji-Yuan Chen Kai Chen Mali Chen mingjun Chen mingshui Chen Ning Chen shanhong Chen shanzhen Chen Shao-Long Chen Shaomin Chen Shiqiang Chen Tianlu Chen Wei Chen Xiang Chen Xiaoyu Chen Xin Chen xun Chen xurong Chen Ye Chen ying Chen Yukai Chen Zelin Chen Zilin Chen Gang Chen Boping Chen Chunhui Chen Hok Chuen cheng huajie cheng shan cheng Tongguang cheng Yunlong Chi Pietro Chimenti wen Han Chiu Guk Cho ming-Chung Chu Xiaotong Chu Ziliang Chu Guglielmo Coloretti Andreas Crivellin Hanhua Cui Xiaohao Cui Zhaoyuan Cui Brunella D'Anzi ling-Yun Dai Xinchen Dai xuwen Dai Antonio De Maria Nicola De Filippis Christophe De La Taille Francesca De Mori Chiara De Sio Elisa Del Core Shuangxue Deng Wei-Tian Deng Zhi Deng Ziyan Deng Bhupal Dev Tang Dewen Biagio Di Micco Ran Ding Siqin Dingl yadong Ding Haiyi Dong jianin AGH University of Science and Technology Faculty of Physics and Applied Computer ScienceKrakow Anhui University HefeiAnhui Applied Physics Department Federal Urdu University of ArtsScience and TechnologyIslamabad Banaras Hindu University Institute of ScienceVaranasi Bandirma Onyedi Eylul University Bandirma Beihang University Beijing Beijing Computational Science Research Center Beijing Beijing Conveyi LTD Beijing Beijing Glass Research Institute Co. LtdBeijing Beijing Institute of Technology Beijing Beijing Normal University Beijing Brown University ProvidenceRI Budker Institute of Nuclear Physics Novosibirsk Cadi Ayyad University Laboratory of Fundamental and Applied PhysicsPolydisciplinary FacultyMarrakech Cairo University Giza Center for Theory and Computation National Tsing Hua UniversityHsinchu Central China Normal University WuhanHubei Central South University ChangshaHunan Centro de Fisica Teorica de Particulas Universidade Tecnica de LisboaLisboa chengdu KaitengSifang Digital Radio&TV Equipment Co. LtdChengduSichuan China academy of engineering physics MianyangSichuan China building materials academy Beijing China Center of Advanced Science and Technology Beijing China Institute of Atomic Energy Beijing China Jiliang University HangzhouZhejiang China Nuclear Instrument CO. LTDBeijing China University of Geosciences Beijing China University of Geosciences WuhanHubei China University of Mining and Technology XuzhouJiangsu China West Normal University NanchongSichuan Chongqing University Department of PhysicsChongqing Chulalongkorn University Bangkok City University of Hong Kong Department of PhysicsHong Kong Cockcroft Institute Daresbury Cornell University IthacaNY CPPM(AMU/IPhU&CNRS/INP) Marseille Dalian Minzu University DalianLiaoning Dalian University of Technology Department of PhysicsDalian Deutsches Elektronen-Synchrotron DESY Hamburg Dzhelepov Laboratory of Nuclear Problems of Joint Institute for Nuclear Research(DLNP JINR) Dubna East China University Of Science And Technol

The Circular Electron Positron Collider(CEPC)is a large scientific project initiated and hosted by China,fostered through extensive collaboration with international *** complex comprises four accelerators:a 30 GeV linac,a 1.1 GeV Damping Ring,a Booster capable of achieving energies up to 180 GeV,and a Collider operating at varying energy modes(Z,W,H,and tt).The linac and Damping Ring are situated on the surface,while the subterranean Booster and Collider are housed in a 100 km circumference underground tunnel,strategically accommodating future expansion with provisions for a potential Super Proton Proton Collider(SPPC).The CEPC primarily serves as a Higgs *** its baseline design with synchrotron radiation(SR)power of 30 MW per beam,it can achieve a luminosity of 5×10^(34)cm^(-2)s^(-1)per interaction point(IP),resulting in an integrated luminosity of 13 ab^(-1)for two IPs over a decade,producing 2.6 million Higgs *** the SR power to 50 MW per beam expands the CEPC's capability to generate 4.3 million Higgs bosons,facilitating precise measurements of Higgs coupling at sub-percent levels,exceeding the precision expected from the HL-LHC by an order of *** Technical Design Report(TDR)follows the Preliminary Conceptual Design Report(Pre-CDR,2015)and the Conceptual Design Report(CDR,2018),comprehensively detailing the machine's layout,performance metrics,physical design and analysis,technical systems design,R&D and prototyping efforts,and associated civil engineering ***,it includes a cost estimate and a preliminary construction timeline,establishing a framework for forthcoming engineering design phase and site selection *** is anticipated to begin around 2027-2028,pending government approval,with an estimated duration of 8 *** commencement of experiments and data collection could potentially be initiated in the mid-2030s.

关键词： initiated exceeding precise

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Circulatory responses to nasotracheal intubation： comparison of GlideScope videolaryngoscope and Macintosh direct laryngoscope

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Chinese Medical Journal 2008年第14期121卷 1290-1296页

作者： xue fu-shan li xuan-ying liu Qian-jin liu He-ping yang quan-yong xu ya-chao liao xu liu yi Department of Anesthesiology Plastic Surgery Hospital Chinese Academy of Medical Sciences and Peking Union Medical College Beijing 100144 China Department of Anesthesiology Washington University School of Medicine 660 S. Euclid Ave St. Louis MO USA Xinxiang Medical College Xinxiang Henan 453003 China

Background The GlideScope videolaryngoscope （GSVL） has been shown to have no special advantage over the Macintosh direct laryngoscope （MDL） in attenuating the circulatory responses to orotracheal intubation, but no study has compared the circulatory responses to nasotracheal intubation （NTI） using the two devices. This prospective randomized clinical study was designed to determine whether there was a clinically relevant difference between the circulatory responses to NTI with the GSVL and the MDL. Methods Seventy-six adult patients were randomly allocated equally to the GSVL group and the MDL group. After induction of anesthesia, NTI was performed. Non-invasive blood pressure （BP） and heart rate （HR） were recorded before induction （baseline values） and immediately before intubation （post-induction values）, at intubation and every minute for a further five minutes. During the observation, times required to reach the maximum values of systolic BP （SBP） and HR, times required for recovery of SBP and HR to postinduction values and incidence of SBP and HR percent changes 〉 30% of baseline values were also noted. The product of HR and systolic BP, i.e. rate pressure product （RPP）, and the areas under SBP and HR vs. time curves （AUGsBP and AUGHR） were calculated. Results The NTI with the GSVL resulted in significant increases in BP, HR and RPP compared to postinduction values, but these circulatory changes did not exceed baseline values. BPs at all measuring points, AUGSBP, maximum values of BP and incidence of SBP percent increase 〉 30% of baseline value during the observation did not differ significantly between groups. However, HR and RPP at intubation and their maximum values, AUGHR and incidence of HR percent increase 〉 30% of baseline value were significantly higher in the MDL group than in the GSVL group. Times required for recovery of SBP and HR to postinduction values were significantly longer in the MDL group than in the GSVL group. Conclusions The presso

关键词： GlideScope videolaryngoscope Macintosh direct laryngoscope nasotracheal intubation circulatory responses airway management

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儿童光导纤维支气管镜经口气管插管可导致较成人更严重的血压升高反应

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实用儿科临床杂志 2007年第15期22卷 1186-1188页

作者：薛富善许亚超刘建华廖旭佟世义杨泉涌刘毅中国医学科学院整形外科医院麻醉科北京100041

目的比较儿童和成人光导纤维支气管镜(FOB)经口气管插管心血管反应的差异。方法选择美国麻醉医师协会身体状况分级为Ⅰ级、拟在经口气管插管全身麻醉下施择期整形外科手术的儿童和成年患者各30例。在麻醉诱导后实施FOB经口气管插管。记... 详细信息

目的比较儿童和成人光导纤维支气管镜(FOB)经口气管插管心血管反应的差异。方法选择美国麻醉医师协会身体状况分级为Ⅰ级、拟在经口气管插管全身麻醉下施择期整形外科手术的儿童和成年患者各30例。在麻醉诱导后实施FOB经口气管插管。记录麻醉诱导前(基础值)、麻醉诱导后(麻醉诱导后值)、气管插管时及气管插管后1、2、3、4和5min时血压和心率(HR),并计算观察期血压和HR变化率。结果二组气管插管时、气管插管后1～3minHR显著高于基础值和麻醉诱导后值(Pa<0.05)。成年组气管插管血压较麻醉诱导后值显著升高(Pa<0.01),但未超过基础值。儿童组气管插管时和气管插管后1min时血压较基础值和麻醉诱导后值显著升高(Pa<0.05)。观察期儿童组在各对应时间点收缩压(SBP)变化率及气管插管时、气管插管后1和2min时舒张压(DBP)和平均动脉压(MAP)变化率显著高于成年组(Pa<0.05)。除麻醉诱导后值外,二组在观察期其他各时间点HR及观察期HR最大变化率均无显著性差异。结论在常用全身麻醉深度下对儿童实施FOB经口气管插管可引起较成人更明显的血压升高反应。

关键词：儿童成人光导纤维支气管镜经口气管插管心血管反应

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不同剂量左旋甲状腺素钠预处理对幼龄大鼠心肌缺血再灌注损伤的影响

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中华麻醉学杂志 2011年第5期31卷 616-620页

作者：杨泉涌薛富善许亚超张霖罗艺廖旭熊军李杉张雁鸣天津医科大学附属肿瘤医院麻醉科乳腺癌防治教育部重点实验室 300060 中国医学科学院整形外科医院麻醉科

目的评价不同剂量左旋甲状腺素钠预处理对幼龄大鼠心肌缺血再灌注损伤的影响。方法健康雌性Wistar大鼠48只，日龄35d，体重120～140g，采用随机数字表法，将其随机分为6组（n=8）t对照组（c组）、缺血再灌注组（I／R组）和不同剂量左... 详细信息

目的评价不同剂量左旋甲状腺素钠预处理对幼龄大鼠心肌缺血再灌注损伤的影响。方法健康雌性Wistar大鼠48只，日龄35d，体重120～140g，采用随机数字表法，将其随机分为6组（n=8）t对照组（c组）、缺血再灌注组（I／R组）和不同剂量左旋甲状腺素钠预处理组（LS1-4组）。c组和I／R组大鼠采用普通饲料喂养7d；kS。组大鼠除了采用普通饲料喂养之外，每天胃内灌注左旋甲状腺素钠10、20、40和80μg-100g.第8天时，抽取外周静脉血样，测定血清甲状腺激素水平。采用Langendorff装置建立大鼠离体心脏缺血再灌注模型。c组K-H液持续灌注80min；其余各组K-H液平衡灌注30min，然后全心缺血20min，恢复灌注30min。于平衡灌注20min和再灌注30initl时，记录HR、SP、左心室内压最大上升速率（＋dp／dtmax）和左心室内压最大下降速率（-dp／dtmax），计算再灌注30min时HR、SP、＋dp／dtmax和-dp／dtmax的恢复率。于平衡灌注10min和再灌注15min时，收集冠状动脉流出液2ml，测定CK-MB的活性。再灌注30min时，取心室肌组织，采用Westernblot法检测心肌热休克蛋白70（HSP70）的表达，采用RT-PCR法测定甲状腺激素受体（rill）亚型（TRα1、TRa2和TRβ1mRNA以及肌球蛋白重链α和B（MHCα和MHCβ）mRNA的表达。结果与C组相比，I／R组HR、SP和4-dp／dtmax的恢复率降低，冠脉流出液CK—MB活性升高，心肌MHCαmRNA表达下调，LS1-4组SP和±dp/dtmax的恢复率降低，冠脉流出液CK—MB活性升高，心肌HSP70和MHCamRNA表达L调，琏＋。组血清甲状腺激素水平升高，心肌TRa1mRNA表达上调（P〈0．05）。与I／R组相比，IS1-4组HR和±dp／dtmax；的恢复率升高，心肌HSP70表达上调，MHCαmRNA表达上调，MHCOmRNA表达下调，玛。组冠脉流出液CK-MB活性降低，LS2-4组血清甲状腺激素水平升高，心肌TRα1mRNA表达上调（P〈0．05）。LS1组、LS2组、LS3组和LS4组的甲状腺激素血清水平随左旋甲状腺素钠剂量的增加逐渐升高（P〈0．05）。与LS1组和LS2组相比，峨组和蝇组冠脉流出液CK—MB活性升高，心肌HSP70表达下调（P〈0．05）。结论10vg／100g左旋甲状腺素钠胃内灌注预处理可减轻大鼠心肌缺血再灌注损伤，且不会导致甲状腺激素水平升高，其机制可能与心肌HSP70和MHCαmRNA表达上调有关。

关键词：甲状腺激素类缺血预处理心肌再灌注损伤儿童

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2015-2021年CHINET临床分离肠球菌属细菌耐药性变迁

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中国感染与化疗杂志 2024年第3期24卷 300-308页

作者：陈娜季萍杨洋胡付品朱德妹徐英春张小江谢轶康梅王传清付盼徐元宏黄颖孙自镛陈中举倪语星孙景勇褚云卓田素飞胡志东李金俞云松林洁单斌杜艳郭素芳魏莲花邹凤梅张泓王春胡云建艾效曼卓超苏丹虹郭大文赵金英喻华黄湘宁刘文恩李艳明金炎邵春红徐雪松鄢超王山梅楚亚菲张利侠马娟周树平周艳朱镭孟晋华董方吕志勇胡芳芳沈瀚周万青贾伟李刚吴劲松卢月梅李继红段金菊康建邦马晓波郑燕萍郭如意朱焱陈运生孟青王世富胡雪飞沈继录汪瑞忠房华俞碧霞赵勇龚萍温开镇张贻荣刘江山廖龙凤顾洪芹姜琳贺雯薛顺虹冯佼岳春雷新疆医科大学第一附属医院医学检验中心新疆830000 复旦大学附属华山医院抗生素研究所北京协和医院四川大学华西医院复旦大学附属儿科医院安徽医科大学第一附属医院华中科技大学同济医学院附属同济医院上海交通大学医学院附属瑞金医院中国医科大学附属第一医院天津医科大学总医院浙江大学医学院附属邵逸夫医院昆明医科大学第一附属医院内蒙古医科大学附属医院甘肃省人民医院上海交通大学医学院附属儿童医院北京医院广州医科大学附属第一医院哈尔滨医科大学附属第一医院四川省人民医院中南大学湘雅医院山东省立医院吉林大学中日联谊医院河南省人民医院陕西省人民医院江西省儿童医院山西省儿童医院首都医科大学附属北京儿童医院贵州省人民医院南京大学医学院附属鼓楼医院宁夏医科大学总医院深圳市人民医院河北医科大学第二医院山西医科大学第二医院厦门大学附属第一医院福建省泉州市第一医院深圳市儿童医院山东大学齐鲁儿童医院南昌大学第一附属医院安徽医科大学第四附属医院上海市浦东新区人民医院浙江省宁波市镇海龙赛医院湖北省秭归县人民医院福建省晋江市医院甘肃省金昌市中西医结合医院江西省赣县区人民医院山东省广饶县人民医院河南省辉县市人民医院辽宁省营口市经济技术开发区中心医院青海省互助县人民医院四川省邻水县人民医院吉林省九台区人民医院

目的了解2015-2021年中国主要地区临床分离肠球菌属细菌的分布及耐药性变迁。方法按CHINET统一技术方案,采用自动化仪器法、纸片扩散法或E试验条法对CHINET成员单位临床分离的肠球菌属细菌进行药物敏感性试验,结果参照2021年CLSI标准判... 详细信息

目的了解2015-2021年中国主要地区临床分离肠球菌属细菌的分布及耐药性变迁。方法按CHINET统一技术方案,采用自动化仪器法、纸片扩散法或E试验条法对CHINET成员单位临床分离的肠球菌属细菌进行药物敏感性试验,结果参照2021年CLSI标准判读,采用WHONET 5.6软件进行统计分析。结果7年间共分离肠球菌属细菌124565株,主要分离菌仍为屎肠球菌(50.7%)、粪肠球菌(41.5%)。标本来源主要为尿道标本(46.9%±2.6%),科室来源主要分离自内科、外科、ICU。屎肠球菌和粪肠球菌对万古霉素、替考拉宁、利奈唑胺的耐药率均保持在较低水平(≤3.6%)。万古霉素耐药的粪肠球菌和屎肠球菌检出率为0.1%和1.3%,利奈唑胺耐药的粪肠球菌从2015年的0.7%上升至2021年的3.4%、屎肠球菌的检出率为0.3%。结论肠球菌属临床分离菌对万古霉素、替考拉宁、利奈唑胺保持较好的体外敏感性,细菌耐药率低。但利奈唑胺耐药的粪肠球菌检出率有逐年增高的趋势,应加强细菌耐药监测,及时发现耐药菌的发生和遏制耐药菌播散。

关键词：肠球菌属细菌耐药性监测耐药性变迁

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维普期刊数据库

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2015—2021年CHINET临床分离铜绿假单胞菌耐药性变迁

引用

中国感染与化疗杂志 2024年第2期24卷 198-205页

作者：谢潋滟孙景勇杨洋胡付品朱德妹蒋晓飞徐英春张小江付盼季萍谢轶康梅王传清张峰波徐元宏黄颖孙自镛陈中举褚云卓田素飞胡志东李金俞云松林洁单斌杜艳郭素芳魏莲花邹凤梅张泓王春胡云建艾效曼卓超苏丹虹郭大文赵金英喻华黄湘宁刘文恩李艳明金炎邵春红徐雪松鄢超王山梅楚亚菲张利侠马娟周树平周艳朱镭孟晋华董方吕志勇胡芳芳沈瀚周万青贾伟李刚吴劲松卢月梅李继红段金菊康建邦马晓波郑燕萍郭如意朱焱陈运生孟青王世富胡雪飞沈继录汪瑞忠房华俞碧霞赵勇龚萍温开镇张贻荣刘江山廖龙凤顾洪芹姜琳贺雯薛顺虹冯佼岳春雷上海交通大学医学院附属瑞金医院临床实验诊断中心上海200025 复旦大学附属华山医院抗生素研究所复旦大学附属华山医院检验科北京协和医院新疆医科大学第一附属医院四川大学华西医院复旦大学附属儿科医院安徽医科大学第一附属医院华中科技大学同济医学院附属同济医院中国医科大学附属第一医院天津医科大学总医院浙江大学医学院附属邵逸夫医院昆明医科大学第一附属医院内蒙古医科大学附属医院甘肃省人民医院上海交通大学医学院附属儿童医院北京医院广州医科大学附属第一医院哈尔滨医科大学附属第一医院四川省人民医院中南大学湘雅医院山东省立医院吉林大学中日联谊医院河南省人民医院陕西省人民医院江西省儿童医院山西省儿童医院首都医科大学附属北京儿童医院贵州省人民医院南京大学医学院附属鼓楼医院宁夏医科大学总医院深圳市人民医院河北医科大学第二医院山西医科大学第二医院厦门大学附属第一医院福建省泉州市第一医院深圳市儿童医院山东大学齐鲁儿童医院南昌大学第一附属医院安徽医科大学第四附属医院上海市浦东新区人民医院浙江省宁波市镇海龙赛医院湖北省秭归县人民医院福建省晋江市医院甘肃省金昌市中西医结合医院江西省赣县区人民医院山东省广饶县人民医院河南省辉县市人民医院辽宁省营口市经济技术开发区中心医院青海省互助县人民医院四川省邻水县人民医院吉林省九台区人民医院

目的了解2015—2021年中国主要地区临床分离铜绿假单胞菌对各类抗菌药物的耐药性变迁。方法对CHINET 51所医院临床分离铜绿假单胞菌按照CHINET技术方案采用纸片扩散法或自动化仪器法进行抗菌药物敏感性试验,按照CLSI 2021年标准判读药... 详细信息

目的了解2015—2021年中国主要地区临床分离铜绿假单胞菌对各类抗菌药物的耐药性变迁。方法对CHINET 51所医院临床分离铜绿假单胞菌按照CHINET技术方案采用纸片扩散法或自动化仪器法进行抗菌药物敏感性试验,按照CLSI 2021年标准判读药敏结果,并用WHONET 5.6软件进行数据分析。结果2015—2021年从51所医院临床标本中共分离到129701株铜绿假单胞菌,检出率为8.6%,历年该菌检出率在不发酵糖革兰阴性杆菌中次于不动杆菌属排第二位。其中(91.4±1.0)%菌株分离自住院患者,(66.4±2.8)%菌株分离自呼吸道分泌物。铜绿假单胞菌对各种抗菌药物耐药率均有所下降,对阿米卡星、多黏菌素及头孢他啶-阿维巴坦的敏感率>90%。分离自门急诊的菌株对各抗菌药物的耐药率在1.0%~19.8%,分离自ICU的菌株耐药率为0.6%~40.5%,分离自内科和外科的菌株耐药率分别为0.8%~28.8%和1.2%~23.3%。分离自儿童的菌株耐药率在0.8%~18.8%,成人株为1.2%~26.1%,老年株为1.0%~28.5%。二级医院、三级医院和儿童医院分离菌株的耐药率分别为2.5%~24.2%、0.7%~27.6%和0.6%~20.3%。碳青霉烯类耐药铜绿假单胞菌共35153株,检出率为27.1%。结论铜绿假单胞菌是最常检出的不发酵糖革兰阴性杆菌之一,该菌对各抗菌药物耐药率逐年下降,耐药监测是控制细菌耐药发生和发展行之有效的手段。来自不同标本类型、不同科室及患者年龄的菌株耐药性相差较大,临床中更应该加强监测,协助医师合理用药,预防和控制耐药菌的流行。

关键词：耐药监测铜绿假单胞菌药物敏感性耐药性变迁

来源：

维普期刊数据库

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2015-2021年CHINET尿液分离菌分布和耐药性变迁

引用

中国感染与化疗杂志 2024年第3期24卷 287-299页

作者：李艳明邹明祥刘文恩杨洋胡付品朱德妹徐英春张小江张峰波季萍谢轶康梅王传清付盼徐元宏黄颖孙自镛陈中举倪语星孙景勇褚云卓田素飞胡志东李金俞云松林洁单斌杜艳郭素芳魏莲花邹凤梅张泓王春胡云建艾效曼卓超苏丹虹郭大文赵金英喻华黄湘宁金炎邵春红徐雪松鄢超王山梅楚亚菲张利侠马娟周树平周艳朱镭孟晋华董方吕志勇胡芳芳沈瀚周万青贾伟李刚吴劲松卢月梅李继红段金菊康建邦马晓波郑燕萍郭如意朱焱陈运生孟青王世富胡雪飞沈继录汪瑞忠房华俞碧霞赵勇龚萍温开镇张贻荣刘江山廖龙凤顾洪芹姜琳贺雯薛顺虹冯佼岳春雷中南大学湘雅医院检验科长沙410008 复旦大学附属华山医院抗生素研究所北京协和医院新疆医科大学第一附属医院四川大学华西医院复旦大学附属儿科医院安徽医科大学第一附属医院华中科技大学同济医学院附属同济医院上海交通大学医学院附属瑞金医院中国医科大学附属第一医院天津医科大学总医院浙江大学医学院附属邵逸夫医院昆明医科大学第一附属医院内蒙古医科大学附属医院甘肃省人民医院上海交通大学医学院附属儿童医院北京医院广州医科大学附属第一医院哈尔滨医科大学附属第一医院四川省人民医院山东省立医院吉林大学中日联谊医院河南省人民医院陕西省人民医院江西省儿童医院山西省儿童医院首都医科大学附属北京儿童医院贵州省人民医院南京大学医学院附属鼓楼医院宁夏医科大学总医院深圳市人民医院河北医科大学第二医院山西医科大学第二医院厦门大学附属第一医院福建省泉州市第一医院深圳市儿童医院山东大学齐鲁儿童医院南昌大学第一附属医院安徽医科大学第四附属医院上海市浦东新区人民医院浙江省宁波市镇海龙赛医院湖北省秭归县人民医院福建省晋江市医院甘肃省金昌市中西医结合医院江西省赣县区人民医院山东省广饶县人民医院河南省辉县市人民医院辽宁省营口市经济技术开发区中心医院青海省互助县人民医院四川省邻水县人民医院吉林省九台区人民医院

目的了解2015-2021年CHINET细菌耐药监测网中尿液分离菌的分布和耐药性。方法收集CHINET细菌耐药监测网51家医疗机构2015-2021年所有尿液标本临床分离菌的耐药监测数据资料,采用WHONET 5.6软件进行统计分析。结果2012-2021年尿液标本共... 详细信息

目的了解2015-2021年CHINET细菌耐药监测网中尿液分离菌的分布和耐药性。方法收集CHINET细菌耐药监测网51家医疗机构2015-2021年所有尿液标本临床分离菌的耐药监测数据资料,采用WHONET 5.6软件进行统计分析。结果2012-2021年尿液标本共分离细菌261893株,其中革兰阳性菌62219株,占23.8%,革兰阴性菌199674株占76.2%。常见的分离菌依次为大肠埃希菌(46.7%)、屎肠球菌(10.4%)、肺炎克雷伯菌(9.8%)、粪肠球菌(8.7%)、奇异变形杆菌(3.5%)、铜绿假单胞菌(3.4%)、无乳链球菌(2.6%)和阴沟肠杆菌(2.1%)。上述细菌主要分离自住院患者,女性多见于男性,成人多见于儿童。大肠埃希菌、肺炎克雷伯菌和奇异变形杆菌中产超广谱β内酰胺酶(ESBL)菌株分别占53.2%、52.8%和37.0%。耐碳青霉烯类的大肠埃希菌、肺炎克雷伯菌、铜绿假单胞菌和鲍曼不动杆菌中检出率分别为1.7%、18.5%、16.4%和40.3%。粪肠球菌对氨苄西林、呋喃妥因、利奈唑胺、万古霉素、替考拉宁和磷霉素的耐药率90%,对万古霉素、利奈唑胺和替考拉宁的耐药率<2%。ICU住院患者分离的大肠埃希菌、肺炎克雷伯菌、铜绿假单胞菌和鲍曼不动杆菌对大部分抗菌药物的耐药率明显高于门诊患者和非ICU住院患者。结论尿液标本临床分离菌主要以大肠埃希菌、肠球菌和肺炎克雷伯菌为主,不同人群尿液标本中分离的细菌种类和耐药性不尽相同,应重视细菌耐药监测,减少抗菌药物的不合理使用。

关键词：尿液细菌耐药性监测药物敏感性试验大肠埃希菌多重耐药菌

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