This doctor has a system

Chapter 323 304. New Project Development

"Can you conduct mycoplasma resistance gene testing?"

"Let me ask." The young man who came to collect the specimens was not very clear about the situation. He had just joined the company, and his current task was to go back and forth to various hospitals to collect specimens for examination. He was not familiar with the company's other businesses.

"It's possible, but it's not cheap." The young man quickly received a reply, "The results will be released with NGS at that time."

In the afternoon of the next day, the results of the delivered specimens came out. The NGS test report showed a high sequence number for Mycoplasma pneumoniae, and the Mycoplasma pneumoniae drug resistance gene was positive for A2063G.

This shows that the patient indeed has mycoplasma pneumonia, and the positive drug resistance gene A2063G indicates that the patient is resistant to 14-cyclic macrolide drugs.

No wonder Wen Yushan's condition did not improve after taking azithromycin. The reason was finally found.

Generally speaking, a positive Mycoplasma pneumoniae drug resistance gene may be caused by factors such as extensive use of antibiotics, incomplete treatment, long-term use of low-dose antibiotics, Mycoplasma pneumoniae gene mutations, cross-infection and other factors.

Some patients with skeletal abnormalities are naturally resistant to 14-cyclic macrolides.

Wen Yushan is under 18 years old. Fluoroquinolone drugs are not available in this age group, so the only remaining drugs are tetracyclines.

As mentioned before, this kind of drug is prohibited for children under 8 years old. Fortunately, Wen Yushan is 14 years old this year. As long as it is not used for a long time, there will generally be no adverse reactions.

With the introduction of doxycycline injection into the body, Wen Yushan's condition gradually improved. The first thing that stabilized was her body temperature. After the body temperature became normal, the symptoms of chest tightness were significantly relieved, but the cough was still obvious, especially at night. when.

"Why does this medicine hurt so much when infused?" Wen Yushan cried every time she was infused with doxycycline injection. Like azithromycin, this medicine can easily irritate blood vessels and cause pain at the infusion site.

This is also impossible.

"When you get better, you can switch to oral doxycycline capsules." Bu Zhengyang comforted, "Just stick with it for another two days."

Gao Feng was contemplating a topic at this time. Mycoplasma infections have been rampant recently. He went to the Department of Respiratory Medicine and found that there were many patients with severe mycoplasma pneumonia living in the department.

Most of these patients had been treated with drugs such as azithromycin or roxithromycin in the early stages, but their condition was not under control. Many of them stayed at home for a period of time, and their condition became more and more serious.

When I came to the hospital for a chest CT scan, I found that there were many large areas on the lungs, so I had no choice but to be hospitalized. Some unlucky patients were even more seriously ill and were admitted to the intensive care unit.

Of course, there are also those who simply turn their back on their hair. This is the fate of people. Some people donated 53 billion to their alma mater when they were 10 years old, and some people owe millions to the bank.

Very few children from ordinary families can change their lives against the odds. It is too difficult to achieve a class jump by your own efforts. Of course, if you have a system, that is another matter.

But no matter what, physical health comes first.

"Has this happened before?" Gao Feng asked Li Xundao.

"I don't know." Li Xun was stunned for a moment, "I just went to work, you know."

Oh, I forgot that you are still useless now, Gao Feng thought to himself.

"I have never encountered such a situation before." Dong Qianqian on the side replied loudly, "This year's situation is indeed unusual. Many cases occur in groups in families."

"Beds 23, 25, and 26 are a family of three who came to the hospital together the day before yesterday."

Tang Zhiyong is a patient in bed 23. He developed fever and cough more than 10 days ago, and then his wife also developed the same symptoms. His son is in high school and only went home for one day on the weekend. He started to have a fever after returning to school.

The doctor at the community hospital initially thought the family had the flu. After all, the onset of flu is sudden and it is highly contagious.

The family of three took oseltamivir capsules to fight the influenza virus at the same time, but Mao Yong didn't have it, and Tang Zhiyong's wife had a fever and couldn't get out of bed.

In fact, doctors in community hospitals think less about it. There is a big difference between influenza and mycoplasma infection.

Influenza has an acute onset, and its clinical manifestations are mainly systemic poisoning symptoms such as high fever, fatigue, headache, cough, and body muscle aches, while respiratory symptoms are mild. The body temperature of most people exceeds 39°C.

In case of mycoplasma infection, the body temperature is generally moderate to low fever, and rarely exceeds 39°C, but this is not absolute.

Influenza and mycoplasma infections sometimes coexist.

"Is drug resistance common?" Gao Feng picked up a pen and wrote down.

"This has not been checked," Dong Xixihui reported, "Our respiratory department basically treats adults. Once it is discovered that it is a mycoplasma infection, those who were previously ineffective with azithromycin will be directly treated with levoxacin or moxifloxacin."

It is very rare for mycoplasma to be resistant to fluoroquinolones. As long as there are no other diseases combined, most adults will get significantly better after taking the medicine for a few days.

Besides, drug resistance gene testing is not cheap at this time, and it is still at your own expense.

Gao Feng took Li Youliang to the pediatric department, where he found that there were many young patients hospitalized with mycoplasma pneumonia, and it was even hard to find a bed.

Li Youliang saw a parent pushing a camper van as a bed and letting his child lie in it for infusion.

"Don't you have any beds?" he asked, "Isn't it appropriate for you to push your child around like this?"

"There are bed numbers, but no beds." The parent said with a wry smile, they had 108 beds. Li Youliang took a look and found that bed 108 was a small stool.
  "Why don't you go to another hospital for hospitalization?"

"The children's hospital is also full, and they don't even give out stools there." The child's mother said, it's better here, at least they give out a useless small stool.
  My husband likes fishing and bought a camper last year. She even scolded him at that time, saying that he was mentally ill. Is it worth buying this thing?
  The result is now in use.
  Don't tell me it's pretty useful.

Many parents saw how convenient it was and hurriedly bought it online. For a while, the manufacturers selling camper vans felt baffled. Why did sales increase instead of falling in such a cold weather? How strange.

"Are there many mycoplasma patients this year?" Gao Feng asked the doctor on duty at the pediatrician's office.

The doctor on duty, Qiao Feichi, was almost going crazy with his work. He actually didn't want to talk to Gao Feng. The doctor's orders hadn't been written yet, and he couldn't finish them. He couldn't finish them at all.

The nurse has come here to urge her three times, each time with a more serious tone. According to his guess, the situation will break out after two more times.

But he was not worried at all. People who are often scolded have big hearts, and he was already calm about it.

"Who are you?" He asked without raising his head, "I'm quite busy right now, what can I do?"

"Oh, I'm Gao Feng, a general practitioner." Gao Feng sympathized with him when he saw how busy he was. Seeing how exhausted the children were, "You go ahead and do your work. We'll come back later."

"Okay." Qiao Feichi felt that the other party was quite discerning. "Gao Feng?" He suddenly stopped clicking the mouse with his right hand, "Why does this sound so familiar?"

Suddenly he remembered, Gao Feng! The famous Gao Feng in the hospital? By the way, the other person seems to be the director of the Department of General Medicine now.

Thinking of this, Qiao Feichi quickly stood up and chased after him.

"Director Gao!"

Gao Feng had already reached the elevator entrance, and stopped when he saw Qiao running quickly.

"Director Gao, I didn't recognize you just now." Qiao Feichi explained, "What's the matter with you coming to the pediatric department? I called our director and he will be here right away."

"No, no, no, I'm just here to ask some questions." Gao Feng was a little embarrassed. They were so busy, and he was really suspected of causing trouble.

"Director Shi, where are you going!?" The triage nurse stopped him, "There are so many patients, you can't run around."

"There is something urgent in the department. I have to go back." Director Shi Deming said, "I have already called Director Ma and asked him to come over first."

"Then you wait until he comes before leaving." The triage nurse was unwilling to let him go. "There are too many patients waiting. Someone will definitely complain when you leave."

The current situation in pediatrics is like this. Today's children are all precious babies. A small patient is usually accompanied by 2-3 family members when he goes to the hospital. If the waiting time is long, it will easily ignite the anger of the parents.

Every winter and spring or when there is a virus pandemic, the pediatric triage department will feel tremendous pressure. Quarrels are common, and physical violence is not uncommon.

Ma Shufen is an old nurse. She has worked in pediatric triage for more than 10 years. She is currently the oldest baby and the nurse who has received the most complaints in the hospital.

Last year, I won a grievance award with a bonus of 1000 yuan.

There are too many patients today, many children have fevers, and some parents are already dissatisfied because of the long waiting time. If Director Shi leaves at this time, what will happen to the parents outside?
  By then she will definitely become an outlet for her anger again. Ma Shufen is not a bitch, and she doesn't want to be scolded. ·

Director Shi was a little helpless and had to call Director Ma again, urging him to come quickly.

"I can't take a break." Director Ma, who arrived, was very dissatisfied. He would only have one day off in the past two weeks.

"No way, who told you to live close by?" Director Shi said with a smile. Director Ma lives in the family home, just one building away from Gao Feng's home.

Gao Feng was looking through medical records in the pediatrician's office at this time. He found that 60% of the patients currently hospitalized were diagnosed with mycoplasma pneumonia. This situation was obviously abnormal.

"You are busy with your business, let's just take a look." Li Youliang said to Qiao Feichi. At this time, the nurse in charge came in aggressively. She was about to scold Qiao Feichi when she suddenly found two people standing in the office. A doctor I don’t know.

"Dr. Qiao, hurry up, we're almost there." The nurse still gives the undergraduate doctor face in front of outsiders.

"Their director's surname is Shi Deming. He is a very kind person." Li Youliang said to Gao Feng, "I have a good relationship with my teacher."

Director Shi went straight to the doctor's office as soon as he arrived. He was no stranger to Gao Feng. He was so famous that there were probably not many people in the hospital who didn't know him.

"Director Gao is here to give you any advice?"

"Haha, don't you dare." Gao Feng stood up immediately, "Director Shi, I'm really sorry to bother you today."

"No, haha." Director Shi said with a smile, "Actually, the outpatient clinic is not very busy." There are only about 100 patients, he opened his eyes and said nonsense.

"Director Shi, I see a lot of patients in your department, and most of them are patients with mycoplasma pneumonia," Gao Feng said straight to the point, "This wasn't the case in previous years, right?"

"It's not true. There weren't that many patients like this in previous years." Director Shi glanced at the student following him. The latter was stunned for a moment. What do you mean?

What do you mean, why are you harder to guess than my girlfriend's thoughts? The student complained in his mind while thinking about what the teacher wanted to do.

Want me to move a stool? No, both of them are sitting down.

Wai Ri, what do you want to do? It’s not like you don’t have a long mouth, you do! The students were very anxious.

Li Youliang immediately went to pour 2 glasses of water.

"Youliang, you are just a quickie." Director Shi finished the drink in one breath. He was so busy today that he didn't even have time to drink water. He was so thirsty.

Director Shi and Director Zhao were college classmates, and they had a good relationship. He was very familiar with Li Youliang.

"I don't know what happened this year, but it suddenly broke out." Director Shi said to Gao Feng, "We are doing better here. The Children's Hospital is even more exaggerated. The Department of Respiratory Medicine is absolutely packed with people."

He has several classmates at Zzhou Children's Hospital, and everyone is surprised and puzzled by this year's situation.

"Is it because of macrolide drug resistance?" Gao Feng asked.

"It should have a lot to do with this." Director Shi replied, "Many patients have been treated with azithromycin in lower-level hospitals, but their conditions continue to progress."

"Then how do you treat me here?"

"For those over 8 years old, use doxycycline." Director Shi said, "If doxycycline is not effective, then use levofloxacin."

"Isn't levofloxacin contraindicated for children under 18 years old?" Li Youliang on the side asked puzzledly, "Can this be used?"

"There's nothing we can do about it. It's important to save our lives first." Director Shi was also a little helpless. "Besides, not every child will have side effects, and the incidence rate is still very low."

Taking medication beyond the prescribed instructions can easily lead to doctor-patient disputes, but it must be done at critical times. All we can say is that we should communicate with the family members in advance and sign as evidence.

Many parents are also worried about the side effects of the drug. After all, levofloxacin may affect the development of cartilage in children, causing them to not grow taller. However, if the child is dead, there is no point in saying this.

"Do you routinely conduct mycoplasma drug resistance gene testing?" Gao Feng asked. He came today mainly to ask about this.

"This is very expensive, and we don't do many." Director Shi was stunned for a moment, "And this project needs to be paid for at one's own expense. There is no way to reimburse, and many parents can't accept it."

Nowadays, testing for mycoplasma resistance genes costs thousands of dollars. At this time, prices are not as expensive as in later generations. Thousands of dollars is a lot of money. The total cost of hospitalization for many patients may not be that much.

(End of this chapter)