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ObjectiveTo explore the constitute and antimicrobial susceptibility of pathogenic fungi causing candidemia in Nanchang City of Jiangxi Province. MethodsCandida spp. isolated from blood specimens of patients at a hospital in Nanchang in MarchOctober 2015 were collected, fungal strains were identified by amplifying the internal transcribed spacer (ITS) and large ribosomal subunit (D1/D2 region of 26rRNA), antifungal susceptibility of fungi was detected. ResultsA total of 1 332 positive blood culture specimens were collected, including 74 fungal positive specimens, accounting for 5.56%, 52 strains of Candida spp. were obtained, most were Candida tropicalis (n=17，32.69%），followed by Candida albicans(n=16, 30.77%） and Candida parapsilosis complex (n=16, 30.77%). Identification results of ITS and D1/D2 region were identical. 52 strains of Candida spp. were sensitive to both micafungin and caspofungin, epidemiological cutoff value(ECV) of amphotericin B showed that 52 strains were all wild type. Resistance rates of Candida tropicalis to fluconazole and voriconazole were 29.41% and 17.64% respectively, ECV of itraconazole and posaconazole showed that wild type accounted for 82.35% and 94.12% respectively；resistance rates of Candida albicans to fluconazol and voriconazole were 93.75% and 81.25% respectively, ECV of itraconazole and posaconazole showed that wild type accounted for 75.00% and 81.25% respectively；Candida parapsilosis complex strains were sensitive to both fluconazole and voriconazole, ECV of itraconazole and posaconazole showed that all were wild type;  all Candida glabrata strains had intermediate resistance rates to fluconazole, ECV of voriconazole, itraconazole, and posaconazole showed that wild type accounted for 66.67%, 100.00%, and 100.00% respectively. ConclusionCandida tropicalis is the most common pathogenic fungus causing candidemia in Nanchang of Jiangxi, followed by Candida albicans and Candida parapsilosis complex. Azole, echinocandin, and amphotericin B are still firstline antifungal agents.

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ObjectiveTo investigate the inhibitory effect of cryptotanshinone on different maturation stages of Staphylococcus epidermidis (S. epidermidis) biofilm. MethodsThe biofilm model of S. epidermidis was constructed in vitro, the timing of adhesion, accumulating, and maturation was determined; matrix quantity, bacterial metabolism, microstructure of biofilm were detected with semiquantitative adhesion test, XTT assay, and scanning electron microscope(SEM) respectively. ResultsThe timing of adhesion, accumulating, and maturation of S. epidermidis biofilm were 6h, 24h,and 48h respectively; in adhesion period, cryptotanshinone at the concentration of 128μg/mL and 32μg/mL could both obviously reduce the matrix and kill bacteria inside biofilm, difference was statistically significant(P＜0.05)，inhibitory effect of 128μg/mL cryptotanshinone was better than 32μg/mL (P＜0.05), the microstructure was destroyed by both concentrations. During accumulating and mature period, only cryptotanshinone at 128μg/mL could reduce the matrix of biofilm and kill bacteria inside biofilm (P＜0.05), the microstructure was damaged by cryptotanshinone at concentration of 128μg/mL, while 32g/mL of cryptotanshinone had no obvious inhibitory effect（P＞0.05）.ConclusionCryptotanshinone has a certain inhibitory effect on different stages of S. epidermidis biofilm, and there is a certain dose effect.

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ObjectiveTo investigate the clinical distribution and antimicrobial resistance of Streptococcus agalactiae(S. agalactiae) in neonatal intensive care unit(NICU), and provide reference for antimicrobial use and intervention measures. MethodsSpecimens from neonates in the NICU of a hospital in 2010-2014 were collected, the department sources and antimicrobial susceptibility testing results of 62 strains of S. agalactiae isolated from children were analyzed. Results62 strains of S. agalactiae were mainly distributed at fullterm NICU, accounting for 64.52%; the main source of specimens was blood, accounting for 90.33%, followed, by cerebrospinal fluid (6.45%）, sputum, and secretion（both were 1.61%）. S. agalactiae had the highest resistance rate to tetracycline(79.03%)；resistance rates to erythromycin and clindamycin were both 74.19%, resistance rate to levofloxacin was 40.32%， susceptibility rates to penicillin and ampicillin were both 100%. ConclusionS. agalactiae infection mainly occurred in neonates in fullterm NICU, and has high resistance rate to multiple antimicrobial agents, penicillin and ampicillin can be used as the preferred antimicrobial agents for the treatment of S. agalactiae infection.

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ObjectiveTo investigate the resistance of Staphylococcus aureus (S. aureus) to vancomycin and linezolid in Sichuan Province, and provide reference for clinical antiinfection treatment. MethodsS. aureus and methicillinresistant S. aureus(MRSA) from 71 hospitals in Sichuan Province in 2011-2015 were collected, minimum inhibitory concentration（MIC） values of vancomycin and linezolid against S. aureus and MRSA in each year were calculated. ResultsA total of 51 976 strains of S. aureus were collected in 5 years, 14 361 of which were MRSA, isolation rate of MRSA decreased from 36.02% in 2011 to 25.56% in 2015, which showed a downward trend (χ2=160.72，P＜0.05）. From 2011 to 2015, MIC50 of vancomycin against S. aureus were 1, 0.5, 0.5, 1, and 1μg/mL respectively，MIC90 increased from 1μg/mL to 2μg/mL；the mean MIC50 of linezolid was 2μg/mL，MIC90 increased from 2μg/mL to 4μg/mL. Change in MIC50 and MIC90 of vancomycin against MRSA in 2011-2015 were obvious, which increased from 0.5, 1μg/mL to 2μg/mL respectively；the mean MIC50 of linezolid was 2μg/mL，MIC90 increased from 2μg/mL to 4μg/mL. ConclusionThe isolates rate of MRSA had a decreasing trend，but there is a upward trend of MIC50 and MIC90 of vancomycin and linezolid against MRSA, bacterial resistance surveillance needs to be strengthened to provide evidence for rational clinical antimicrobial therapy.

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ObjectiveTo understand the occurrence of healthcareassociated infection(HAI) in intensive care units (ICUs) in secondary and above hospitals in a province, and provide basis for HAI management. MethodsHAI management quality control center in a province performed targeted monitoring on HAI in ICUs in secondary and above hospitals in a province from July 1, 2010 to June 30, 2015. ResultsICUs in 176 hospitals were monitored, the incidence of HAI in ICUs for 6 consecutive years was 7.23%, case incidence of HAI was 9.72%； incidence of HAI showed a decreased trend in 6 years（P＜0.001）. The adjusted rate of HAI per 1 000 patient days in the general hospital ICUs was higher than that of special hospital ICUs (4.30‰ vs 3.53‰）. Incidence of HAI in surgical ICUs and general ICUs were both relatively higher, adjusted rates of HAI per 1 000 patient days were 4.79‰ and 4.21‰ respectively. Respiratory tract, urinary tract, and bloodstream infection were major HAI in ICUs, accounting for 68.64%, 14.45%, and 10.09% respectively, the utilization rates of central venous catheter, ventilator, and urinary catheter were 49.86%, 39.16%, and 81.95% respectively, incidence of three catheterassociated infection were 1.74‰, 13.77‰, and 2.08‰ respectively, incidence of three catheterassociated infection decreased year by year (P<0.001). The utilization rates of ventilator, central venous catheter, and urinary catheter in different ICUs were not correlated with the incidence of infection(all P>0.05). A total of 36 223 strains of pathogens were isolated, the top 6 isolated pathogens were Acinetobacter baumannii(22.77%), Klebsiella pneumoniae (11.96%), Pseudomonas aeruginosa(11.94%), Staphylococcus aureus (8.08%), Candida albicans (5.63%), and Escherichia coli（5.55%）. The isolation rates of carbapenemresistant Klebsiella pneumoniae showed a increased tendency for 6 years(P<0.05). ConclusionContinuous targeted monitoring on HAI in ICUs, regular analysis on risk factors for HAI, and timely implementation of intervention measures can effectively decrease the incidence of HAI.

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ObjectiveTo investigate the current status of nurses’ needlestick injuries during venous blood sampling, evaluate effective prevention strategies. MethodsA stratified cluster sampling method was used to investigate clinical nurses in China by questionnaire, contents of questionnaire included the general information of nurses, training and management on venous blood sampling among nursing staff, adherence to wearing gloves before blood sampling, the occurrence of needlestick injuries during the process of venous blood sampling in the past year and so on. ResultsA total of 2 861 questionnaires were distributed, and 2 575 valid questionnaires were recovered. 93.17% of the investigated nurses had participated in the training of venous blood sampling regularly; 87.15% received regular check of venous blood sampling; before venous blood sampling, only 72.74% knew whether the patient had bloodborne infectious disease; only 61.01% wore gloves during blood sampling. Incidence of needlestick injuries during venous blood sampling was 20.78% in the past year. There was no significant differences in the incidence of needlestick injuries when using 3 different types of needles(Pearson χ2=1.649, P=0.438). 48.21% of needlestick injuries occurred during disposing medical waste．ConclusionThe training and management on nurses’ venous blood sampling is better in China, but incidence of needlestick injuries is still high. It is necessary to formulate safety operation regulations of venous blood sampling, standardize the operation procedures and specify the contents of training, so as to correct nurses’ unsafe behavior during venous blood sampling.

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ObjectiveTo understand the cognition about healthcareassociated infection(HAI) management among directors in secondary and above hospitals in Shaanxi Province. MethodsQuestionnaire survey was adopted to investigate hospital directors who participated in “The third session of Shaanxi Provincial HAI management training course for hospital directors”. ResultsA total of 181 questionnaires were distributed, 173 (95.58%) were qualified. 74.57% of surveyed hospitals were secondary hospitals, 61.85% were comprehensive hospitals, 67.05% of respondents received HAI training in recent 3 years, 81.50% and 55.49% of hospital directors thought the main factors influencing the HAI management were health care workers’ awareness on HAI and leaders’ attention respectively. 58.96%, 60.12%, and 46.82% of hospital directors thought the director of HAI management department should have intermediate and above professional title, bachelor degree or above education, and preventive medicine professional requirements respectively. The awareness rate of HAI managementrelated knowledge was 86.71%, difference in awareness rate of HAI managementrelated knowledge among respondents of different job, gender, and HAI training in recent 3 years were all significantly different(all P<0.05). ConclusionHospital directors’ cognition on HAI management affect the development of HAI work, strengthen the training on HAI knowledge among administrators can improve hospital administrators’ awareness on HAI prevention and control.

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ObjectiveTo explore the cleaning status and cleaning quality of dental handpieces in various types of medical institutions in Suzhou City. MethodsOn October 2631, 2015, dental clinics in the whole city were sampled according to crosssectional survey and proportional sampling method, the cleaning quality of dental handpieces in each clinic was detected by ATP bioluminescence assay. Results72 medical institutions, 201 handpieces, 402 samples in 10 administrative regions of the city were sampled, 42 samples was unqualified, unqualified rate was 10.45%, unqualified rate of cleaning of dental handpiece surface was higher than waterline of dental handpiece(17.91% vs 2.99%, P＜0.05). Cleaning quality of dental handpieces in different grades of medical institutions was different(P<0.05), tertiary medical institutions were all qualified, medical institutions without grade was 14.45%. According to the classification based on name of different medical institutions, cleaning quality of handpieces was statistically significant(P<0.05), cleaning efficacy of dental handpieces in department of stomatology of public hospitals was best(unqualified rate was 4.31%), while private dental clinics had the worst cleaning efficacy(unqualified rate was 13.81%). ConclusionEducation and training of dental handpieces cleaning in the whole city should be strengthened, especially the management of cleaning of dental handpieces in low grade and private dental clinics.

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ObjectiveTo realize the clinical characteristics of fungemia in premature infants. MethodsClinical characteristics of fungemia in premature infants in the intensive care unit of a children’s hospital between January 2011 and December 2015 were analyzed retrospectively, general condition of premature infants, laboratoryrelated indicators, and antimicrobial susceptibility testing results were compared.ResultsFrom January 2011 to December 2015, 42 premature infants with confirmed fungemia were treated in this hospital, 22 (52.38%) of whom were with fungemia caused by Candida albicans(C. albicans), 13 (30.95%) by Candida parapsilosis (C. parapsilosis), 3 by Candida krusei (C. krusei), and 4 by other fungi. Patients were grouped according to the main pathogens causing infection: C. parapsilosis group and C. albicans group. Maternal genitourinary tract infection rate and incidence of fungal meningitis in C. albicans group were both higher than C. parapsilosis group(27.27% vs 7.69%, 27.27% vs 0.00% respectively), peripherally inserted central catheter (PICC) rate in C. albicans group was lower than that in C. parapsilosis group(22.73% vs 69.23%), platelet count in C. parapsilosis group was lower than C. albicans group, differences were all statistically significant (all P<0.05). ConclusionThe major fungi causing fungemia in premature infants were C. parapsilosis and C. albicans, maternal reproductive system infection during pregnancy can easily lead to candidemia, premature infants with candidemia are more vulnerable to developing fungal meningitis; PICC is more likely to lead to C. parapsilosis fungemia, and platelet decline is more obvious.

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ObjectiveTo understand the distribution and drug resistance of pathogens from patients with anastomotic fistula infection after esophageal cancer surgery, and provide basis for clinical diagnosis and treatment. MethodsPatients were admitted to a hospital due to anastomotic fistula after esophageal cancer surgery between January 2012 and December 2015, microbial culture and antimicrobial susceptibility testing results of patients were retrospectively analyzed. Results1 986 patients underwent radical resection of esophageal cancer within 4 years, 148 of whom developed anastomotic fistula, 104 (70.27%) were with positive microbial culture. A total of 197 pathogenic strains were isolated, 52（26.40%）and 145 （73.60%）strains were isolated from intrathoracic anastomotic fistula and cervical anastomotic fistula respectively；127 (64.47%）strains were gramnegative bacteria, the major were Pseudomonas aeruginosa, Klebsiella pneumoniae, and Acinetobacter baumannii, 62(31.47%) strains  were grampositive bacteria, the major were Staphylococcus aureus, Enterococcus spp., and Streptococcus viridans, 8 strains (4.06%) were fungi. 49（47.12%） cases were with mixed pathogenic infection. The resistance rates of gramnegative bacteria to imipenem were 17.86%47.62%, to polymyxin B was 0, resistance rates of Pseudomonas aeruginosa to other antimicrobial agents were all<50%, Klebsiella pneumoniae to piperacillin and aztreonam were both>70%, Acinetobacter baumannii to most antimicrobial agents were all>50.00%; resistance rates of grampositive bacteria to clindamycin and tetracycline were both>50.00%, to linezolid, vancomycin, and teicoplanin were all 0, resistance rates of Staphylococcus aureus to penicillin, oxacillin, and ciprofloxacin were all>60%，resistance rate of Enterococcus spp. to quinupristin/dalfopristin was 100.00%. ConclusionPostoperative anastomotic fistula combined with infection can affect the prognosis of patients after esophageal cancer surgery, regular monitoring on distribution and drug resistance of pathogens can provide the basis for initial empirical treatment, and is conducive to the early treatment and rational use of antimicrobial agents.

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ObjectiveTo evaluate the value of peripheral blood Mycobacterium tuberculosis interferonγ release assay（TBIGRA ）in early adjuvant diagnosis of  tuberculous meningitis(TBM).  Methods56 patients with TBM (trial group) and 56 patients with nonTB meningitis (control group) admitted to West China Hospital of Sichuan University in JanuaryDecember 2015 were analyzed, results of TBIGRA, cerebrospinal fluid(CSF) Mycobacterium tuberculosis(MT) culture, and CSF TBDNA testing of two groups of patients were analyzed, the sensitivity and specificity of each diagnostic method were calculated. ResultsThe sensitivity of TBIGRA, CSF MT culture, and CSF TBDNA for diagnosis of TBM were 87.5%（49/56）, 19.6%（11/56）, and 60.7%（34/56） respectively，specificity were 89.3%（50/56）, 100.0%（56/56）, and 76.8%（43/56）respectively. The sensitivity of TBIGRA for diagnosing TBM was higher than that of CSF TBDNA and CSF MT culture, specificity of TBIGRA was higher than that of CSF TBDNA(89.3%>76.8%), pairwise comparison showed a significant difference(all P<0.01). Among 11 cases confirmed by CSF culture, 10 (90.9%［10/11］）were positive for TBIGRA; among 45 cases with clinical diagnosis and effective antituberculosis treatment, 39 (86.7%［39/45］）were positive for TBIGRA. ConclusionTBIGRA is highly sensitive and specific in the early adjuvant diagnosis of TBM, it is convenient, rapid, effective, and worthy to be popularized in clinical practice.

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ObjectiveTo evaluate the differences of serum RANTES(regulated on activation, normal T cell expressed and secreted), MCP1 (monocyte chemoattractant protein), and SDF1β (stromal cellderived factor1β) in patients with acquired immunodeficiency syndrome (AIDS) and healthy people. Methods38 AIDS patients who were admitted to a hospital between January 2010 and January 2015 were as AIDS groups, 38 healthy persons were as a healthy group, serum levels of RANTES, MCP1, and SDF1β in two groups were detected, and the subgroup analysis was carried out according to the viral load. ResultsSerum levels of RANTES, MCP1, and SDF1β in AIDS group were （1 392.55±227.69）pg/mL,（450.91±103.04）pg/mL, and（104.82±22.52）pg/mL respectively，all were significantly higher than those in healthy group（［120.58±55.87］ pg/mL, ［74.25±33.62］ pg/mL, and ［39.04±11.43］pg/mL respectively）(all P<0.05). Among AIDS patients with HIV viral load 4≤Log（VL）＜5 and Log（VL）≥5, serum RANTES were （1 470.34±155.01）pg/mL and （1 408.29±181.54）pg/mL respectively，which were both significantly higher than patients with HIV viral load Log（VL）＜4(［1 183.12±174.54］pg/mL)；serum MCP1 and SDF1β levels in AIDS patients with HIV viral load 4≤Log (VL)<5 were （537.93±89.32）and（149.31±18.05）pg/mL respectively，which were significantly higher than patients with HIV viral load Log（VL）≥5(［410.26±80.57］ pg/mL, ［81.53±20.31］pg/mL respectively) and HIV viral load Log（VL）＜4(［381.71±77.26］ pg/mL, ［72.90±21.62］pg/mL respectively)， differences were both statistically significant（both P<0.05）.ConclusionSerum levels of RANTES, MCP1, and SDF1β are significantly increased in AIDS patients, which are related to the level of viral load.

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ObjectiveTo explore clinical distribution characteristics of carbapenemresistant Klebsiella pneumoniae (CRKP), analyze enzyme production of strains and verify the in vitro antimicrobial activity of tigecycline. MethodsAntimicrobial susceptibility testing results of 53 strains of CRKP isolated from clinical specimens of patients in a hospital from January to December 2015 were analyzed, carbapenemase production of target strains was detected by modified Hodge test, metalloβlactamase was detected by EDTA synergy test, minimum inhibitory concentration(MIC) of tigecycline susceptibility testing result detected by instrument was confirmed by MIC test strip(MTS method). Results53 CRKP strains were mainly isolated from patients in intensive care unit (n=14, 26.42%) and burn unit(n=13, 24.53%); sputum(n=23, 43.40%) and wound secretion(n=15, 28.30%) were the main specimen sources; isolation rate of CRKB was highest in the elderly≥60 years old, 35 strains（66.04%）of CRKP were isolated. CRKP was most sensitive to tigecycline（96.2%）. The modified Hodge test showed that 48 strains(90.6%) produced carbapenemases and 15 strains produced metalloβlactamase. MICs of tigecyclineresistant strains detected by instrument were all confirmed as susceptibility by MTS.ConclusionCRKP mainly produce carbapenems in this hospital, some strains can produce two types of different βlactamases; antimicrobial susceptibility testing showed that tigecycline has good antimicrobial activity against CRKP, tigecyclineresistant strains detected by instrument must be confirmed by MTS method.

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ObjectiveTo investigate the hygienic status of large bottles of medical ultrasonic coupling gel in medical institution. MethodsFrom February 2012 to April 2016, microbial contamination of large bottles of medical ultrasonic coupling gel in a women and children’s hospital was investigated and analyzed through onthespot random sampling and detection method. ResultsA total of 170 large bottles of medical ultrasonic coupling gel specimens were collected, 25 specimens were qualified, the qualified rate was 14.71%. Specimens were mainly from inpatient wards(58.24%) and operating departments(21.76%); there was no statistical difference in the qualified rate of specimens in each department(P>0.05). Contamination rates of coupling gel before and after the opening were both>80%, difference was not significant(P>0.05). A total of 145 strains of pathogenic bacteria were isolated, 18 of which were from unopened bottles, and 127 from opened bottles. Burkholderia cepacia was the main strain in both unopened and opened bottles, which accounting for 83.33% and 54.33% respectively，in addition, Pseudomonas aeruginosa and Serratia marcescens were also isolated from opened bottles, both were 15.75%, mixed contamination bacteria all included Serratia marcescens. ConclusionThe total bacteria counts in medical ultrasonic coupling gel in large bottles exceed the standard seriously, the manufacturer should strictly observe the quality control standards, medical institutions should adopt effective cleaning and disinfection measures.

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Melioidosis is a endemic infectious disease caused by Burkholderia pseudomallei, and is considered one of the major causes of fatal pneumonia and sepsis. This paper reports diagnosis and treatment course of one case pulmonary melioidosis, and reviews the related literatures, so to improve clinical workers’ understanding towards melioidosis, avoid misdiagnosis and missed diagnosis.

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ObjectiveTo understand the epidemiological and clinical features of Brucella infection outbreak, provide basis for the timely diagnosis, prevention and control of brucellosis. MethodsEpidemiological history, clinical symptoms and  signs, auxiliary examination, and therapeutic efficacy of 8 patients with brucellosis and admitted to a hospital between December 2015 and April 2016 were analyzed retrospectively. ResultsAll 8 patients had touched stray sheep and participated in the butchering, all were male patients, with the average age of 50 years; all patients had sweating, fatigue and other symptoms, 7 had a fever, 6 were with lumbago, 3 with muscular soreness, and 2 had a cough. Brucella was cultivated from blood specimens of 8 patients, the specific antibody titers ranged from 1:200 to 1:1 600. All patients recovered from illness through 6week treatment with rifampin plus levofloxacin, without recurrence after 6month observation. ConclusionClinical manifestations of brucellosis are atypical, history of epidemiology should be carefully inquired, combined with etiology, early diagnosis and early treatment can be performed.

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ObjectiveTo investigate the effectiveness of training at morning shift meeting in improving healthcareassociated infection(HAI) prevention and control among health care workers(HCWs) in newly established hospital departments. MethodsOn July 11-22, 2016, HAI management fulltime personnel performed training for HCWs about HAI prevention and control at morning shift meeting of 8 newly established clinical departments and 1 laboratory, the questionnaire survey was conducted before, immediately after, and 3 months after training, training effectiveness was evaluated. ResultsA total of 239 HCWs were required to receive training, including 85 doctors (35.6%), 150 nurses (62.8%), and 4 technicians (1.7%). The knowledge of HAI prevention and control that most HCWs wanted to know was occupational exposure and occupational precaution（85.6%）；most HCWs wanted to obtain knowledge of HAI through training in their respective department by HAI management fulltime personnel（87.1%）. Total awareness rates of HAI knowledge before, immediately after, and 3 months after training were 45.1%, 96.7%, and 83.9% respectively, difference was significant(P<0.001); comparison among groups showed that HCWs’ awareness in influencing factors of HAI, hand hygiene opportunity, isolation measures, and medical waste classification 3 months after training was significantly lower than immediately after training（all P<0.001）；the average scores of HAI prevention and control knowledge among HCWs immediately after and 3 months after training were both higher than before training(P<0.001); average score of HAI prevention and control knowledge among HCWs 3 months after training was lower than that of immediately after training（P<0.001）. ConclusionThe training at morning shift meeting of clinical departments can improve the awareness of HAI prevention and control knowledge among HCWs.

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ObjectiveTo investigate the therapy and influencing factors for prognosis of ventilatorassociated pneumonia(VAP) caused by multidrugresistant organisms(MDROs). Methods169 patients with VAP who were admitted to a hospital between January 2012 and December 2013 were included in analysis, 125 were in MDRO infection group and 44 in nonMDRO infection group. MDRO infection group was subdivided into MDRA group(n=78, resistant to selected antimicrobial agents) and MDRB group (n=47, sensitive to at least one kind of selected antimicrobial agent). Antimicrobial choice and prognosis between each group were analyzed and compared. Results242 strains of pathogenic bacteria were isolated from airway secretion of VAP patients, 173(71.49%) were MDROs. The major pathogens causing VAP were Klebsiella spp. (n=66), Pseudomonas aeruginosa(n=64), Acinetobacter spp. (n=60), Staphylococcus aureus(n=27), and Escherichia coli (n=17), the percentages of MDROs of above pathogens were 68.18%, 50.00%, 91.67%, 88.89%, and 76.47% respectively. The prognosis of MDRO infection group was poorer than that of nonMDRO infection group, MDRA group had the worst prognosis(P＜0.001). Persistent fever, leukocytosis, and progress of pulmonary inflammation in VAP patients suggested poor prognosis(all P＜0.001)；antimicrobial use in patients with effective therapy was higher than those in a worsened condition  before onset, at the beginning of onset, and after culture of specimens(all P＜0.001), while coma, earlyonset VAP and multiple bacterial infection had no prognostic significance in patients with VAP(all P＞0.05). ConclusionThere is high incidence of MDRO infection in patients with VAP, effective antimicrobial therapy can improve the prognosis.

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ObjectiveTo investigate the healthcareassociated infection(HAI) status, common infection sites, and antimicrobial use in a county hospital in 2011-2015. MethodsWith combination of bedside survey and case history reviewing, HAI among all hospitalized patients at 0:00－24:00 on April 26, 2011, April 25, 2012, May 14, 2013, September 9, 2014, and August 12, 2015 were surveyed, survey data were analyzed by software SPSS17.0. ResultsA total of 5 165 patients participated in 5 surveys of HAI prevalence rate, 132 patients had 138 cases of HAI, prevalence rate and case prevalence rate were 2.56% and 2.67% respectively. Intensive care unit had the highest average HAI prevalence rate(22.58%). Lower respiratory tract was the main HAI site (58.70%), followed by urinary tract (12.32%), upper respiratory tract (10.14%), and skin soft tissue（5.07%）. A total of 45 strains of pathogens were isolated, mainly gramnegative bacteria (n=30, 66.67%). The total usage rate of antimicrobial agents was 45.27%, in 5 prevalence surveys were 61.48%, 43.89%, 37.81%, 39.43%, and 44.79% respectively. The main purpose of antimicrobial use was therapy (including therapy + prevention), accounting for 78.27%； monotherapy accounted for 81.27%. ConclusionThrough prevalence rate survey for 5 consecutive years, HAI management departments can be more comprehensively understand HAI in key departments, key patients, key sites of HAI, and antimicrobial use in this hospital, and provide basis for the formulation and implementation of HAI prevention and control measures according to the actual situation of the hospital.

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ObjectiveTo study the application effectiveness of standard operating procedure (SOP) video in management of minimally invasive device cleaning. MethodsStandard management began to be implemented in a hospital since January 2015, training was mainly conducted with videobased SOP lecture, defect rate of devices, qualified rate of sterilization package, and satisfaction of surgical staff before (in 2014) and after (in 2015) implementing SOP were compared, management efficacy was evaluated. ResultsAfter the implementation of SOP, device defect rate reduced from 6.19% before the implementation to 0.99%, qualified rate of sterilization package increased from 90.03% to 98.34%, satisfaction of surgical staff increased from 80.00% to 97.78%, differences were all statistically significant(all P<0.05). ConclusionThe implementation of SOP management can effectively improve the cleaning quality of surgical devices, reduce defect rate of devices, and improve the learning effect of staff, which is worth to be popularized and applied in clinical practice.

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目的了解不同季节外科手术部位感染发病率及其病原菌构成，为预防与控制手术部位感染提供科学依据。方法对某院2012—2014年开展的胆囊或胆管手术、颅脑手术、阑尾手术、疝手术、直肠或结肠手术5种常见外科手术的病例进行调查和统计分析。结果5 746例手术患者，218例发生切口感染，手术部位感染发病率为3.79%，2012—2014年不同季节5种手术的手术部位感染发病率比较，差异无统计学意义(均P＞0.05)。检出病原菌218株，居前３位的依次为大肠埃希菌（34.86%）、铜绿假单胞菌（22.02%）、金黄色葡萄球菌（16.97%），其中多重耐药菌47株（21.56%），产超广谱β内酰胺酶菌27株（12.39%），耐甲氧西林金黄色葡萄球菌15株（6.88%），多重耐药铜绿假单胞菌5株（2.29%）。结论季节因素对手术部位感染无明显影响。采取完善感染监控体系，进行微生物培养及针对性的应用抗菌药物，改进手术方法等综合性防治措施才是降低手术部位感染发病率的关键。

Abstract:

万古霉素耐药肠球菌（vancomycinresistant enterococcus，VRE）于二十世纪八十年代末第一次被分离，并迅速蔓延至整个美国、欧洲及其他地方［1］。美国国家医疗保健安全网络2009—2010年监测数据显示，多重耐药菌医院感染占所有医院感染的20%，其中VRE占3%［2］。我国某院2011年1月—2013年12月对15 946例住院患者送检的腹腔感染标本进行菌种鉴定及药物敏感性检测，屎肠球菌检出率（15.06%）位居前五，耐万古霉素屎肠球菌占检出多重耐药菌的8.26%［3］。VRE相关疾病发病率增加，治疗费用增加，住院时间延长，VRE血流感染病死率高［2］，是长期透析的肾病患者死亡的主要原因之一［4］，仅次于心血管并发症［5］。万古霉素耐药肠球菌感染形势愈加严重，不同地区VRE流行状况不同，VRE的易感因素包括抗菌药物使用史、住院史、VRE感染患者接触史、VRE定植史，而采用抗菌药物的使用管理、加强环境卫生、积极监测及隔离感染患者等措施，能有效预防VRE感染。本文将VRE的流行现状及其防控措施进行综合概述。

Abstract:

多重耐药菌（multidrugresistant organism，MDRO）是医院重症监护病房（intensive care unit, ICU）患者医院感染的重要病原菌［1］。有效预防和控制MDRO在ICU的传播是医院感染管理的难题之一［2］，许多学者对MDRO医院感染的预防与控制措施及其效果进行了研究，现综述如下。

Abstract: