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Antimicrobial resistance (AMR) is increasing rapidly worldwide［1］. The European Centre for Disease Prevention and Control (ECDC) estimates that 25 000 deaths, 2.5 million extra hospital days, and 1.5 billion extra Euros are associated with AMR infection in Europe each year ［2］. In the United States, according to the Centers for Disease Control and Prevention(CDC), healthcareassociated infections (HAIs) caused by carbapenemresistant Enterobacteriaceae are responsible for 610 deaths annually［3］. Therefore, it’s urgent to prevent and control the spread of AMR.

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ObjectiveTo explore the effect of 5M1E quality analysis toolbased hand hygiene(HH) comprehensive intervention measures on pediatric healthcareassociated infection(HAI).MethodsHH status of 29 health care workers(HCWs) in the pediatric department of a hospital was monitored, AprilJune 2015 was baseline survey stage, 5M1E quality analysis tool was adopted to analyze various factors affecting the compliance rate of pediatric HH, intervention measures began to be taken in June 2015, and compared with HH in July 2015March 2016. The occurrence of HAI between July 2014March 2015 and July 2015March 2016 was compared.ResultsHH compliance rate of HCWs increased from 30.86% in AprilJune 2015 to 81.94% in JanuaryMarch 2016; HH correct rate increased from 68.14% to 93.75%; HH compliance rate and correct rate of HCWs gradually increased（χ2=2 608.626, 630.798，respectively, both P＜0.001）. Qualified rate of detection of HCWs’ HH sampling increased from 20.69% in AprilJune 2015 to 89.66% in JanuaryMarch 2016（χ2=31.957，P＜0.001）. Incidence of HAI decreased from 7.74% in July 2014March 2015 to 3.62% in July 2015March 2016（χ2=46.717，P＜0.001）.ConclusionApplication of 5M1E quality analysis tool in the investigation, analysis, and comprehensive intervention in HCWs’ HH in pediatric department has greatly enhanced HCWs’ HH compliance rate, and reduced the incidence of HAI in pediatric patients.

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ObjectiveTo understand the status of hand hygiene(HH) among patients hospitalized in departments of infectious diseases and their families in Yantai City, and provide reference for HH intervention.MethodsPatients and their families(n=221) in  departments of infectious diseases of secondary and above levels of hospitals as well as infectious diseases hospitals in Yantai in JulyAugust 2015 were selected for questionnaire survey, education and implementation status of HH were investigated; hand bacteriological sampling was performed on some patients and their families (n=62) to investigate effect of handwashing. Results61.99% of patients and their families had received verbal HH education, only 18.55% indicated to have seen health care workers(HCWs) to perform the six step handwashing method; 50.68% of the respondents didn’t understand the six step handwashing method, and 85.52% never performed the six step handwashing, the main reason is that they didn’t know how to perform. 93.21% of patients(n=206) and their families believed that handwashing was important. The cognition of HH opportunities in daily life was relatively higher(61.54%94.51%)，and in hospital environment was relatively lower(36.15%49.23%)，only 36.15% of the families washed hands before left the hospital. Unqualified rate of detection results of sampling of hands of patients with infectious diseases and their families was 83.87%. ConclusionPatients with infectious diseases and their families are deficient in HH knowledge and behavior, medical institutions should carry out systematic and standard HH education to reduce the risk of healthcareassociated infection.

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ObjectiveTo evaluate the effect of patients’ participating supervision on improving nurses’ compliance to hand hygiene(HH) in intensive care unit(ICU).MethodsImplementation of HH of ICU nurses was investigated by field observation and investigation of patients, intervention measures were began to be implemented in February 2016, HH compliance among ICU nurses after(FebruaryMay 2016) and before (November 2015January 2016) intervention was compared.ResultsA total of 81 patients were included in the study, 38 were in preintervention group and 43 were in postintervention group. 52.63%（20/38）in preintervention group and 88.37%（38/43）in postintervention group seen, heard or recalled that nurses had performed HH, difference was significant(χ2=12.67, P＜0.005)；after intervention, HH rates before and after touching a patient, before aseptic procedure, and after touching patient surroundings were all higher than before intervention (all P<0.01).ConclusionPatients’ participation in improving HH compliance of ICU nurses is feasible, and it is worth to be popularized.

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ObjectiveTo carry out hand hygiene(HH) quality control circle(QCC) activity by using WeChat group, improve HH compliance of health care workers(HCWs), and enhance the circle members’ ability to solve problems.MethodsIn June 2015, 11 healthcareassociated infection control professionals in a hospital created HH WeChat group by using cellphones, activity cycle was once every two weeks, professionals analyzed the existing problems, and formulated countermeasures as well as implemented methods by group chat form, circle members introduced and implemented strategies to HCWs in their departments, so as to achieve the implementation effect.ResultsAfter the creating of WeChat QCC, HCWs’ HH compliance increased from 56.71% before activity to 85.94% after activity, difference was statistically significant (χ2=61.928, P<0.05); QCC members’ responsibility, selfconfidence, enthusiasm, harmony degree, team cohesiveness, quality control technique, communication, coordination, and problemsolving skill were all significantly improved.ConclusionApplication of WeChat QCC activity can improve HH compliance of HCWs and the ability of circle members.

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ObjectiveTo understand the cleanliness of hands and uniforms of health care workers（HCWs）while they were working in a hospital.MethodsSpecimens of hands and uniforms of HCWs while they were working were collected and detected.ResultsA total of 342 specimens were collected, 173 were specimens from hands and 169 were from uniforms, the total qualified rate was 78.65%，qualified rates of hands and uniforms were 76.30% and 81.07% respectively. Qualified rates of hands and uniforms of different HCWs were compared respectively, differences were both statistically significant （both P＜0.05）； qualified rates of hands and uniforms of nurses were both highest (87.93% and 92.86% respectively), followed by doctors (75.86% and 87.72% respectively）, while medical auxiliary persons were the lowest（64.91% and 62.50% respectively）. Correlation analysis between qualified rates of hands and uniforms of HCWs in general wards showed that the correlation coefficient was 0.930 (P<0.01).ConclusionCleanliness of hands and uniforms of HCWs needs to be further improved, especially medical auxiliary persons; cleaning frequency and cleanliness standard of HCWs’ uniforms needed to be studied further.

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ObjectiveTo understand hand hygiene(HH) compliance among health care workers(HCWs) and incidence of healthcareassociated infection(HAI) in surgical patients before and after the intervention, analyze the effect of HH on costeffectiveness of HAI. MethodsFrom December 2012June 2014, 78 HCWs in the department of neurosurgery of a hospital were as the intervention objects of HH compliance, 325 patients who underwent craniocerebral clean operation were as the surveyed objects, HH compliance among HCWs, incidence of HAI in surgical patients, cost of HH, and hospitalization expense before and after intervention were compared respectively. ResultsHH compliance among HCWs before and after intervention were 35.24% (216/613) and 73.75%（486/659）respectively (χ2=180.091，P<0.001）; incidence of HAI in surgical patients before and after intervention were 31.85%（50/157）and 18.45%（31/168）respectively（χ2=7.782，P<0.001）. Hospitalization expense before and after intervention were （89 524.90±38 856.70）￥ and （61 401.00±29 237.80）￥ respectively; average length of hospital stay before and after intervention were 36.70 days and 26.90 days respectively（t=3.296, 3.511，respectively, both P＜0.01). ConclusionImproving HH compliance among HCWs can reduce the incidence of HAI and hospitalization cost, and shorten the average length of hospital stay of patients.

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ObjectiveTo investigate the change in antimicrobial susceptibility of Enterococcus faecalis (E. faecalis) and Enterococcus faecium (E. faecium) isolated from clinical urine specimens, so as to provide laboratory evidence for clinical antiinfective treatment.MethodsAntimicrobial susceptibility of E. faecalis and E. faecium isolated from urine specimens from 20 tertiary hosptials in China between 2004 and 2014 were analyzed, drugresistant genes of vancomycinresistant Enterococcus（VRE）were detected with polymerase chain reaction (PCR).ResultsA total of 788 Enterococcus strains were isolated in 2004-2014, 371 strains were E. faecalis strains, 417 were E. faecium strains. Susceptibility rates of E. faecalis to ampicillin, nitrofurantoin, fosfomycin, vancomycin, and teicoplanin were all>90%, susceptibility rates to rifampin, minocycline, and erythromycin were all<20%, there was significant difference in the susceptibility rate of E. faecalis to fosfomycin betwen July 2011June 2012 and July 2009June 2010(P<0.0167). Susceptibility rates of E. faecium to vancomycin and teicoplanin were 96.9% and 97.4% respectively, susceptibility rates to nitrofurantoin, minocycline, and fosfomycin were 41.7%, 51.8%, and 78.2% respectively, susceptibility rates to ampicillin, levofloxacin, rifampicin, and erythromycin were all<10%; susceptibility rates of E. faecium to nitrofurantoin had decreased tendency in different years (any two group comparison, all P<0.0167), susceptibility rates to fosfomycin in July 2011June 2012 and July 2013June 2014 both decreased compared with July 2009June 2010(both P<0.0167），there were no significant changes in antimicrobial usceptibility rates in different years. 14 strains of VRE all carried vanA resistance gene.ConclusionE. faecalis strains isolated from urine are susceptible to ampicillin, nitrofurantoin, and fosfomycin, E. faecium are not susceptible to most antimicrobial agents; E. faecalis and E. faecium are both susceptible to vancomycin and teicoplanin, only a few strains are resistant to antimicrobial agents.

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ObjectiveTo type Streptococcus pneumoniae(S. pneumoniae) isolated from children, and provide scientific basis for the correct selection of S. pneumoniae vaccine.Methods182 strains of S. pneumoniae were collected from Children’s Hospital of Hebei Province in 2014, species of strains were identified by polymerase chain reaction (PCR), types of strains were analyzed with multiplex PCR.ResultsPCR detection showed that cpsA gene amplification of 182 strains were all positive; multiplex PCR detection revealed that except 8 strains were not typed, the main types of the remaining 174 strains were 19 F (n=68, 37.36%）, 19A(n=33, 18.13%）, and 6A/6B (n=26,14.28%）, the other types were 35B, 14, 6C/6D, 23F, 15B/15C, and so on.ConclusionThe main types of 182 strains of S. pneumoniae are 19 F, 19A, and 6A/6B, which provide scientific basis for the correct selection of S. pneumoniae vaccine for this province.

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ObjectiveTo evaluate the incidence of central lineassociated bloodstream infection（CLABSI） among critically ill children, and provide basis for making preventive and control measures. MethodsProspective surveillance was performed to monitor CLABSI among children (including neonates) with central lines in 7 children’s intensive care units(ICUs) from January 2012 to December 2015. ResultsOf 37 712 hospitalized patients, the overall length of hospital stay were 268 531 days, the overall central lineday was 57 639, utilization rate of central line was 21.46%; 126 patients had CLABSI, CLABSI rate per 1 000 central linedays was 2.19, there was no significant difference in the CLABSI rate among each year（P＞0.05）；CLABSI rate in the third quarter was higher than that in other quarters(all P＜0.05，compared with the first quarter，RR［95%CI］=1.98［1.20, 3.29］)；CLABSI rates were different among different types of ICUs, surgical neonatal ICU （SNICU）(6.12/1 000 central linedays) was higher than other types of ICUs (all P<0.05, compared with pediatric ICUs［PICUs］, RR［95%CI］=3.02［1.51-6.04］）. 126 patients with CLABSI were isolated 139 strains of pathogenic bacteria, the main pathogens were Klebsiella pneumoniae (20.86%) and Staphylococcus epidermidis (15.83%). ConclusionCritically ill children in SNICU are high risk population of CLABSI infection, intensified intervention measures should be developed for the department , so as to reduce CLABSI effectively.

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ObjectiveTo investigate the incidence and risk factors of surgical site infection(SSI) in patients with internal fixation surgery for limb fracture. MethodsMedical data of patients with internal fixation surgery for limb fracture in a hospital from January 2013 to January 2016 were collected, 39 patients with SSI following internal fixation was as infection group, according to the 1:2 ratio, 78 patients without SSI following operation during the same period were randomly selected as the control group, risk factors of SSI were analyzed. ResultsAmong 4 125 patients undergoing internal fixation surgery, incidence of SSI was 0.95% (n=39), the positive rate of bacterial culture in infection group was 87.2% (34/39), a total of 38 strains of pathogenic bacteria were isolated, among which 22 were grampositive strains (57.9%), 15（39.5%）were gramnegative strains，1（2.6%） was fungi，Staphylococcus aureus was the main pathogenic bacteria (47.4%), and there were 20 isolates of multidrugresistant organisms. Univariate analysis showed that infection group and control group was significantly different in the following aspects: combined underlying diseases, time from injury to operation≥8 hours, open fracture, multiple fracture, duration of operation≥180 minutes, intraoperative blood loss≥400 mL, allogeneic blood transfusion, duration of postoperative indwelling drainage tube≥5 days, and average length of hospital stay≥14 days (all P＜0.05）. Multivariate logistic regression analysis showed that the following factors were risk factors for SSI following internal fixation surgery for fracture: time from injury to operation≥8 hours, open fracture, duration of operation≥180 minutes, duration of postoperative indwelling drainage tube≥5 days, and average length of hospital stay≥14 days (all P＜0.05）. ConclusionRisk factors for SSI in patients with internal fixation surgery for limb fracture are multiple, reducing risk factors has a positive effect on decreasing the incidence of SSI and improving the cure rate.

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ObjectiveTo understand the epidemic characteristics and regularity of influenza B virus in Guizhou Province, and provide  scientific evidence for the control and prevention of influenza. MethodsResults of reverse transcription polymerase chain reaction(PTPCR) of influenza B virus in Guizhou Province from April 1, 2013 to March 31, 2016 were statistically analyzed. ResultsA total of 1 904 samples were detected influenza B virus by RTPCR, B/Yamagata (By) lineage and B/Victoria (Bv) lineage were 1 215 and 642 respectively. In April 2013March 2014 and April 2014March 2015, the predominant strains of influenza B were both  By lineage, in April 2015March 2016, the predominant strains of influenza B were Bv and By lineages, the epidemic peaks were in winter and spring; there’s a higher positive percentage of influenza B in male, accounting for 56.83%；the highest detection rate of influenza B virus was found in population aged <15 years（70.80%），Bv and By lineages were the highest in the 0~ (42.37%) and 5~ age groups (35.56%) respectively; the main pathogen causing mixed infection was By+Bv (67.65%)，mixed infection with influenza B virus accounted for 95.59%. ConclusionThere are two lineages By and Bv epidemic in Guizhou Province, the epidemic peaks of influenza B are in winter and spring, male cases are higher than female, people under 15 years old are the highrisk group for influenza B, it is of great significance to strengthen the vaccination and surveillance of influenza in low age population.

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ObjectiveTo study the homology characteristics of clinicaly isolated and colonized linezolid（LZD）resistant Enterococcus faecalis (E. faecalis ) strains from a patient.MethodsTen E. faecalis  strains (2 were isolated from urine specimens and 8 were from stool specimens) isolated from a patient with pulmonary infection were performed antimicrobial susceptibility testing, homology of E. faecalis  was determined by pulsedfield gel electrophoresis (PFGE).ResultsBefore and after patients received LZD therapy, 2 E. faecalis  strains isolated form urine specimens were both resistant to LZD (MICs: 8 mg/mL, 16 mg/mL, respectively),  among 8 strains from stool specimens (6 were isolated before therapy, and 2 were isolated after therapy), LZD susceptible, intermediate, and resistant strains were 4, 2, and 2 respectively（MICs: 0.25-12 mg/mL）. 10 strains of E. faecalis  were homologous by PFGE typing. ConclusionIn this case, the detection of E. faecalis  from urinary tract and intestinal tract is homologous, which suggested that LZDresistant Enterococcus may be colonized in vivo for a long time, and may be shift to cause bacterial infection.

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ObjectiveTo introduce practice efficacy and achievement of medical waste management project in medical institutions.MethodsTwenty pilot medical institutions in 6 provinces and 1 520 extended medical institutions in each provinces (municipality, city) in China were selected to perform medical waste management project, the current situation of medical waste management in China was explored to develop a new feasibility plan and practice. Results“ Catalogue of medical waste classification (revised manuscript)” and “Medical waste classification collection list)” were formulated, which enhanced supervision ability of medical and health administration on medical waste management. Medical waste management training system was established, best available techniques/best environmental practices(BAT/BEP）for medical waste management were achieved, cooperation and promotion ability of medical waste management project was strengthened. ConclusionMedical waste management project has made great achievements since it is implemented in medical institutions, the achievement can be used as reference for medical waste management in China.

Abstract:ObjectiveTo investigate the clinical value of serum procalcitonin (PCT) in diagnosis of urinary tract infection(UTI) in elderly patients.Methods114 elderly patients with UTI in the department of infectious diseases of a hospital from January 2013 to December 2014 were analyzed retrospectively, clinical data of patients with abnormal and normal serum PCT were compared, PCT levels in patients with positive and negative blood cultures were compared, PCT receiver operating characteristic (ROC) curve for the diagnosis of bacteremia were drawn.ResultsAmong 114 elderly patients with UTI, 46 were with abnormal PCT, 68 were with normal PCT. In abnormal PCT group, the proportions of patients with highest body temperature within 24 hours of admission, white blood cell count, neutrophil granulocyte percentage, Creactive protein (CRP), blood urea nitrogen（BUN）, creatinine(Cr), and urinary tract obstructive disease were all higher than those with normal PCT (all P<0.05). Among 42 patients with blood culture, PCT level in positive blood culture group(n=12) was higher than negative blood culture group(n=30)(1.93 ［0.57-8.32］ μg/L vs 0.36［0.15-1.01］μg/L, P=0.028）. The area under the ROC curve (AUC) of the patients with bacteremia diagnosed by PCT was 0.72（95%CI：0.54-0.90），at the optimal value of 0.52 g/L, sensitivity, specificity, positive predictive value, and negative predictive value were 83.3%, 63.3%, 47.6%, and 90.5% respectively.ConclusionSerum PCT level can well reflect the severity of elderly patients with UTI, and is of great value in early diagnosis of bacteremia in elderly patients with UTI

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ObjectiveTo observe the blocking efficacy of mother to child transmission (MTCT) in pregnant women with positive human immunodeficiency virus(HIV), and explore proper MTCT blocking mode for acquired immunodeficiency syndrome.MethodsClinical data of 23 HIVpositive pregnant women in a hospital from 2005 to 2015 were retrospectively analyzed.ResultsAll 23 HIVpositive pregnant women received highly active antiretroviral therapy (HAART) and comprehensive intervention for blocking MTCT of HIV. Among these women, 12 got pregnant after receiving HAART, 10 were detected positive HIV in early pregnancy (within 28 weeks) and then received HAART, 1 was detected positive HIV 28 weeks after pregnancy and then received HAART. 23 HIVpositive pregnant women all delivered normal newborns, followup observation of babies found no HIV infection.ConclusionHAART for HIVpositive pregnant women is the key to block MTCT of HIV, combined with preventive medication and artificial feeding of newborns, HAART can effectively prevent MTCT. Mutual blocking mode, such as HAART for HIVpositive pregnant women by specialists, pregnancy checkup, and preventive medicine for infants provided by maternity and child care hospital, is highly efficiency.

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ObjectiveTo study bacteriablocking effect of surgical gowns with new material. MethodsSemiquantitative and qualitative testing methods were used to detect bacteriablocking rates of key sites of surgical gowns(chest and forearm), the detected samples included sample A (composite material, unused）, sample B (composite material, after washing 100 times), and sample C (monolayer material, unused）. ResultsIn semiquantitative testing，the average bacteriablocking rates of three samples were 75.47%, 70.78%, and 73.73% respectively. In qualitative testing，three samples could effectively block the penetration of Staphylococcus aureus under wet condition and Bacillus subtilis var.niger spores under dry condition. ConclusionIn semiquantitative testing, all three kinds of samples had bacteriablocking effect, and the average bacteriablocking rate was> 70%; in qualitative testing, three samples all meet requirements of bacteriablocking effect under wet and dry condition.

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ObjectiveTo evaluate the effect of multidisciplinary intervention on antimicrobial prophylaxis in neurosurgical patients undergoing craniotomy for tumor resection.MethodsBy standardizing preoperative disinfection and surgical procedures, training and education of antimicrobial use, conducting quality control activities, and performing periodic feedback of supervised results, efficacy of improvement of antimicrobial prophylaxis in neurosurgical patients undergoing craniotomy for tumor resection in a hospital was observed.ResultsIn 2013 and 2014, incidences of surgical site infection(SSI) were 7.66%（17/222）and 6.80%（27/397） respectively，there was no significant difference between two groups（χ2 =0.158，P＞0.05）. Prophylactic use of antimicrobial agents in surgical patients were as follows: cefuroxime(n=495), cefazolin(n=103), cefathiamidine(n=9), clindamycin(n=8), and cefotaxime(n=4), types of used antimicrobial agents were rational. In 2014, the implementation rate of necessary intraoperative antimicrobial adding was 95.02%, which was higher than 87.66% in 2013（χ2=7.969，P＜0.05）, 30.73% of patients received antimicrobial prophylaxis for>48 hours, which was lower than 57.66% in 2013, difference was significant（χ2=42.88，P＜0.05）.ConclusionMultiintervention measures, including standard preoperative disinfection and surgical procedures, education and training, quality control circle, and feedback of supervised results can improve standard antimicrobial prophylaxis in neurosurgical patients undergoing craniotomy for tumor resection.

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ObjectiveTo understand occurrence of handfootandmouth disease (HFMD) in Wuchuan Gelao Miao Autonomous County(hereinafter referred to as Wuchuan Autonomous County), and provide scientific basis for making measures of prevention and control of HFMD epidemic. MethodsDescriptive epidemiological method was used to analyze the occurrence of HFMD in Wuchuan Autonomous County in 2009-2014. ResultsIn 2009-2014, a total of 912 cases of HFMD in Wuchuan Autonomous County were reported, reported average incidence was 33.74/100 000, reported annual incidence were 5.83/100 000-87.88/100 000，incidence increased year by year, which peaked in 2014; Durn Town had the highest incidence (88.75/100 000), followed by Bocun Town(59.19/100 000) and Zhennan Town (46.30/100 000). Cases mainly concentrated in AprilJune, incidence in male was higher than female, HFMD mostly occurred in children under 3 years old, EV71 virus was the main pathogen, accounting for 45.05% of the total monitored cases. ConclusionIncidence of HFMD increased year by year in Wuchuan Autonomous County, cases mainly occurred in summer, scattered children are high risk population of HFMD.

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目的了解某院血液病医院住院患者医院感染情况，为有效控制和预防医院感染提供依据。方法采用病历查阅和床旁调查相结合的方法,调查该院2012—2014年血液病住院患者医院感染情况。结果共调查患者1 963例，2012—2014年医院感染现患率分别是20.44%、20.76%、22.70%；感染部位主要以下呼吸道为主（34.50%～36.18%），其次为皮肤与软组织和上呼吸道。检出病原菌207株，其中革兰阴性杆菌139株（67.15%），革兰阳性球菌47株（22.71%），真菌21株（10.14%），主要致病菌为大肠埃希菌（50株）、肺炎克雷伯菌（24株）、铜绿假单胞菌（17株）。医院感染现患率3年均以移植科最高（30.16%～32.69%），其次为白血病科（25.26%～29.35%）和骨髓增生异常综合征（MDS）科（21.95%～25.00%）。血液儿科3年现患率比较，差异有统计学意义（χ2=9.66，P=0.008），其他科室3年现患率比较，差异无统计学意义。多重耐药菌由2012年的12株增加至2014年的22株，以大肠埃希菌为主。结论医院感染现患率较高，大肠埃希菌为主要致病菌和多重耐药菌，应加强对感染高发科室、部位以及重点致病菌感染等高危因素的监测，并采取相应干预措施，减少医院感染。

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大肠埃希菌是肠杆菌科中常见的细菌，为革兰阴性杆菌，能发酵多种糖类产酸、产气。本例患者为大肠埃希菌感染所致背部皮下软组织，脾脏后缘、左肾后方、左侧后腹部、盆腔及左下肢大量积气、积液，其临床表现为气性坏疽，在大肠埃希菌感染病例中实属罕见，故结合文献复习与大家分享，以提高对糖尿病合并产气细菌感染的认识。

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奴卡菌是一种条件致病菌，多见于免疫功能低下的患者。临床上长期使用糖皮质激素、免疫抑制剂、血液透析等患者出现难以控制的感染，要警惕奴卡菌感染的可能。本文对本院收治的1例狼疮性肾炎维持性血液透析患者感染星形奴卡菌致死的病例进行总结分析，以期加强临床医生对此病的认识。

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艰难梭菌（Clostridium difficile, CD）是一种革兰阳性厌氧芽孢杆菌，20世纪80年代发现它是引起抗生素相关性假膜性肠炎的原因之一，由其引起的艰难梭菌感染（Clostridium difficile infection, CDI）现已成为抗生素相关性腹泻的主要原因［12］。CDI可表现为从轻度的自限性腹泻到严重的假膜性肠炎甚至死亡。在过去的十多年中，CD的流行病学情况发生了变化，自2004年起在北美和欧洲相继出现了CD强毒株：NAP1/027/ST1［34］。到2008年，又发现了另一强毒株PCR RT078/NAP 07-08/ST11的传播流行［5］。快速、准确的分子分型对CD暴发流行的早期监测和追踪溯源具有重要意义。本文对常用的CD分型方法及其最新研究进展进行综述。

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目前医院感染已成为威胁住院患者健康的全球性问题［1］。据美国疾病控制与预防中心（Centers for Disease Control and Prevention，CDC）统计［2］，全世界医院感染发生率占住院患者的5%~10%。每年美国有大约7.5万例患者死于医院感染，相关医疗费用近达98亿美元［3］；我国约有400万例患者发生医院感染，直接经济损失超过150亿元［4］。研究表明，约1/3的医院感染可通过实施感染控制进行预防［5］。感染控制专科护士（infection control nurse，ICN）（以下简称“感控护士”）作为医院感染管理人员的主要组成部分，对医院感染的预防、控制和管理起到了至关重要的作用［6］。目前国外感控护士的培养已较成熟，而我国还处于起步阶段。现对国内外感控护士发展、培养教育、资格认证与工作职能进行综述，以期为我国感控专科护理的发展和感控护士的培养提供参考依据。

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