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ObjectiveTo understand the changing characteristics of drug concentration in the serum and cerebrospinal fluid(CSF) after intravenous (IV) drip of norvancomycin in patients after neurosurgery procedure. MethodsPatients with surgical cavity/ventricular drainages after neurosurgery procedure in a hospital in  2014 were selected, and they were divided into 2 groups according to the administration modes (12 in each group), conventional administration group: 0.8 g  norvancomycin IV drip for 60 minutes, repeated every 12 hours; continuous administration group, 0.8 g norvancomycin, IV drip for 60 minutes, followed by 0.4 g of IV drip for 11 hours, then 0.4 g for 12 hours, serum and CSF specimens were collected at different time points after administration, concentration of norvancomycin was determined. ResultsSerum norvancomycin concentration reached a peak of （55.52±26.04） and （59.22±41.88） mg/L in conventional administration group and continuous administration group respectively, 24hour serum concentration were （8.21±6.04） and （9.11±5.09）mg/L respectively；CSF norvancomycin concentration reached a peak of （16.31±11.15） and （8.82±8.91）mg/L in conventional administration group and continuous administration group respectively, 24hour CSF concentration were （6.12±2.34）and （5.71±4.72）mg/L respectively； CSF penetration rate of conventional administration group was calculated by ratio of area under curve (AUCCSF/AUCserum), at 0-12 and 12-24 h hour were 63.3% and 59.0% respectively；in continuous administration group were 25.4% and 47.4% respectively. According to 95% of the minimum inhibitory concentration (MIC90) 2 mg/L of target bacteria methicillinresistant Staphylococcus aureus (MRSA), AUC0-24/MIC90 in conventional administration group and continuous administration group were 192 and 184 respectively. ConclusionFor patients who receives early use of standard dose of norvancomycin after neurosurgery procedure, CSF drug concentration after convention and continuous administration of norvancomycin can both reach MIC90 against target bacteria.

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ObjectiveTo investigate the age distribution and types of human papillomavirus (HPV) cervical infection in patients in Wuhan region, so as to provide scientific basis for the prevention and treatment of HPV infection and cervical cancer. Methods9 915 exfoliated cervical cell specimens from patients in Wuhan Medical and Health Center for Women and Children between January 2015 and March 2016 were performed HPV genotyping (21 subtypes), clinical data of 1 732 HPV positive cases were statistically analyzed. ResultsHPVpositive rates in ≤25, 26～, 36～, 46～, and ≥56 age groups were 22.15%, 15.90%, 17.04%, 19.97%, and 17.57%，respectively (χ2=36.587，P＜0.01)，HPVpositive rates in ≤25 and 46～ age groups were both higher than other age groups. There were significant differences in single infection and multiple infection rates among different age groups respectively（χ2=14.39, 36.51，respectively, both P＜0.05），single infection rate was highest in 46～ and ≤25 age groups (15.41% and 15.24% respectively)；multiple infection rates was highest in ≤25 and ≥56 age groups (6.90% and 5.86% respectively). The percentage of single infection and multiple infection were 75.58% and 24.42% respectively, the major single infection type was HPV highrisk subtype （84.34%），the major multiple infection types were highrisk and highrisk compound subtype as well as highrisk and lowrisk compound subtype, accounting for 60.52% and 38.77% respectively. The main single infection types were HPV highrisk subtypes 33, 68, 31 and 16, as well as and lowrisk subtype 11, the ratios of single infection to multiple infection were 3.13, 2.03, 1.71, 1.67 and 2.00 respectively. ConclusionCervical infection rates in women in Wuhan region is high in ≤25 and 46～ age groups, there are differences in the distribution of different HPV subtypes of single infection and multiple infection.

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ObjectiveTo study the resistance mechanisms of carbapenemresistant Enterobacteriaceae(CRE) to carbapenems and cephalosporins, and provide molecular evidence for the treatment of CRE infection and control of healthcareassociated infection.MethodsClinically isolated bacteria in 2014-2015 were identified and performed antimicrobial susceptibility testing by MicroScan Walkaway40 plus system, encoding genes of carbapenems（blaNDM1 and blaKPC2） and encoding genes of extendedspectrum βlactamases （blaTEM, blaSHV, blaCTXM1like, blaCTXM2like, blaCTXM8like, and blaCTXM9like）were detected, multidrugresistance organismrelated class I integron encoding gene blainT1 was also detected. ResultsSeven CRE strains were isolated in 2014-2015, isolation rate was 0.30%, strain 16 was Klebsiella pneumoniae, strains 7 was Citrobacter freundii, all 7 strains were resistant to βlactamase inhibitor compound, cephalosporins, cephamicins, and carbapenems, 3 strains were sensitive to amikacin and tetracycline, 2 strains were sensitive to compound sulfamethoxazole. 3, 2, 5, 7, 1, 4, and 5 strains of CRE were detected carrying blaNDM1， blaKPC2， blaTEM， blaSHV，blaCTXM1like， blaCTXM9like，and blainT1 respectively, no strain was found to carry blaCTXM2like and blaCTXM8like genes. ConclusionblaNDM1 and blaKPC2 are important mechanisms leading to carbapenem resistance of 7 CRE strains; blaTEM, blaSHV, and blaCTXM9like are important mechanism leading to cephalosporin resistance, blainT1 plays an important role in multidrugresistance to CRE and spread of multidrugresistant genes.

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ObjectiveTo systematically evaluate the risk factors for hospitalacquired pneumonia(HAP) in patients in departments of neurosurgery.MethodsLiteratures about the risk factors for HAP in patients in departments of neurosurgery published at home and abroad between 2001 and 2016 were retrieved, the standard clinical data were selected for Meta analysis, the combined OR value for each factor was calculated. ResultsA total of 7 literatures (3 250 studied objects) were included in the study. Publication bias was excluded, a total of 8 factors were statistically significant, which including age （OR, 1.68 ［95% CI, 1.16-2.11］）, endotracheal intubation or tracheotomy（OR, 11.31 ［95% CI, 9.14-13.63］）, disturbance of consciousness（OR, 12.74 ［95% CI, 10.63-15.91］）, length of hospital stay（OR, 2.36 ［95% CI, 1.42-4.81］）, underlying diseases（OR, 3.17 ［95% CI, 2.18-5.24］）, use of ventilator（OR, 2.38 ［95% CI, 1.56-4.32］）, nutritional status（OR, 4.92 ［95% CI, 2.69-6.47］）, and invasive procedure（OR, 2.13 ［95%CI, 1.34-3.86］）. ConclusionRisk factors for HAP in patients in departments of neurosurgery are age, endotracheal intubation or tracheotomy, disturbance of consciousness, length of hospital stay, underlying diseases, use of ventilator, nutritional status, and invasive procedure. While smoking, gender, and types of surgery are not identified as risk factors for HAP in patients in departments of neurosurgery.

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ObjectiveTo explore clinical features and antimicrobial resistance of Klebsiella pneumoniae (K. pneumoniae) lower respiratory tract infection(LRTI) in children. MethodsClinical data of 107 children with K. pneumoniae LRTI confirmed by sputum culture from January to December 2015 were analyzed retrospectively. Results62.62% of children with LRTI were aged less than 6 months and 64.49% episodes occurred in autumn and winter. All cases had cough and 39 had fever, the main complications were type I respiratory failure, type Ⅱ respiratory failure, cardiac insufficiency, and electrolyte disturbance, 39 cases（36.45%） had complications involving two systems, 5 cases（4.67%）had complications involving three systems，47 cases (43.93%) met the diagnostic criteria of severe pneumonia. 43 cases (40.19%) had primary underlying diseases, the major were congenital heart disease, preterm and low birth weight, and malnutrition. Children with imipenemresistant bacteria infection were more prone to develop extrapulmonary complications than those with nonresistant pathogenic infection. The resistance rate of K. pneumoniae to amikacin was the lowest(9.35%). 90 cases were recovered and markedly effective, 11 cases were effective, 4 cases were not healed and voluntarily discharged from hospital, and 2 cases died. ConclusionChildren aged less than 6 months and with underlying diseases are prone to develop LRTI, and complications are more.

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ObjectiveTo study the correlation between lactate/albumin ratio level and incidence of multiple organ dysfunction syndrome (MODS) as well as mortality in patients with severe sepsis or septic shock.MethodsIn January 2012September 2013, 54 patients who were admitted to the intensive care unit(ICU) of a hospital developed severe sepsis and septic shock on the first day of admission, clinical data of patients were analyzed. ResultsOn the first and second days of admission, 30（55.56%）and 26（53.06%）patients developed MODS；lactate/albumin ratio between MODS group and nonMODS group on the first and second days of admission were both significantly different (both P＜0.05). Multivariate logistic regression analysis showed that lactate/albumin ratio, oxygenation index (PaO2/FiO2), as well as acute physiology and chronic health evaluation (APACHE Ⅱ) were independent risk factors for predicting MODS in patients with severe sepsis. Lactate/albumin ratios between MODS group and nonMODS group, death group and nondeath group were both significantly different (both P＜0.05); lactate/albumin ratio was correlated with APACHE Ⅱand PaO2/FiO2, the higher the APACHE Ⅱ score and the lower the PaO2/FiO2, the higher of lactate/albumin ratio. The area under the receiver operating curve (ROC curve) analysis showed that incidence and mortality of MODS on the first day of admission predicted by lactate /albumin ratio were 0.85 and 0.84 respectively; sensitivity, specificity, positive predictive value, and negative predictive value of occurrence of MODS predicted by lactate /albumin ratio＞1.735 were 80.00%, 79.17%, 82.67%, and 75.92% respectively, sensitivity, specificity, positive predictive value, and negative predictive value of mortality were 100.00%, 51.02%, 17.23%, and 100.00% respectively. ConclusionLactate/albumin ratio level is closely correlated with incidence and mortality of MODS in patients with severe sepsis or septic shock.

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ObjectiveTo investigate hand hygiene(HH) status among health care workers(HCWs) in municipal hospitals in Chongqing City, and provide the basis for making effective HH management strategies. MethodsIn AprilJune 2016, HH status among 111 HCWs in 24 municipal hospitals of this city were investigated through questionnaire survey, onsite observation, and hand surface sampling.ResultsAll surveyed departments are installed special hand washing facilities, all surveyed HCWs were performed HH through handwashing by running water. The proportion of HCWs’ handwashing by disinfectant was higher than sixstep hand washing (73.87% ［n=82］ vs 37.84%［n=42］, χ2=29.23, P＜0.01）；the implementation rate of HH before touching patient was higher than that after touching patients ( 99.10%［n=110］ vs 89.19%［n=99］, χ2= 9.88, P＜0.01）. During the process of diagnosis and treatment activities, the maximal total number of bacteria on the surface of hand before and after HH were 475 CFU/cm2 and 85 CFU/cm2 respectively, hand surface colony count after HH was higher than before HH（P＜0.01）.  Age, gender, department, and occupation are important factors influencing HH. The total number of bacteria on hand surface of nurses was higher than nonnurse HCWs, the total number of bacteria on hand surface of female, nurses, and HCWs in class I environment were all higher than male, nonnurse HCWs and HCWs in other types of environment, there were significant difference among the groups （all P＜0.05）. Qualified rates of HH of each group improved after hand washing, the total number of bacterial colony on hands of HCWs all decreased. ConclusionHand washing facilities and HH efficacy are good in Chongqing municipal hospitals, however，HH compliance needs to be improved among HCWs aged≥35 years，male HCWs， HCWs in class III and IV environmental departments, as well as nonnurse HCWs.

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ObjectiveTo survey the clinical application of glycopeptide antibiotics in hospitalized patients, and evaluate the rationality of drug use, so as to provide reference for rational clinical drug use. MethodsA retrospective study was conducted to investigate the application of glycopeptide antibiotics among inpatients in a hospital from January to December in 2014, relevant clinical data were recorded. ResultsA total of 727 cases were included , 471 (64.79%) of which were infected cases. Respiratory tract infection was the main site of both healthcareassociated infection and communityassociated infection (39.17% and 45.98%, respectively). The average days of glycopeptide antibiotic use were 6.06 day (4 403/727). Patients who used glycopeptide antibiotics were mainly from intensive care unit, department of oncology, and department of neurosurgery, accounting for 20.36%(n=148) , 12.10%(n=88), and 11.14%(n=81) respectively. Glycopeptide was used in 338 patients（46.49%），the average types of combined use was 4.43, triple and above was used in 99 patients（13.62%），combination of the second generation cephalosporins was the highest(20.48%）. 450（61.90%） patients used vancomycin, 260（35.76%）used teicoplanin，17（2.34%）used both vancomycin and teicoplanin. A total of 847 pathogenic strains were isolated, the major were Acinetobacter baumannii (n=111, 13.10%), Klebsiella pneumoniae (n=80, 9.45%), Pseudomonas aeruginosa (n=68, 8.03%), and Staphylococcus aureus (n=54 , 6.37%), methicillinresistant Staphylococcus aureus was 50 strains. 490 (67.40%) patients treated with glycopeptide antibiotics were effective. Of 727 patients, 86 (11.83%) used antibiotics rationally, 315（43.33%） basically rational，and 326 (44.84%) irrationally. ConclusionApplication of glycopeptide antibiotics in this hospital is basically rational, but indications should be paid attention.

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ObjectiveTo understand the awareness rate of pulmonary tuberculosis(TB) prevention and control among residents in Beijing, so as to provide basis for giving publicity on knowledge of pulmonary tuberculosis prevention and control. MethodsResidents in Beijing were randomly selected for questionnaire survey, the main content of questionnaire included “The 2006 national survey on knowledge, attitudes and practice about tuberculosis prevention and control”, the core knowledge of pulmonary TB prevention and control, as well as the related symptoms of suspected tuberculosis were also included. ResultsA total of 520 questionnaires were collected, 503 of which were qualified, the effective rate was 96.73%. Among respondents, the total awareness rate of five core knowledge about pulmonary TB prevention and control was 40.87%, 78.93% of the respondents knew that pulmonary TB was a chronic respiratory infectious disease which could seriously damage people’s health，48.51% knew that the majority of patients with pulmonary TB could be cured as long as they persisted in correct treatment, only 19.68% knew that examination and treatment of pulmonary TB in the county (district) level TB control institutions could enjoyed national free policy. Nearly 53.48% of respondents knew 4 or more suspected pulmonary TB symptoms, only 7.36% of respondents could recognize all eight symptoms of pulmonary TB. ConclusionResidents in Beijing have low awareness of pulmonary TB prevention and control knowledge. If patients in the early stage of pulmonary TB can not identify symptoms, it is not only delay treatment and increase the spread of tuberculosis, but also induce the transmission of multidrugresistant Mycobacterium tuberculosis, so produce more challenges to pulmonary TB prevention and control.

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ObjectiveTo investigate the current situation of healthcareassociated infection（HAI）in hospitals in Yunnan Province in 2015, and provide basis for formulating HAI control measures. MethodsA crosssectional survey on HAI prevalence rate , antimicrobial use，and pathogenic detection in 116 hospitals in Yunnan Province were conducted by combined methods of bedside survey and medical record reviewing. ResultsA total of 64 386 hospitalized patients participated in the survey, the prevalence rate of HAI was 2.11%(n=1 357), and case prevalence rate was 2.29%(n=1 476).  Difference in prevalence rates of HAI, antimicrobial usage rates, and pathogenic  detection among hospitals of different beds were all significant（all  P ＜0.01）.  The top 3 departments of HAI distribution were intensive care units(20.99%), burn departments（8.00%）, and hematology departments (7.34%) ; the main infection site was lower respiratory tract(42.68%);  HAI mainly caused by gramnegative bacteria（69.28%）, the major were Escherichia coli , Klebsiella pneumoniae, and Pseudomonas aeruginosa. Antimicrobial usage rate at the survey day was 35.62 %, bacterial detection rate in patients receiving therapeutic antimicrobial use was 59.56%.  ConclusionThe crosssectional survey on prevalence of HAI is helpful for understanding the current status of HAI, calculation of the percentile distribution of each index can promote selfevaluation for HAIrelated work in each hospital.
［Key words］healthcareassociated infection; crosssectional survey; prevalence rate; antimicrobial agent; pathogen

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ObjectiveTo investigate the diagnostic value of combined detection of procalcitonin (PCT), Creactive protein (CRP), white blood cell (WBC), and neutrophil percentage (NEU%) in bloodstream infection with grampositive coccus(G+), gramnegative bacillus (G- ）and fungus. MethodsDetection results of positive blood culture of 389 patients in a hospital between January 2014 and December 2015 were analyzed retrospectively, according to the results of blood culture, patients were divided into G+ coccus, G- bacillus and fungal bloodstream infection groups, inflammatory indicators of different groups of patients were compared. ResultsMannWhitney U test revealed that PCT level of G- infection group was higher than that of G+ and fungal infection group (comparison between G- infection group and G+ infection group : Z=-2.68，P＜0.01；comparison between G- infection group and fungal infection group: Z=-2.46，P＜0.05）. If PCT≥0.5 ng/mL, CRP≥5.0 mg/L, NEU%≥70% and WBC≥10×109/L were as the cutoff point, statistical analysis revealed the positive rate of PCT in G- infection group was higher than that in G+ and fungal infection group(comparison between G- infection group and G+ infection group：χ2=5.94，P＜0.05；comparison between G- infection group and fungal infection group：χ2=7.721，P＜0.01）；the positive rate of CRP in G- infection group was higher than that in G+ infection group (χ2=5.03，P＜0.05）. Binary logistic regression was adopted to analyze the efficacy of four indicators for the differentiation of bloodstream infection caused by G+ coccus,   G- bacillus, and fungus, only PCT had significant difference in the identification of bloodstream infection caused by G- bacillus, G+ coccus and fungus(P<0.01). ConclusionPCT has high accuracy in differentiating G- bacillus, G+ coccus, and fungus of blood culture, dynamic monitoring of PCT combined with detection results of CRP, WBC, and NEU%, patient’s condition can be judged rapidly, and antimicrobial agents can be used rationally, so the mortality of patients with bloodstream infection can be reduced.

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ObjectiveTo carry out patients’ participation in promoting health care workers(HCWs) to improve hand hygiene (HH) compliance in the outpatient transfusion room, obtain real data of HH, and further provide basis for performing the activity in the whole hospital. MethodsHH compliance of nurses in outpatient transfusion room during four stages was observed by using the healthcareassociated infection control toolkit mobile phone APP. Intervention was not implemented at the first stage, HH promotion was implemented at the second stage, simulation of patients participated in promoting HCWs to improve HH compliance was performed at the third stage, and patients actually participated in promoting HCWs to improve HH compliance at the fourth stage. A questionnaire about patients’ willingness to participate in the promotion of HCWs to improve HH compliance was developed and filled out by patients and nurses. ResultsHH compliance rates of nurses in transfusion room at four stages were 21.43%, 44.27%, 61.48%, and 82.88% respectively, differences was significant（χ2=110.35，P＜0.01）; HH correct rates at four stages were 44.44%, 74.14%, 81.33%, and 81.82% respectively, differences was significant（χ2=18.50，P＜0.01）. ConclusionPatients participating in promotion of HH can significantly improve HH compliance of HCWs, which is simple and effective, and worth to be popularized.

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ObjectiveTo analyze the clinical characteristics and therapy of Nocardia infection, and provide reference for clinical practice．MethodsPatients with positive specimen culture of Nocardia from May 2014 to June 2016 were surveyed retrospectively, the body status, clinical features, therapeutic regimen, and prognosis were analyzed. ResultsA total of 10 cases of Nocardia infection were surveyed, there were 7 males and 3 females; average age was (49.90+13.75) years old. Nocardia infection occurred mostly in population with impaired immune status or underlying diseases, the main infection site was lung, compound sulfamethoxazole was the first choice drug for treatment of infection, amikacin, imipenem/cilastatin and so on were alternative choice according to disease condition, 8 patients all improved after therapy.ConclusionThe diagnosis made on the basis of microbiological examination, imaging, and pathological examination, combined with comprehensive judgment according to risk factors of Nocardia infection, patient can be treated timely and rationally, and the prognosis is better.

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Streptococcus dysgalactiae subspecies equisimilis (SDSE) belongs to group C or group G βhemolytic Streptococcus, SDSE infection cases are mostly related with the consumption of contaminated dairy or meat products, the major symptom is upper respiratory tract infection, and is easily to be misdiagnosed. In June 2014, an outbreak of acute upper respiratory tract infection due to SDSE occurred in a kindergarten in Xi’an City. All cases were followed up, the initial case developed as latent nephritis, the main cause for the development of latent nephritis was not performing diagnosis and treatment timely. In order to enhance the understanding of the epidemiological and clinical features of SDSE infection, strengthen prevention and control ability, and reduce the occurrence of adverse sequelae, investigation of the case and epidemic situation should be reported.
Streptococcus dysgalactiae subspecies equisimilis; latent nephritis; epidemiological survey； foodborne pathogenic bacteria

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ObjectiveTo understand multidrugresistant organism (MDRO) healthcareassociated infection(HAI) in patients with malignant tumor, so as to provide basis for making HAI prevention and control measures. MethodsTargeted surveillance method was used to survey MDRO HAI in patients with malignant tumor in a hospital from January 1 to December 31, 2014, WHONET 5. 3 software was used to analyze the data. ResultsA total of 54 056 patients with malignant tumor were surveyed, HAI occurred in 3 542  (6.55%) patients, 847（23.91%）of  which were MDRO HAI. Most patients(54.55%) with MDRO HAI were >60 years old. A total of 2 606 bacterial strains were isolated from patients with HAI, 847 (32.50%) of which were MDROs, and most were extendedspectrum betalactamases (ESBLs)producing Escherichia coli (n=459, 54.19%）. The major site of MDRO HAI was lower respiratory tract (47.34%). The top 3 departments of detection of MDROs were departments of thoracic surgery（17.12%）, colorectal and anal surgery（9.92%）, and general surgery (8.26%). ConclusionIncidence of MDRO HAI is higher in patients with malignant tumor, surveillance of high risk population and monitoring of antimicrobial resistance of pathogens should be strengthened, so as to reduce the occurrence of HAI.

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ObjectiveTo investigate the current status of hand hygiene(HH) among health care workers(HCWs) in clinical laboratories in medical institutions in Xi’an City. MethodsHH status of HCWs in clinical laboratories in medical institutions in Xi’an was performed random onthespot sampling and monitoring. ResultsA total of 240 HH specimens of HCWs in clinical laboratories in 80 medical institutions in Xi’an City were collected, 127 detected results were qualified, the total qualified rate was 52.92%. The qualified rates of medical institutions were as follows: municipal hospitals 62.67%，workers’ hospitals 55.95%，private hospitals 40.74%；comprehensive medical institutions 67.68%，specialized medical institutions 42.55%；tertiary medical institutions 79.63%（n=43），secondary and below medical institutions 45.16%（n=84），there were significant differences in HH qualified rate among HCWs in different types of medical institutions（all P＜0.01）. Of different HH detection items, detection rates of Escherichia coli and Staphylococcus aureus were 0.83% and 8.33% respectively. There were significant differences in HH compliance rates among HCWs of all age groups(χ2=9.103，P<0.05), HCWs aged≥50 years had the highest qualified rate of HH（71.43%）, followed by those aged＜30 years (67.82%)，HCWs in 40～ year age group had the lowest HH qualified rate (39.66%). ConclusionThe qualified rate of HH of HCWs in clinical laboratory of medical institutions in Xi’an City is low, it is necessary to enhance the procaution awareness of HCWs in clinical laboratories, strengthen quality control of HH, strictly implement standard handwashing procedures to reduce occurrence of HAI.

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ObjectiveTo establish an epidemic dynamics model of the transmission and prevention strategies of rotavirus infection in hospital.MethodsRotavirus SEIR model based on different isolation measures was constructed using epidemic dynamics method, the effectiveness of isolation measures was evaluated.ResultsSupposing that all patients were isolated, isolation measures were taken on the 3rd day of transmission, there were 4.3 cases of infection on the 5th day of transmission, peaked on the 7th  day(n=6.4), until the 14th  day of transmission, the number of infected persons fell to 3.4 cases. If isolation measures were taken on the 2nd day of transmission, the infected persons reached 4.0 on the 6th day, and reduced to 3.2 cases on the 8th day. If isolation measures were taken on the 1st day of transmission, the infected persons reached 2.4 at most,  healthcareassociated infection would not occur. Early isolation can effectively prevent the outbreak of rotavirus infection, the later the isolation, the more the infection occurs and the longer the outbreak lasts.ConclusionRotavirus infection can easily break out in hospital, early discovery and early isolation of rotavirus infected child is the effective measure to avoid rotavirus infection outbreak in hospital.

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目的评价不同清洁方法对儿童雾化器的清洁效果。方法随机抽取某院门诊雾化中心进行雾化吸入治疗的患儿27例，以及同期入住该院呼吸内科且每日至少接受2次雾化吸入治疗的患儿30例（分为对照组：雾化器由家属自行清洗和保存；干预A组：雾化器由指定医务人员统一清洗；干预B组：统一回收后浸泡于含少量清洗剂的温水中5 min，其余步骤同干预A组），比较不同部位、不同使用时间、不同分组雾化器的细菌菌落数。结果雾化吸入治疗的第1天、第2天，以及≥3 d门诊患儿雾化器不同部位均报告有大量的细菌菌落数，其中以雾化器面罩内壁污染最重（中位数：1 250～1 775.00 CFU）。对照组住院患儿不同时间（雾化第1、3、5、7天）雾化器面罩内壁和储药杯内壁平均细菌菌落数（中位数分别为：100.00～625.00、50.00～625.00 CFU）均高于干预A、B组（中位数：0.00～12.50 CFU）；对照组、干预A组、干预B组患儿空气导管接口的平均细菌菌落数（中位数：0.00～25.00 CFU）比较，干预A组和B组间平均细菌菌落数比较，差异均无统计学意义（均P＜0.05）。结论规范的清洁保存可降低雾化器细菌污染程度,使用清水冲洗，不加用清洗剂，也可保证雾化器的清洁效果。

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目的提高隔夜手术器械的清洗质量。方法将2014年11月10—14日某院隔夜手术器械随机分为3组，每组各700件，常规组（直接使用全自动单舱清洗消毒器清洗）、试验A组和B组（分别将器械置于多酶、碱性含酶清洗液中超声5 min，再放入全自动单舱清洗消毒器清洗），比较3组方法的清洗效果。结果常规组、试验A组和试验B组三组器械的清洗合格率依次为74.14%、87.57%、96.86%，差异有统计学意义（χ2=153.39，P＜0.05），试验B组合格率高于常规组和试验A组。结论将隔夜手术器械置于碱性含酶清洗液超声清洗后再使用全自动清洗消毒器清洗是隔夜手术器械理想的清洗方法。

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目的调查分析某院重症监护病房（ICU）和普通病房医护人员手卫生依从性差异。方法对某院2015年8月临床科室在岗的医生及护士进行手卫生依从性调查。结果共调查医护人员手卫生指征5 109次，执行手卫生3 745次，依从率73.30%。ICU医护人员手卫生依从率为92.24%（1 319/1 430），普通病房医护人员手卫生依从率为65.94%（2 426/3 679），ICU医护人员手卫生依从率高于普通病房，差异有统计学意义（χ2=52.772，P＜0.001）。接触患者前、接触患者后及接触患者周围环境物品后3个时刻ICU医护人员的手卫生依从率均高于普通病房（χ2值分别为12.264、6.650、37.430，均P＜0.05）。结论ICU与普通病房医护人员手卫生依从性存在差异，需有针对性的采取措施提高手卫生依从性。

Abstract:

随着医疗技术的快速发展，各种医用材料和侵入性操作技术在临床广泛应用，广谱抗菌药物、糖皮质激素和免疫抑制剂在临床的大量使用，医院内真菌感染的比例越来越高，其中白假丝酵母菌在真菌感染中所占比例最高，是临床中常见的致病菌之一。白假丝酵母菌主要引起皮肤、黏膜的浅表部位感染，侵袭性呼吸系统感染和血流感染等，其中血流感染相对严重，如白假丝酵母菌血症。早在二十世纪八十年代，Pfaller等［1］报道，侵袭性假丝酵母菌感染的发病率有上升趋势，应引起临床医生的重视。近十几年，假丝酵母菌在美国和欧洲引起医院感染的致病菌中分别占第四位和第六位［2］。在亚洲假丝酵母菌引起医院感染的发病率也相对较高［3］。尽管有较多抗真菌药物可以用来治疗侵袭性假丝酵母菌感染，但其病死率仍然在30%左右［23］。利用分子生物学的方法，可以对假丝酵母菌进行同源性分析和查找传播途径。从而为制定预防和控制假丝酵母菌医院感染流行、传播的有效措施提供理论依据。

Abstract:

医务人员职业暴露是指在工作过程中，发生针刺伤、锐器伤或破损皮肤黏膜接触患者血液、体液等，从而增加感染的机会［1］。助产士是职业暴露的高危群体之一［2］，在最有职业危害的相关科室中，分娩室位于第2位。这是由于助产士的服务对象均为分娩的孕产妇，在进行各项操作时，容易接触到产妇的血液、体液、羊水以及分泌物。2011年《中国护理事业发展规划纲要（2011—2015年）》提出需规范化加大培养临床专科护士，而目前我国每1 000人口中仅0.04名专职助产士、0.05名专职和兼职助产士、0.09名助产技术人员［3］，数量远低于其他国家。随着二胎政策的逐步放开，助产士已成为产科的核心力量之一。本文综述近年来有关国内外助产士职业暴露情况及研究进展，以期为临床助产士的职业防护提供依据。

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