2012 11 43 11 855 35-80 55 P < 0. 05 1. 2. 2 168 - P < 0. 05 53 31. 5% 48 28. 6% α = 2α /k k - 1 α = 0. 05 k = 3 α = 0. 016 7 P < 20 0. 016 7 2 40 2.

854 林 伟 1, 程 金 妹 2* 2, 王 英 歌 1 350000 2 * E-mail chengjinmei0687@ sina.com 目 的 方 法 2008-01 ~ 2012-01 结 果 10. 43% 3. 93% P < 0. 05 34. 4% 30. 4% P > 0. 05 7 d 0. 63% 7 d P < 0. 05 结 论 R763 A 1007-6611 2012 11-0854 - 05 DOI 10. 3969 /J. ISSN. 1007-6611. 2012. 11. 015 Research on multidrug-resistant bacterial infection in otolaryngology patients LIN Wei 1 CHENG Jinmei 2* WANG Yingge 2 1 Dept of Otolaryngology Third Affiliated Hospital of Fujian Medical University Fuzhou 350000 China 2 Dept of Otolaryngology First Affiliated Hospital of Fujian Medical University * Corresponding author E-mail chengjinmei0687@ sina. com Abstract Objective To investigate the distribution of multi-drug resistant MDR bacterial infection in patients with otolaryngology diseases and analyze its environment and causes of bacterial resistance and to explore the related measures. Methods The clinical data of multi-drug resistant bacterial infections in otolaryngology patients from January 2008 to January 2012 were analyzed according to community and hospital. The correlation between drug resistance detection rate and the days of antibiotic use were analyzed. Results The community acquired infection rate was higher than that of nosocomial infection 10. 43% vs 3. 93% P < 0. 05. Community acquired infections were mainly caused by chronic inflammation and the multiple drug-resistant bacterium was mainly on gram-positive Staphylococcus aureus which accounted for 34. 4%. However the hospital infections mainly occurred in perioperative period of otolaryngology head and neck malignant tumors and the multiple drug-resistant bacterium focused on gram-positive Pseudomonas aeruginosa 30. 4%. The resistance rates of Staphylococcus aureus and Pseudomonas aeruginosa in hospital infection were almost equal to those in community infection P > 0. 05. The detection rate of multi-drug resistant bacterial infection which was treated by the antibiotics less than 7 days 0. 63% was lower than that over 7 days P < 0. 05. Conclusion The antibiotics should be rationally used according to the infection types of otolaryngology multiple drug-resistant bacteria to reduce the occurrence of otolaryngology multiple drug-resistant infections and increase the detection rate of specimens. Key words otolaryngology infection multidrug-resistant bacteria nosocomial infection 3 3 2008-01 ~ 2012-01 pan drug resistant bacteria PDR 1. 2 1 1. 1 2008-01 ~ 2012-01 1. 2. 1 1 160 734 426 1.72 1 J - S6048

2012 11 43 11 855 35-80 55 P < 0. 05 1. 2. 2 168 - P < 0. 05 53 31. 5% 48 28. 6% α = 2α /k k - 1 α = 0. 05 k = 3 α = 0. 016 7 P < 20 0. 016 7 2 40 2. 1 2 1. 3 VITEK-TWO MRSA MRSE MRSH CISI-2005 34. 4% 2 R I S 1 β - ESBLs ATCC25922 ATCC27853 Fisher s 4 6 1. 4 3 30. 4% SPSS19. 0 2 1 Tab 1 Distribution of multi-drug resistant bacteria in hospital and community infections of otolaryngology 75 61. 47 14 30. 43 MRSA 42 20 34. 43 11 3 23. 91 MRSE 27 1 22. 13 1 1 2. 17 MRSH 0 0 1 2. 17 5 4. 10 0 0 1 0. 82 1 2. 17 47 38. 52 32 69. 57 17 13. 93 14 30. 43 ESBLs 12 1 9. 84 7 15. 22 ESBLs 9 1 7. 38 6 13. 04 6 4. 92 3 6. 52 2 1. 64 1 2. 17 1 0. 82 1 2. 17 122 46 2. 2 G 90. 90% 53 95. 24% 2

856 64. 71% 31 3 50% 2 Tab 2 Comparison of drug-resistant rates to Staphylococcus aureus between hospital and community infections of otolaryngology n = 11 n = 42 χ 2 8 72. 72 22 52. 38 0. 75 4 36. 36 9 21. 43 0. 39 10 90. 90 38 90. 47 0. 28 3 27. 27 11 26. 19 0. 09 4 36. 36 16 38. 10 0. 05 - - 3 7. 14-0 0 0 0 - G 10 90. 90 40 95. 24-8 72. 72 11 26. 19 8. 28 4 36. 36 15 35. 71 0. 09 0 0 0 0-3 27. 27 2 4. 76 2. 87 α = 0. 05 G Fisher s P = 0. 423 > 0. 05α = 0. 05 3 Tab 3 Comparison of drug-resistant rates to Pseudomonas aeruginosa between nosocomial and community infections with otolaryngology n = 14 n = 17 Fisher s 7 50. 00 7 41. 18 0. 72 6 42. 85 5 29. 41 0. 47 3 21. 42 5 29. 41 0. 69 6 42. 86 7 41. 18 1. 00 7 50. 00 11 64. 71 0. 48 6 42. 85 4 23. 53 0. 44 5 35. 71 5 29. 41 1. 00 3 21. 42 4 23. 53 0. 47 6 42. 85 5 29. 41 1. 00 1 7. 14 1 5. 88 0. 57 2 14. 28 1 5. 88 0. 48 / 0 0 2 11. 76 0. 56 α = 0. 05 2. 3 7 d 0. 63% 7 d

2012 11 43 11 857 7 d 4 mec PBP 2a 4 β - % ESBLs Tab 4 Correlation between drug resistance detection rate and the days of antibiotic use cases % bacterial biofilm BF 7 < 7 d 7 0. 63 103 110 7-14 d 84 7. 60 449 533 > 14 d 74 6. 69 388 462 165 940 1 105 χ 2 = 7. 07 P = 0. 029 < 0. 05 α = 0. 016 7 - < 7 d 7-14 d > 14 d P 0. 010 0. 009 8 9 Pawlowski 10 Antonelli 11 3 2 3. 1 3. 3 48 h 2 4-3 7 d + 4 3. 2 MRSA MRSE MRSH 2 7 d + 5 6 1 DNA DNA β - 2 DNA

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