• Issue 5,2012 Table of Contents
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    • Hunan Provincial Bacterial AntimicrobialResistance Surveillance System:2011 surveillance report

      2012, 11(5):321-327.

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      ObjectiveTo investigate the source, distribution and antimicrobial susceptibility of bacteria in patients with bacterial infection in Hunan Province, so as to provide reference for clinical empirical antimicrobial use.MethodsWHONET 5.6 software was used for analyzing bacterial drugresistance surveillance data reported to Hunan Provincial Bacterial AntimicrobialResistance Surveillance System in 2011 by hospitals participating in the system.ResultsA total of 24 632 bacterial isolates were collected, 17 413 (70.69%) isolates had information about the sources of specimens, 48.87%, 11.95% and 8.14% of which were sputum, urine and blood specimens respectively. Distribution of bacteria was as follows: grampositive bacteria 7 784 isolates(31.60%), gramnegative bacteria 16 848 isolates(68.40%), the top three bacteria were Escherichia coli(17.68%), Klebsiella pneumoniae(12.85%), and Staphylococcus aureus(11.69%). Enterobacteriaceaes were most sensitive to carbapenems(sensitive rate were 90.2%-98.9%); among nonfermentative bacteria, the sensitive rate of Pseudomonas aeruginosa to amikacin was 80.0%, Acinetobacter baumannii to cefoperazone/sulbactam was 77.1%; the sensitive rate of Staphylococcus spp. to teicoplanin, quinupristin/dalfopristin, linezolid, and vancomycin were 90.5%-100.0%, and 37.4% of Staphylococcus aureus and 69.8% of coagulase negative Staphylococcus(CNS) were methicillinresistant; Among Enterococcus spp., Enterococcus faecalis had the highest sensitive rate to teicoplanin(98.2%), and Enterococcus faecium had the highest sensitive rate to linezolid(96.4%).ConclusionSpecimens from sterile sites are not common, delivery rate of specimens from sterile sites should be enhanced; the main bacteria are gramnegative bacteria, for the empirical antimicrobial use, antimicrobial agents should be chosen according to probable pathogens.

    • Inhibition of cellular immune response by CD4+CD25+Foxp3+T lymphocyte in drugresistant tuberculosis patients

      2012, 11(5):328-331.

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      ObjectiveTo explore the difference in CD4+CD25+Foxp3+T lymphocytes and their secretion of cytokines transforming growth factorβ1(TGFβ1) and interleukin10 (IL10)among drugresistant tuberculosis (DRTB) patients, nondrugresistant tuberculosis(nonDRTB) patients and healthy control subjects, and evaluate its role in the inhibition of specific cellular immune response.MethodsFlow cytometry was applied to detect the expression levels of peripheral blood CD4+CD25+T lymphocytes and CD4+CD25+Foxp3+T lymphocytes in 30 healthy subjects(control group), 39 nonDRTB patients(nonDRTB group) and 35 DRTB patients(DRTB group) ; enzymelinked immunosorbent assay (ELISA) was used to detect TGFβ1 and IL10 levels in peripheral blood in different groups.ResultsCD4+CD25+T and CD4+CD25+Foxp3+T lymphocytes accounted for (17.09±5.43)% and (0.78±0.88)% respectively of total number of CD4+T cells in the peripheral blood of control group, (22.12±3.43)% and (2.79±1.65)% respectively in nonDRTB group, (24.01±5.65)% and (4.51±1.47)% respectively in DRTB group. The percentage of CD25+CD4+T lymphocytes in CD4+T lymphocytes in DRTB group was higher than that of nonDRTB group, but the difference was not significant(P>0.05); the percentage of CD4+CD25+Foxp3+T lymphocytes in CD4+T lymphocytes in DRTB group was significantly higher than control and nonDRTB group (P<0.05), and levels of TGFβ1([4.15±1.39]ρ/ng·L-1) and IL10([872.17±269.75]μg/L) were significantly higher than those of nonDRTB group ([3.03±1.42]ρ/ng·L-1 and [266.83±57.09]μg/L, respectively) as well as control group ([2.12±0.77]ρ/ng·L-1 and [105.21±23.56]μg/L, respectively) (P<0.05).ConclusionCD4+CD25+Foxp3+T lymphocytes may weaken elimination funtion of immune system on Mycobacterium tuberculosis in TB patients,and related to the progress of tuberculosis infection as well as multidrugresistance. TGFβ1 and IL10 may be involved in the inhibition of cellular immunity and have some correlation with the formation and the severity of the DRTB.

    • Surveillance on methicillinresistant Staphylococcus aureus infection in an intensive care unit

      2012, 11(5):332-335.

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      ObjectiveTo investigate methicillinresistant Staphylococcus aureus (MRSA) infection in an intensive care unit (ICU), and evaluate the efficacy of intervention.MethodsFrom August 2008 to September 2010, all MRSA infection cases in ICU were collected, and all isolated MRSA strains were tested by molecular biology method, from september 2009 to September 2010, patients infected with MRSA were intervened and monitored, and compared with MRSA infection rate of one year before intervention, the efficacy of all measures was evaluated.ResultsThe detection rate of MRSA from ICU environment was 29.90%(87/291) before intervention and 7.90% (23/291) after intervention (χ2=45.910, P<0.05); the infection rate of MRSA in ICU patients was 35.87% (113/315) before intervention and 14.66%(51/348) after intervention (χ2=25.11, P<0.05). The risk factors for MRSA infection before and after the intervention were similar, the main risk factors were tracheal intubation and use of ventilator, neurosurgery operation, longterm application of broadspectrum antimicrobial agents, application of immunosuppressive agents, as well as nonisolation, et al.MRSA infection appeared mostly two weeks after patients’ admission, the longer time the patients were in hospital, the less effect of the intervention achieved.Conclusion ICUacquired MRSA infection rate is relatively high, early intensifying strategies, monitor, and control can reduce cross infection rate of MRSA.

    • Two methods for the detection of ESBL phenotypes

      2012, 11(5):336-340.

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      ObjectiveTo investigate antimicrobial resistance and genotypes of extendedspectrum βlactamases (ESBLs)producing strains isolated from clinic in a hospital, and to establish an effective method to analyze ESBL phenotypes.MethodsOne hundred ESBL positive isolates (initial screen test was positive) were randomly selected as experimental group, and 30 ESBL negative isolates (initial screen test was negative) was as control group. All strains were identified by Vitek2 Compact automatic system,and antimicrobial susceptibility test was performed by KirbyBauer disc diffusion method; Carbapenemresistant isolates were detected by modified Hodge test; βlactamase phenotypes were detected by both ESBL phenotypic confirmatory test recommended by Clinical Laboratory Standard Institute(CLSI) and modified ESBL confirmatory test incorporating 3aminophenylboronic acid; ESBL genes of all isolates were detected by PCR and DNA sequencing. ResultsESBL screen positive isolates were all resistant to cefotaxime, but susceptible to carbapenems; the modified Hodge tests were positive in two carbapenemresistant isolates. The detection rate of ESBL genes was 84.00%, the dominant genes were SHV and CTXM type. PCR detection for ESBL genes was regarded as a golden standard,and the sensitivity,specificity,negative predictive value, as well as positive predictive value of ESBL phenotype confirmatory test and modified ESBL phenotype confirmatory test was 72.61%, 100.00%, 100.00%, 66.67% and 98.81%,100.00%,100.00%, 97.87% respectively, the difference was significant (χ2=7.53, P=0.006). ConclusionESBL screen test positive isolates still have a high susceptible rate to carbapenems. ESBL phenotypes can be effectively detected by modified ESBL confirmatory test incorporating 3aminophenylboronic acid.

    • Distribution and drugresistance of pathogens isolated from AIDS patients with bacteremia in Changsha

      2012, 11(5):341-344.

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      ObjectiveTo evaluate the distribution and drugresistance of pathogens isolated from acquired immunodeficiency syndrome (AIDS) patients with bacteremia, so as to provide reference for clinical diagnosis and treatment.MethodsThe isolation and drug susceptibility of pathogens in blood culture of AIDS patients who were hospitalized between January 2009 and December 2010 were analyzed retrospectively, and compared with blood culture result of other patients during the same hospitalization period.ResultsA total of 9 554 blood specimens were collected, 1 522 of which were from AIDS patients, 77 blood specimens from AIDS patients and 571 from the other patients were positive for blood culture. The main isolated pathogens in AIDS patients were fungi(81.82%), the isolation rate of Penicillium marneffei, Cryptococcus neoformans, and Kluyveromyces marxianus was 66.23%,7.79%, and 5.19% respectively, bacterial infection was sporadic (18.18%); the major pathogens in blood culture of the other patients was bacteria (91.42%), while fungi was 8.58%; the difference in pathogens in blood culture between two groups was significant (χ2=254.55,P<0.01). Penicillium marneffei exhibited low sensitivity to amphotericin B and fluconazole, while Cryptococcus neoformans and Kluyveromyces marxianus were sensitive to antifungal agents.ConclusionThe key to the control of infection in AIDS patients with bacteremia is to strengthen epidemiological survey and find pathogens as soon as possible.

    • Difference between community and healthcareassociated MRSA infection

      2012, 11(5):345-347.

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      ObjectiveTo realize the characteristics and drug resistance of communityassociated(CA) and healthcareassociated(HA) methicillinresistant Staphylococcus aureus(MRSA) infection, and provide reference for the prevention and control of MRSA infection.MethodsData of MRSAinfected patients who were hospitalized between January and June 2010 were reviewed and analyzed retrospectively. ResultsThe major CAMRSA infection site was skin and soft tissue (58.82%). The rate of CAMRSA respiratory tract infection and HAMRSA respiratory tract infection was 29.41% and 29.63% respectively. There was significant difference in age, length of hospital stay, ICU stay, surgical operation and invasive operation between CAMRSA and HAMRSA infected patients(P<0.05). The resistant rate of HAMRSA to rifampicin, gentamicin,moxifloxacin, and ciprofloxacin were all higher than those of CAMRSA (74.19%-93.33% vs 37.50%-52.94%, P<0.05).ConclusionCAMRSA infection varies from HAMRSA infection in infection characteristics and drug resistance, prevention and control measures should be strengthened, and antimicrobial agents should be used according to antimicrobial susceptibility testing result.

    • Correlation between intervention in preventive antimicrobial application and surgical site infection in type Ⅰ incision operation in a general surgery department

      2012, 11(5):348-351.

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      ObjectiveTo compare correlation between preventive perioperative antimicrobial application and surgical site infection (SSI) of type Ⅰ incision operation in a general surgery department.MethodsSince 2010, preventive perioperative use of antimicrobial agents in thyroid surgery, breast surgery and hernia repair surgery has been intervened, a series of control measures on the use of antimicrobial agents have been established according to The detailed management rules of preventive perioperative antimicrobial agents use in type Ⅰ incision operation in general surgery department. Difference in the use of antimicrobial agents and SSI rates before and after intervention were analyzed.ResultsThe usage rate in three kinds of operations was 21.28%(60/282) before intervention and 3.21%(15/468) after intervention (χ2=63.85,P<0.05);the average hospitalization day was (4.09±2.99)d before intervention and (3.67±2.47)d after intervention(χ2=3.704,P=0.000); the types of antimicrobial agents decreased after intervention; SSI rate was both 0.00% before and after intervention.ConclusionSSI won't increase if preventive perioperative antimicrobial agents aren't used in type Ⅰ incision operation.

    • Influence of bundle treatment on prognosis of encephalopathy patients with ventilatorassociated pneumonia

      2012, 11(5):352-354.

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      ObjectiveTo evaluate the prognostic value of bundle treatment on prognosis of encephalopathy patients with ventilatorassociated pneumonia(VAP).MethodsSeventytwo mechanically ventilated patients admitted to an intensive care unit (ICU) from September 2010 to March 2012 were randomly divided into experimental and control group, 37 patients in experimental group adopted bundle treatment, 35 patients in control group received conventional treatment, the length of ICU stay, hospital cost and 28day mortality following admission of two groups were compared.ResultsLength of ICU stay in experimental group was significantly shorter than that of control group ([11.93±6.25] vs [18.08±7.53] days, t=3.27, P=0.00); hospitalization cost in experimental group was significantly less than that of control group ([68.7±32.5] vs [95.8±38.2] thousand yuan, t=2.81, P=0.01); 28day mortality following admission in experimental group and control group was 24.32% (9/37) and 31.43% (11/35) respectively, there was no significant difference (χ2=0.22, P>0.05).ConclusionThe bundle treatment can reduce length of hospital stay and hospital cost of encephalopathy patients with VAP, but can not reduce mortality.

    • Healthcareassociated infection and risk factors in elderly lung cancer patients

      2012, 11(5):355-356.

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      ObjectiveTo explore healthcareassociated infection(HAI) and risk factors in elderly lung cancer patients.MethodsMedical data of lung cancer patients aged≥60 years in a tumor hospital between May 2006 and May 2011 were analyzed retrospectively.ResultsOf 324 patients,63 (19.44%) developed HAI,the major pathogens were gramnegative bacilli (37 isolates, 58.73%), the next were grampositive cocci (20 isolates, 31.75%), fungi accounted for 9.52% (6 isolates); the main infection sites were respiratory tract and oral cavity,the constituent ratio was 47.62%(30 cases) and 17.46%(11 cases) retrospectively. Univariate analysis revealed that the stage of TNM, invasive operation, antitumor therapy, smoking and associated underlying diseases were related risk factors for HAI in elderly patients with lung cancer(P<0.05).ConclusionHAI in elderly lung cancer patients is high, prevention and control should be taken according to related risk factors.

    • Survey on prevalence rates of healthcareassociated infection and antimicrobial use in a hospital in two consecutive years

      2012, 11(5):357-359.

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      ObjectiveTo evaluate the prevalence rates of healthcareassociated infection (HAI) and antimicrobial use in a hospital in 2011 and 2012, so as to provide a scientific basis for the prevention and control of HAI as well as rational use of antimicrobial agents. MethodsSurveys were conducted on hospitalized patients from June 20, 2011 to June 23, 2011 and those from May 21, 2012 to May 23, 2012, HAI prevalence rates as well as antimicrobial use were analyzed.ResultsA total of 987 patients were investigated, the actual investigation rate was 99.60%(495/497) in 2011and 100.00%(492/492) in 2012 respectively; there was no significant difference in HAI prevalence rate between 2011 and 2012 (2.42% vs 2.64%, χ2=0.05,P>0.05). In 2011 and 2012, the daily usage rate of antimicrobial agents was 41.41% and 25.61% respectively (χ2=27.65,P<0.01), the usage rate of therapeutic antimicrobial agents was 58.05% and 83.33% respectively (χ2=29.108,P<0.01), pathogenic detection rate increased from 56.49% in 2011 to 76.77% in 2012(χ2=45.45,P<0.01). ConclusionSurvey on HAI prevalence rate is helpful for realizing the occurrence and control efficacy of HAI; the reducing of prophylactic antimicrobial application and rational use of antimicrobial agents will not lead to the increase of HAI rate.

    • Influence of different hand lotions on the efficacy of chlorhexidine surgical hand disinfectant

      2012, 11(5):360-362.

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      ObjectiveTo evaluate the influence of different hand lotions on the efficacy of chlorhexidine surgical hand disinfectant.MethodsSixty health care workers were randomly divided into group A, B, and C. All subjects washed their hands for 1 minute according to sixstep hand washing technique, and hands were dried with sterile paper towels. Group A didn't use hand lotion, group B and C used 3M 9260 hand lotion (waterinoil emulsion) and certain brand vaseline hand lotion (oilinwater emulsion) respectively. Bacterial cultures of hands in three groups were performed after washing hands, using hand lotions 30 minutes later and disinfecting with surgical hand disinfectant, bacterial colonies were counted.ResultsAfter washing hands, the difference in colony count was not significantly different among three groups (P>0.05). Thirty minutes after using hand lotions, colony count in group A, B, and C was (3.33±0.64) CFU/cm2, (3.32±0.97) CFU/cm2, and (4.05±1.78) CFU/cm2 respectively, colony count in group C was significantly higher than group A and B (P<0.05); there was no significant difference between group A and B (P>0.05). After surgical hand disinfection, both group A and B met requirements for surgical hand disinfection, the difference was not significantly different (P>0.05); two subjects in group C didn't meet requirements for surgical hand disinfection, and the colony count ([1.28 ± 1.45]CFU/cm2) was significantly higher than group A ([0.07 ± 0.10]CFU/cm2) and B ([0.06 ± 0.12]CFU/cm2) (P<0.05).ConclusionHand lotion containing latex and chlorhexidine can protect hand skin and doesn't reduce efficacy of surgical hand disinfection.

    • A comparative study on community and healthcareassociated Staphylococcus aureus infection

      2012, 11(5):363-365.

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      ObjectiveTo investigate the epidemiology and drug resistance of Staphylococcus aureus (S. aureus) from hospital and community, so as to provide reference for clinical diagnosis and treatment.MethodsThe isolation, identification and antimicrobial susceptibility testing of S. aureus from inpatients and outpatients from January 2008 to January 2010 were performed, epidemiological data of infected patients were studied.ResultsA total of 140 communityassociated(CA) and 135 healthcareassociated(HA) S. aureus isolates were collected, isolation rate of methicillinresistant Staphylococcus aureus (MRSA) in two groups was 22.86%(32/140)and 50.37%(68/135) respectively,the difference was significantly different (χ2=22.482,P=0.000); the main isolation sites of two groups were skin and soft tissue and respiratory tract, but constituent ratio was significantly different (χ2=79.741,P=0.000), CAS.aureus had more sources of isolation sites. HAS.aureus had higher resistant rate to ampicillin, cefoxitin, tetracycline, gentamicin, chloramphenicol, rifampicin, ciprofloxacin,and imipenem than that of CAS.aureus (all P<0.01).ConclusionCAS.aureus varied from HAS.aureus in infection sites and antimicrobial resistance, pathogenic detection and antimicrobial susceptibility testing should be performed timely, antimicrobial agents should be chosen rationally, and disinfection and isolation should be paid more attention, so as to avoid the transmission of S.aureus in family and hospital.

    • Detection and drug resistance of βlactamaseproducing Staphylococcus from clinical specimens

      2012, 11(5):366-369.

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      ObjectiveTo realize the detection and drug resistance of βlactamaseproducing Staphylococcus isolated from clinical specimens in a hospital, so as to provide reference for preventing and treating Staphylococcus infection.MethodsClinical and laboratory data of 1 725 βlactamaseproducing Staphylococcus isolated from clinical sepcimens between 2005 and 2010 were analyzed retrospectively.ResultsThe total detection rate of βlactamaseproducing Staphylococcus was 94.83% (1 725/1 819). The detection rate of each year was 88.68%(94/106), 89.69%(174/194), 91.72%(155/169),97.58%(242/248),96.10%(591/615) and 96.30%(469/487) respectively,there was an increased tendency(χ2=51.11, P<0.01; The detection rate of βlactamase was the highest in Staphylococcus sciuri(99.50%,198/199) and the lowest in Staphylococcus auricularis (80.37%,86/107)(χ2=58.08,P<0.01). Antimicrobial susceptibility testing results showed that βlactamaseproducing Staphylococcus isolates were sensitive to vancomycin, linezolid, furantoin and rifampicin, but were highly and multiply resistant to penicillin, ampicillin, ampicillin/sulbactam, oxacillin, cefazolin, ciprofloxacin, tetracycline, clindamycin, erythromycin, gentamicin and sulfamethoxazole/trimethoprim, the resistant rate was between 51.74% and 100.00%, and resistant rate of βlactamaseproducing Staphylococcus was higher than nonβlactamaseproducing Staphylococcus (χ2=7.00-485.39. P<0.01). 72.86% of βlactamaseproducing Staphylococcus aureus and 78.30% of βlactamaseproducing coagulase negative Staphylococcus were oxacillinresistant strains.ConclusionThe high detection rate and high drug resistant rate of βlactamaseproducing Staphylococcus is serious, it is necessary to intensify the monitor and stop quick increase of βlactamase producing Staphylococcus.

    • Evaluation on efficacy of improving sputum specimen quality through bundle of interventions

      2012, 11(5):370-371.

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      ObjectiveTo improve the quality of sputum specimen collection through a bundle of interventions.MethodsSputum specimens of patients who were hospitalized between February and October 2011 were collected through routine method. Intervention in respiratory department was carried out from May 2011(intervention group, followup and feed back, continuing education, as well as health education were carried out), the other inpatient departments was as control group, the efficacy of intervention was evaluated through investigation on sputum collection, delivery and quality. Results After intervention, the qualified rate of sputum specimens of the intervention group was 41.94%, which was significantly higher than 21.62% of control group (χ2=18.76, P<0.05) and 24.19% of intervention group before intervention (χ2=10.85, P<0.05). ConclusionThe qualified rate of routinely collected sputum specimens is low, the quality of sputum specimens can be improved by a bundle of interventions.

    • Control of bacterial contamination on direct drinking water in a hospital

      2012, 11(5):372-373.

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      ObjectiveTo explore bacterial contamination of direct drinking water system in a hospital.MethodsFrom January 2011 to February 2012, random sampling of finished water, drinking water on clientserver and inner surface of outlet of drinking water machine in a hospital were taken and performed bacterial culture.ResultsThrough the formulation of management system and standardization of operation, maintenance, cleaning and disinfection process of drinking water system, the qualified rate of finished water, drinking water on clientserver,and bacterial culture of inner surface of outlet increased from 93.33% (28/30)to 100.00%(90/90), 89.80%(88/98) to 98.91%(182/184), and 91.11%(41/45) to 100.00% (150/150)respectively (all P<0.05).ConclusionBacterial contamination existed in finished water and drinking water on clientserver, strengthening the standardized disinfection management of drinking water pipes and the clientservers can effectively improve the qualified rate of direct drinking water.

    • Central venous catheterrelated infection in an intensive care unit

      2012, 11(5):374-375.

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      目的了解某院综合重症监护室(ICU)患者中心静脉导管相关性感染(CRI)发生情况,分析其感染特点,为预防感染提供对策。方法对该院综合ICU 2008年10月—2011年10月留置中心静脉导管的209例患者病历资料进行回顾性调查。结果209例患者共留置中心静脉导管256例次,发生CRI 60例次(23.44%),其中导管相关血流感染率为18.75%(48例次),导管出口部位感染率为4.69%(12例次)。发生CRI的中位时间为8.9(2~49)d。置管时间≤2周、>2周的CRI 发生率分别为16.09%、39.02%,两者比较,差异有统计学意义(χ2=16.334,P=0.000);股静脉、颈内静脉、锁骨下静脉3种置管方式CRI发生率分别为40.00%、21.53%、18.06%,差异有统计学意义(χ2=7.570,P=0.023)。血及导管尖端培养病原菌48株,以革兰阴性杆菌为主(47.92%),其次为革兰阳性球菌(37.50%)和真菌(14.58%)。结论置管部位和导管留置时间是发生CRI的危险因素,应针对相关危险因素,采取有效措施,防范CRI的发生。

    • Related factors for hepatitis C virus infection in maintenance hemodialysis patients at a primary hospital

      2012, 11(5):376-377.

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      目的调查某基层医院维持性血液透析患者丙型肝炎病毒(HCV)感染情况及相关因素。方法用酶联免疫吸附试验(ELISA) 法检测54例维持性血液透析患者血清中的HCV抗体(抗 HCV),同时对患者既往HCV病史、透析时间、输血史、血液透析频率及接受过透析的医院数等进行调查。结果54例维持性血液透析患者,抗 HCV阳性22例,阳性率40.74%。其中透析时间≤2年者抗 HCV阳性率为7.69%(2/26),>2年者则达71.43%(20/28),显著高于前者(χ2=22.68,P<0.01); 透析频率3次/周的患者抗 HCV阳性率为91.67%(11/12),明显高于透析频率为1~2次/周的患者(26.19%,11/42)(χ2=16.57,P<0.01)。结论该基层医院维持性血液透析患者HCV感染率较高,应引起重视。血液透析时间和透析频率是HCV感染的危险因素。

    • One case of severe exeeding of bacterial standard for hemodialysis fluid caused by high temperature of raw water

      2012, 11(5):378-379.

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      目的调查一起透析用水细菌超标的原因,预防此类事件的再次发生,确保医疗安全。方法对透析用水进行细菌学监测。采用现场调查和流行病学调查相结合的方法对透析水处理系统进行调查分析,并于改装供水专用管路前后增加采样点进行检测。结果原水高温(>50℃)导致透析用水细菌超标。结论血液透析应实行专用管路直供水,透析水处理系统应加强日常维护和定期水质监控。

    • Management status and countermeasures of hemodialysis units in Yichang

      2012, 11(5):380-382.

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      目的了解宜昌市城区医疗机构血液透析管理现状。方法现场调查该市城区7所设有血液透析室/中心的医院。结果该市城区开展血液透析的7所医院在基础设施、布局流程、人员配备、手卫生依从性等方面均存在不足。结论应提高医院血液透析室的准入门槛,建立健全岗位责任制,落实层级培训,完善血液透析质量管理体系,加大日常监督管理的执法力度。

    • Distribution and drug resistance of pathogens causing urinary tract infection inchildren

      2012, 11(5):383-384.

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      Abstract:

      目的了解某院小儿尿路感染病原菌分布及其耐药情况。方法对分离自188例尿培养阳性患儿的病原菌构成及其耐药性进行分析。结果188株病原菌中,革兰阴性杆菌占76.60%,革兰阳性球菌占20.74%,真菌占2.66%;居前3位的病原菌分别为大肠埃希菌(47.87%)、肺炎克雷伯菌(13.83%)、屎肠球菌(13.30%)。大肠埃希菌和肺炎克雷伯菌产超广谱β内酰胺酶(ESBLs)率较高,分别为55.56%(50/90)、53.85%(14/26);其对亚胺培南无耐药,耐药率较低的抗菌药物依次为呋喃妥因、哌拉西林/他唑巴坦、头孢哌酮/舒巴坦、阿米卡星和氧氟沙星。屎肠球菌对万古霉素无耐药,其次对替考拉宁、呋喃妥因和利福平的耐药率较低。结论该院小儿尿路感染病原菌以大肠埃希菌为主,细菌耐药性严重,临床治疗小儿尿路感染应根据药敏试验结果选择用药,避免滥用抗菌药物。

    • Surveillance on bacterial resistance in Dongguan Donghua Hospital in 2010

      2012, 11(5):385-387.

      Abstract (868) HTML (0) PDF 775.00 Byte (1371) Comment (0) Favorites

      Abstract:

      目的了解某院2010年临床分离菌对常用抗菌药物的耐药性。方法采用纸片扩散(KB)法检测细菌对各种常用抗菌药物的耐药性。结果全年共检出细菌2 418株,其中革兰阳性菌占43.71%(1 057/2 418),革兰阴性菌占56.29%(1 361/2 418)。耐甲氧西林金黄色葡萄球菌(MRSA)和耐甲氧西林凝固酶阴性葡萄球菌(MRCNS)的检出率分别为32.00%(72/225)和77.02%(238/309);肠杆菌科细菌对头孢菌素类药物敏感性较低,肺炎克雷伯菌和铜绿假单胞菌对亚胺培南的耐药率分别为0.9%、16.4%。结论该院临床分离的细菌耐药性比较严重,定期进行监测有助于了解医院细菌耐药性变迁,为临床经验用药提供依据。方法结果结论

    • Sterilization effect and cost of nonwoven fabrics and cotton used for wrapping package

      2012, 11(5):388-389.

      Abstract (1040) HTML (0) PDF 798.00 Byte (1391) Comment (0) Favorites

      Abstract:

      目的对一次性无纺布与全棉布的灭菌、阻菌效果和成本进行比较,为医院选择经济适用的灭菌包装材料提供依据。方法设实验组与对照组。实验组灭菌包采用一次性无纺布包装,对照组灭菌包采用全棉布包装,两组灭菌包在同一锅次中灭菌。分别于灭菌当天和不同保存时间采样、细菌培养,同时比较两组的包装成本。结果全棉布包装的灭菌包在保存第30天后开始有细菌生长,一次性无纺布包装的灭菌包6个月内未发现细菌生长。50 cm×50 cm规格的一次性无纺布单包包装成本价格为2.6元,全棉布为4元;一次性无纺布单包包装成本每月每包比全棉布少42元。结论灭菌包装材料一次性无纺布与传统全棉布相比,具有理想的灭菌和阻菌效果,且能降低包装成本,节省医疗资源,可替代全棉布应用于临床。

    • Survey on healthcareassociated infection in patients at three secondlevel hospitals in Foshan

      2012, 11(5):390-391.

      Abstract (1034) HTML (0) PDF 710.00 Byte (1199) Comment (0) Favorites

      Abstract:

      目的了解佛山市二级医院医院感染情况,为制定医院感染控制措施提供依据。 方法对佛山市3所二级医院2010年1—12月所有住院患者病历进行回顾性调查。结果共调查病历40 436份,发现医院感染病例798例,854例次,医院感染率为1.97%,例次感染率为2.11%;常见医院感染部位为下呼吸道(51.05%)、上呼吸道(19.32%)、泌尿道(9.25%);医院感染率居前5位的科室依次为重症监护室 (24.20%)、肿瘤科(3.15%)、神经内科(2.69%)、呼吸内科(2.22%)、儿科(2.03%);病原体以革兰阴性杆菌为主(占64.21%),其次为真菌(占18.14%)和革兰阳性菌(占17.65%)。结论应重点监控医院感染多发科室和住院患者常见感染部位,重视细菌培养,预防控制医院感染的发生。

    • Healthcareassociated infection management during the operation of regional sterilization and supply center

      2012, 11(5):392-393.

      Abstract (962) HTML (0) PDF 753.00 Byte (1376) Comment (0) Favorites

      Abstract:

      目的探讨区域化消毒供应中心运行过程各环节中医院感染控制措施。方法通过合理的布局流程,优质的设备资源,严格的清洗质量控制,规范的灭菌效果监测,先进的质量追溯系统,专业的工作团队,加强消毒无菌物品和可重复使用器械在收送过程各环节中的严格把关,加强医院感染管理。结果加强医院感染管理后,区域化消毒供应中心的消毒无菌物品和可重复使用器械等灭菌合格率达100%。结论加强区域化消毒供应中心运行过程中的感染管理,对控制医院感染十分重要。

    • One case report on clean incision infection caused by Streptococcus anginosus

      2012, 11(5):394-395.

      Abstract (976) HTML (0) PDF 769.00 Byte (1409) Comment (0) Favorites

      Abstract:

      咽峡炎链球菌(Streptococcus anginosus)是人体泌尿生殖道和胃肠道的正常菌群,近年来引起的感染日趋增多。现将本院2011年6月收治的1例咽峡炎链球菌导致清洁切口感染病例报告如下。

    • Advances in the incubation period of AIDS and its influencing factors

      2012, 11(5):396-400.

      Abstract (1207) HTML (0) PDF 804.00 Byte (1574) Comment (0) Favorites

      Abstract:

      获得性免疫缺陷综合征(acquired immunodeficiency syndrome, AIDS)简称“艾滋病”,是目前缺乏有效预防药物和治疗方法的传染病。艾滋病潜伏期的长短为判断其流行规律提供了重要依据;深入研究艾滋病潜伏期,对了解自然史,制订防治策略、疫情预警,预测需要接受抗病毒治疗的人数及评价治疗效果等都有重要意义。本文主要对国内外艾滋病潜伏期及其影响因素的研究作一综述,旨在为国内艾滋病潜伏期研究提供参考。

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