Abstract:

Objective To realize the molecular epidemiology and antimicrobial susceptibility patterns of Pseudomonas aeruginosa (PA)in a children's hospital.MethodsFiftysix  strains of PA isolated  from hospitalized children  were performed antimicrobial susceptibility test and pulsedfield gel electrophoresis( PFGE) genotyping.ResultsAll strains were resistant to ampicillin, resistant rate was 100.00%， and the resistant rate to amikacin and ciprofloxacin were both 0.00%, the resistant rates to the other antimicrobial agents  were between 1.79%-96.43%; isolates were  classified into 18 types by PFGE typing，26 of which were type A (all  were isolated from children in respiratory department )  , 12 were type B(11 strains from endocrinology department), 3 were type C , and 1 was type DR each , the isolated bacteria varied with different department, respiratory tract department had the most isolated strains (27 strains, 48.21%), the next was endocrinology department(13 strains, 23.21%).ConclusionTwo different major epidemic isolates of PA were isolated from  respiratory and endocrinology department in this hospital.  PFGE typing is a reliable method to characterize the prevalence isolates.

Abstract:

ObjectiveTo understand the incidence of healthcareassociated infection（HAI）, particularly the deviceassociated (DA) infection, and the effectiveness of implementing infection control interventions in surgical intensive care unit (SICU). MethodsProspective surveillance of patients who had been in SICU for more than 48 hours from January 1, 2007 to December 31, 2009 were conducted. The main monitoring programs were incidence of HAI and  DA infection including ventilatorassociated pneumonia (VAP), central lineassociated bloodstream infection (CLABSI),  and urinary catheterassociated urinary tract infection (CAUTI) rates and their corresponding device utilization(DU) rate.  Interventions were carried out according to the existent problems, infection rates before and after carrying out intervention measures were compared. ResultsA total of 639 patients in SICU were surveyed,  there were 129 (20.19%)  cases of  HAIs,  including 77 (59.69%)DA infections (52 VAP,12 CLABSI, 13 CAUTI) . Through carrying out the interventions, the compliance of hand hygiene of healthcare workers  increased year by year, the usage of hand hygiene products per hospitalization day from 2007 to 2009 were 41.59 mL/HD, 82.71 mL/HD and 84.33 mL/HD respectively; The incidence of VAP  decreased from 27.17 per 1 000 mechanical ventilation days in 2007 to 9.09 per 1 000 mechanical ventilation days in 2009（χ2＝2.79，P＝0.00）, but there was no remarkable change in  incidence of CLABSI and CAUTI.ConclusionThe rates of HAI and DA infection in SICU are high, but it can be reduced effectively through carrying out appropriate interventions.

Abstract:

ObjectiveTo explore the method that can block the infection route from stomach to lung so as to reduce the incidence of ventilatorassociated pneumonia (VAP) in neonates.MethodsNeonates with mechanical ventilation were randomly divided into two groups，the experimental group (38 cases) were given Bifidobacteria by nasogastric feeding, control group (43 cases) were given nothing, prospective survey was performed on the  incidence of VAP, gastric juice PH, gastric bacterial colonization, the homology between  gastric bacterial colonization and  VAP pathogen.ResultsThe VAP incidence of experimental group and  control group was 13.16 %(5/38) and 46.51% (20/43) respectively,there was significant difference between two groups （χ2=10.52,P＜0.01）.The onset time of VAP in  experimental group （5.4±2.07d）was later than that of  control group(4.25±1.00d) (t=3.24,P<0.01). The ratio of experimental group that gastric juice dropped to pH ≤3 was higher than that of control group(46.51%)（χ2=12.47,P＜0.01）; and the ratio of gastric bacterial colonization in experimental group(31.58%) was lower than that in control group(74.42%)（χ2=14.42,P＜0.01）.The homology ratio between VAP pathogen and colonization bacteria in experimental group (40.00%) was lower than that  in control group(75.00%) (χ2=8.00,P＜0.01）. The univariate analysis of risk factors showed that Bifidobacterium use and gastric bacteria  juice PH≤ 3 were protective factors , but gastric bacterial colonization was the risk factor. OR and 95% CI were statistically significant.ConclusionBifidobacterium can reduce gastric juice PH of neonates and inhibit gastric bacterial colonization . The onset time of VAP can be delayed, the incidence of earlyonset of VAP can be reduced effectively.

Abstract:

ObjectiveTo evaluate the effect of mucosolvan bronchoalveolar lavage  on stroke patients with pulmonary infection.MethodsFortytwo stroke patients with pulmonary infection were randomly divided into two groups, normal saline group and mucosolvan group were 21 cases respectively. All  patients were treated with antiinfection, bronchodilatation, aerosol inhalation and intravenous drip of mucosolvan in ICU. Observed indicators included acute physiological and chronic health evaluation (APACHE Ⅱ ) score, Glasgow coma scale (GCS) ,Creaction protein (CPR), and clinic pulmonary infection score (CPIS) in all cases. The number of alveolar lavage ,the average duration of lavage,  aspirated sputum volume, the days in ICU , duration of using ventilators and CPIS were compared before and after lavage between two groups.ResultsThere were no significant difference in age, gender, GCS score, APPACHE Ⅱ score and CRP before lavation in both groups(P>0.05), and there was also no  statistical difference in lavage number, average duration of lavage, and aspirated sputum volume between two groups (P=0.05); mucosolvan group had less time on the ventilator ( ［63.57±21.94］h )and less  day to stay in ICU(［6.24±1.04］d) than saline group（［88.24±21.35］h, ［7.95±1.36］d ,respectively）(t=-3.69,P=0.00;t=-4.58,P=0.00) ; at the 3rd  and 4th day after lavage ,  CPIS in mucosolvan group was (2.36±0.77) and ( 2.17±0.81) respectively, which were significantly lower than saline group(［4.16±0.86］,［3.54±1.09］, respectively)(t=3.60,P=0.00;t=2.25,P=0.03).ConclusionMucosolvan bronchoalveolar lavage can promote stroke patients to  recover from pulmonary  infection.   

Abstract:

ObjectiveTo realize the status and causes of catheterassociated nosocomial infection (CANI) in surgical intensive care unit (SICU) , so as to decrease the incidence by taking proper measures.MethodsSix hundred and fifteen patients with catheters  in SICU between  2005 and 2009 were  monitored prospectively,  including the occurrence of CANI, patients’ age, length of hospital stay, invasive procedures, and pathogens.ResultsOne hundred and ninetyseven of 615 patients (32.03%) developed CANI,  and CANI rate was 2.60%,12.85% and 56.40% in patients with 1 kind , 2  or 3 kinds of catheters simultaneously respectively, there were significant difference among three groups (χ2=151.55,P<0.001). The rate of ventilatorassociated pneumonia (VAP), catheterassociated urinary tract infection (CAUTI) , and  central venous catheter (CVC)associated bloodstream infection (CVCBSI) per 1 000 catheter days was 15.51, 13.70 and 5.79 respectively. The average catheter  utilization days before the occurrence of CANI were as follows:  ventilator (12.22±11.29) days, urinary catheter (13.09±13.29) days , CVC (20.64±18.39) days respectively. The major pathogen in  VAP , CAUTI and  CVCBSI  was Acinetobacter spp.(18.80%), Candida albicans (36.46%) and Acinetobacter spp.(18.75%) respectively.ConclusionPatients with more catheters , long hospital stay and long duration of catheters are prone to develop nosocomial infection . The key to the prevention of emerging of drugresistant strain and decrease in NI are strengthening of  disinfection and isolation, shortening  the time of catheter  retaining, implementing hand hygiene, and using antimicrobial drug rationally.

Abstract:

ObjectiveTo understand the status of nosocomial infection (NI) and communityacquired infection (CAI) and antimicrobial use in  Fujian Province, and provide the evidence for targeted monitoring.MethodsAll inpatients in 116 hospitals were requested to make a prevalence survey of NI and CAI and antimicrobial use by bedside visiting and patients’ medical records checking, and data were analysed statiscally.ResultsA total of 116 surveyed data were collected, 113(97.41%) of which were qualified , 48 947 patients were actually investigated.1 595 (3.26%) patients developed 1 739 cases(3.55%) of NI ; 9 751(19.92%) patients developed 10 062 cases(22.56%) of CAI.The major  infection site was lower respiratory tract, which accounting for 49.34% of NI,and 45.70% of CAI. Gramnegative bacilli were the major pathogens , and Pseudomonas aeruginosa was the most common pathogen（15.05%） in NI，Escherichia coli was the major pathogen in CAI(8.90%). The departments with high NI prevalence rates were general intensive care unit (38.22%,99/259), hematological unit(12.54%, 85/678), and neurosurgical unit(9.44%, 152/1 611); the department with high CAI prevalence were nonneonatal group of pediatric unit (82.02%, 2 053/2 503), respiratory unit(70.46%, 1 577/ 2 238), neonatal group in pediatric unit(52.23%, 409/783). The daily usage rate of antimicrobial agents was 38.28% (18 738/48 947), and pathogen detection rate in patients with curative antimicrobial use was 42.68%(4 735/11 093).ConclusionThe management of departments with high NI rate should be strengthened , pathogen detection rate should be enhanced, monitor on multidrugresistant pathogens and management of antimicrobial agents should be intensified.

Abstract:

ObjectiveTo study the characteristics of the drinking behavior of  male hepatitis B virus (HBV) carriers. Methods935 male HBV carriers in outpatient department were investigated by questionnaires.ResultsThe annual and the monthly drinking rate of male HBV carriers  was 58.18% and 34.97% respectively. The highest group of the monthly drinking rate was at the age of 20-29 years old, which was 39.15% (139/355)；According to the educational background, patients with undergraduate course and above had the highest rate ( 46.75%,79/169); In the occupational aspect, patients who were officials and professional staff had the highest rate (50.26%,97/193);As to the monthly income, patients who earned at least 2 000 yuan had the highest monthly drinking rate (42.39%, 39/92). There were 2.57% (14/544)heavy drinkers, 6.62% (36/544) drinking four times per week, annual acute drunken rate was 31.43% (171/544), 17.83% (97/544) drank white spirits, 39.41% (214/543) drank at least 2 kinds of alcohol, 9.12% (49/537) drank alone, 3.72% (20/537) drank on an empty stomach; 63.50% (327/515)drank before 18 years old , 6.07% (33/544) addicted to drinking.ConclusionAmong male HBV carriers, those who aged 20 to 39 , with undergraduate course and above, possess specialized skill or high income are high risk population and should be intervened specially. Many problems exist in male HBV carriers such as heavy drinking, frequent drinking, fast drinking, high degree or mixed alcohol , drinking alone and drinking on an empty stomach, underage drinking and addicted drinking, it cannot be ignored.

Abstract:

ObjectiveTo investigate the changes in serum procalcitonin (PCT) levels in patients with different bacterial infections and to evaluate the significance of PCT levels for differentiating grampositive and gramnegative bacterial infection. MethodsTwo hundren and sixtysix intensive care unit（ICU）patients infected with severe bacterial infections were divided into 2 groups (grampositive bacteria group and gramnegative bacteria group) according to the bacterial culture results, and serum PCT, Creaction protein(CRP), white blood cell(WBC) and neutrophil ratio（Neu%） were detected, and data of two groups were analysed statiscally. ResultsSerum levels of PCT in patients with severe bacterial infection significantly rose. When defined by the value of PCT ≥2 ng/mL as positive, the positive rate of PCT in gramnegative bacteria group (92.36%) was significantly higher than that of grampositive bacteria group (76.23%)(χ2=13.45, P<0.001); When the value of PCT ≥10 ng/mL, the possibility of gramnegative bacterial infection was great. The routine infection markers, including CRP,WBC and Neu% , were not significantly different between grampositive bacteria group and gramnegative bacteria group( both P＞0.05）. ConclusionPCT levels can be used as indicator for differentiating grampositive and gramnegative bacterial infection, and may provide valuable information for sensitive antimicrobial selection.

Abstract:

ObjectiveTo analyze the pathogen colonization and risk factors of burn wounds in different periods.MethodsExcretion of burn wounds in 131 patients were performed bacterial culture in different periods , relevant data were surveyed retrospectively, pathogen colonization and influencing factors were analyzed.ResultsThe pathogen colonization rate increased gradually at the 3rd，7th，14th day after burn ,which was 26.72%,61.32% and 89.93% respectively, there were significant difference (χ2=71.02, P<0.00), the influence of six risk factors on the pathogen colonization had statistical significance , including unit environment，patients’ age， drug application at wound，combination use of antimicrobial agents , depth and types of burn(all P<0.05).ConclusionThe pathogen colonization rate , multiple drugresistant pathogen constantly increase after burn, it’s very important to prevent burn wound infection by division management for burn patients, rational use of drug , active treatment of wounds, and strict executing of disinfection and isolation measures.

Abstract:

ObjectiveTo investigate the relationship between human parvovirus B19 and spontaneous abortion by detecting human parvovirus B19 DNA and IgM of women in normal pregnancy and spontaneous abortion .MethodsThe blood of women in abortion (observation group, 28 cases) and normal pregnancy (control group, 33 cases) were collected, human parvovirus B19 DNA and IgM were detected with PCR and ELISA.ResultsThe positive rate of human parvovirus B19 DNA was 28.57% (8/28) in observation group and 9.09% (3/33) in control group, there was significant difference between two groups(χ2=3.98, P<0.05); human parvovirus B19 IgM was detected in one sample of observation group(3.57%,1/28), positive samples were not detected in the control group(0.00%).ConclusionHuman parvovirus B19 infection rate is higher in women of spontaneous abortion than in normal pregnant women,suggesting that human parvovirus B19 infection may be one of the causes leading to abortion.

Abstract:

ObjectiveTo understand the risk factors for antimicrobialassociated diarrhea (AAD) in hospitalized children.MethodsClinical data of children with AAD who were hospitalized between， June，2008 and June， 2010 were analyzed.ResultsA total of 4 368 children were investigated, antimicrobial usage rate was 84.96% (3 711/4 368); AAD rate was 29.21%(935/3 201). AAD rate was 35.14% in children ≤1 year of age, which was significantly higher than that of the other groups (P<0.01) ; AAD rate was 27.63% and 41.60% respectively in common illness cases and critical illness cases(P<0.01); AAD rate was 26.39% and 34.01% respectively in children who had received antimicrobial agents for ≤7 days and >7 days respectively(P<0.01); AAD rate was 40.45% in children who had received at least 4 kinds of antimicrobial agents,which was significantly higher than those who had received 1-3 kinds of antimicrobial agents(P<0.01).ConclusionChildren who were small ages,critical sickness, with long terms and frequent use of antimicrobial agents can easily develop AAD . The incidence of AAD can be reduced by rational use of antimicrobial agents .

Abstract:

ObjectiveTo study the distribution and drugresistance of pathogens isolated from children with lower respiratory tract infections in a hospital.MethodsBacterial strains isolated from sputum specimens from February to September,2010 were identified and performed antimicrobial susceptibility test by VITEK2compact system.ResultsA total of 4 094 strains (34.74%) were isolated from 11 785 sputum samples, 2 826 (69.03%) of which were gramnegative bacilli, including 1 012 strains of Klebsiella pneumoniae, 574 Escherichia coli, 438 Acinetobacter baumannii, 221 Enterobacter cloacae,and so on; 1 167 (28.50%) strains of grampositive cocci were detected, including 402 strains of Staphylococcus aureus, 296 Streptococcus pneumoniae, and 193 Staphylococcus epidermidis; 101 (2.47％) strains of fungi were also detected. Positive rate of extendedspectrum betalactamases in Klebsiella pneumoniae and Escherichia coli was 23.91% and 22.13%, respectively; gramnegative bacilli were highly sensitive to imipenem, the resistant rate was between 0.00%-2.97%. 12.19% of Staphylococcus aureus, 35.75% of Staphylococcus epidermidis, and 47.87% of Staphylococcus haemolyticus were methicillinresistant, these strains were highly sensitive to vancomycin, the resistant rate was 0.00%. Eight strains (2.70%) of Streptococcus pneumoniae were resistant to vancomycin, while sensitive to linezolid, the resistant rate was 0.00%. ConclusionThere are multidrugresistant strains in children with lower respiratory tract infection, in order to reduce the emergence of drug resistant strain, antimicrobial agents should be used according to antimicrobial susceptibility test results.

Abstract:

ObjectiveTo investigate the distribution characteristics of pathogens isolated from clinical blood specimens from a hospital. MethodsBacteria isolated from 55 606 bottles of 28 292 blood specimens between 1999 and 2008 were cultured and identified by mimi VITAL Blood Culture Automation System and Bact/ALERT 3D System and VITEK 32 Automicrobic System,and the culture result was analysed statistically .ResultsIn aerobic and anaerobic culture of 28 292 blood specimens,5 837 showed positive culture results， the positive rate was 20.63%;The positive rate of aerobic and anaerobic bacteria was 83.50%(4 874/5 837) and 82.30%（4 804/5 837）respectively. A total of 5 837 strains of 117 species of 43 genus were detected, Salmonella paratyphi A accounted for 4 486 stains(76.85%).The distribution showed three peaks of bacterial detection were in the year of 2001 (1 263 strains) , 2004 (740 strains) and 2006 (713 strains). Grampositive cocci were the main isolated bacteria ,the ratio of grampositive cocci to gramnegative bacilli and fungi was 65.73∶25.30∶2.74. Coagulase negative Staphylococcus(CNS) accounted for 37.46%(493/1 316) of the detected bacteria except Salmonella spp., and had a tendency of increasing gradually(χ2=127.81,P＜0.01).The isolation rate of fungus was increasing gradually(χ2=29.77,P＜0.01). The obligate anaerobes accounted for 0.38%(22/5 837) of all isolated bacteria , and accounted for 1.67%(22/1 316) except Salmonella.Conclusion Performing both aerobic and anaerobic culture can enhance the positive detection rate. Constant detection of Salmonella paratyphi A and increasing tendency of opportunistic pathogens(CNS and fungus) should be paid much attention to .

Abstract:

ObjectiveTo evaluate the effective cleaning methods for complex medical instruments, improve the cleaning quality, ensure sterilization effect， and control nosocomial infection . MethodsFive hundred pieces of moderately contaminated medical instruments recycled from central sterile supply department were divided into two groups, each group included 150 pieces of sawshaped instruments and 100 pieces of lumen instruments; Observation group performed hand washing and multienzyme ultrasound machine cleaning method, control group adopted hand washing with flowing water, the cleanliness and positive rates of occult blood test (OBT)of two groups after cleaning were compared .ResultsThe qualified rate of cleanliness of sawshaped and lumen instruments after cleaning in observation group was 98.67% and 98.00% respectively, the positive rate of OBT was 0.67% and 1.00% respectively; The cleanliness of sawshaped and lumen instruments after cleaning in control groups was 78.67% and 70.00% respectively, the positive rate of OBT was 28.67% and 34.00% respectively (P<0.01); The efficacy of cleaning method in observation group was obviously superior to that in control group. ConclusionCombination of hand and multienzyme ultrasonic cleaning can improve the cleaning quality of complex medical instruments.

Abstract:

目的了解某院重症监护室(ICU)患者发生呼吸机相关性肺炎(VAP)的病原菌及其耐药性，为临床诊断与治疗提供参考依据。方法对该院ICU 2009年7月—2010年8月发生VAP患者的目标性监测资料进行分析。结果63例VAP患者共分离病原菌115株，其中革兰阴性杆菌80株(69.56％)，居前4位者分别为:铜绿假单胞菌 (23株)、鲍曼不动杆菌(22株)、嗜麦芽窄食单胞菌(10株)、洋葱伯克霍尔德菌(8株)；革兰阳性球菌23株(20.00％)，以金黄色葡萄球菌(18株)为主要致病菌；真菌12株(10.44％)，以白假丝酵母菌（6株）为主 。铜绿假单胞菌对复方磺胺甲口恶唑、头孢曲松、头孢噻肟、亚胺培南的耐药率较高，分别为100.00%、65.22%、47.83%、43.48%；鲍曼不动杆菌对氨曲南、左氧氟沙星的耐药率较低，分别为4.55%和27.27%，对其他抗菌药物的耐药率均>60%；未发现对氯霉素、利奈唑胺、利福平、复方磺胺甲口恶唑、万古霉素耐药的金黄色葡萄球菌。结论该院ICU导致VAP的主要病原菌是非发酵革兰阴性杆菌，耐药性严重；预防和控制VAP的发生，加强对其病原菌分布及耐药性的监测是工作重点。

Abstract:

目的了解某院重症监护室（ICU）患者下呼吸道医院感染病原体种类及其耐药性。方法对ICU 2008年9月—2010年6月发生的192例下呼吸道医院感染患者的资料进行分析。结果共分离24种192株病原体,其中革兰阳性(G+)球菌52株（27.08%），主要为金黄色葡萄球菌（38株，73.08%）、表皮葡萄球菌(5株,9.61%)；革兰阴性（G-）杆菌138株（71.88%），主要为铜绿假单胞菌(43株, 31.16％)、肺炎克雷伯菌(36株, 26.09％）、鲍曼不动杆菌(30株，21.74％)、 大肠埃希菌(13株，9.42％)；真菌2株（1.04%）。肺炎克雷伯菌和大肠埃希菌中，产超广谱β内酰胺酶株分别为24株（66.67%）和9株（69.23%)。金黄色葡萄球菌与表皮葡萄球菌除对替考拉宁、夫西地酸与万古霉素的耐药率为0.00%外，对其余抗菌药物耐药率均较高（13.16%～100.00%）。铜绿假单胞菌对头孢噻肟、头孢呋辛的耐药率均为2.33%，对亚胺培南、美罗培南的耐药率分别为18.60%、23.26%，对其他抗菌药物的耐药率为37.20%～100.00%；鲍曼不动杆菌对头孢噻肟、头孢呋辛的耐药率均为16.67%，对其他抗菌药物耐药率达46.67%～93.33%；肺炎克雷伯菌和大肠埃希菌对亚胺培南、美罗培南、阿米卡星的耐药率为0.00%～23.08%，对其他抗菌药物耐药率为30.56%～92.31%。结论该院ICU下呼吸道医院感染病原体主要为G-杆菌，出现了多种多重耐药菌；应加强对病原体耐药性监测，密切关注病原体分布及其耐药性变迁, 合理使用抗菌药物。

Abstract:

目的探讨血液病患者医院感染的特点，分析易感因素，以利医院感染的预防与控制。方法采用前瞻性调查方法对2008年1月1日—2009年12月31日血液科所有住院患者进行医院感染情况调查，并分析其危险因素。结果共调查2 025例患者，发生医院感染269例（13.28%），290例次（14.32%）。医院感染部位以呼吸道为主，占58.96%(171/290)；其次是血流感染46例次，占15.86%。年龄＞60岁和住院时间＞30 d的患者医院感染率分别为27.72%和37.80%,显著高于年龄≤60岁和住院时间≤30 d者的医院感染率8.49%、9.17%（χ2分别为121.76、177.32，均P＜0.01）；使用化疗药物和接受侵入性诊疗患者的医院感染率分别为22.61%和22.06%，显著高于未接受上述诊疗者的感染率5.66%、12.65%（χ2分别为125.10、9.75，均P＜0.01）。共检出病原菌152株，其中革兰阴性杆菌95株，革兰阳性球菌19株，真菌38株。结论血液病患者是医院感染的高危人群，其医院感染的发生与住院时间、年龄、化疗药物的使用及侵入性诊疗密切相关。应重点监测此类患者，采取有效的防控措施，降低医院感染率。

Abstract:

目的了解某三级中医医院铜绿假单胞菌（PA）耐药情况，为临床抗感染治疗提供可靠依据。方法对该院2006 年1 月— 2009 年11 月临床科室送检的感染性标本中分离的529株PA的临床分布及耐药现状进行回顾性调查，并用WHONET5.3软件进行数据分析。结果529株PA，分离自痰标本 359株（67.86%），脓液及伤口分泌物标本82株（15.50%），尿标本41株（7.75%），其他标本47株（8.88%）。4年间PA对常用抗菌药物的耐药率较高，耐药率＞70%的抗菌药物有：氨苄西林（98.49%）、头孢唑林（98.49%）、氨苄西林/舒巴坦（96.98%）、复方磺胺甲口恶唑（96.98%）、头孢曲松（73.53%）；耐药率在50%～70%的抗菌药物有：妥布霉素（68.43%）、头孢他啶（68.24%）、氨曲南（65.60%）、环丙沙星（60.87%）；耐药率＜30%的抗菌药物为：哌拉西林/ 他唑巴坦（27.98%）、头孢哌酮/ 舒巴坦（27.79%）、阿米卡星（24.20%）、亚胺培南（15.12%）、头孢吡肟（14.74%）。结论PA主要分离自呼吸道标本（痰），耐药性高；及时准确的细菌鉴定及药物敏感性分析，能指导临床合理选择抗菌药物治疗。

Abstract:

目的了解各级医疗机构医院感染管理现状,为卫生行政部门合理配置预防控制医院感染卫生资源，制定防控医院感染宏观对策提供依据。方法对2010年9月参加中国医师协会主办，曲靖市医学会医院感染管理专业委员会承办的“全国医院感染管理与持续质量改进培训班”的251名学员（为119所医疗机构医院感染管理负责人）进行问卷调查。结果不同级别医院的医院感染管理现状存在差异（P＜0.01）。三级医院的医院感染管理工作已逐步规范化、标准化；二级及以下基层医疗机构从医院感染管理组织、培训状况、综合与目标监测、手卫生、医院感染管理标准操作规程及消毒供应中心清洗、消毒、灭菌监测与设备投入等方面都存在不同程度的问题。结论卫生行政部门应加大对基层医疗机构医院感染管理工作的支持与监管，合理配置预防控制医院感染卫生资源。

Abstract:

目的比较2类包内化学指示卡［3M第4类(1250)多参数化学指示卡、第5类(1243)移动式化学指示卡］在不同物品灭菌监测结果的精确度和判读效率。方法选择敷料包90个、器械包120个，比较上述2类化学指示卡的监测效果。结果敷料包组和器械包组的 1243指示卡合格率均为 100%；而敷料包组的1250指示卡合格率为82.22%（74/90）,器械包组的1250指示卡合格率为 76.67%（92/120）；生物监测显示2组的合格率为 100%。结论1250指示卡变色效果受人为因素影响大，易造成判断失误；1243指示卡在变色和移动过程中不受外界因素影响，判断准确、便捷。

Abstract:

目的了解某院医生对医院感染的认知情况，针对现存的不足,对医生进行教育培训。方法自行设计问卷调查表，采用随机抽样的方法，选取某三级乙等医院128名临床注册医生进行问卷调查，并对调查结果进行统计分析。结果128名医生对医院感染的定义及现行医院感染报告制度的知晓率分别为99.22％、92.19％，顾虑诊断和上报医院感染后影响个人诊疗水平者占28.91％，顾虑诊断和上报医院感染后导致医疗纠纷者占32.03％，其中低年资医生所占百分比较高,为45.90%。结论该院医生对医院感染病例自愿报告的认知情况较好，但低年资医生有待提高。应加强对医院感染病例上报重要性的认识，以提高自觉上报的依从性。

Abstract:

目的探讨现代医院消毒供应中心的持续质量改进效果。方法在医院领导的支持下，加快硬件设施和软件技术的投入，按照国家标准结合医院实际建立健全各项规章制度,改进操作流程,实行全院集中供应及管理,加强工作人员专业知识学习,提高业务水平。结果通过管理和质量改进，使消毒供应质量逐步达到标准，无菌物品灭菌合格率和保供率达100%,消毒供应满意率由89%提高至98%，确保消毒供应适应医院发展的需要。结论消毒供应中心持续质量改进有效降低了医疗风险，增强了医院感染管理,是现代消毒供应中心提高质量的目标。

Abstract:

真空负压采血是目前被广泛推广的采血技术，与传统的一次性注射器采血相比，具有安全、全封闭、高效和有助于防止交叉感染等许多优点，为广大医务工作者所接受［1］。
血液标本质量对临床检验结果的影响至关重要。血液标本采集的影响因素广泛而复杂，真空负压采血也不例外。笔者将深入探讨真空采血操作的每个环节，包括采血装置、操作、样本的运输和处理等，分析其可能的干扰因素及对临床检测结果的影响，探索如何最大程度减少这些不利因素。