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ObjectiveTo investigate the association between  serum antibodies or glycoprotein B (gB) genotype of human cytomegalovirus (HCMV) with liver damage or birth defect.MethodsFrom January 2009 to December 2010, 337 hospitalized infants whose serum HCMV IgG antibody was positive and HCMV  DNA in urine exceeded 500 copies/mL were included in the  study. HCMV antibodies (IgG,IgM) of infants and mothers were detected by capture  enzymelinked immunosorbent assay; HCMV DNA in infants were detected by realtime polymerase chain reaction; HCMV from clinical specimens were cultured in human embryonic lung fibroblasts; HCMV gB was genotyped by nested PCRrestriction fragment length polymorphism.ResultsOf  337 infants infected with  HCMV, serum HCMV antibodies of  124 were both IgM(+) and IgG(+), liver damage rate and birth defect rate were higher in infants whose mothers’HCMV IgG were negative than that were positive(86.42% vs 65.12% for liver damage, 40.74% vs 34.88% for birth defect, P<0.01); Serum HCMV antibodies were IgM(-) and IgG(+) in 213 infants,liver damage rate in infants whose mothers’serum antibodies were IgG(+)  was not significantly different compared with that were IgG(-)(53.85% vs 66.89%, P>0.05),but birth defect rate in IgG(-) group was higher than  IgG (+) group (28.38% vs 23.08%, P<0.05). Isolation rate of HCMV from urine was 50.00%(31/62) in infants whose HCMV IgG were positive and urine HCMV DNA  ≥104 copies/mL.  gB genotype of 8 randomly selected  HCMV strains(7 were from infants with liver or brain damage) were all gB1,  compared with AD169 or TOWNE strain, DNA sequence  homology  was 94.8% and 97.0% respectively, homology of DNA sequence among 8 strains was 98.5%,and amino sequence was 99.4%.ConclusionThe liver damage and birth defect are lower in infants whose mothers’ HCMV IgG were positive than that were negative. Urine HCMV DNA ≥104 copies/mL in infants can be a marker for HCMV infection. gB1 may be the main genotype in infants’ liver and brain damage.

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ObjectiveTo study the correlation between expression of natural killer T (NKT) cells and virological response to treatment with peginterferon alfa2a （PegINFα2a）in patients with HBeAgpositive chronic hepatitis B(CHB).MethodsA cohort of 63 HBeAgpositive CHB inpatients and outpatients in a hospital between January and December 2010 were treated with 18MIU PegIFNα2a once a week for 48 weeks. The percentage of NKT cells in T lymphocytes,five serological markers of hepatitis B and HBV DNA load were assessed by flow cytometry and quantitative real time PCR.ResultsAt the end of 48week treatment, 26 cases achieved complete virological response, 21 achieved partial response, and 16 didn’t achieve response. The percentage of NKT cells in T lymphocytes in complete virological response group before treatment and after 4, 8, 12, 16 and 24 weeks of treatment all increased markedly compared with partial and non response group(all P<0.01); At the end of 48week treatment and 24 weeks after withdrawing from the treatment, the expression level of NKT cells of complete response group was also higher than partial response group(t=32.0，P＜0.01；t=27.6，P＜0.01）. Within 4 weeks after the start of treatment, the expression level of NKT cells in complete response group increased fastest and reached highest at week 12, then decreased slowly, and at week 24-48 was slightly higher than pretreatment; the expression level of NKT cells in partial response group reached highest at week 12, which was much higher than that before treatment (t=12.83，P＜0.05）.Liver function in complete response group returned to normal at week 12, and continued to remain normal, HBV DNA level also decreased gradually, but in partial and nonresponse groups, the liver function fluctuated at（1-2）×ULN. Followup to 24 weeks after stopping treatment, 27 cases appeared HBeAg seroconversion.ConclusionThe expression of NKT cells in HBeAgpositive CHB patients’ peripheral blood can help predict response to PegIFNα2a therapy.

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ObjectiveTo analyze drug resistance and distribution of integron in Pseudomonas aeruginosa (P. aeruginosa) isolated from patients with pulmonary infection, and evaluate antimicrobial therapeutic efficacy and influencing factors.MethodsClinical data of 114 patients with P. aeruginosa pulmonary infection in a hospital between September 2008 and December 2010 were reviewed retrospectively. P. aeruginosa isolated from above patients were performed antimicrobial susceptibility testing; the segments of integron were amplified by polymerase chain reaction; risk factors influencing the prognosis of P.aeruginosa pulmonary infection were analyzed.ResultsA total of 114 P. aeruginosa isolates were collected, 47(41.23%) were multidrugresistant strains; 71 (62.28%) were detected class Ⅰ integron. Patients’ prognosis were as follows:21 (18.42%) were cured, 63(55.26%) were improved, and 30(26.32%) died. Except gentamycin, amikacin, tobramycin, piperacillin and piperacillin/tazobactam, drug resistance rate of class Ⅰ integron positive strains was obviously higher than class Ⅰ integron negative strains(P<0.05). Factors influencing the prognosis of P.aeruginosa pulmonary infection included positive class Ⅰ integron,multidrugresistant strain, inappropriate empirical therapy, combination use of three or more types of antimicrobial agents,mixed infection and use of carbapenems, but combination use of two types of antimicrobial agents was the protective factor for prognosis.ConclusionMultidrug resistance rate and positive rate of class Ⅰ integron of P.aeruginosa are relatively high in pulmonary infection patients, integron is closely related to drug resistance, it is necessary to strengthen surveillance. Be sure to avoid using carbapenem for empirical treatment; combination of two types of antimicrobial agents for antiinfection treatment is recommended.

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Objective To evaluate the epidemiological characteristics and related risk factors for surgical site infection (SSI),so as to propose intervention measures.MethodsMedical records of 25 228 surgery patients who were discharged between January 2009 and September 2011 were surveyed retrospectively, distribution of healthcareassociated infection(HAI), influencing factors and distribution of pathogens were analyzed,and possible risk factors were conducted Logistic analysis.ResultsAmong 25 228 surgery patients, 539 developed 554 times of SSI, SSI rate was 2.14%, case infection rate was 2.20%. Logistic analysis showed the risk factors for SSI infection were as follows: classification of operation(OR 95% CI, 1.29-18.43), incision type (OR 95% CI, 1.19-9.28), diabetes(OR 95% CI, 1.25-7.23), duration of operation (OR 95% CI, 1.14-6.69), age (OR 95% CI, 1.13-3.99), intraoperative bleeding (OR 95% CI, 1.25-2.78), length of hospital stay (OR 95% CI, 1.38-2.39), preoperative infection focus (OR 95%CI, 1.21-1.50). SSI mainly concentrated in departments of hepatobiliary surgery（6.53%）, cardiothoracic surgery（4.87%） and urology（3.91%）; a total of 506 pathogenic isolates were detected, the majority were Pseudomonas aeruginosa（22.33%），Acinetobacter baumannii（14.62%） and Enterococcus faecalis（11.07%）.ConclusionThe occurrence of SSI is related to multiple factors, incision infection surveillance should be intensified.

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ObjectiveTo evaluate the effectiveness of Kirkpatrick fourlevel training evaluation model on evaluating healthcareassociated  infection(HAI) training program,so as to improve the training quality of HAI  knowledge gradually.MethodsThrough combination of questionnaires, field survey and expert interviews, the effectiveness of HAI knowledge training among new employees was  evaluated by Kirkpatrick fourlevel training evaluation model.ResultsA total of 192 new employees participated in the training program, including 132 (68.75%) doctors and technicians (D&T), 60 (31.25%) nurses, the response rate was 100%, the overall satisfaction rate was 89.41%. The posttraining score was significantly increased  compared with pretraining score(［83.43±5.56］ vs ［54.22±5.13］,t=54.15, P<0.001); The yearend assessment score was significantly different compared with posttraining score (［82.38±4.28］ vs ［83.43±5.56］, t=2.16,P=0.03), the yearend assessment score decreased by 1.05 points compared with posttraining score. Multiple comparison of pre and posttraining score on HAI knowledge among D&T and nurses were conducted, except the scores on “hospital cleaning, disinfection and sterilization and isolation” as well as “aseptic technique”, the scores on the other aspects were significantly different (P<0.05). Multiple comparison of posttraining and yearend assessment score on HAI knowledge among D&T and nurses showed that the scores on most  knowledge points have declined (P<0.05). Doctors and technicians’ knowledge on “hand hygiene” and “occupational safety” decreased,  and the nurses’ knowledge on “bacterial resistance mechanisms” and “rational use of antimicrobial agents” decreased.ConclusionKirkpatrick fourlevel training evaluation model can objectively reflect the internal and external effectiveness of training, the training has achieved a significant shortterm effect, but  longterm effect is not obvious. The quality of training can be improved by perfecting training mode and establishing a systematic evaluation system.

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ObjectiveTo investigate knowledge, attitude and behavior about acquired immunodeficiency syndrome （AIDS） among normal and nonnormal school students in Huanggang City, and provide basis for making policies on health education about AIDS knowledge among college students.Methods220 normal school students and 250 nonnormal school students were randomly selected as studied subjects, a questionnaire survey was conducted among them,and the surveyed results were compared.ResultsThe average score of general knowledge related to AIDS and attitude toward AIDS patients was 77.61% and 87.35% in normal school students,  69.15% and 79.14% in nonnormal school students respectively,  there were significant difference between them(u=2.03，P<0.05；u=2.34，P<0.05); the average score on related knowledge about AIDS transmission routes and attitude toward AIDS was 82.80% and 92.99% in normal school students,  76.50% and 89.84% in nonnormal school students respectively,  there were no significant difference between them(both P＞0.05).ConclusionIt is necessary and important to develop AIDS health education among college students.

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ObjectiveTo investigate the occurrence and susceptibility factors of surgical site infection(SSI) in patients undergoing oralmaxillofacial surgery with microvascular freeflap reconstruction.MethodsFrom December 2010 to September 2011, a prospective survey was performed to monitor the susceptibility factors for SSI in 257 patients undergoing oralmaxillofacial surgery with microvascular freeflap reconstruction, the surveyed contents  included age, sex, the nature of disease, American Society of Anesthesiologists(ASA) score, white blood cell, hematoglobin, length of hospital stay, length of surgery, types of incision, intraoperative blood loss and so on. Patients were followed up after  1, 3 and 6 months of operation,the occurrence of SSI at different stages were surveyed.ResultsOf 257 patients, 46 (17.90%) developed SSI, and all were deep wound infection,19 (41.30%) of whom had SSI during hospitalization period, and 27 (58.70%) were found through postdischarge followup investigation. Infection occurred 5-34 days  after  operation, the median time was 11 day. Monitoring of susceptibility factors showed that,except  the duration of intraoperative antimicrobial use  (≤110 min) was statistically significant (P<0.05), other factors were not statistically significant (P>0.05).ConclusionIncidence of SSI is high  in oralmaxillofacial surgery with microvascular freeflap reconstruction, and mostly  occur in patients after discharging from  hospital. In order to reduce SSI effectively, clinical attention should be paid, postoperative followup should be intensified, intervention in susceptibility factors should be performed, and antimicrobial agents should be used rationally.

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ObjectiveTo investigate the causes of an outbreak of healthcareassociated infection (HAI) with multidrug resistance Acinetobacter baumannii  (MDRAb) in an intensive care unit(ICU).MethodsBy combination of prospective and retrospective investigation, 10 ICU patients who were infected with MDRAb lower respiratory infection from January 25 to February 10, 2012 were performed epidemiological study.ResultsAb isolated from 10 patients’ sputum  were resistant to 16 antimicrobial agents except sensitive to cefoperazone/sulbactam  and intermediate sensitive to levofloxacin. Seven patients  were recovered after therapy,  3 died. A total of 104 environmental specimens (before cleaning) were taken,  Ab were isolated from 16 specimens such as faucet, treatment trolley, bedside table, nebulizer tube,  breathing tube, operation screen of  breathing machine, and hands of health care workers; Ab from 16 environmental specimens and patients’ sputum had the same antimicrobial resistance pattern. Outbreak was controlled after comprehensive measures were taken.ConclusionThe outbreak of MDRAb HAI  in  ICU is closely related to the contamination of  health care workers’  hands and hospital environment.

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ObjectiveTo investigate the distribution and drug resistance of Candida spp. from respiratory tract of inpatients in recent years, and provide reference for rational use of antifungal agents.MethodsRespiratory specimens from 38 326 inpatients in several hospitals between 2007 and 2011 were cultured by Sabouraud agar culture,and Candida were identified by VITEK 32 or FUNGS CA20;antifungal susceptibility testing of Candida was performed by ATB FUNGUS 3. WHONET5.4 software was used for analyzing antifungal susceptibility testing result.ResultsA total of 2 745 （7.16%）Candida isolates were isolated, including 2 036 (74.17%)isolates of Candida albicans, 348 (12.68%) of Candida tropicalis,118(4.30%)of Torulopsis glabrata, 57 (2.08%) of Candida parapsilosis, 57 (2.08%)of Candida krusei, and 129 (4.70%)of other types of Candida. Resistant rate of fungi from high to low were itraconazole, fluconazole, voriconazole, flucytosine and amphotericin B, χ2 test showed that drug resistance rate of all Candida to flucytosine, amphotericin B and fluconazole didn’t change from 2007 to 2011(P>0.05),while resistance rate to itraconazole and voriconazole increased（P＜0.05）.ConclusionThe major Candida spp. in respiratory infection are Candida albicans, the resistant rate to antifungal agent is increasing．

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ObjectiveTo realize the condition and clinical characteristics of bacterial colonization in newborns in a neonatal intensive care unit(NICU).Methods277 newborns admitted in a NICU from April, 2011 to March 2012 were as studied subjects, newborns’ pharyngeal swab, induced sputum, umbilical secretion and blood specimens were screened for bacterial colonization or infection, newborns without infection were only performed pharyngeal swab culture.ResultsTwentynine newborns’ specimens were detected bacteria,bacterial isolation rate was 10.47%; the isolated bacteria included 19 Staphylococcus epidermidis isolates, 5 Escherichia coli, 3 Klebsiella pneumoniae, 1 Staphylococcus aureus and 1 Enterobacter cloacae.Bacterial isolation rate was 2.20%, 21.54% and 36.67% in newborns aged ≤2 d, 3-7 d and 8-28 d respectively, bacterial isolation rate between newborns ≤2 d and 3-7 d as well as 8-28 d was both significant （χ2=26.52, χ2=46.54 respectively，both P＜0.01）,the difference between bacterial isolation rate of newborns aged 3-7 d and 8-28 d was not significant（χ2=2.42，P＞0.05）. ConclusionThe main colonized bacteria in newborns in this NICU is Staphylococcus epidermidis. Bacterial colonization rate is low in newborns within 48 hours after birth, clinical screen of colonized bacteria is not significant, screen on colonized bacteria in newborns within 48 hours after birth is not recommended, and screen on bacterial colonization in newborns 3 d after birth is suggested.

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ObjectiveTo investigate the prevalence rates of healthcareassociated infection(HAI) and communityassociated infection(CAI) in 19 secondary general hospitals in Handan.MethodsHAI and CAI prevalence rates of inpatients in 19 hospitals were investigated by means of medical record checking and bedside visiting.ResultsA total of 4 897 patients should be surveyed, 4 879 (99.63%) were actually surveyed. Of 4 879 investigated patients, 174 had HAI, and the prevalence rate was 3.57%，1 113 developed CAI,the prevalence rate of CAI was 22.81%; Pediatric department had the highest prevalence rates of HAI (5.16%) and CAI(71.56%);The main infection sites of HAI were lower respiratory tract (36.65%), upper respiratory tract (30.89%) and urinary tract (9.42%); the main infection sites of CAI were lower respiratory tract (40.99%), upper respiratory tract (22.17%) and gastrointestinal tract (5.30%). Antimicrobial usage rate was 60.05%. In patients used antimicrobial agents, 43.92% received curative use, 39.97% received prophylactic use, 16.11% received both. Single antimicrobial use accounted for 68.02%, twodrug 29.56%, threedrug 2.15%, and fourdrug and above 0.27%.ConclusionSurveillance of prevalence rate helps to know the current state and antimicrobial use of HAI and CAI, and make proper prevention and control measures.

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ObjectiveTo investigate the basic situation of healthcareassociated infection(HAI) in a tumor hospital, so as to provide reference for the surveillance of HAI. MethodsAccording to the requirements of the National HAI Surveillance Network, on August 31, 2011, a survey on HAI prevalence rate among all hospitalized patients in this hospital were carried out, data were statistically analyzed. ResultsA total of 737 patients were surveyed, 36 HAI cases occurred, the prevalence rate was 4.88%; lower respiratory tract was the main infection site, accounting for 38.89%(14/36%); daily antimicrobial usage rate was 21.30%(157/737), pathogenic detection rate in patients receiving therapeutic antimicrobial use was 74.29%(78/105); 27 pathogens were detected in patients with HAI, 74.07% (20/27) of pathogens were gramnegative strains, 7 Escherichia coli isolates were multidrugresistant strains.ConclusionSurvey of HAI prevalence rate can realize the occurrence of HAI in specialty hospitals, promote the implementation of measures on prevention and control of HAI, and effectively reduce HAI rate.

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ObjectiveTo realize  pathogens and infection characteristics of acute respiratory infections in children.Methods1 410 hospitalized children with acute respiratory  infection were selected from a hospital in 2011. Seven  types of viruses(parainfluenza virus Ⅰ, Ⅱand Ⅲ,Influenza virus A and B,respiratory syncytial virus  and adenovirus) were detected by direct immunofluorescence assay, bacteria were cultured.  Viral infection rate in different months, different ages, and associated infection were analyzed. ResultsOf 1 410 specimens, 594 (42.13%) were detected positive for virus, and the main viruses were respiratory syncytial virus and adenovirus; 258 (18.30%) specimens were detected positive for bacteria. Virus detection rates were high in March, April, October and November(all>50%), while low in JulySeptember (22.89%-31.40%);Virus detection rate  was high in 1-3 year age group(58.04%), while low in 6-14 year age group (22.15%). Mixed virus were detected  in 22  (1.56%) specimens, 157 children (27.45%) had coinfection of single virus and bacteria. The coinfection rate of influenza virus A or B and bacteria was 47.06% and 47.27% respectively.ConclusionRespiratory virus infection rate in children is associated with age and season. After viral infection, the associated bacterial infection is relatively higher, influenza virus A and B are more easily associated with bacterial infection.

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目的调查某院2009—2011年嗜麦芽窄食单胞菌和洋葱伯克霍尔德菌的耐药情况，为合理选用抗菌药物提供依据。方法对该院2009年1月—2011年12月各种标本分离的嗜麦芽窄食单胞菌和洋葱伯克霍尔德菌进行耐药性分析。结果2009—2011年共分离嗜麦芽窄食单胞菌238株，分离居前3位的科室依次为老年科（46株，19.33%）、神经内科（43株，18.07%）及神经外科（33株，13.87%）；共分离洋葱伯克霍尔德菌86株，分离居前3位的科室依次为神经内科（36株，41.86%）、重症监护室（26株，30.23%）及普通外科（8株，9.30%）。嗜麦芽窄食单胞菌对复方磺胺甲口恶唑、米诺环素及左氧氟沙星的耐药率基本平稳，为11.11%～11.69%、1.12%～2.60%、5.61%～9.72%；对头孢哌酮/舒巴坦的耐药率有所增高，为11.11%～23.59%，但各组间比较，差异均无统计学意义（均P>0.01）。洋葱伯克霍尔德菌对上述4种抗菌药物耐药率均略有上升，为9.37%～17.39%，其中米诺环素增加了7.7%，但各组间比较，差异均无统计学意义(均P>0.01)。结论2009—2011年该院嗜麦芽窄食单胞菌和洋葱伯克霍尔德菌的耐药率基本稳定。

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目的了解某妇幼保健院婴幼儿感染常见病原菌的分布及耐药性。方法采用回顾性调查方法，对该院2010年10月—2011年10月收治的≤2岁患儿临床送检标本分离的病原菌进行分析。结果共分离病原菌582株，标本来源以呼吸道为主，占92.78％（540株）；菌种分布以克雷伯菌属（163株）、大肠埃希菌（160株）、肺炎链球菌（138株）和金黄色葡萄球菌（23株）为主。共检出4株耐甲氧西林金黄色葡萄球菌。克雷伯菌属和大肠埃希菌对氨苄西林耐药率达70%，对第一~三代头孢菌素的耐药率＞40%，对碳青霉烯类药物耐药率＜2%；肺炎链球菌对青霉素耐药率达80%，对红霉素耐药率达100%，对红霉素、克林霉素同时耐药情况严重，占90%以上，对左氧氟沙星的耐药率为0.00%；金黄色葡萄球菌对苯唑西林和第一~三代头孢菌素耐药率低，在11%左右,对青霉素耐药率已达70%，对大环内酯类、四环素类耐药率增高至40%。结论此次调查有助于了解婴幼儿常见感染病原菌的分布及耐药性，为临床医生合理使用抗菌药物提供依据。

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目的了解某院儿科住院患儿下呼吸道感染的大肠埃希菌和肺炎克雷伯菌耐药情况。方法对2009年1月—2011年8月该院儿科送检痰标本中分离的大肠埃希菌和肺炎克雷伯菌的耐药性进行分析。结果共送检痰标本665份，分离鉴定病原菌310株，阳性率为46.62％，其中居前2位的是大肠埃希菌（101株,32.58%）和肺炎克雷伯菌(54株,17.42%)，此两种菌超广谱β内酰胺酶（ESBLs）检出率分别为65.35%（66/101）、48.15%(26/54)。连续3年，大肠埃希菌和肺炎克雷伯菌对美罗培南、亚胺培南、头孢哌酮/舒巴坦的敏感率均为100%，对阿米卡星、哌拉西林/他唑巴坦和头孢西丁的耐药率相对较低,对其他抗菌药物的敏感率均有不同程度下降。结论大肠埃希菌和肺炎克雷伯菌是小儿肺炎的重要病原菌，其产酶率高，耐药性强，临床应规范合理使用抗菌药物，降低细菌耐药率，延长抗菌药物的使用寿命。

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目的了解某县级医院临床病原菌的分布及对常用抗菌药物的耐药情况。方法 2010年1月1日—2011年12月31日，对该院临床各科室送检的标本进行细菌培养、分离与鉴定，同时做药敏试验。结果2年各科室共送检标本12 175 份，检出阳性标本2 641份，阳性率21.69%。检出革兰阴性菌1 524株（57.71%），革兰阳性菌585株（22.15%），真菌532株（20.14%）；居前6位的病原菌分别为大肠埃希菌（328株）、鲍曼不动杆菌（301株）、肺炎克雷伯菌（266株）、铜绿假单胞菌（208株）、表皮葡萄球菌（168株）、金黄色葡萄球菌（113株）。金黄色葡萄球菌对苯唑西林耐药率为60.18%，木糖葡萄球菌、屎肠球菌和粪肠球菌对万古霉素耐药率分别为34.69%、5.26%和3.33%；对美罗培南和亚胺培南的耐药率，鲍曼不动杆菌分别为78.74%、82.72%，铜绿假单胞菌分别为42.31%、46.63%，肺炎克雷伯菌分别为3.01%、2.63%，大肠埃希菌均<2%。结论该院临床分离的病原菌呈多重耐药状态，应定期进行监测;同时加强临床抗菌药物管理，合理使用抗菌药物。

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目的了解孝感市二级及以上医疗保健机构新生儿病室的医院感染现状，为预防控制新生儿医院感染提供科学依据。方法采用查阅住院病历与床旁调查相结合的方法调查孝感市12所二级及以上医疗保健机构住院新生儿的医院感染现患情况。结果12所医院实查住院新生儿142例，医院感染现患率为3.52％（5/142）；医院感染部位均为呼吸道。综合医院（7所）新生儿医院感染现患率为3.66%（3/82），专科医院（5所）为3.33%（2/60），两者差异无统计学意义（P=1.000）；三级医院（2所）新生儿医院感染现患率为6.25%(3/48)，二级医院（10所）为2.13%(2/94)，两者差异无统计学意义（P=0.336）。共119例新生儿使用抗菌药物，总抗菌药物使用率为83.80%，其中预防用药占68.07%（81/119）。38例治疗用抗菌药物者中有15例送病原学检查，病原学送检率为39.47%；其中综合医院病原学送检率为59.09%（13例），显著高于专科医院的12.50%（2例），差异有统计学意义（χ2=5.749，P=0.016）。结论需要加强新生儿病室的医院感染管理，降低抗菌药物使用率，尤其减少预防用药；提高专科医院病原学送检率，预防控制新生儿医院感染的发生。

Abstract:

目的利用自主开发的供应室质控可追溯软件管理区域性消毒供应中心（CSSD），保障区域性无菌产品安全。方法基层医疗机构与区域性CSSD签订消毒供应质量目标协议书，区域性CSSD根据基层医疗机构的医疗需求提供有质量保障的无菌物品。同时通过开发信息化条码标签，收集记录再生器械处理流程中清洗、消毒、灭菌及发放使用各个环节的信息，实现灭菌产品质量的过程控制和追踪管理。结果区域性CSSD解决了城区及周边8个基层医疗机构手术器械的消毒供应，再生器械合格率100%；患者手术后1月随访，无因手术器械灭菌质量问题引发感染病例发生。结论区域性CSSD解决了基层医疗机构缺乏建设CSSD能力和无菌物品需要量少的问题；将质控可追溯软件应用于区域性CSSD质量管理，保障了产品质量，有利于举证倒置，让无菌物品进入了医疗市场，实现资源共享，有效改善了区域公共卫生基础服务。

Abstract:

目的分析使用中戊二醛浓度不合格原因，提出相应对策，以保证医疗器械消毒灭菌质量。方法按照《消毒技术规范》（2002年版）要求，采用戊二醛浓度测试卡对全院用于小手术器械、内镜、口腔科器械消毒灭菌的使用中戊二醛浓度进行检测。结果共抽查1 219份戊二醛溶液进行浓度测定，结果合格1 099份（90.16%），不合格120份（9.84%）。不合格原因为：未按时更换、浸泡器械过多、测试卡浸入消毒剂测试的时间过短、误将乙醇用作戊二醛、戊二醛浓度测试卡过期。经干预整改， 2011—2012年（干预后）戊二醛浓度监测不合格样本数显著减少，不合格样本率（5.41%，17/314）显著低于2007—2010年（干预前，11.38%，103/905），差异有统计学意义（χ2=9.35，P＜0.05）。结论医疗机构应加强对使用中戊二醛浓度的监测。

Abstract:

目的了解天津市医务人员对设置肠道门诊的认知，为合理设置肠道门诊提供科学依据。方法 采取面对面调查方式，对所有开设肠道门诊的医院中医务人员进行调查。结果共调查275所医院，其中一级医院219所，二级医院38所，三级医院18所；调查医务人员623名。医务人员对设置肠道门诊总赞成率为89.09%；一、二、三级医院赞成率分别为88.08%、91.30%和94.34%，差异无统计学意义（χ2=2.47，P=0.29）。医务人员不赞成设置肠道门诊的主要理由为：认为一级医院肠道门诊就诊患者少，造成资源浪费；一级医院房屋结构、人员等配套不完善，不具备设置肠道门诊的条件；大多数医院肠道门诊未真正独立布局，形同虚设；霍乱等肠道传染病发病率呈下降趋势，收治患者多为非感染性腹泻，造成医院资源浪费等。结论应结合霍乱等肠道传染病的流行状况、医院规模、服务范围、就诊人数等重新设置一级医院的肠道门诊，改变部分一级医院肠道门诊形同虚设的局面；二、三级医院则应加强肠道门诊规范管理，充分发挥其在防治霍乱等重点肠道传染病中的作用。

Abstract:

目的了解临床医务人员对消毒供应中心工作的满意度，并提出有效的改进措施。方法采用自行设计的《消毒供应中心满意度调查表》，于2011年对某院25个临床科室的医务人员进行每月一次的问卷调查，并运用PDCA循环规则进行持续改进。结果共发放300份调查问卷，回收率100%。全年满意度为100%的项目有“运送车辆洁污分开”、“物品灭菌标识清楚容易识别”、“保证临床新业务新技术开展物质需要”3项。1—6月临床医务人员对消毒供应中心工作的总体满意率为89.33%,满意率最高的项目达100%，最低为63.33%;7—12月总体满意率为99.00%,满意率最高达100%，最低为97.33%，其中“工作人员仪表规范、语言文明、解释耐心”和“灭菌物品无过期、失效、潮湿，质量达标”的满意率也提升至100%。1—6月和7—12月临床医务人员对消毒供应中心工作的总体满意率比较，差异有统计学意义（χ2=127.6, P<0.001）。 结论运用PDCA循环规则可以有效提高临床医务人员对消毒供应中心工作的满意度，提高工作质量。

Abstract:

目的了解消毒供应中心去污区工作人员面临的职业危害。方法总结和分析消毒供应中心去污区工作人员面临的危害因素，并提出相应对策。结果消毒供应中心去污区工作人员面临的职业危害包括生物因素、物理因素、化学因素、心理社会因素。针对各种危害因素采取相应的防护措施是降低工作人员职业危害，保持身心健康的关键。结论了解消毒供应中心去污区工作人员面临的职业危害，有利于采取预防措施，降低职业危害的发生。

Abstract:

缺陷短波单胞菌(Brevundimonas diminuta)原称微小假单胞菌,为革兰染色阴性的短小杆菌。国内外尚未见缺陷短波单胞菌致颅内感染的报道。近期，在1例脑膜瘤术后患者脑脊液中培养出缺陷短波单胞菌，现将其诊治情况报告如下。

Abstract:

锐器伤是医院内常见的职业伤害，也是医护人员感染血源性病原体的重要途径［1］。近年来，国内外的监测和研究发现，大部分锐器伤可以通过减少锐器使用、推广安全器具、操作行为控制及采取标准防护等措施预防。目前，包括世界卫生组织在内的许多国际组织或国家都出台了医务人员职业暴露的相关指南或指引，美国及欧洲等发达国家和地区更是以立法的形式对医疗机构提出强制性要求，以保证医务人员职业安全［2-3］。近年来，通过推行安全器具等工程控制的方法，在某种程度上降低了职业暴露的发生率［4］。但安全器具只能降低锐器伤害的危险，增加安全的程度，并不能完全保证操作者的安全，因此规范的操作行为、安全的工作实践依然十分重要。