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ObjectiveTo prepare and identify polyclonal antibodies against secretory aspartyl proteinase 2(Sap2) of Candida albicans.MethodsCandida albicans genomic DNA was extracted as template, target gene fragment SAP2 was obtained by standard PCR amplification; SAP2 and plasmids pMALc2x (+) were cleaved with two restriction endonucleases,and digested products were joined,then the recombinant plasmid pMALc2x/SAP2 was constructed; Sap2 was expressed as soluble form after induced by IPTG in Escherichia coli strain BL21 (DE3). Nine BALB/c mice were immunized with soluble Sap2,so as to produce antiserum against Sap2.The titer of antiserum was determined by indirect enzymelinked immunosorbent assay(ELISA). After purified by ProteinG affinity chromatography, antiSap2 polyclonal antibody was resolved by SDSPAGE and its specificity was determined by Western Blot.ResultsAntiSap2 polyclonal antibody was successfully prepared and the titer was >1∶51 200. The antibody could specifically recognize Sap2 by Western Blot analysis. ConclusionSoluble Sap2 protein can be used as antigen to immunize animal. It has better antigenicity and immunogenicity. Polyclonal antibody against Sap2 can be prepared by animal immunization and expressed high specificity, which has laid the foundation for development of rapid diagnosis of invasive Candida albicans infection.

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ObjectiveTo study genetic variation and drugresistance of HIV1 after the failure of highly active antiretroviral therapy(HAART) in HIV1/AIDS patients.MethodsFiftyseven patients with HAART failure, including 45 with D4T/3TC/NVP regime，7 with 3TC/AZT/NVP，and 5 with 3TC/TDF/ LPV/r, were enrolled in the study, viral RNA was extracted from plasma, partial HIV1pol gene was amplified by reverse transcription polymerase chain reaction(RTPCR)and nested PCR,and the amplified fragment was sequenced,the phylogenesis of sequences were analyzed by landing the websites http://HIV1db.stanford.edu., and drug resistance variation was analyzed.ResultsPatients with the failure of 3 types of therapeutic regimes all developed drug resistance. Among 57 patients, drugresistant variation in protease inhibitors(PIs) was identified in 7 patients, 1 of whom （1.75%）produced variation in M46IM which resulted in lowlevel resistance to ATV/r,FPV/r,IDV/r,LPV/r and highlevel resistance to NFV; Drugresistant variation in reverse transcriptase inhibitors (RTs) was identified in 32 patients（56.14%）,and 14 （43.75%,14/32）of whom had resistance to 11 kinds of inhibitors(//HIV1db.stanford.edu)，11 (78.57%,11/14) cases were with the regime of D4T/3TC/NVP. Mutation site in patients with secondline drugs(TDF,LPV/r)were less than firstline drugs(D4T,3TC,NVP,AZT). ConclusionDrug resistance variation is the major cause of failure of HIV1 therapy, drug resistance should be monitored during the course of antiHIV therapy.

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ObjectiveTo investigate the occurrence of incidence of sharp injuries (SI) among health care workers(HCWs) in Shaanxi province, and provide scientific basis for taking preventive measures to reduce incidence of SI.MethodsA crosssectional investigation on the occurrence of SI in medical facilities at 30 hospitals of Shaanxi province in May 2011 was carried out through questionnaire.ResultsAmong 16 386 investigated HCWs, 1 489 (9.09%) occurred 1 901 times of SI, the average frequency was 0.12 times / person / month; nurses(10.36%) and HCWs who worked for 5 to 10 years (10.38%) were the highrisk groups for SI; the locations where SI usually occurred were general wards (37.88%) and operating rooms (23.25%); the major medical devices causing SI were syringe needles (33.98%), intravenous infusion needles(23.25%) and surgical needles(16.73%); the major procedures involving in SI were surgical suture(14.31%)，putting needles into sharps containers (11.20%),removing needles from artery or vein(9.89%), and putting needle cap back(9.68%);1 351 cases (71.07%) of SI can be traced to exposure sources,781 (41.08%) were contaminated SI, 54 were bloodborne disease exposure, the exposure rate of bloodborne diseases was 4.00%. Of bloodborne exposure, hepatitis B virus exposure accounted for 74.07%（40/54），syphilis 12.96%（7/54），hepatitis C virus 11.11%（6/54），and human immunodeficiency virus 1.85%（1/54）.ConclusionSI is a common occupational injury in medical facilities, incidence of SI can be reduced by reducing unnecessary sharps exposure,promoting the use of safe medical devices, performing the standard operation and taking safe protective measures.

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ObjectiveTo study the distribution and drugresistance of multidrugresistant bacteria(MDRB) from inpatients with acquired immunodeficiency syndrome (AIDS), so as to provide reference for clinical therapy.MethodsAntimicrobial susceptibility testing result of 426 MDRB isolates from AIDS inpatients during 2009-2011 was analyzed by WHONET 5.4 software.ResultsThe isolated MDRB included 213 isolates of extendedspectrum βlactamaseproducing Enterobacteriaceae bacteria, 41 methicillinresistant Staphylococcus aureus (MRSA), 21 methicillinresistant coagulase negative Staphylococcus (MRCNS), 79 MDRAcinetobacter baumannii (MDRAB), and 72 MDRPseudomonas aeruginosa (MDRPA). Except lower drugresistance rate to a minority of broad spectrum antimicrobial agents, ESBLproducing Enterobacteriaceae bacteriaca had higher resistance rates (3.74%-100%） to other antimicrobial agents.ConclusionThe major MDRB from AIDS inpatients is Enterobacteriaceae bacteria, clinicians should choose antimicrobial agents for empirical treatment, surveillance should be intensified, so as to avoid the outbreak of MDR infection in hospital.

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ObjectiveTo investigate the resistance of clinical bacterial isolates to commonly used antimicrobial agents in a hospital during 2011-2012.MethodsAntimicrobial susceptibility testing of clinically isolated pathogens was performed by KirbyBauer method.ResultsA total of 3 946 pathogenic isolates were detected, grampositive bacteria, gramnegative bacteria, fungi and mycoplasma accounted for 43.92%, 37.91%, 15.91%, and 2.26% respectively.The top one isolate was Escherichia coli (16.32%), followed by Streptococcus pneumoniae (16.02%), Staphylococcus aureus (9.00%), and Klebsiella pneumoniae （7.40%） and so on. Methicillinresistant Staphylococcus aureus (MRSA) and methicillinresistant coagulasenegative staphylococcus (MRCNS) respectively accounted for 41.41%（147/355）of Staphylococcus aureus and 81.40%（197/242）of coagulasenegative staphylococcus；extendedspectrum βlactamaseproducing rate of Escherichia coli and Klebsiella pneumoniae was 68.17%(439/644) and 72.95%（213/292）respectively. The resistant rate of Streptococcus pneumoniae to erythromycin and clindamycin was 99.84% and 98.58% respectively； the resistance rate of MRSA to clindamycin and erythromycin was higher (>75%),the resistance rates of MRSA and MRCNS to vancomycin, teicoplanin and linezolid were all 100.00%；the resistance rate of Enterococcus faecium to vancomycin was 98.31%；the resistance rate of Acinetobacter baumannii to cefoperazone/sulbactam was low(8.70%), while to the other antimicrobial agents were all high； the resistance rate of Pseudomonas aeruginosa to imipenem, meropenem, ceftazidime,amikacin and ciprofloxacin were all low (<26%). Four carbapenemresistant ESBLproducing Klebsiella pneumoniae isolates and 15 pandrugresistant Acinetobacter baumannii were detected.ConclusionRegular monitor on drug resistance of bacteria helps to understand the changes in bacterial resistance in hospitals, and provide the basis for empirical antimicrobial use.

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ObjectiveTo evaluate the occurrence and risk factors of healthcareassociated infection (HAI) in very low birth weight infants (VLBWI, including extremely low birth weight infants).MethodsData of VLBWI (birth weight <1 500 g,length of hospital stay >48 hours)in a neonatal intensive care unit(NICU) from January 2008 to January 2010 were analyzed retrospectively.ResultsOf 77 VLBWI, 18 developed 29 times of HAI, HAI rate was 23.38%, HAI case rate was 37.66%; the main infection site was respiratory tract (55.17%),followed by skin and soft tissue (17.24%) and blood stream (13.79%); a total of 34 pathogenic isolates were isolated, 67.64% (23 isolates)were gramnegative bacilli,the most common pathogens were Klebsiella pneumoniae and Escherichia coli; 14.71%(5 isolates) were grampositive bacteria;17.65% (6 isolates) were fungi, the main fungus was Candida albicans. Univariate analysis indicated that gestational age,birth weight, mechanical ventilation, premature rupture of fetal membrane, and parenteral nutrition were risk factors for HAI（P＜0.05）; multivariate logistic regression analysis showed that birth weight <1 kg(OR 95% CI:1.65-90.95), mechanical ventilation＞7 d(OR 95% CI: 2.71-129.15), and duration of parenteral nutrition＞14 d(OR 95% CI: 1.83-76.52) were independent risk factors for HAI.ConclusionThe incidence of HAI in VLBWI is high and risk factor is multiple. Respiratory tract is the main infection site, gramnegative bacillus is the most frequently isolated pathogen,more attention should be paid to fungal infection.

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ObjectiveTo evaluate the incidence rate and risk factors for catheterassociated urinary tract infection （CAUTI）in patients with gynecologic malignant tumor surgery.MethodsA prospective and retrospective investigation was carried out on patients who received indwelling urinary catheter after gynecologic malignant tumor surgery from July 2010 to December 2011, and the risk factors for CAUTI were analyzed.ResultsA total of 353 patients who received indwelling urinary catheter after gynecologic malignant tumor surgery were investigated, 62 cases suffered from CAUTI, the infection rate was 17.56%; the duration of catheter use was 2 292 days,and the average incidence rate was 27.05 per 1 000 catheter days. Multivariate logistic regression analysis showed that cervical cancer (OR 95% CI：1.791-8.269) and the duration of catheterization(OR 95% CI：2.823-8.735) were the independent risk factors for CAUTI in inpatients with indwelling urinary catheter after surgery. A total of 60 pathogenic isolates were detected, 90.00%（54/60） were gramnegative bacilli，the top one was Escherichia coli（44 isolates，73.33%）.ConclusionThe incidence rate of CAUTI is high in patients with gynecologic malignant tumor surgery in this hospital, which can be reduced by improving skill in surgery and quality for urinary catheter care, and removing catheter timely.

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ObjectiveTo investigate the occurrence of ventilatorassociated pneumonia(VAP) in an intensive care unit (ICU), and evaluate the efficacy of intervention measures.MethodsPatients receiving mechanical ventilation for >48 h in an ICU from January 2010 to June 2012 were performed targeted surveillance, problems were found out and intervened, incidence of VAP and compliance with infection control measures before and after intervention were compared.ResultsA total of 1 724 patients with mechanical ventilation were investigated, 21.93%(378 cases) of whom developed VAP; incidence of VAP in 2010 and JanuaryJune 2012 was 51.54‰ and 19.53‰ respectively（χ2=12.13，P＜0.01）. The amount of consumption of hand sanitizer and liquid soap per patient per day in 2010, 2011 and JanuaryJune 2012 was 5.21mL/HD,10.98mL/HD and 30.48 mL/HD respectively.ConclusionThe incidence of VAP in this ICU is high, VAP can be controlled effectively through the enforcement of intervention measures and health care workers' compliance with infection control measures.

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ObjectiveTo evaluate the basic protocol,rationality and therapeutic effect of antimicrobials used in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD).MethodsMedical data of all AECOPD patients who were discharged from a hospital between July and December 2011 were analyzed retrospectively, antimicrobial use was statistically analyzed, and the rationality of antimicrobial use in AECOPD patients was evaluated according to “Guideline for the Diagnosis and Treatment for COPD”.ResultsAfter intervention, antimicrobial use density dropped from 210.36 to 94.89; length of hospital stay, number of antimicrobial combination use, number of change in antimicrobial with no reason, average cost of hospitalization, drug use, antimicrobial use, as well as ratio of drug or antimicrobial cost to all hospitalization cost all decreased significantly(P<0.05); sputum culture rate and positive detection rate of sputum culture increased significantly (P<0.05).ConclusionIntervention in antimicrobial use can improve the rational application rate and decrease the cost of drug use.

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ObjectiveTo realize the impact of hepatitis A or E viral superinfection on liver function and prognosis of patients with chronic hepatitis B(CHB).Methods45 CHB patients with hepatitis A superinfection (CHB+HA group), 47 CHB patients with hepatitis E superinfection(CHB+HE group),and 60 patients with CHB alone (CHB group) were studied and compared. HBsAg, antiHBs, HBeAg, antiHBe, antiHBc, antiHAV IgM and antiHEV IgM were detected by enzymelinked immunosorbent assay(ELISA), HBV DNA was detected by fluorescent quantitative polymerase chain reaction (FQPCR). Liver function and prothrombin time(PT) were detected.ResultsCompared with CHB+HA and CHB groups, in CHB+HE group, the total bilirubin(TB) and aminotransferase increased, albumin(ALB) decreased, the time of normalization of TB and aminotransferase as well as PT prolonged, morbidity and mortality of severe hepatitis increased (P<0.05). In CHB+HA group, TB and aminotransferase increased, the time of normalization of TB and aminotransferase prolonged significantly compared with CHB group(P<0.05), but difference in decrease in ALB, prolongation of PT, and morbidity and mortality of severe hepatitis between two groups were not significantly different(P>0.05).ConclusionThe superinfection of hepatitis A has certain impact on TB and aminotransferase; chronic hepatitis B patients superinfected with hepatitis E virus have more severe hepatic damage and higher mortality.

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ObjectiveTo evaluate the significance of procalcitonin(PCT) test in guiding antimicrobial therapy in patients with liver cirrhosis ascites.MethodsOne hundred patients with liver cirrhosis ascites in a hospital between January 2009 and January 2012 were randomly divided into routine therapy group(routine comprehensive therapy, n=20) and antiinfective therapy group(cefotaxime therapy in addition to routine therapy, n=80),then antiinfective group was subdivided into antiinfective group A（PCT＜0.5 ng/mL）, antiinfective group B（0.5 ng/mL≤PCT≤2 ng/mL）and antiinfective group C（PCT＞2 ng/mL）.Liver function, prothrombin activity （PTA）and therapeutic efficacy between three groups were compared.ResultsAfter therapy, the difference in serum alanine transaminase（ALT）, aspartic transaminase（AST）,total bilirubin（TBIL）,and PTA between antiinfective group A and routine therapy group were not significantly different(all P＞0.05);compared with antiinfective group A and routine therapy group, ALT,AST and TBIL in antiinfective group B and C decreased significantly, while PTA increased significantly (all P＜0.05）. The total efficacy rate in routine therapy group, antiinfective group A, B and C was 60.00%（12/20）,66.67%（18/27）,87.50%（28/32）,and 90.48%（19/21），respectively（χ2=9.04，P=0.03）, the total efficacy rate in antiinfective group B and C increased significantly.ConclusionDetection of PCT is benefit to judge the development of bacterial peritonitis in patients with liver cirrhosis ascites and guide rational use of antimicrobial agents.

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ObjectiveTo evaluate the efficacy of targeted monitor and comprehensive intervention measures for promoting rational use of perioperative antimicrobial agents in vitrectomy.MethodsClinical data of 160 patients receiving vitrectomy between March 2011 and September 2012 were collected, patients were divided into preintervention group(80 cases receiving vitrectomy between March and December 2011, antimicrobial use was not intervened) and postintervention group (80 cases receiving vitrectomy between January and September 2012, antimicrobial use was intervened). The postoperative infection rates, antimicrobial prophylaxis,and expense and so on between two groups were compared.ResultsThere was no surgical site infection in both groups. The average duration of antimicrobial use in postintervention group was significantly shorter than that of preintervention group(［1.81±1.52］ d vs ［4.02±1.67］ d, P＜0.01）;the rate of perioperative prophylactic antimicrobial use and duration of postoperative antimicrobial use＞48 h in preintervention group were both significantly higher than those of postintervention group (100.00%［80/80］ vs 28.75%［23/80］; 82.50%［66/80］ vs 18.75%［3/16］; both P＜0.05）;the cost of antimicrobial drugs,total drug cost, and total hospitalization cost in postintervention group was significantly lower than those of preintervention group (［151.47±6.64］ vs ［507.96±7.67］;［922.56±8.46］ vs ［1 444.63±11.65］;［8 842.43±8.76］ vs ［9 891.92±10.93］）yuan (P＜0.01），ConclusionTargeted monitor and comprehensive intervention measures can promote the rational perioperative antimicrobial use in vitrectomy and reduce the medical cost of patients.

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ObjectiveTo evaluate multidrugresistant bacterial (MDRB) healthcareassociated infection (HAI) in malignant tumor patients, so as to provide basis for the effective prevention and control measures.MethodsData on MDRB isolated from various specimens in Henan Tumor Hospital in JanuaryDecember 2011 were analyzed retrospectively.ResultsA total of 2 562 pathogenic strains were isolated, 449 (17.53%) of which were MDRB. Of all MDRB，305 （67.93%）were gramnegative bacteria,the isolation rate of Escherichia coli was the highest （54.57%，245 isolates）, followed by Klebsiella pneumoniae (9.80%，44 isolates);grampositive bacteria were 144 isolates（32.07%），the isolation rate of Staphylococcus aureus (11.80%，53 isolates) and Staphylococcus epidermidis (11.58%，52 isolates) were higher. MDRB infections were mainly concentrated on general surgery (26.73%，120 isolates)and hepatobiliary surgery（21.83%, 98 isolates); the major specimen was drainage fluid of pleuroperitoneal cavity(39.42%), followed by sputum （19.82%）and blood（19.16%）.ConclusionHAI monitoring helps to realize MDRB infection and prevent outbreak of HAI.

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ObjectiveTo evaluate the efficacy of different dosage regimen of cefuroxime for preventing surgical site infection(SSI) following laparoscopic cholecystectomy.MethodsA retrospective study was performed by collecting and comparing the data of patients who received laparoscopic cholecystectomy between June 2011 and May 2012. Sixtyeight patients in group A were given 1.5g cefuroxime intravenous drip before operation, and 61 patients in group B were sequentially given another 1.5g cefuroxime postoperatively, SSI in both groups were compared.ResultsSSI in group A and B were 3(4.41%) and 2(3.28%) cases respectively, there was no statistical difference in SSI between two groups（P>0.05）.ConclusionPreoperative prophylactic use of 1.5g cefuroxime can prevent SSI effectively for patients undergoing elective laparoscopic cholecystectomy.

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ObjectiveTo evaluate the efficacy of combination therapy of ribavirin and xiyanping on the treatment of handfootmouth disease (HFMD).MethodsFrom April to July 2012,one hundred and eightysix cases of HFMD admitted to a hospital were randomly divided into two groups, 90 patients in control group received ribavirin intravenous drip (10 mg/kg·d),and 96 patients in treatment group added xiyanping intravenous drip (5-10 mg/kg·d) in addition to ribavirin,all were once a day for 7 days. The efficacy, length of hospital stay, and adverse reactions and so on in two groups were observed after treatment.ResultsTotal efficacy rate was 92.71% （89/96）in treatment group and 68.89% （62/90）in control group（χ2=7.98，P＜0.05）.Defervescence time,deflorescence time, oral ulcer healing time and length of hospital stay in treatment group were significantly shorter than those in control group（［2.51±1.12］ d vs ［4.29±1.61］d，t=8.80;［2.68±0.82］ d vs ［3.89±1.33］d，t=6.40; ［3.78±1.23］d vs ［4.91±1.77］d，t=5.08; ［4.82±1.48］d vs ［7.12±1.89］d，t=9.27;all P<0.05）.ConclusionThe combination of ribavirin and xiyanping has a better clinical efficacy on ordinary cases of HFMD, and adverse reaction is little.

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ObjectiveTo analyze the clinical treatment and control of healthcareassociated infection(HAI) in a patient with afferent O139 cholera, so as to provide the basis for strengthening diagnosis, treatment, prevention and control measures of cholera. MethodsPatients were diagnosed with cholera according to “Health Industry Standard of the People's Republic of China─Cholera Diagnosis Criteria”,and were isolated and treated; the close contacts were isolated and given medical observation; strict disinfection and education were adopted.ResultsAll patients were cured and discharged, and none of the close contacts was infected, transmission of pathogen was prevented effectively.ConclusionTimely diagnosis and isolation measures can effectively control the epidemic of cholera.

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ObjectiveTo investigate the distribution and drug resistance of major pathogens in a neonatal intensive care unit (NICU), so as to provide evidence for the clinical therapy of infection.MethodsSpecies and antimicrobial susceptibility testing of the major pathogens isolated from NICU patients who were hospitalized between January 2011 and March 2012 were analyzed retrospectively.ResultsAmong 5 612 detected specimens, 3 060 (54.53%) pathogenic isolates were isolated. The major strains were Streptococcus viridans（29.93%）, Staphylococcus epidermidis（14.48%）, Moraxella catarrhalis（14.02%）, and Escherichia coli（9.48%）.The major grampositive cocci had very low resistant rates to vancomycin, teicoplanin and cefoperazone/sulbactam, the resistant rates were 0.00%-3.03%, 0.00%-5.83% and 6.73%-36.36%, respectively, while resistant rates to penicillin,erythromycin, ampicillin/sulbactam and cefoxitin were high (42.60%-100.00%). The major gramnegative bacilli had very low resistant rates to imipenem, piperacillin/tazobactam and cefoperazone/sulbactam,the resistant rates were 0.00%, 0.00%-9.05% and 0.00%-18.55%, respectively, while the resistant rates to cefuroxime, compound sulfamethoxazole and ampicillin/sulbactam were high（42.53%-100.00%）.ConclusionRealizing the distribution and drug resistance is helpful for the rational use of antimicrobial agents in clinic.

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目的探讨某院老年病房多重耐药菌感染患者的临床特点，为其防治提供依据。方法采用回顾性调查方法，对该老年病房2007年1月—2011年12月发生多重耐药菌感染患者的病历资料进行分析。结果共132例老年患者发生多重耐药菌感染，均为医院感染, 以肺部感染为主（66.67%）。患者平均年龄（85.7±2.1）岁，其中80岁以上高龄106例（80.30%）；所有患者均有基础疾病，其中有2种以上基础疾病者119例（90.15%）；平均住院日51.8 d；所有患者在检出多重耐药菌前均有抗菌药物使用史，其中使用2种或2种以上抗菌药物者116例（87.88%）。132株多重耐药菌中，革兰阴性（G-）菌90株（68.18%），革兰阳性（G+）菌42株（31.82%），主要为假单胞菌属（36.36%）、葡萄球菌属（21.97%）、鲍曼不动杆菌（13.64%）、肺炎克雷伯菌（12.88%）。G-菌最为敏感的抗菌药物为亚胺培南，其次为头孢他啶；G+菌中无论金黄色葡萄球菌还是肠球菌属，对利奈唑胺的敏感率均为100%。结论多重耐药菌感染好发于老年人，减少住院时间及合理使用抗菌药物是预防多重耐药菌感染的重要手段。

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目的了解精神病住院患者医院感染发病情况，并探讨干预措施及效果。方法回顾性调查分析2009—2011年某精神卫生中心住院患者病历资料。结果2 715例精神病住院患者，115例发生医院感染；2009、2010、2011年医院感染率分别为6.77%、3.70%、2.34%，差异有统计学意义（P＜0.01）；3年期间急性病区与慢性病区总体感染率差异有统计学意义(P＜0.01）。感染部位以下呼吸道（占48.70%）居首位；季节分布以夏秋季（占71.30%）较多。结论针对精神病住院患者医院感染特点及易感因素，实施一系列干预措施是有效的。

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目的探讨使用感染控制（感控）措施温馨提示牌提高医务人员感控措施依从性的效果。方法2012年1—6月，对医院不同专业人员（医生、护士、实习人员）进行感控措施的培训，并将感控措施制作成感控措施温馨提示牌，张贴在病区的换药室、处置室或治疗室等诊疗区域的显眼处。观察医务人员在温馨提示牌使用前（2012年1—3月）和使用后（2012年4—6月）执行感控措施的依从性。结果感控措施温馨提示牌使用前，调查1 299人次，其中773人次依从，依从率为59.51%;使用后，调查1 377人次，其中1 199人次依从，依从率为87.07%，两者比较，差异有统计学意义（χ2=262.00,P＜0.01）。感控措施温馨提示牌使用后，医务人员在手卫生依从性、标准预防、无菌操作和医疗废物分类方面的依从性均显著高于使用前（均P＜0.01）；医生、护士、实习医生和实习护士的感控措施依从性亦均高于使用前，差异有统计学意义（均P＜0.01）。结论病区诊疗区域使用感控措施温馨提示牌，可以提醒、引导和规范医务人员的医疗行为，提高医务人员执行感控措施的依从性，减少不规范或不安全的医疗操作。

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目的了解某院应用切口层保护器预防胆道手术切口感染的效果。方法选取2011年4月—2012年4月在该院行剖腹胆道取石手术患者120例，随机分为实验组和对照组，各60 例。实验组术中使用切口层保护器，对照组术中未使用切口层保护器,比较两组患者住院时间及切口感染率。结果实验组住院时间为（12±2）d，显著低于对照组的（16±3）d（t=7.94，P=0.017）；实验组发生切口感染1例（1.67%），对照组9例（15.00%），实验组切口感染率显著低于对照组(χ2=6.982， P=0.008)。结论切口层保护器能有效降低胆道结石手术切口感染率。

Abstract:

目的分析某院新生儿医院获得性脓疱疮的感染情况并探讨其预防控制措施。方法对2009年10月—2012年3月该院产科36例新生儿脓疱疮病例进行回顾性调查分析。结果调查期间出生新生儿5 334例，发生新生儿感染51例(0.96%)，其中感染脓疱疮36例（70.59%），居感染首位；日龄4～<6 d的新生儿所占比率最高，达55.56%。36例患儿经过严密隔离，切断传播途径，合理治疗等处理均治愈。结论严格执行消毒隔离制度，遵守医院感染管理标准操作规程，采取积极有效的预防措施，可减少新生儿医院获得性脓疱疮感染的发生。

Abstract:

目的了解医院感染现状，制定科学的医院感染控制措施。方法采用横断面调查方法对某院2011年6月25日0∶00—24∶00所有住院患者进行医院感染现患率调查。结果实际调查1 380例住院患者，发现医院感染34例，34例次，医院感染现患率和例次现患率均为2.46%。医院感染现患率较高的科室为：外科重症监护室（ICU）、内科ICU、 脑外科、血液科和干部科；调查日使用抗菌药物者539例，抗菌药物使用率为39.06%；医院感染部位以下呼吸道最多，占50.00%，其次为心肌炎，占14.71%；共检出病原菌23株，其中鲍曼不动杆菌和铜绿假单胞菌各5株，肺炎克雷伯菌和肠杆菌属各3株，其他革兰阴性菌2株。结论医院感染现患率调查可以发现医院感染的高发科室、部位及病原菌,为采取有效预防控制措施提供依据。

Abstract:

气性坏疽（gas gangrene）是厌氧菌感染的一种，即由梭状芽孢杆菌所致的肌坏死或肌炎；主要表现为患部肿胀、产气，肌肉皮肤由红肿到发紫发黑，以致坏死，蔓延快、腐肉恶臭，极易引起严重毒血症，是创伤后最严重的并发症之一［1］。此类感染发展急剧，预后较差，死亡率高［2］。本院于2011年10月收治1例会阴、阴囊气性坏疽并行急诊切开引流术的患者，现将手术配合介绍如下。

Abstract:

由于广泛使用抗菌药物、医院内外交流及医疗服务进社区，导致社区多重耐药菌感染日益频发［1］。近10年，在研究社区获得性感染（CAI）时，发现一部分具有医疗相关病史的社区血流感染、肺炎及泌尿系感染患者的病情、病死率及分离的病原菌有别于CAI，而与医院获得性感染（HAI）相似，命名为医疗相关感染（HCAI）［2-5］。HCAI分为社区和医院两类，医院发生的HCAI，已被重视，常能及时、合理治疗，但对社区发生的HCAI认识不足，早期无法可靠地与CAI区分，常延误合理治疗,导致高病死率［1，5-6］。临床上急症老年医疗相关性肺炎（HCAP）与社区获得性肺炎（CAP）极为常见，故两者区别的研究受到关注［1，3-5］。为准确判断HCAP与CAP，力争及时、合理治疗成为重要议题，对防控耐药菌株扩散极为重要。