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ObjectiveTo evaluate  the effect of recombinant bacillus CalmetteGuerin (BCG)rBCGAg85AESAT6（rBCGAE)on immunostimulatory activity of human macrophages, and  provide theoretical proof and experimental basis for  vaccine use.MethodsThe previously constructed rBCGAE and BCG strains were obtained respectively to infect the THP1 cells that stimulated by phorbol12myristate13acetate（PMA）. 24 h,48 h and 72 h after infection, expression of macrophage surface markers CD80 and CD86  were measured by flow cytometry, and the concentration of interferonγ (IFNγ) and tumor necrosis factorａ(TNFａ) in supernatant were detected with ELISA kit. ResultsAfter four hours culture, phagocytic rate of THP1  stimulated by PMA was  significantly higher than that nonstimulated by PMA （［91.26±2.13］% vs ［8.45±1.54］%，P=0.01）； 24 h,48 h and 72 h after infection, the percentages of CD86 positive cells (［32.84±7.13］%, ［48.42±5.46］%, ［39.48±5.67］%) and CD80 positive cells (［20.28±1.13%］, ［23.67±1.23］%, ［23.19±1.58］%) in rBCGAE group were obviously higher than those in BCG group (CD86：［28.17±5.26］%, ［40.09±7.21］%, ［31.26±6.85］%; CD80：［22.15±1.82］%, ［23.27±1.91］%, ［22.68±0.87］%, P<0.01). 24 h,48 h and 72 h after infection, the concentration of IFNγ (［1 986±156］pg/mL,［ 4 687±168］ pg/mL, ［3 238±97］ pg/mL) and TNFа(［1 153±48］ pg/mL, ［5 864±97］ pg/mL, ［4 129±68］pg/mL) in rBCGAE group were higher than those in BCG group (IFNγ：［1 245±32］pg/mL, ［3 067±143］ pg/mL, ［2 879±186］ pg/mL; TNFа：［486±18］ pg/mL, ［3 237±86］ pg/mL, ［1 068±74］ pg/mL, P<0.01).ConclusionRecombinant BCGAE can enhance immunostimulatory activity of human macrophages, and it is an improved TB vaccine as an alternative to BCG for further study.

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ObjectiveTo evaluate drug resistance mechanisms of Ochrobactrum anthropi (O. anthropi) isolated from blood of children with septicemia. MethodsVITEK2 compact automatic machine was used to identify and analyze antimicrobial resistance of O. anthropi, and drugresistance gene AmpC, AmpR, DHA1, AcrA,RamA,OprD,TEM and SHV were determined by polymerase chain reaction (PCR) method, then PCR products were purified and sequenced. ResultsA total of 155 O. anthropi isolates were isolated, 30 of which were randomly selected for detection. Of 30 tested isolates, 20 were resistant to piperacillin / tazobactam, 16（80.00%，16/20） of which were detected AmpC/R genes, 2 （10.00%，2/20）were detected DHA1 gene. None of 30 isolates were amplified AcrA,RamA,OprD,TEM and SHV gene. According to the resistance to piperacillin/tazobactam, 155 isolates were divided into drugresistance group (126 isolates) and nondrugresistance group (29 isolates), drugresistance group were all resistant to ampicillin, firstthird generation cephalosporins, aztreonam, but resistant rates to levofloxacin, imipenem, meropenem, ciprofloxacin, amikacin and gentamycin were low （0.00%-1.59%）.ConclusionProduction of AmpC/R is the mechanism of multidrug resistance of O. anthropi,critically ill patients can choose imipenem. The detection of drug resistance of O. anthropi should be reinforced to prevent the prevalence of DHA gene among gramnegative bacteria.

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ObjectiveTo investigate the epidemiologic characteristics and drug resistance mechanism of carbapenemresistant Acinetobacter baumannii (CRAB) isolated from a hospital, so as to guide prevention and control of  healthcareassociated infection(HAI).MethodsA total of 32 CRAB strains  isolated clinically from January 2010 to May 2012 were performed  genotyping by randomly amplified polymorphic DNA fingerprinting, and epidemiological analysis was conducted; carbapenemase were screened by modified Hodge test and EDTAdisk synergy test. The effect of efflux pump inhibitor carbonyl cyanide mchlorophenyl hydrazone （CCCP）on minimum inhibitory concentration of meropenem  was detected, efflux pump positive strains were screened.Results32 CRAB strains displayed 9 kinds of genotypes,  type A, H, I,B, E, and other types were 10,7,4,3,3,and 1-2 isolates respectively. From March to May,2012, 11 CRAB strains were isolated,  type H,I,and A were 7,3, and 1 isolates respectively. 21  (65.63%) CRAB strains expressed oxacillinase (OXA23), and were positive in  modified Hodge test (including 11 strains isolated in MarchMay,2012); Except 1 isolate was detected New DelhiMetallo1(NDM1), all other strains were negative for metallolactamase test; the presence of CCCP slightly changed the  MIC of meropenem to CRAB,all were negative for phenotype of efflux pump. CRAB strains were mainly isolated from patients in intensive care unit(13 isolates)  and neurology department(7 isolates).ConclusionThe outbreak of HAI of the clone with identical genotype occurred in this ICU between March and May,2012. Carbapenemresistance mechanism of A. baumannii can be attributed to the expression of OXA23, and meropenemresistance is not related to the efflux pump, CRAB strain expressing NDM1 has been detected in this hospital.

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ObjectiveTo evaluate healthcareassociated infection (HAI) in HIV/AIDS death cases and risk factors for death in a hospital in Guangdong area.MethodsA retrospective case control study on 345 HIV/AIDS death cases in a hospital from January 2001 to December 2011was conducted.ResultsOf 345 HIV/AIDS death cases, 47 developed 52 times of HAI,HAI infection rate was 13.62%, case infection rate was 15.07%; 15(31.91%) cases of HAI were directly related to death. HAI usually occurred in lower respiratory tract (18 episodes, 34.62%), gastrointestinal tract(13 episodes, 25.00%),and skin and soft tissue (11 episodes, 21.15%). Pathogens of HAI included bacteria（12 isolates，25.53%）, virus（10，21.28%）, fungus（6，12.77%）and others（19，40.43%）.Independent risk factors for HAI were length of hospital stay >30 days, invasive operation, opportunistic infection of at least two sites, combination use of antimicrobial agents, and CD4+T lymphocyte <200/μl.ConclusionHAI is one of the important causes of death in hospitalized HIV/AIDS patients. Early diagnosis and treatment for the opportunistic infection, shortening of hospital stay, control of invasive operations, rational administration of antimicrobial agents are the key measures to prevent and control HAI in HIV/AIDS patients.

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ObjectiveTo design a webbased realtime automatic information system platform for the purpose of healthcareassociated infection(HAI) case surveillance and targeted surveillance. MethodsSystem requirement analysis was adopted to compare current webbased HAI surveillance systems and current state of HAI surveillance and management, realtime automatic information system platform design was demonstrated based on the idea of realtime automatic surveillance, hardware and software requirement, and basic function design. Results The framework protocol of realtime automatic information system has been designed and four basic requirements must be met: the platform for massive data storage and processing, the device for data transmission between hospital network and the network outside the hospital, uniform reporting table for HAI surveillance, and information system based on the network outside the hospital, such as the internet. The system had three main functions: data sending automatically, data analysis and sharing, decision supporting and early warning.ConclusionThere is a clear idea for the design of webbased realtime automatic surveillance and management of HAI platform, which is very powerful, accurate and reliable. The establishment of this platform will greatly reduce the cost of HAI surveillance and improve the quality of HAI management.

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Objective To investigate the prevalence of healthcareassociated infection(HAI) in the healthcare settings of Sichuan province in 2011, and establish the reference system of HAI indicators.Methods248 hospitals of Sichuan province participated in HAI prevalence survey in September 1st30th, 2011. Hospitals were surveyed for a given day（0∶00—24∶00）decided by each hospital, point prevalence of HAI among all hospitalized patients were investigated by combination of bedvisiting and medical records checking.Results75 822 patients in 248 hospitals should be surveyed, 74 457 patients (98.20%)were actually surveyed. 1 966 patients had 2 001 times of HAI, HAI rate and case rate was 2.64% and 2.69% respectively; HAI prevalence rates of hospitals with different sizes were statistically different (χ2=46.70，P＜0.01), and HAI prevalence rate increased with the increase of hospital size. The top 3 HAI sites were respiratory tract (55.77%), urinary tract (12.79%) and surgical site (11.99%); HAI were high in oncology department(4.52%), surgery department (3.28%) and internal medicine department (3.02%); pathogenic detection rate of specimens from HAI patients was 42.13%（843/2 001）;39 440 patients used antimicrobial agents on the day of survey, antimicrobial usage rate was 52.97%, of which 15.05% (11 209 cases) were prophylactic and 37.92% (28 231) were therapeutic. Pathogenic detection rate of specimens from patients receiving therapeutic antimicrobial agents was 21.63%（6 105/28 231）.ConclusionThis prevalence survey is helpful for realizing the HAI state in healthcare settings of Sichuan province, and guide the prevention and control of HAI.

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ObjectiveTo study the effect of standard indwelling urinary catheterization and nursing procedures on reducing the incidence of catheterassociated urinary tract infection(CAUTI).MethodsPlanedocheckact(PDCA) cycle model was used to manage the inpatients with indwelling urinary catheterization, standard manipulation procedures of indwelling urinary catheterization were formulated by analyzing the risk factors of CAUTI, the training, guidance, assessment and check were strengthened to find out the problems and propose improvement measures timely,and the continuous quality improvement was performed.ResultsThrough one year implementation of PDCA cycle management, the qualified rates of routine care for urinary meatus, connection between urinary catheter and urine collection bags, and outlets of urine collection bags, as well as implementation rate of external fixation and signs of catheters were significantly higher than those before PDCA management respectively (98.59%［70/71］ vs 34.92%［22/63］;95.77%［68/71］ vs 28.57% ［18/63］;95.77%［68/71］ vs 17.46%［11/63］; 100.00%［71/71］ vs 0.00%［0/63］); the incidence of CAUTI in neurosurgery patients from quarter 1 to 4 of 2011 was 1.86‰,1.63‰,1.10‰ and 0.95‰ respectively，there was a decreased tendency（χ2=3.951，P=0.047）.ConclusionThe implementation of PDCA cycle model can bring the function of surveillance system into full play, and effectively reduce the incidence of CAUTI.

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ObjectiveTo evaluate the effectiveness of healthcareassociated infection(HAI) monitoring team on preventing ventilatorassociated pneumonia (VAP) in patients undergoing mechanical ventilation in an intensive care unit(ICU).MethodsFrom January to December, 2011, 480 ICU patients receiving mechanical ventilation for >48 hours were studied. Patients were divided into two groups, control group included 233 patients who admitted to ICU between January and June received VAP prevention bundle, but without being monitored by HAI monitoring team; intervention group included 247 patients who admitted to ICU between July and December received routine preventive measures and were supervised the implementation of VAP prevention measures by HAI monitoring team. The elevation rate of the head of bed, incidence of VAP, duration of mechanical ventilation and mortality in two groups were compared and analyzed.ResultsThe elevation rate of the head of bed of intervention group was significantly higher than control group (93.79% vs 61.11‰, χ2=703.43, P<0.001）; duration of mechanical ventilation in intervention group was significantly lower than control group (［5.56±4.43］d vs ［6.87±6.76］d, t=2.49，P=0.013）; the incidence of VAP in intervention group was significantly lower than control group (11.00‰ vs 24.62‰, χ2=6.87, P=0.009）; there was no significant difference in mortality of two groups （6.07% vs 9.44%, χ2=1.91，P=0.142）.ConclusionThe preventive measures of VAP can be carried out effectively by the strict supervision of infection monitoring team, VAP can decrease through effective work of infection monitoring team.

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ObjectiveTo evaluate the occurrence and intervention effectiveness on multidrugresistant organism (MDRO) infection in general intensive care unit (ICU) patients.MethodsTargeted monitor and proper measures on general ICU were performed, the occurrence of MDRO infection before and after infection was compared.ResultsA total of 1 184 patients were investigated, there were 77 cases of healthcareassociated infection(HAI) and 109 communityassociated infection, 186 (15.71%) isolates of MDROs were isolated, the main bacteria were Acinetobacter baumannii (43.55%), methicillinresistant Staphylococcus aureus(29.57%), and Pseudomonas aeruginosa(23.66%). The major infection site was respiratory tract (79.22%, 61/77). After intervention, MDRO infection in this ICU decreased from 6.92%(38/549) to 4.25%(27/635), the difference was significant（χ2=4.04，P＜0.05）.ConclusionMDROs are important pathogens in HAI in general ICU patients, effective measures can reduce the occurrence of MDRO infection.

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ObjectiveTo evaluate the influence of comprehensive intervention model on reducing surgical site infection(SSI) in patients with caesarean section. MethodsPatients were divided into two groups: control group included 500 patients who were undergone emergency caesarean in JanuaryDecember 2011; intervention group included 501 patients who were undergone emergency caesarean section in JanuaryDecember 2012, patients were matched in a 1∶1 ratio. SSI rates between two groups were compared, the average hospitalization days and hospitalization expense between infected patients and noninfected patients after comprehensive intervention were compared.ResultsAfter intervention, the rate of correct surgical handwashing increased from 54.55% before intervention to 90.48%; pathogenic detection rate increased from 18.42% to 89.66%; timely reporting rate of SSI increased from 16.67% to 80.00% (all P<0.05); SSI in intervention and control group was 1.00% (5/501) and 3.60% (18/500) respectively (χ2=8.40, P<0.01).The average length of hospital stay of 23 SSI patients was significantly longer than 978 noninfected patients (［16.61±4.81) d vs ［6.09±1.37］ d, t=32.60, P<0.01); hospitalization expense in SSI patients was significantly higher than noninfected patients (［7 042.43±1 229.57］ yuan vs ［5 085.80±737.14］ yuan, t=12.34, P<0.01).ConclusionComprehensive intervention can effectively reduce SSI following caesarean section and warn the outbreak and epidemic of HAI.

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ObjectiveTo analyze clinical characteristics of communityacquired pneumonia (CAP)in diabetic and nondiabetic patients.MethodsFrom January 2008 to May 2011,100 CAP patients in a hospital were selected, 50 of whom had diabetes (group A) and 50 without diabetes (group B), their clinical data were analyzed.ResultsThe average length of hospital stay in group A was significantly longer than that of group B (［18.52±4.32］ d vs ［12.64±4.18］ d, χ2=6.92，P＜0.01); serum alanine aminotransferase (ALT) and aspartate transaminase (AST)in group A were significantly higher than group B (［52.26±15.18］ U/L vs ［40.39±15.42］ U/L; ［48.44 ±10.25］ U/L vs ［35.70±9.98］ U/L, P<0.05, respectively); blood urea nitrogen (BUN) and serum creatinine (SCr) in group A were significantly higher than group B (［8.02±2.12］ mmol/L vs ［5.35±1.99］ mmol/L; ［128.05±21.25］ μmol/L vs ［98.20±20.93) μmol/L, P <0.05, respectively). Mixed infection rate in group A was significantly higher than group B (26.00% vs 10.00%); metabolic syndrome and incidence of macrovascular complications were significantly higher than group B (28.00% vs 12.00%; 36.00% vs 10.00%, P<0.05, respectively). Rate of severe pneumonia and mortality in group A was 12.00% (6 cases) and 6.00% (3 cases) respectively,and group B was 4.00% (2 cases) and 2.00% (1 case) respectively, sputum culture positive rate in group A and B was 82.00% (41/50) and 88.00% (44/50) respectively, Streptococcus pneumoniae (16 isolates in group A and 17 in group B) and Klebsiella pneumoniae (4 isolates in group A and 5 in group B)were common in both groups.ConclusionDiabetic patients with CAP have long disease course, with severe illness and multiple complications, controlling blood glucose is the basis of treatment, antiinfection is the key, and improving nutritional state and organ function is important aspect.

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ObjectiveTo realize surgical site infection (SSI) following gynecological surgical procedure, analyze the possible risk factors, and explore effective measures on reducing the incidence of SSI.MethodsFrom January 1 to December 31,2011, patients receiving abdominal hysterectomy, vaginal hysterectomy, and laparoscopic hysterectomy in two gynecological departments of a hospital were monitored, SSI rates before intervention(from January 1 to June 30,2011, control group) and after intervention(from July 1 to December 31,2011, intervention group) were analyzed and compared.ResultsA total of 1 120 patients were in control group, including 648 cases of abdominal hysterectomy, SSI rate was 4.94%; 212 vaginal hysterectomy, SSI rate was 9.43%; 260 laparoscopic hysterectomy, there was no SSI; the average SSI rate in two departments was 4.64%(52/1 120), SSI rate between two departments was not significantly different(5.38% vs 4.00%, χ2=1.206，P＞0.05）, the average SSI rate in intervention group was significantly lower than control group (1.57%［20/1 272］ vs 4.64%, χ2=19.23，P＜0.001）.ConclusionThrough targeted monitor, risk factors are analyzed, intervention measures are performed,and SSI can be reduced.

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ObjectiveTo ensure the quality safety of sterile products in regional central sterile supply department (CSSD), and promote smooth development of CSSD.Methods61 750 pieces of reusable medical instruments from 22 medical institutes which treated in a regional CSSD were divided into group A(moisture store) and group B(dry store), the rusting rate between two groups was compared, and problems in cleaning, packaging, transportation, and storage were resolved.ResultsThe rusting rate in group A was significantly higher than group B(11.71%［3 835/32 760］） vs 0.54% ［156/28 990］,χ2＝244.10，P＜0.01）. After one year training and improvement in CSSD, medical staff’s satisfaction with regional CSSD improved significantly compared that before training(90.91%［20/22］ vs 45.45%［10/22］,χ2＝13.26，P＜0.01）). The cost and expiration date of nonwoven fabrics and paperplastic wrapping material were lower and longer than cotton wrapping.ConclusionContinuous quality improvement of regional CSSD management can ensure the quality safety of supplied products and safety of medical treatment, as well as improve both social and economical effectiveness.

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ObjectiveTo explore the characteristics and antimicrobial susceptibility of bacteria (especially Staphylococcus aureus) isolated from skin lesion of eczema patients,and evaluate the effect of antiinfective therapy on eczema. MethodsSpecimens taken from lesion secretion of 100 eczema patients and forearm skin of 60 healthy control were performed bacterial culture, and the isolated bacteria were performed antimicrobial susceptibility testing, 88 eczema patients with positive bacterial culture of lesion were randomly divided into experimental and control group, control group was treated with oral loratadine plus external use of Halometasone cream, experimental group was treated with the method of control group plus sensitive antimicrobial agents clindamycin palmitate dispersible tablets, the therapeutic effect between two groups was compared. ResultsThe detection rate of total bacteria and Staphylococcus aureus from lesion of eczema patients was higher than healthy control respectively (88.00% vs 66,67%, P<0.01; 58.00% vs 6.67%, P<0.01). Drug resistance rate of Staphylococcus aureus from skin lesion to penicillin, erythromycin, and tetracycline was 87.93%，68.97% and 62.07% respectively; the sensitive rate to minocycline, vancomycin, fusidic acid, and furadantin were all 100.00%. The cure rate and effective rate of experimental group was higher than that of control group respectively (40.91% vs 18.18%, P＜0.05; 81.82% vs 54.55%, P＜0.05）. Total bacterial clearance rate and Staphylococcus aureus clearance rate of experimental group was higher than that of control group respectively (93.18% vs 59.09%, χ2=14.07，P＜0.01；93.10%［27/29］vs 68.97%［20/29］，χ2=5.50，P=0.019）.No side effect was found in two groups.ConclusionEczema is closely related to bacterial infection, especially Staphylococcus aureus infection; monitor on drug resistance is helpful to guide clinical antimicrobial use, improve clinical efficacy and shorten the course of disease.

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Objective To realize the isolation and drug resistance of major pathogens from bile of patients with biliary tract infection, so as to provide reference for rational use of antimicrobial agents.MethodsBile specimens collected from 197 operated patients in a hospital from January 2010 to December 2011were performed aerobic culture, bacteria were identified and performed antimicrobial susceptibility testing. ResultsOf 197 bile specimens, 130 (65.99%) were positive culture; 151 aerobic isolates were obtained, 21 specimens isolated mixed bacteria. The isolated pathogens included 114(75.50%) isolates of gramnegative bacilli, 36 (23.84%) of grampositive cocci, and 1 (0.66%) of fungus. The top 6 pathogens were Escherichia coli(48.34%), Enterococcus faecium(10.59%), Enterobacter cloacae(6.62%), Enterococcus faecalis(5.96%), Klebsiella pneumoniae(5.96%), and Pseudomonas aeruginosa(4.64%). Sensitive rates of Escherichia coli, Enterobacter cloacae and Klebsiella pneumoniae to carbapemem (imipenem, meropenem) were 100.00%; Escherichia coli, Klebsiella pneumoniae and Pseudomonas aeruginosa to piperacillin/tazobactam and amikacin were 77.78%-100.00%; Enterococcus spp. to tigecycline and linezolid were 100.00%, all Enterococcus faecalis to vancomycin were 100.00%, 1 Enterococcus faecium isolate was resistant to vancomycin. Sensitive rates of gramnegative bacilli to penicillins, cephalosporins, and quinolones decreased.ConclusionBiliary tract infection is mainly caused by Enterobacteriaceae and Enterococcus spp., bile culture and antimicrobial susceptibility testing of pathogens should be performed as early as possible, clinicians should choose antimicrobial agents according to antimicrobial susceptibility testing results.

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目的了解某院多重耐药鲍曼不动杆菌（MDRAb）分离率及感染患者基本情况，为预防和控制MDRAb引起的医院感染提供依据。方法查阅该院2009年1月1日—2011年9月30日期间99 665份出院病历，对其中126例MDRAb感染患者病历进行回顾性调查分析。结果126例MDRAb感染患者科室分布为：重症监护室（ICU） 63例，普通外科14例，呼吸科12例，颅脑外科10例，骨科8例，心胸外科6例，脑血管科3例，心内科3例，综合内科2例，血液科、产科、消化科、中西医科和口腔科各1例；其中特级护理89例（70.63%）、有侵入性操作史89例（70.63%）、住院时间和抗菌药物使用时间＞7 d者各75例（59.52%）；采集环境标本387份，检出MDRAb 14株（3.62％）。结论该院MDRAb医院感染严重，应采取有效措施预防和控制MDRAb医院感染的发生和流行。

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目的了解某院感染疾病科重症监护室(ICU)短期内出现的5例患儿下呼吸道感染的原因，以探讨预防发生感染的有效措施。方法运用“三间分布”对2012年4月17—28日该ICU出现的5例发热患儿进行调查，并对工作中环境进行采样检测。结果5例患儿，4例诊断为下呼吸道感染，1例为下呼吸道感染合并导管相关血流感染；4例痰培养阳性；对工作中ICU环境，包括物体表面、工作人员手等进行采样检测，合格率为25.00%（5/20），工作中医务人员手、物体表面、呼吸机管道冷凝水等培养出鲍曼不动杆菌、肺炎克雷伯菌、溶血葡萄球菌等条件致病菌。采取相关措施后（包括环境清洁及手卫生），对该环境再次采样检测，合格率为86.36%（19/22）。未再出现疑似病例。结论该ICU应加强消毒隔离工作和医务人员手卫生，保持环境有效清洁，预防医院感染的发生。

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目的探讨采用酸性氧化电位水对先天性心脏病(先心病)术后经口气管插管患儿进行口腔护理，对预防呼吸机相关性肺炎（VAP）的效果。方法对某院2011年3月—2012年1月106例经口气管插管机械通气的危重先心病患儿进行分组研究（实验组：56例，使用酸性氧化电位水进行口腔护理；对照组：50例，使用0.9%氯化钠溶液进行口腔护理），比较操作前后两组患儿有无口腔异味、溃疡和VAP发生情况等。结果实验组患儿口腔异味发生率（10.71%,6/56）和口腔溃疡发生率（5.36%，3/56）显著低于对照组［分别为26.00%（13/50）和34.00%（17/50）］，差异有统计学意义（χ2=4.19，P＜0.05；χ2=14.16，P＜0.01）；VAP发生率（7.14%，4/56）亦明显低于对照组（28.00%，14/50），差异有统计学意义（χ2=8.15，P＜0.01）。结论使用酸性氧化电位水进行口腔护理，可有效减少和控制经口气管插管患儿口腔细菌的定植，降低VAP发生率。

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目的调查分析某院神经内科住院患者泌尿道医院感染情况及危险因素，探讨有效的预防与控制对策。方法2011年7月—2012年6月，采用前瞻性监测和回顾性调查相结合的方法，对该院神经内科发生泌尿道感染的住院患者进行调查分析。结果2 114例神经内科住院患者发生医院感染171例次，感染例次率为8.09%；其中泌尿道感染52例次，占医院感染例次数的30.41%。单因素分析结果显示，患者年龄、性别、是否留置导尿管、抗菌药物使用情况、住院时间是医院泌尿道感染的危险因素。共检出病原菌39株，其中革兰阴性杆菌29株（74.36%），革兰阳性球菌6株（15.38%），真菌4株（10.26%）。结论泌尿道感染是神经内科病房常见的并发症，应针对其相关危险因素采取干预措施，有效预防和控制。

Abstract:

目的了解某县级医院重症监护室（ICU）住院患者感染的病原菌分布及耐药性，为临床治疗提供依据。方法回顾性分析2009年1月—2011年12月该院ICU送检标本分离的病原菌资料。结果1 096份标本（以痰标本为主，占80.15%）共分离病原菌755株，其中革兰阴性（G-）杆菌527株(69.80%)，革兰阳性（G+）球菌129株(17.09%)，真菌99株(13.11%)。分离率居前4位的病原菌依次为铜绿假单胞菌(163株，21.59%)、大肠埃希菌(129株，17.09%)、金黄色葡萄球菌(115株，15.23%)、鲍曼不动杆菌(74株，9.80%)。铜绿假单胞菌、大肠埃希菌和鲍曼不动杆菌对亚胺培南、美罗培南及哌拉西林/他唑巴坦的耐药率均较低，为0.00%～17.79%；对头孢呋辛的耐药率＞90%。金黄色葡萄球菌对多种抗菌药物耐药，共检出耐甲氧西林金黄色葡萄球菌(MRSA)76株，占总金黄色葡萄球菌株数的66.09%。结论该县级医院ICU住院患者感染部位以呼吸道为主；病原菌以G-杆菌所占比例较高，耐药性严重，需加强监测。

Abstract:

目的了解某妇幼保健院医院感染现况，对引起医院感染的相关因素进行调查与分析。方法采用横断面调查方法，床旁调查与查阅病历相结合，对该院2012年4月11日0︰00—24︰00所有住院患者进行调查。结果应查人数769例，实查769例，实查率100.00%。发现医院感染12例，医院感染现患率为1.56%；现患率居前3位的科室分别为产科重症监护室（8.33%）、儿内科（5.08%）及新生儿重症监护室(3.08%）。调查日抗菌药物使用率为44.10%（351/796），其中治疗用药者病原学送检率为60.90%（81/133），医院感染患者病原学送检率为66.67%（8/12）。检出1株产超广谱β内酰胺酶大肠埃希菌和1株多重耐药菌。241例预防性使用抗菌药物者中，233例（96.68%）术前用药控制在0.5～2 h，8例（3.32%）术前用药时间＞2 h。结论医院感染现患率调查，有利于了解医院感染发生情况和采取相应控制措施。该院检出了多重耐药菌，需引起高度重视。

Abstract:

目的了解某肿瘤医院医院感染现患率及抗菌药物的使用情况，为提高医院感染管理水平提供科学依据。方法采取床旁询问病史、体格检查与病历调查相结合的方法,对该院2011年9月15日0∶00—24∶00的所有住院患者进行调查。结果调查当日应查住院患者325例，实查321例,实查率98.77%。发生医院感染15例,16例次，医院感染现患率为4.67%，例次现患率为4.98%。现患率较高的科室有化疗一科(19.05%)、妇瘤科(14.29%)、中医科(10.00%)和呼吸科(4.44%)。抗菌药物当日使用率为47.98%（154/321）。医院感染部位以下呼吸道居首位，占37.50%；其次为皮肤软组织(18.75%)和胃肠道(12.50%)。结论医院感染现患率调查有利于了解医院感染发生情况，加强对高危科室的目标性监测和进一步规范抗菌药物的使用。

Abstract:

马尔尼菲青霉病(Penicilliosis marneffei，PSM)是由马尔尼菲青霉菌(Penicillium marneffei，PM)引起的一种少见的深部真菌感染性疾病。PM是青霉菌属中唯一的温度双向型真菌，属条件致病菌，主要侵犯人体单核巨噬细胞系统及感染免疫力低下患者，尤其是艾滋病(获得性免疫缺陷综合征，AIDS)患者。PSM主要分布于东南亚和我国南部广东、广西地区，在湖南省感染的相关报道较少，其临床表现复杂多样，误、漏诊率及病死率较高［1］。现将近期本院收治的首例AIDS合并PSM患者的临床、实验室检查结果和微生物特性报告如下。

Abstract:

植入式静脉输液港（implantable venous access port，IVAP）简称静脉输液港，是一种由注射座和硅胶导管组成的可植入皮下并长期留置体内的静脉输注系统。作为肿瘤专科医院，本中心早在2002年即开展IVAP植入术，已成功用于大批需长期支持治疗和化学治疗的恶性肿瘤患者。IVAP的并发症包括植入过程的并发症和导管留置的并发症，而感染是导管留置时常见并发症之一，可分为局部感染和导管相关性血流感染（catheterrelated blood stream infection，CRBSI）。近期，本中心诊治了1例由抗肿瘤化学治疗所用的IVAP导致的导管相关性血流感染嗜麦芽窄食单胞菌（Stenotrophomonas maltophilia，SMA）患者，现将救治情况报告如下。

Abstract:

慢性肾脏病所致尿毒症而接受血液透析的患者逐年递增，而血液透析是一项极其复杂的特殊治疗技术，感染危险因素很多，其中透析液存放、配制过程及存放容器的污染均可导致透析液污染［1］。为避免发生透析感染事件，医务人员对浓缩透析液的管理作了大量研究，现对其盛装容器清洗消毒方面的研究总结如下。