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ObjectiveTo investigate the expression and variation of MIP1β, MIP2, and IL12p70 in mice with bloodstream infection caused by 4 kinds of bacteria.MethodsCD1 (ICR) mouse models of bloodstream infection with Staphylococcus aureus (S. aureus), Enterococcus faecalis(E. faecalis), Escherichia coli(E. coli), and Klebsiella pneumoniae(K. pneumoniae) were established. After mice in each trial group and PBS control group were infected by bacteria for 0.5h, 1h, 3h, 6h, 12h, 24h, and 48h, concentrations of MIP1β, MIP2, and IL12p70 were detected by Luminex liquid suspension chip system.ResultsConcentrations of MIP1β increased significantly 1h after bacteria was in blood, S. aureus, E. faecalis, E. coli, K. pneumoniae, and control groups were (134.5±18.3), (61.5±15.4), (3 354.0±809.0), (6 888.4±1 100.2), and (28.9±4.6) pg/mL respectively; the peak values of IL12p70 were (389.3±118.1), (127.6±10.0), (42.2±3.5), (62.8±8.4), and (4.8±0.3) pg/mL respectively. Concentrations of MIP1β and MIP2 in E. coli and K. pneumoniae groups were significantly higher than other trial groups and control group (all P<0.01), while concentrations of IL12p70 in S. aureus and E. faecalis groups were both significantly higher than E. coli, K. pneumoniae, and control groups (all P<0.01).ConclusionConcentrations of MIP1β and MIP2 in E. coli and K. pneumoniae groups were both significantly higher than those in S. aureus and E. faecalis groups, while concentrations of IL12p70 in S. aureus and E. faecalis groups were both significantly higher than those in E. coli and K. pneumoniae groups. The combination detection of multiple cytokines or chemokines are valuable in predicting grampositive or gramnegative bacterial infection, and can provide basis for treatment of early infection.

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ObjectiveTo study virulence factors and drug resistance mechanism of linezolidintermediate Enterococcus faecalis(E. faecalis) isolated from patients with bloodstream infection.MethodsTwo linezolidintermediate E. faecalis strains, namely A and B, were isolated from two patients with bloodstream infection, the treatment of two patients was analyzed. The minimum inhibitory concentration (MIC) of linezolid and vancomycin were determined. The virulence genes (esp, asa1, gelE, ace, agg, efaA, cylA, and hyl) and linezolid resistance genes (domain V region of the 23SrRNA, cfr, cfr［B］, optrA) were amplified by polymerase chain reaction (PCR). PCR products of domain V region of 23SrRNA gene were sequenced and analyzed.ResultsSymptoms of two patients who isolated two linezolidintermediate E. faecalis strains were controlled after accepted linezolid therapy. Strains A and B were both susceptible to vancomycin(MICs were 1μg/mL and 4μg/mL respectively）, teicoplain, ampicillin, and nitrofurantoin, while intermediate to linezolid（MIC were both 4μg/mL）. Two strains both contained multiple virulence factors, strain A were negative for cylA and hyl, strain B were negative for hyl and esp, but positive for other virulence genes. There was G2621T mutation in domain V region of 23SrRNA in strain A, and no variation was found in strain B. Drug resistance genes of cfr, cfr(B), and optrA were all negative in both strain A and B.ConclusionIn the present study, two linezolidintermediate E. faecalis strains isolated from patients with bloodstream infection were susceptible to vancomycin and ampicillin, although the treatment of linezolid in two patients is effective, the utilization of linezolid therapy in clinical practice still needs to be cautious. The mutation of target site is a significant resistance mechanism, it is necessary for us to pay more attention to these clinical strains which are nonsusceptible to such antimicrobial agents, and the treatment strategy needs further study.

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ObjectiveTo understand the clinical distribution and antimicrobial resistance of Enterococcus spp. isolated from blood culture. MethodsEnterococcus spp. isolated from blood culture specimens of hospitalized patients between January 2012 and December 2016 was analyzed, antimicrobial susceptibility testing results were analyzed. ResultsA total of 139 strains of Enterococcus spp. were isolated, including 78 strains of Enterococcus faecium (E. faecium), 60 Enterococcus faecalis (E. faecalis), and 1 Enterococcus avium(E. avium), accounting for 56.11%, 43.17%, and 0.72% respectively; 56.83% of patients were >60 years and 17.27% were ≤28 days. The main department sources of strains were intensive care unit and neonatal department, accounting for 34.53% and 18.70% respectively. There was only 1 strain of E. avium, which was isolated from neonatal department. Resistance rates of E. faecium to penicillin, ampicillin, levofloxacin, ciprofloxacin, moxifloxacin, and nitrofurantoin were all higher than E. faecalis（all P＜0.05）, while resistance rate to tetracycline was lower than E. faecalis（P=0.001）. Resistance rates of E. faecium to vancomycin and linezolid were 2.56% and 6.41% respectively; resistance rates of E. faecalis to vancomycin and linezolid were 0 and 3.33% respectively. ConclusionE. faecium and E. faecalis are the main Enterococcus spp. isolated from blood culture, most are isolated from the elderly patients and newborns. Resistance rates of E. faecium to most antimicrobial agents are higher than E. faecalis, resistance rates of E. faecium and E. faecalis to linezolid are both higher than resistance rates to vancomycin, key monitoring needs to be continued.

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ObjectiveTo explore the diagnostic value and clinical significance of serum procalcitonin (PCT), erythrocyte sedimentation rate(ESR), and Creactive protein(CRP) in intracranial infection after craniocerebral surgery in patients in intensive care unit(ICU). Methods21 patients who were admitted to the ICU in a hospital between June 2011 and January 2016 were as infection group, 42 patients without intracranial infection after craniocerebral surgery during the same period were as control group. Levels of PCT, ESR, and CRP in two groups were detected and analyzed statistically. ResultsDifferences in age, gender, average body mass index, types of craniocerebral diseases, and postoperative indwelling drainage between infection group and control group were all not statistically significant (all P>0.05). Patients with elevated serum PCT, ESR, and CRP in infection group accounted for 95.24%, 80.95% and 90.48% respectively, in control group were 4.76%, 14.29%, and 4.76% respectively；the average concentrations of serum PCT, ESR, and CRP between two groups were compared respectively, differences were all significant(all P<0.05). The sensitivity of PCT, ESR, CRP, and PCT+ESR+CRP in the diagnosis of intracranial infection after craniocerebral surgery in ICU patients were 95.24%, 80.95%, 90.47%, and 95.61% respectively; specificity were 95.23%, 85.71%, 95.23%, and 89.37% respectively. ConclusionThe combined detection of PCT, ESR, and CRP is helpful for the diagnosis of intracranial infection after craniocerebral surgery in ICU patients, it has important guiding significance for the rational use of antimicrobial agents in early stage.

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ObjectiveTo study the effect of application of plandocheckact (PDCA) on reducing the incidence of healthcareassociated infection(HAI) in department of neurosurgery. MethodsQuality control circle activity group was established, programme of activities was formulated, four stages and ten steps of PDCA were adopted, incidences of HAI in department of neurosurgery before (SeptemberNovember 2015) and after (MayJuly 2016) the implementation of PDCA were observed, causes were analyzed based on implementation of hand hygiene, aseptic technique manipulation, and environmental sanitation, countermeasures were found out, and continuous quality improvement was performed for 6 months.ResultsComparison between before and after implementation of PDCA was conducted, incidence of HAI in department of nerosurgery decreased from 10.9% to 5.8%, difference was significant（P＜0.05）, control rate was 100%, incidence of HAI dropped by 46.8%; hand hygiene implementation rate increased from 27.2% to 76.9%, aseptic technique implementation rate increased from 76.0% to 96.9%, environmental sanitation increased from 51.0% to 90.0%, differences before and after implementation were all statistically significant(all P<0.001). ConclusionQuality control circle activities implemented jointly by multiple departments can reduce the incidence of HAI in department of neurosurgery, rules can be observed, measures can be further improved, it is worthy of clinical application.

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ObjectiveTo investigate the clinical characteristics and antimicrobial resistance of Acinetobacter baumannii(A. baumannii) in neonatal intensive care units (NICUs). MethodsThe clinical isolation and antimicrobial resistance of A. baumannii causing healthcareassociated infection(HAI) in 4 NICUs of a hospital from October 2012 to October 2014 were analyzed statistically. Results A total of 11 640 neonates were admitted in 4 NICUs, 500(4.3%) developed HAI, 51(10.2%) developed 52 cases of A. baumannii infection. Distribution of A. baumannii infection was as follows: NICU of extremely premature infants, premature infants, fullterm infants，and surgical NICU were 42, 1, 4, and 5 cases respectively. Incidences of A. baumannii HAI in 4 seasons were compared, difference was statistically significant(χ2=16.05，P<0.05），infection mainly occurred in the spring and summer. A. baumannii had high resistance rates to βlactam antibiotics (such as piperacillin/sulbactam, cefepime, imipenem) and gentamycin（＞90%），resistance rate to amikacin was the lowest (51.9%). Among 52 strains of A. baumannii, 46 were multidrugresistant strains, and 3 were extensively drugresistant strains. ConclusionA. baumannii HAI is most serious in NICU of extremely premature infants, resistance rates to commonly used antimicrobial agents are high.

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ObjectiveTo investigate isolation of pathogens from bile and clinical characteristics of patients with hepatobiliary diseases. MethodsBacterial culture result of bile and related clinical data of patients with hepatobiliary diseases in a hospital were collected and analyzed by retrospective survey. ResultsA total of 406 bile specimens from patients with hepatobiliary diseases were collected, the positive rate of culture was 64.53%. Of 262 positive specimens, 62.21%（n=163）, 32.83%（n=86）, and 4.96%（n=13） were isolated single pathogen, 2 kinds of pathogens，and 3 kinds of pathogens respectively. 374 pathogenic strains were isolated, 242（64.71%）, 131 （35.02%）, and 1（0.27%）were gramnegative bacteria, grampositive bacteria, and fungus respectively. Patients with cirrhosis of liver, history of hepatobiliary surgery, and cholelithiasis had higher isolation rates of pathogens from bile than control group(all P<0.05), isolation rates of pathogens from bile in patients with cholelithiasis of different sites were varied; but there was no significant differences among patients of different age, gender, and whether or not with hepatobiliary tumors(all P>0.05). There were no statistical difference in constitute of pathogenic species from bile between patients with and without gallstones, as well as with and without history of hepatobiliary surgery（both P＞0.05）；while constitute of pathogenic species from bile between patients with and without cirrhosis of liver was statistically different（χ2=14.058，P=0.001）. ConclusionPathogens from bile in patients with hepatobiliary diseases are mainly Enterobacteriaceae and Enterococcus spp. which caused single infection. Positive culture rate of pathogens from bile is higher in patients with cholelithiasis, history of hepatobiliary surgery, and liver cirrhosis.

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ObjectiveTo understand the prevalence and risk factors of healthcareassociated infection(HAI), and provide evidence for prevention and control of HAI. MethodsA crosssectional survey was adopted, bedside survey and medical record reviewing method was combined to investigate and analyze the prevalence of HAI in a tertiary firstclass hospital in 2012-2015. ResultsA total of 4 725 hospitalized patients were surveyed，the prevalence rates in 2012-2015 were 6.00%，4.77%，3.93%，and 3.05% respectively, difference was significant（P＜0.05）； antimicrobial usage rates were 30.56%，33.82%，32.84%, and 34.48% respectively, difference was not significant（P>0.05）；the main infection site was lower respiratory tract（43.00%），followed by surgical site (16.43%); the risk factors for HAI were age ≥65 years, chronic systemic diseases(diabetes, cirrhosis, chronic renal failure, chronic lung disease), immunodeficiency（white blood cell<1.5×109/L), coma, tracheotomy, and mechanical ventilation. ConclusionSurvey on HAI prevalence can promote continuous improvement of HAI management, surveillance on surgical site infection and risk factors of HAI should be strengthened.

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ObjectiveTo investigate the distribution and antimicrobial resistance of bacteria isolated from sputum of patients in respiratory intensive care unit (RICU). MethodsNonrepetitive bacteria isolated from sputum specimens of 557 hospitalized patients in RICU of a tertiary firstclass hospital between January 2013 and December 2015 were collected, antimicrobial resistance of bacteria was analyzed. ResultsA total of 1 131 bacterial strains were isolated, 212(18.8%) were grampositive bacteria and 919(81.2%) were gramnegative bacteria. The top five species were Acinetobacter baumannii (30.2%), Pseudomonas aeruginosa (21.1%), Staphylococcus aureus (18.2%), Klebsiella pneumoniae (9.8%), and Serratia marcescens (8.3%). In 20132015, isolation rate of Staphylococcus aureus and nonfermentative bacteria showed no obvious changing tendency, but isolation rate of Enterobacteriaceae strains had increasing tendency. Antimicrobial susceptibility testing results showed that Acinetobacter baumannii and Pseudomonas aeruginosa exhibited high resistance rates to imipenem, levofloxacin, and gentamicin (all >60%), resistance rate of Pseudomonas aeruginosa to ceftazidime showed a downward trend (from 59.4% to 37.5%); isolation rate of methicillinresistant Staphylococcus aureus (MRSA) was 96.1%, susceptibility to tigecycline, vancomycin, linezolid, compound sulfamethoxazole, quinupristin/dalfopristin were almost 100%; resistance rates of Enterobacteriaceae strains to sulfonamide decreased from 55.6% to 14.3%，but resistance rates to ceftazidime, cefotaxime, imipenem, levofloxacin, and gentamicin were all >60%. ConclusionThe major bacteria isolated from sputum of patients in RICU are Acinetobacter baumannii, Pseudomonas aeruginosa, and Staphylococcus aureus, antimicrobial resistance of isolated bacteria is serious.

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ObjectiveTo explore the infection status and clinical characteristics of healthcareassociated infection(HAI) in patients initially diagnosed with multiple myeloma(MM) during the induction period. MethodsClinical data of 116 patients diagnosed with MM and initially treated with PAD(bortezomib+adriamycin+dexamethasone) or PDD(bortezomib+liposome doxorubicin+dexamethasone) regimen in a hospital were collected, infection rates and clinical characteristics of patients during the induction therapy period were analyzed statistically. ResultsAmong 116 patients, 69 received PAD regimen, and 47 received PDD regimen, infection rates in two groups were 79.7% and 89.4% respectively; 73 patients received subcutaneous injection of bortezomib, 43 received intravenous injection of bortezomib, infection rates in subcutaneous injection group and intravenous injection group were 78.1% and 93.0% respectively，difference was statistically significant between two groups(P<0.05). During the induction period, HAI rate was 83.6%（n=97），81 patients developed infection during the first course, infection status of 3 patients were not clear due to therapy outside the hospital, the actual infection rate was 71.7% (81/113); infection rate during the second course was 56.6%（64/113）；a total of 98 patients completed three therapy courses, infection rate was 43.9%（43/98）；66 patients completed four therapy courses, infection rate was 28.8%(19/66). With the increase of the therapy course, infection rate showed a downward trend. Infection sites from high to low were respiratory system, skin and mucosa, oral and gastrointestinal system, bloodstream, and urinary tract. Difference in constitute of clinical diagnosis between patients receiving and without receiving prophylactic antifungal agents during chemotherapy period was not statistically significant （P=0.063）. ConclusionInfection rate is very high during induction period, the main infection site is respiratory system, clinicians and patients need to pay more attention to the prevention and treatment of respiratory system infection.

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ObjectiveTo investigate the clinical distribution and antimicrobial resistance of carbapenemresistant Enterobacteriaceae (CRE) in Dongguan. MethodsCRE isolated from hospitalized patients in 22 secondary and above medical institutions which participated in bacterial monitoring in Dongguan between January 2015 and June 2016 were retrospectively analyzed, antimicrobial resistance was analyzed by WHONET 5.6 software. ResultsA total of 71 CRE isolates were detected, with a isolation rate of 0.34% (71/20 713). 53 strains(74.65%) of CRE were isolated from patients aged 15-60 years old; 46(64.79%) were from male patients；CRE were mainly isolated from patients in intensive care unit(36 strains，50.70%）；the main specimen was sputum(34 strains, 47.89%），followed by urine （11strians，15.49%）and wound secretion（6 strains，8.45%）；the main infection type was healthcare associated infection (64 strains, 90.14%); CRE were mainly distributed in tertiary hospitals（56 strains，78.87%）, the isolation rate of CRE in tertiary and secondary hospitals were 0.41%（56/13 677）and 0.21%（15/7 036） respectively. 71 strains of CRE were all resistant to imipenem, resistance rate to meropenem was 81.12%， only amikacin and tobramycin had drug resistance rates of <40%( 21.38% and 38.79% respectively）, resistance rate to trimethoprim/sulfamethoxazole was 48.23%，while resistance rates to fluoroquinolones, thirdgeneration cephalosporins, and enzyme inhibitors were all>60. ConclusionThe isolation rate of CRE in Dongguan is lower than that of the whole nation and the other provinces, effective prevention and control measures should be taken according to the key population and departments that isolated CRE, antimicrobial use should be rational.

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ObjectiveTo investigate the occurrence and risk factors of vascular access infection(VAI) in hemodialysis outpatients. MethodsProspective surveillance method, monitoring methods was formulated and adopted by referring to the relevant guidelines and regulations at home and abroad, targeted surveillance was performed among all outpatients receiving hemodialysis in a hospital from June 1, 2014 to May 31, 2016. ResultsA total of 584 outpatients received hemodialysis from June 1, 2014 to May 31, 2016, with 64 203 times of vascular access, 79 patients developed 85 cases of infection, case incidence of VAI was 1.32‰. 36 cases（42.35%） were infection at vascular puncture sites, 49 (57.65%） were vascular accessrelated bloodstream infection. Among patients with different types of vascular access, incidence of VAI was the highest among patients with artificial vascular graft（19.67‰），followed by those with nontunneled central venous catheter（4.91‰）, with tunneled central venous catheter（0.73‰）, and with arteriovenous fistula（0.09‰）. Age＞60 years, hemodialysis time>1 year, diabetes, and hypertension were risk factors for VAI in outpatients with hemodialysis(all P<0.05). 39 strains of pathogens were isolated from 49 patients with vascular accessrelated bloodstream infection, including 36 (92.31%) grampositive bacteria, mainly Staphylococcus aureus(n=30, 6 of which were methicillinresistant Staphylococcus aureus); 3(7.69%) gramnegative bacteria. ConclusionStrengthening prospective targeted surveillance can better understand the status, characteristics, and risk factors of VAI in hemodialysis outpatients, it is conducive to taking targeted prevention and control measures, thus reduce the incidence of VAI in hemodialysis outpatients.

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ObjectiveTo evaluate the clinical efficacy and prognosis of cefoperazone/sulbactam combined with thymosin α1 in the treatment of severe pneumonia caused by  Acinetobacter baumannii(A. baumannii ). Methods84 patients with severe pneumonia caused by  A. baumannii  were randomly selected, they were divided into treatment group(n=42, cefoperazone/sulbactam combined with thymosin α1 treatment) and control group(n=42, only cefoperazone/ sulbactam treatment). Procalcitonin（PCT）, Creactive protein（CRP）, white blood cell（WBC）count, peripheral blood T lymphocyte subsets, interleukin6（IL6）, interleukin10（IL10）, immunoglobulin G (IgG), and APACHE II score of two groups before treatment and 7 days after treatment were compared, ventilator weaning success rate, length of ICU stay, and 28day mortality were also observed. ResultsAfter 7 day treatment, compared with the control group, CD4+T cells, CD4+／CD8+, IL10, and IgG in the treatment group were all significantly higher (all P<0.05); PCT, CRP, WBC, IL6, and APACHE II score all significantly declined, difference were all significant(all P<0.05). Ventilator weaning success rate in treatment group was higher than control group（64.29% vs 38.10%），mean length of ICU stay was shorter than control group（［12.41±2.25］d vs［18.23±2.50］d），28day mortality was lower than control group（19.05% vs 45.24%）, difference were all significant(all P<0.05). ConclusionCefoperazone/sulbactam combined with thymosin α1 for the treatment of severe pneumonia caused by  A. baumannii  can improve the immune function of patients, reduce inflammation, increase ventilator weaning success rate, shorten ICU stay， and decrease 28day mortality.

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ObjectiveTo compare bacterial blocking rate of different medical packaging material, as well as weight loss rate, tear strength, and abrasion resistance of cotton cloth with different times of washing. MethodsAccording to test methods for sterile medical device packaging, bacterial blocking rates of cotton cloth, nonwoven fabric, and disposable filter paper were tested. Weight loss test, tensile test, and abrasion resistance test of cotton cloth were performed to test weight loss rate, tear strength, and abrasion resistance of cotton cloth with different times of washing. ResultsIn test for microbial barrier ranking of porous package material, the average bacterial blocking rates of doublelayer new cotton cloth, doublelayer old cotton cloth, disposable filter paper, and nonwoven fabric were 62.15%, 31.39%, 82.04%, and 89.71% respectively; after cotton cloth was washed 30 times, the weight loss rate decreased by 1.22%, tear strength decreased by 6.70%, fabricrubbing test revealed there was no pilling. ConclusionBacterial blocking effect ranked as follows: nonwoven fabric, disposable filter paper, doublelayer cotton cloth. After 30 times of washing, the weight loss rate and tear strength decreased, and bacterial blocking effect was worse than that of new cotton cloth.

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ObjectiveTo evaluate the effect of carbapenem exposure on isolation rate of multidrugresistant organisms(MDROs) and prognosis of elderly patients with severe pneumonia. MethodsElderly patients with severe pneumonia and admitted to the intensive care unit in a hospital between February 2014 and February 2016 were investigated retrospectively. According to whether there was carbapenem exposure, patients were divided into group A(carbapenem exposure group) and group B(carbapenem nonexposure group). Patients in group A were subdivided into two subgroups according to exposure time of carbapenems, group A1 received carbapenems for>7 days, group A2 received carbapenems for ≤7 days. The isolation rates of MDROs, mechanical ventilation days, length of stay in ICU, and 28day mortality among groups were compared and analyzed. ResultsA total of 86 patients were enrolled in the investigation, 57 were males and 29 were females; the average age was(80.12+10.45) years (range: 65-92 years). There were 40 cases in group A, 46 in group B; 24 cases in group A1, and 16 in group A2. The isolation rates of MDROs in group A and group B were 65.00% and 36.96% respectively, difference was statistically significant（P＜0.05）；Comparison between two groups of patients revealed that mechanical ventilation days, length of stay in ICU, and 28day mortality in group A were all higher than group B, difference was statistically significant（all P＜0.05）；the isolation rates of MDROs in group A1 was higher than group A2 (75.00% vs 43.75%, P＜0.05）; mechanical ventilation days of group A1 was higher than group A2 （［7.69±2.22］d vs ［6.34±1.56］d, P＜0.05）；28day mortality and length of stay in ICU between group A1 and A2 were not significantly different（both P＞0.05）. ConclusionCarbapenem exposure can increase the occurrence of MDRO infection, especially the nonfermentative bacterial colonization or infection, and prolong the mechanical ventilation days and length of stay in ICU, thus affect the prognosis of patients.

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ObjectiveTo investigate the value of TSPOT in the diagnosis of tuberculosis（TB） in children. Methods43 children who were admitted to a hospital and confirmed with TB between March 2015 and May 2016 were as TB group, 50 children who were excluded TB as well as healthy children in the outpatient and inpatient departments of this hospital during the same period were as control group, two groups were underwent detection of TSPOT, PPD, MTBAb, and acid fast stain, results were compared, subgroup analysis was conducted on the positive of TSPOT in children with different infection sites and in different age groups. ResultsSensitivity and negative predictive value of TSPOT were significantly higher than the other three methods（P＜0.05），specificity was also higher than that of PPD（P＜0.05）；positive rates of TSPOT in pulmonary tuberculosis and extrapulmonary tuberculosis were 88.9% and 81.3% respectively，difference was not statistically significant（P＞0.05）；positive rates of TSPOT in children ≤5 years and >5 years were 70.6% and 96.2% respectively，difference was statistically significant（P<0.05）. The sensitivity and specificity of combined detection of TSPOT and PPD for diagnosis of TB were 95.3% and 98.0% respectively，which were both higher than the single method（P＜0.05）.ConclusionThe sensitivity and specificity of TSPOT for detecting TB in children are both superior to traditional methods, TSPOT is also suitable for the detection of extrapulmonary tuberculosis, and can be used as the main method for laboratory diagnosis of tuberculosis in children, but it is uncertainty in children under 5 years of age, and should be rationally combined with PPD to improve the diagnosis of TB among children.

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ObjectiveTo investigate the distribution and antimicrobial susceptibility of pathogens causing maxillofacial infection in patients, and provide evidence for rational use of antimicrobial agents in clinical practice. MethodsSpecimens of patients infected with oral and maxillofacial infection in a hospital between January 2012 and December 2016 were performed microbial culture, pathogens were identified and performed antimicrobial susceptibility testing, distribution of pathogens and antimicrobial resistance were analyzed. ResultsOf 882 patients with maxillofacial infection, male and female accounted for 32.20% and 67.80% respectively; 35.38% and 32.65% of patients aged ～40 years and ～60 years respectively; a total of 145 strains were isolated, 88(60.69%) of which were gramnegative bacteria, mainly Klebsiella pneumoniae and Pseudomonas aeruginosa; 56(38.62%) of which were grampositive bacteria, mainly Staphylococcus aureus. Resistance rates of Klebsiella pneumoniae to 16 kinds of antimicrobial agents were all<50%，resistance rates to imipenem and meropenem were the lowest, both were 3.45%, 11 strains were extendedspectrum βlactamasesproducing strains; resistance rates of Pseudomonas aeruginosa to 10 kinds of antimicrobial agents were all<40%. Staphylococcus aureus was susceptible to tigecycline, linezolid, and vancomycin, resistance rate to penicillin was the highest（66.67%），resistance rate to oxacillin was 20.83%. ConclusionThe main pathogens causing oral and maxillofacial infection are gramnegative bacteria, different pathogens have different antimicrobial resistance, antimicrobial agents should be used rationally during clinical treatment according to antimicrobial susceptibility testing result.

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ObjectiveTo understand the pathogenic distribution and epidemiological trend of handfootandmouth disease (HFMD), and provide evidence for the prevention and control of HFMD. MethodsChildren who were diagnosed with HFMD in a hospital between January and December 2015 were investigated, realtime fluorescence PCR was used to detect enterovirus universal type EV, enterovirus 71 (EV71), and Coxsackievirus A16 (CoxA16) in specimens from children with HFMD. Positive rates and distribution of various types of EV among children of different months, genders, age groups, and infection types were analyzed. ResultsA total of 837 throat swab specimens from HFMD children were collected in 2015, 380 (45.40％) of which were EV positive specimens. Virus typing showed that 110 (28.95%), 7 （1.84％）, 6（1.58％）, and 257（67.63％） were positive specimens for EV71, CoxA16, EV71+CoxA16, and other types of EV.  HFMD had a high prevalence since April, reached a peak in MayJune, and remained high incidence in JulyDecember. Positive rates of EV in children of different months were statistically different (P<0.05). The age of onset was mainly in children under 3 years. Positive rates of EV and constitute ratios of different types of EV in children of different age groups were all statistically different (all P<0.05). The positive rate of EV in severe HFMD cases was higher than common cases (65.34% vs 27.06%, P＜0.001）. The proportion of severe cases in children with EV71 infection and other types of EV infection were 90.00% and 60.70% respectively; children with EV71+CoxA16 double infection were all severe cases. Constitute of EV types in children with different infection types was statistically different(P<0.001). ConclusionIn 2015, EV infection in hospitalized children with HFMD in this hospital was mainly caused by other types of EV (nonEV71 and nonCoxA16), the high prevalence season, highrisk population under 3 years of age, and severe cases should be paid high attention, prevention and treatment should be performed well.

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ObjectiveTo understand the current status of hand hygiene(HH) compliance among doctors and nurses, and strengthen the management of HH of health care workers(HCWs). MethodsOnthespot observation of HH implementation in clinical departments of the whole hospital was performed by a singleblind method, data were collected for statistical analysis. ResultsHH compliance rate of all clinical departments was 69.28%（309/446）, HH compliance rate of intensive care unit was the highest(87.93%)，department of internal medicine was the lowest(63.03%), there were significant differences among different departments（P=0.001）. Compliance rate of HH of nurses was higher than that of doctors（74.47% vs 39.39%），difference was significant（P＜0.001）； of different indications for HH, the lowest compliance rate was before contact patients（43.04%）， HH of doctors after contact with patients and patients’ surrounding were both lower than nurses, difference was significant(both P<0.05).  ConclusionHH compliance rate of doctors is lower than nurses, compliance rate  of HH is the lowest before contact patients, awareness of HH among doctors and nurses before contact patients should be emphasized, targeted training should be conducted, thus reduce the incidence of healthcareassociated infection.

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目的探讨低温等离子灭菌在消毒供应中心的应用效果。方法对某院过氧化氢低温等离子灭菌循环结果进行回顾性分析，查找灭菌循环取消的原因。结果在1 056锅次灭菌循环中，灭菌合格994锅次，合格率94.13%，循环取消62锅次，主要原因为灭菌物品潮湿(28次，45.16%)、物品超载(14次，22.58%)、人为因素(11次，17.74%)、灭菌物品中有禁忌物(4次，6.45%)、吸附性物质较多(2次，3.23 %)及其他(3次，4.84%)。结论保证待灭菌物品干燥，灭菌前认真检查及规范的操作能提高低温等离子灭菌循环的成功率，降低运行成本，提升工作效率，保证灭菌质量。

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目的调查无偿献血者人类免疫缺陷病毒（HIV）感染情况，了解无偿献血者HIV感染流行趋势，筛选安全献血者，促进输血安全。方法选择2008年1月—2015年12月周口市中心血站的无偿献血者为研究对象。所有献血者均按照《血站技术操作规程》采集血液并检测，初复检有反应性的献血者样本送周口市疾病预防控制中心做确认实验。结果参加无偿献血的共334 560人次，确认HIV阳性44人次，HIV抗体阳性率为13.15/10万。继2010年低值后呈逐年上升趋势，近三年以每年5/10万的速度递增。不同文化程度、职业的无偿献血者HIV抗体阳性率比较，差异均有统计学意义（均P＜0.05）；而不同性别、年龄的无偿献血者HIV抗体阳性率比较，差异无统计学意义（均P＞0.05）。结论近年来无偿献血者HIV流行趋势发生变化，为保证输血安全，采供血机构应加强HIV筛查，建立HIV筛查信息屏蔽系统，普及艾滋病防治知识。

Abstract:

目的改进医院重复使用医疗器械表面黄斑去除方法，减少微生物负荷过高引起的排异和热原反应，降低医院感染。方法收集医院肉眼可见黄斑的重复使用医疗器械（弯盘200件），使用不同比例黄斑清洗剂、除锈剂（工作液1：除锈剂按照1︰5的稀释比例进行配制；工作液2：除锈剂原液；工作液3：黄斑清洗剂按照1︰1的稀释比例进行配制；工作液4：黄斑清洗剂原液；）对器械进行清洗处理，各组50件，比较黄斑的去除效果。结果用各类清洗剂处理黄斑的弯盘20 min后均未见明显效果；作用30 min后工作液2（除锈剂原液）的去除效果达58%（29件），工作液4（黄斑清洗剂原液）的去除效果达68%(34件)，工作液3（黄斑清洗剂稀释液）的去除效果为30%(15件)；作用50 min上述三者的去除效果达100%，除锈剂稀释液的去除效果达94%，但除锈剂会对器械造成一定腐蚀。比较不同方法弯盘黄斑彻底去除情况，结果显示黄斑清洗剂原液去除黄斑的效果最好（Z=56.61，P＜0.001）。结论黄斑清洗剂可用于各类重复使用医疗器械的残留黄斑去除，值得推广应用。

Abstract:

创伤弧菌自然存在于近海和海湾的海水、海底沉积物及寄生在贝壳类的海洋生物(如牡砺、蚌、蟹等)中，海产品创伤弧菌检出率约为20%～40%［1］。该菌最适生长于30℃，pH 7.0，盐度为0.7%～1.6%的海水中，当海水盐度＞3.8%时则不易生长［2］。目前，创伤弧菌分为3种生物型，生物Ⅰ型产吲哚，是人类感染最主要的致病型；生物Ⅱ型及Ⅲ型是导致人类感染的条件致病菌［3］。

Abstract:

乙型肝炎病毒（hepatitis B virus, HBV）感染呈世界性流行，但不同地区HBV感染的流行强度差异较大。据世界卫生组织报道，全球约20亿人曾感染HBV，其中3.5亿人为慢性感染者，每年约有65万人死于HBV感染所致的肝衰竭、肝硬化和肝细胞癌（hepatocellular carcinoma, HCC）。其中，大部分人属于HBV携带者，终生未发病，但部分患者因合并肿瘤、自身免疫性疾病、器官移植等而需运用免疫抑制剂或细胞毒性药物，使其免疫功能状态改变，可能导致HBV再激活，从而引起肝功能受损，甚至发生暴发性肝衰竭或者死亡。1975年，Wands等［1］首次描述了进行化学治疗（化疗）/免疫抑制治疗的慢性乙型肝炎患者的HBV再激活。美国肝病研究学会（AASLD）、欧洲肝病学会（EASL）、亚太肝病学会（APASL）等在近几年来陆续提出并更新HBV再激活的推荐意见，HBV再激活得到越来越多的重视。HBV再激活本属于感染科处理范畴，但这类患者往往最先就诊于血液科、肾病科、肿瘤科、风湿免疫科及移植科等非感染病科室，因此，HBV再激活是一个跨学科的临床问题。在本文中，我们就HBV再激活的定义、特征、发生率、危险因素、防治及其管理等进行简要综述。

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