• Issue 5,2011 Table of Contents
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    • Current status and clinical study  of  suspected pneumonia cases of   unknown origin  in China

      2011, 10(5):321-325.

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      ObjectiveTo realize the current status and clinical characteristics of suspected  pneumonia cases of unknown origin (PUO)  in China, so as to  provide the appropriate reference for revising and adjusting the definition of PUO. MethodsOne provincial, one municipal and one county level hospital were selected from 2 provinces participating in the project, clinical data of communityacquired pneumonia(CAP) patients who were hospitalized between April 1, 2008 and March 31, 2009 were collected,  screened and analyzed. ResultsA total of 1 506 CAP case histories  were collected,  442 (29.35%) of which were conformed with PUO definition. The peak incidence season was winter (32.35%); 60.63% were male patients , 57.24% were ≤ 14 years old;  The main clinical manifestations were acute onset, fever, cough, and expectoration, most  patients had promising prognosis (recovery rate>95%), and no clustering events occurred. ConclusionA large part of CAP in inpatients were conformed with suspected cases of PUO, but the clinical course is good. In order to screen out the suspected cases of PUO more specifically and timely, it should be paid more attention to the epidemiological history inquiry into pneumonia cases diagnosed by signs and symptoms or imagings.

    • Investigation on the pathogenesis of severe and critical H1N1 influenza A

      2011, 10(5):326-330.

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      ObjectiveTo investigate the pathogenesis of severe and critical H1N1 influenza A.MethodsBefore and after medical treatment, changes in peripheral blood cells of patients with severe or critical H1N1 influenza A were analyzed, and changes in costimulatory molecules and apoptosis on lymphocytes of patients with severe or critical H1N1 influenza A were dynamically observed via flow cytometry and monoclonal antibodies.ResultsFor patients with severe or critical H1N1 influenza A, the count of leukocytes and lymphocytes before treatment were(2.55±0.87)×109/L and (1.02±0.54)×109/L, respectively, after treatment were (6.95±4.36)×109/ L and (2.13±0.78)×109/L, respectively, there was significant  difference(t=3.28,P=0.01;t=9.52,P=0.00); count of erythrocyte before and after treatment were (4.10±0.45)×1012/L and(4.14±0.39)×1012/L, respectively,  there was no statistical difference (t=0.35,P=0.73). During the recovery phase, lymphocyte count  increased gradually, the expression of  costimulatory molecule CD28 and CD152, and the apoptosis signal CD95 of T lymphocytes decreased. ConclusionH1N1 influenza virus A can repress the activation and proliferation of T lymphocytes, and induce overactivation apoptosis of T lymphocytes,  cause the decrease in lymphocyte and leukocyte count, which may play an important role in the pathogenesis of severe and critical H1N1 influenza A.

    • Effect of suppressive oligonucleotides on mice CD4+T cell transcription factor and its significance

      2011, 10(5):331-335.

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      ObjectiveTo evaluate the effect of suppressive oligodeoxynucleotides (Sup ODN) on expression of Tbet, pSTAT4 and pSTAT6 of CD4+T spleen lymphocytes in vitro.MethodsThe spleen lymphocytes of BALB/c mice were isolated and then CD4+T cells were purified with immunomagnetic microbeads(positive selection),the purification was analysed by flow cytometry.The coculture of CD4+cells, antiCD3ε, antiCD28, IL12 and Sup ODN or control oligodeoxynucleotides(Con ODN) was performed for 72 hours,the nucleoprotein was extracted with regular  procedure. Expression of pSTAT4(phosphorylated STAT4),pSTAT6,and Tbet in nucleoprotein were detected by Westernblot.ResultsCompared with Con ODN and PBS treated group, expression of Tbet and pSTAT4 in Sup ODN treated group decreased significantly (P<0.05), while expression of pSTAT6 in Sup ODN treated group increased significantly (P<0.05).ConclusionSup ODN may inhibit Th1 differentiation of mice CD4+T cell by downregulating expression of pSTAT4 and Tbet, and promote Th2 differentiation by upregulating expression of pSTAT6.

    • Genotyping of Acinetobacter baumannii causing ventilatorassociated pneumonia

      2011, 10(5):337-340.

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      ObjectiveTo evaluate the molecular epidemiological features of Acinetobacter baumannii (Ab) causing ventilatorassociated pneumonia(VAP).MethodsSeven strains of Ab isolated from lower respiratory tract secretion of VAP patients were typied by pulsedfield gel electrophoresis (PFGE), and drugresistance of strains were detected.ResultsThe similarity of PFGE electrophoresis strips of 7 strains was 57%-100%, there were 4 PFGE patterns(A,B,C and D), 2(28.57%) strains were for pattern A, B and D respectively, 1(14.29 %) strain was for pattern C. Ab had different drugresistance to 13 kinds of antimicrobial agents (ceftazidime, imipenem,tobramycin, etc.), all were pandrugresistant strains, pattern C strain was alldrugresistant strain.ConclusionPFGE typing can accurately and quickly trace the homology of nosocomial infection caused by Ab.

    • Investigation on four  nosocomial infection cluster cases caused by drugresistant Acinetobacter baumannii

      2011, 10(5):341-343.

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      ObjectiveTo evaluate the causes of nosocomial infection cluster cases(NICC) caused by drugresistant Acinetobacter baumannii(DRAb). MethodsClinical data and epidemiological survey results of 4 NICC were analyzed and described by statistics.ResultsFourteen cases in 4  DRAb NICC occurred at ICU  in hot weather season; 10(71.43%) were critical patients; 6(42.86%) were older patients (>65 years); the median time of ICU stay were 8 days; the local physiological barriers of all cases were destroyed before developing DRAb infection.12 cases (85.71%) developed pulmonary infection (64.29% for ventilatorassociated pneumonia); 11(78.57%) were infected with pandrug resistant Acinetobacter baumannii (PDRAb). Nine patients (64.29%)  had a history of longterm use of combination  antimicrobial agents before developing NI; 2 NICC  were afferent NI.ConclusionThe occurrence  of ICU DRAb  NICC is  associated with susceptibility of patients, isolation and disinfection, ward NI surveillance, use of antimicrobial agents, and biological characteristics of  Acinetobacter baumannii

    • Biofilm formation and inhibition in Acinetobacter baumannii

      2011, 10(5):344-347.

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      ObjectiveTo realize the antimicrobial resistance of Acinetobacter baumannii (Ab), and effect of  ethylenediaminetetra5 acetic  acid (EDTA ),minocycline and salicylic acid  on  its biofilm formation. MethodsAntimicrobial susceptibilities of 72 strains of Ab were detected with KirbyBauer method; Minimal inhibitory concentrations of EDTA, minocycline and salicylic acid  on Ab were determined by broth microdilution method; The biofilm formation rates of different drugresistant Ab and the effect of different concentrations of EDTA, minocycline and salicylic acid on biofilm formation and mature biofilm were determined by adhesion test.ResultsThe MIC90 of EDTA, minocycline and salicylic acid  for Ab was 200 mg/L,4 mg/L and 600 mg/L, respectively. The biofilmpositive rates in sensitive Ab (SAb)strains, multidrug resistant (MDRAb) strains  and  pandrug resistant (PDRAb) strains was 22.22%, 83.33% and 76.67%, respectively.  EDTA  with concentration of 250 mg/L and 500 mg/L, minocyline 4 mg/L and 8 mg/L,and salicylic acid 1 000 mg/L  can inhibit the mature biofilm.ConclusionThere are a high biofilmpositive rate in multidrug and pandrug resistant Ab . EDTA, minocycline and salicylic acid  can inhibit the formation of biofilm.

    • PFGE typing of 8 Klebsiella pneumoniae strains causing nosocomial bloodstream infections

      2011, 10(5):348-350.

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      ObjectiveTo analyze 8 strains of Klebsiella pneumoniae isolated from the surgical ward in a hospital by pulsedfield gel electrophoresis(PFGE), so as to provide scientific evidence for the control of nosocomial infection. MethodsAntimicrobial susceptibility test of Klebsiella pneumoniae was performed by microbroth dilution and KirbyBauer method, genotyping was performed with PFGE.ResultsAntimicrobial susceptibility test showed that except the strain Kp1, 7 clinical strains were the same sensitivity to 11 antimicrobial agents, and they were all multidrug resistant; PFGE showed that 7 strains were the same pattern. ConclusionSeven of 8 Klebsiella pneumoniae strains came from the same clone, which suggesting it might be an outbreak of nosocomial infection.

    • Species  and drugresistance of fungi causing deep infections in AID patients

      2011, 10(5):351-353.

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      ObjectiveTo explore the characteristics and drug sensitivity of fungi causing deep fungal infections in AIDS patients, so as to provide evidence for clinical choice of drugs.MethodsFungi were cultured and tested by Bact /ALERT 3D120 blood culture system, and were identified and analyzed by Yeast Biochemical Card (YBC card) according the colony growth characteristics; sensitivity of fungi to antifungal drugs were detected by ATB FUNGUS 3 strip.ResultsTwo hundred and eight fungal strains were isolated from 2 868 different specimens, the constituent ratios of fungipositive specimens were as follows: sputum 34.13% (71 isolates), cerebrospinal fluid 27.40% (57 isolates), blood 12.50% (26 isolates), excrement 10.10% (21 isolates),  bone marrow 7.21% (15 isolates), urine 4.81% (10 isolates), and the other sites 3.85% (8 isolates). Fourteen critically ill patients were isolated 2-3 different strains from multiple sits . Among all isolates, the top five constituent ratios were Cryptococcus neoformans 34.13% (71 isolates), Candida albicans 33.65% (70 isolates), Penicillium marneffei 14.90% (31 isolates),Candida glabrata 5.77% (12 isolates), and Candida tropicalis 3.85% (8 isolates). Cryptococcus neoformans and Candida albicans were highly sensitive to amphotericin B and 5fluorocytosin (sensitive rate was 90.63%-100.00%); 45.45%-57.82% of Candida albicans, Candida glabrata and Candida tropicalis were resistant to fluconazole and voriconazole. Penicillium marneffei was sensitive to amphotericin B and itraconazole, sensitive rate was 95.80% and 84.11% respectively . ConclusionDeep fungal infection is specially distributed among AIDS patients. In order to use antifungal drugs rationally and reduce the emergence of resistant strains, it is important to strengthen the detection and surveillance of pathogens from samples at different sites of AIDS patients.

    • Clinical characteristics of 81 cases of handfootmouth disease complicated with encephalitis caused by Enterovirus 71

      2011, 10(5):354-356.

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      ObjectiveTo study the clinical and laboratory characteristics of handfootmouth disease complicated with encephalitis caused by Enterovirus 71(EV71), so as to improve the quality of diagnosis and treatment .MethodsClinical data of 81 patients with handfootmouth disease complicated with encephalitis were analyzed retrospectively.ResultsOf 81 cases, all had fever, 48 had twitch, 45 startled, and 42 had vomiting. Fiftythree cases were with leukocytosis in peripheral blood; 10 with hyperglycemia, 20 with hypoglycemia ; none with abnormal troponin; 73 with leukocytosis in cerebrospinal fluid. All patients used mannitol to reduce intracranial pressure, 32 used methylprednisolone to inhibit inflammation, and 27 used gamma globulin for support treatment ; except 1 case developed flaccid paralysis of left upper limb,the other cases were clinically cured.ConclusionAll patients with handfootmouth disease complicating with encephalitis caused by EV71 had clinical symptoms of fever and poor spirit, some startled, twitched and vomiting, intracranial pressure should be reduced actively, combination therapy with gamma globulin and glucocorticoid should be chosen appropriately.

    • A casecontrol study on risk factors for nosocomial Staphylococcus haemolyticus infections in intensive care units

      2011, 10(5):357-360.

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      ObjectiveTo evaluate the risk factors for nosocomial Staphylococcus haemolyticus (S. haemolyticus) infections (NIs) in intensive care units (ICUs) . MethodsA 1∶4 matched casecontrol study was carried out on ICU patients (28 cases) with S. haemolyticus NIs in an integrated hospital between 2007-2009. Conditional logistic regression analysis was adopted.ResultsUnivariate conditional logistic regression analysis showed that S. haemolyticus NIs were related with the number of underlying diseases,days of ICUs stay,adjusted days of ICUs stay, days of antimicrobial use, combination use of antimicrobials ,use of broadspectrum antimicrobials ,turning over and back patting,sputum aspiration,trachea intubation,use of ventilator,retention of nasogastric tube and central venous catheter. Multivariate logistic regression analysis showed that retention of nasogastric tube(OR=4.89) and ventilator(OR=5.32) were risk factors, and turning over and back patting(OR=0.21)were protective factors.ConclusionSound and effective practice of turning over and back patting ,use of noninvasive ventilation and reducing invasive procedures are helpful for the control and prevention of S. haemolyticus NIs.

    • Clinical analysis on fungal infections in severe patients after craniotomy

      2011, 10(5):361-363.

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      ObjectiveTo explore the risk factors,clinical characteristics,prevention and treatment of fungal infections in severe patients after craniotomy.MethodsClinical data  of 27 severe patients with fungal infections after craniotomy in neurosurgery department in a hospital between January 2009 and June 2011 were analyzed retrospectively.ResultsOf  27 patients, 12 cases had lung fungal infections, 8  had urinary tract infections, 4 had gastrointestinal tract infections, 2 had surgical site infections,  and 1 had bloodstream infections; 22 cases improved or cured, 1 died, 4 patients gave up treatment and were discharged. The major risk factors for fungal infections in postoperative severe patients were coma, application  of broadspectrum antimicrobial agents and glucocorticoids, and a variety of invasive treatment operation. ConclusionThe key to the prevention of nosocomial fungal infection after craniotomy is the rational use of broadspectrum antimicrobial agents and glucocorticoids. The clinical manifestations of fungal infections are not typical. For postoperative severe patients who require longterm use of antimicrobial agents, antifungal agents should be used preventively; Patient who has fungal infection should  choose appropriate antifungal agents, antifungal agents should be used early,enough and full course.

    • Epidemiological investigation and control of nosocomial infections in patients undergoing  prodonor liver transplantation

      2011, 10(5):364-366.

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      ObjectiveTo study the epidemiological characteristics of nosocomial infections (NIs) in patients undergoing prodonor liver transplantation, so as to  evaluate the prevention and control measures.MethodsFiftyfive patients  undergoing prodonor liver transplantation in a hospital between  2007 and  2008  were analyzed statistically. ResultsAmong 55 patients, 14 patients  developed 18 cases  NIs, NI  rate was 25.45%, case infection rate was 32.73%. Forty-eight pathogenic strains were isolated ,the major strains were gramnegative bacilli(32 isolates,66.67%), followed by grampositive cocci(9 isolates,18.75%) and fungi(7 isolates,14.58%). The main infection site was lung(6 cases), followed by abdominal cavity(3), biliary tract (3), upper respiratory tract(3),bacteremia(2), and acute gastroenteritis(1). NI group had more days in intensive care unit (ICU) stay , preoperative antimicrobial application , use of ventilator and  venous catheter ,and perihepatic drainage than those of noninfection group (P<0.05). ConclusionPatients undergoing  prodonor liver transplantation have low postoperative infection rate; the susceptible factors for NI  include longterm ICU stay  and preoperative use of antimicrobial drugs, and the  invasive factors for postopereative NI are  long term  ventilator, intravenous catheter days and perihepatic drainage  .

    • Case control study on the intervention with rational application of perioperative antimicrobial agents in typeⅠ incision operations

      2011, 10(5):367-369.

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      ObjectiveTo evaluate the feasibility of rational application of perioperative antimicrobial agents in a hospital. MethodsApplication of perioperative antimicrobial agents in type Ⅰincision operations of thyroid gland, mammary gland and abdominal external hernia before intervention (AprilJune,2008; 90 cases, nonintervention group) and after intervention (AprilJune,2010 ;90 cases, intervention group) were compared by case control study.ResultsAntimicrobial application rate and nonindicated antimicrobial preventive application rate decreased from 100% and 46.67% in nonintervention group to 42.22% and 8.89% in intervention one respectively; The rate of irrational choice of drugs decreased from 66.67% in nonintervention group to 1.11% in intervention one; The pre and postoperative irrational application rate of antimicrobial agents decreased from 68.89% and 68.89% in nonintervention group to 7.78% and 5.56% in intervention one respectively; The average cost of antimicrobial agents decreased from 220.13 yuan in nonintervention group to 94.24 yuan in intervention one (P<0.01).ConclusionThe intervention for rational application of perioperative antimicrobial agents is feasible and effective.

    • Isolation and antimicrobial resistance of imipenem/cilastatinresistant Acinetobacter baumannii

      2011, 10(5):370-372.

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      ObjectiveTo study the isolation and antimicrobial resistance of imipenem/cilastatin (IPM)resistant Acinetobacter baumannii (A. baumannii) in a hospital.MethodsClinical specimens were collected from January 2006 to December 2010, except the blood culture was performed with United States BD BACTEC9120 system, the other specimens were cultured and isolated bacteria with routine method ; strains were identified and performed drug sensitive test with Phoenix 100 automatic analysis system and reagents. The metalloβlactamases were detected with 2mercaptopropanoic acid inhibited assays.ResultsOne hundred and fiftyfour (74.03%) IPMresistant A.baumannii strains were mainly isolated from sputum and throat swabs, strains mainly distributed in the following departments: intensive care unit (98 isolates,63.64%), department of neurology (25,16.23%), burn unit (13,8.44%), respiratory department(8, 5.19%), geriatrics department (4, 2.60%), department of general surgery(3,1.95%), and hematological department(3,1.95%) . IPMresistant A.baumannii had the lowest resistant rate to cefoperazone/sulbactam (42.21%), and the resistant rates to the other antimicrobial agents were all >65%. The rate of metalloβlactamaseproducing strains was 14.94%(23/154).ConclusionThe IPMresistant A.baumannii are chiefly from specimens in respiratory tract infection, and the susceptibility to antimicrobial agents is low. The strengthening of the monitor and optimization use of antimicrobial agents is important for controlling the prevalence of IPMresistant A. baumannii in hospitals.

    • Distribution and drug resistance of common gramnegative bacilli in an intensive care unit

      2011, 10(5):373-375.

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      ObjectiveTo investigate the distribution and drug resistance of common gramnegative bacilli in intensive care unit (ICU) in a hospital.MethodsThe species and drug susceptibility test of the common gramnegative bacilli isolated from ICU between 2008 and 2010 were analyzed retrospectively. Bacteria were identified and performed antimicrobial  susceptibility test with VITEK2(bioMerieux) system. The date were analyzed by the software “WHONET5.5”.ResultsOf 1 551 gramnegative bacilli isolates, 68.06% were isolated from sputum; among the common gramnegative bacilli, the first one was Acinetobacter baumannii, which accounting for 25.40% (394 strains), followed by  Klebsiella pneumoniae (21.66%,336 strains), Escherchia coli (16.76%,260 strains), and Pseudomonas aeruginosa (15.86%, 246 strains),etc; 198(58.93%) strains of Klebsiella pneumoniae and 174(66.92%) of Escherichia coli were extendedspectrum βlactamaseproducing  strains. The common gramnegative bacilli had very low resistant rates to  piperacillin/tazobactam, imipenem, cefoperizone/sulbactam and amikacin, the resistant rates was 19.23%-31.73%,9.23%-37.40%, 14.88%-32.23%, and 22.92%-27.66%,respectively.ConclusionMultidrug resistance among the common gramnegative bacilli in ICU is very serious . In order to reduce the emergence of drugresistant bacterial strain, it is important to use  antimicrobial agents correctly based on drug susceptibility test result.

    • Detection and antimicrobial resistance of 149 Escherichia coli strains isolated from blood culture

      2011, 10(5):376-377.

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      目的探讨需氧和厌氧配对血培养分离大肠埃希菌的情况及其耐药性。方法采用mini VITAL或BacT/ALERT 3D血培养仪对2001年1月—2008年6月临床送检血液标本进行需氧和厌氧配对培养并分离菌株,用VITEK 32分析系统及配套的鉴定与药敏卡进行细菌鉴定、药敏试验及超广谱β内酰胺酶(ESBLs)检测。结果共分离149株大肠埃希菌,其中需氧和厌氧培养均生长115株(77.18%),仅需氧培养生长14株(9.40%),仅厌氧培养生长20株(13.42%);产ESBLs阳性率为36.91%(55/149)。149株大肠埃希菌对亚胺培南、呋喃妥因、头孢西丁、奈替米星有较高的敏感率,分别为100.00%、94.63%、88.60%和75.84%;对氨苄西林、阿莫西林/克拉维酸、头孢噻吩、头孢噻肟、头孢他啶、庆大霉素、萘啶酸、培氟沙星、复方磺胺甲口恶唑、替卡西林、妥布霉素的耐药率(包括中介)均>40%。结论采用需氧和厌氧配对培养可提高大肠埃希菌阳性检出率。该院血源性大肠埃希菌产ESBLs率较高,对大多数抗菌药物耐药且呈多重耐药性,需高度重视。

    • Survey on the infection prevalence rates in a hospital in 2010

      2011, 10(5):378-379.

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      目的了解某院医院感染的基本情况,为改进医院感染监控措施提供依据。方法对2010年8月18日 0∶00—24∶00入住该院的所有住院患者,以床旁调查和查阅病历相结合的方法进行医院感染现患率调查,并填写统一的个案调查表。对调查日处于医院感染状态的病例资料进行统计分析。结果实查608例患者,发生医院感染29例(4.77%),31例次(5.10%)。医院感染现患率较高的科室依次为:内分泌科(15.79%)、脑外科(13.95%)、骨一科(12.50%)、肾病科(12.00%)、儿科(8.33%)、中医内科(5.00%)。下呼吸道(38.71%)、皮肤软组织(22.58%)、胃肠道(12.90%)为医院感染的高发部位。共检出病原体8株,其中下呼吸道检出1株仅对亚胺培南敏感的大肠埃希菌,手术切口检出1株对苯唑西林耐药的金黄色葡萄球菌。抗菌药物日使用率为47.20%(287/608),治疗性使用抗菌药物病原学送检率为35.10%(53/151)。结论医院感染现患率调查结果提示,应加强对重点科室、重点环节的监控;同时提高治疗性使用抗菌药物病原学送检率,规范、合理使用抗菌药物,以有效降低医院感染率。

    • Nosocomial infections in 1 106 patients in a department of neurology

      2011, 10(5):380-381.

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      目的了解某院神经内科住院患者医院感染发生情况,探寻有效的防控措施。方法对2008年1月—2009年12月神经内科1 106例住院患者进行医院感染情况的回顾性调查。结果调查期间,神经内科1 106例住院患者共发生医院感染84例(7.59%),90例次(8.14%);感染部位以呼吸道(77.78%)、泌尿道(17.78%)为主;发生医院感染患者的病死率为7.14%(6/84)。共分离病原菌36株,以革兰阴性菌为主(25株,69.44%),其次为革兰阳性菌(6株,16.67%)、真菌(5株,13.89%)。结论神经内科住院患者医院感染率高,是医院感染高度易感人群,应重点监控。

    • Status of antimicrobial application in a basiclevel hospital

      2011, 10(5):382-383.

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      目的了解基层医院抗菌药物临床应用现状及普遍存在的问题,促进其合理用药。方法根据调查目的设计表格,回顾性分析2008年1月—2009年12月间15%的出院病历共1 583份,逐一分析抗菌药物使用的合理性,最后进行汇总。结果1 583例患者抗菌药物使用率达78.33%(1 240 例)。其中预防性用药占46.29%,治疗性用药占53.71%;使用一种抗菌药物者占66.53%,二联用药占31.69%,三联及以上用药占1.78%;病原学送检率29.73%;存在无指征用药及联合用药、预防用药时间过长、选用品种和给药方案欠合理等较多问题。结论基层医院抗菌药物不合理应用问题较为突出,管理薄弱,应加大管理、培训和监控力度,促进抗菌药物的合理使用。

    • Bacterial culture results of hands of nurses in 5 posts before and during work

      2011, 10(5):384-385.

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      Abstract:

      目的了解不同工作岗位护士在正常工作中手的污染情况,为提高其手卫生的依从性提供有力依据。方法分别从某院5种岗位(手术室、病房治疗、病房配药、病房护理以及门诊注射室工作)护士中随机抽取20名,同一天分别做洗手前、六步洗手法洗手(或手消毒)后以及工作2 h后手部采样细菌培养,并对结果进行统计分析。结果经统计学分析,不同工作岗位间护士洗手(或手消毒)前手采样培养菌落数均严重超标,差异无统计学意义(P>0.05);同一岗位护士洗手(或手消毒)后手采样培养菌落数显著低于洗手(或手消毒)前(P<0.05);洗手(或手消毒)后,各工作岗位间护士手采样培养菌落数差异无统计学意义(P>0.05)。工作2 h后,从事手术室和病房配药工作的护士与其洗手(或手消毒)后手采样培养菌落数比较,差异无统计学意义(P>0.05);而从事治疗、护理和门诊注射工作的护士上述比较,差异有统计学意义(P<0.05),即菌落数显著增加。结论无论采用何种手卫生方法,只要严格按照规范要求进行,基本都能达到各自岗位规范的要求,能很好地预防因手传播而造成的医院感染。

    • 1 Guangdong Provincial Stomatological Hospital, Guangzhou 510280, China; 2 Centre for Disease Control and Prevention of Guangdong Province, Guangzhou 510280, China

      2011, 10(5):386-387.

      Abstract (1223) HTML (0) PDF 745.00 Byte (1587) Comment (0) Favorites

      Abstract:

      目的调查广州某口腔专科门诊的消毒灭菌质量状况,探讨医院感染管理改进措施并分析效果。方法 回顾性分析2007—2010年该口腔专科门诊消毒灭菌监测数据及其医院感染管理改进措施的实施效果。结果4年共检测样本2 299份,合格2 238份,合格率97.35%。其中灭菌设备及物品合格率均为100.00%。 2007年改进医院感染控制措施初期,空气、医务人员手卫生及各检测项年平均合格率分别为89.04%、95.40%、91.92%、92.28%,至2010年,上述项分别上升至98.72%、98.78%、98.18%、98.52%,两两比较,差异均有统计学意义(均P<0.05)。结论该口腔专科门诊的消毒质量经过加强医院感染管理及持续实施改进措施后有显著提高,其改进措施方案有效。

    • “Positive feedback system” to promote continuous quality improvement of disinfection and sterilization

      2011, 10(5):388-389.

      Abstract (1463) HTML (0) PDF 802.00 Byte (1529) Comment (0) Favorites

      Abstract:

      目的通过实施“阳性反馈制”,达到持续改进消毒灭菌质量的目的。方法感染管理科每月进行消毒灭菌效果监测、汇总,将不合格项目以《阳性反馈单》形式,书面通知科主任、护士长,并在院周会及护士长例会上通报,分析原因,落实整改措施,进行跟踪监测、评价。结果推行“阳性反馈制”一年,总监测合格率由84.80%上升至97.34%(P<0.005),其中空气、医务人员手卫生、无菌物品、消毒器械、使用中消毒液合格率分别由87.10%、75.56%、92.54%、82.98%、84.17%升至100.00%、95.52%、99.07%、96.08%、96.15%(均P<0.05),呈平稳上升趋势。结论“阳性反馈制”的建立和落实,促进了消毒灭菌质量持续改进,全面提高了医院感染管理质量。

    • Standard operation procedure for disinfection of hospital environment and object surface

      2011, 10(5):390-391.

      Abstract (1570) HTML (0) PDF 792.00 Byte (33162) Comment (0) Favorites

      Abstract:

      目的规范医院环境及物体表面消毒标准操作程序(SOP),提高工作效率。方法医院后勤配合医院感染管理科制订医院环境及物体表面消毒SOP;准备规范的清洁车,培训工作人员,实施该SOP。结果通过该SOP的有效实施,规范了工作步骤,使工作人员掌握了消毒技术方法,提高了工作效率;同时消除了安全隐患,保证了环境安全;提升了医院形象。结论要提高医院环境及物体表面消毒工作的效率,必须创新和实践新的管理方法。

    • Training and examination method on knowledge of nosocomial infection

      2011, 10(5):392-394.

      Abstract (1449) HTML (0) PDF 808.00 Byte (1714) Comment (0) Favorites

      Abstract:

      目的发现临床医护人员在医院感染预防与控制知识理解和运用方面的误区,通过完善培训工作,使广大临床医护人员熟练掌握并科学运用感染防控措施。方法先期制定预防管理规范,而后普遍宣传、贯彻与集中重点培训相结合,再通过比赛考核的方式检验培训效果。结果经宣教培训后,比赛考核的总正确率为95.50%,出现错误较多的集中在“多重耐药菌感染患者周围环境消毒采用的消毒剂种类及浓度”、“术前备皮”及“围手术期预防使用抗菌药物”3个方面。结论此次培训所采用的方法系统性较强,理论与实践相结合,有成效。同时提示培训方案应细化,有针对性。

    • Application and sterilization quality control on hydrogen peroxide low temperature plasma

      2011, 10(5):395-397.

      Abstract (1643) HTML (0) PDF 908.00 Byte (2465) Comment (0) Favorites

      Abstract:

      近年来,科学家发现低温等离子体技术不但可以作为辅助加工手段被广泛用于制造各种性能优良的新材料,研制新的化学物质和化学过程,而且还发现低温等离子体对致病菌具有很强的杀伤力,可以应用于医疗器械的灭菌,消除环境中的生物污染等[1]。
      气体等离子体又称气浆,是继液态、气态、固态以外的新的物质聚集态,称为第四态[2]。市场上出现过2种气体等离子体:1994年12月,FDA通过过氧乙酸等离子体(AbTox)系统,但由于灭菌后其残留物引起了眼外科患者的眼损伤, 1998年被禁止销售。1996年10月,FDA通过过氧化氢等离子体(Sterrad)系统。现就过氧化氢低温等离子灭菌原理、临床应用情况等综述如下。

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