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ObjectiveTo investigate the clinical distribution and antimicrobial resistance characteristics of carbapenemresistant Acinetobacter baumannii (CRAB). MethodsCRAB isolated from all inpatients in a hospital in JanuaryDecember 2015 were performed retrospective analysis, antimicrobial susceptibility testing result was analyzed.ResultsA total of 721 AB strains were detected, 231 (32.04%) of which were CRAB, isolation rates of CRAB in quarter 1-4 were 48.99% (73/149), 41.98%（68/162）, 27.39%（63/230）, and 15.00%（27/180）respectively, which showed a decreased trend （P＜0.001）. CRAB mainly came from sputum specimen(n=140, 60.61%), followed by secretion of wound（n=33, 14.28%）and urine specimen(n=24，10.39%）. CRAB mainly distributed in intensive care unit, accounting for 43.72%(n=101), following by department of neurosurgery(n=37, 16.02%) , and burn/plastic surgery (n=22, 9.52%). Resistance rates of CRAB to ampicillin/sulbactam, gentamicin, levofloxacin, and ciprofloxacin were 85.28%-90.48%，resistance rate to tobramycin was low (19.48%），no strains were found to be resistant to polymyxin B. ConclusionAntimicrobial resistance of CRAB is serious, it is necessary to focus on management of key departments, take scientific prevention and control measures, so as to effectively reduce the incidence of healthcareassociated infection.

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ObjectiveTo compare distribution and antimicrobial resistance of methicillinsensitive Staphylococcus aureus(MSSA) and methicillinresistant Staphylococcus aureus(MRSA) in hospitalized children, and provide reference for empirical use of antimicrobial agents. MethodsIsolation and clinical data of Staphylococcus aureus( S. aureus) from hospitalized children in a hospital during 2011-2015 were analyzed retrospectively, distribution and antimicrobial resistance between MSSA and MRSA were compared.ResultsA total of 919 strains of S. aureus were isolated, 632(68.77% ) of which were MSSA, 287（31.23%）were MRSA. 65.03% of MSSA infection and 64.11% of MRSA infection were in children aged 29 day1 year old. 80.38% of MSSA and 79.09% of MRSA were isolated from sputum specimen. MSSA and MRSA were mainly distributed in department of pediatric respiratory medicine（50.73%, 45.89% respectively） and department of pediatric neurology（22.98%, 26.84% respectively）. Resistance rates of MSSA to antimicrobial agents were<20.00% except penicillin and erythromycin; resistance rates of MRSA to penicillin, oxacillin, erythromycin, and clindamycin were all>40.00%; resistance rates of MRSA to tetracycline, erythromycin, clindamycin, levofloxacin, ciprofloxacin, moxifloxacin, nitrofurantoin, and rifampin were all higher than MSSA. ConclusionMSSA is main S. aureus isolated from hospitalized children, infants under 1 year of age are the main population, the main distribution departments of MSSA and MRSA from respiratory tract specimen are similar, antimicrobial resistance of MRSA is generally higher than that of MSSA.

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ObjectiveTo study the homology and clinical characteristics of healthcareassociated infection(HAI) due to Pseudomonas aeruginosa (P. aeruginosa) in medical intensive care unit (MICU), so as to guide the clinical prevention of P. aeruginosa transmission and improve therapeutic effect. Methods55 P. aeruginosa strains isolated from 25 patients with HAI in the MICU of a hospital in JanuaryDecember 2014 were performed pulsedfield gel electrophoresis (PFGE) homology analysis and clustering analysis, clinical characteristics, antimicrobial resistance, and transmission characteristics were analyzed.ResultsA total of 25 patients were investigated, with an average age of (69.62±2.13) years, mean hospital stay (49.34±3.18) days; prior to the isolation of P. aeruginosa, 84.00% of patients were treated with broadspectrum antimicrobial agents for >2 weeks, 76.00% of patients had been admitted to MICU, and 52.00% had a ventilatorassisted ventilation. 55 strains of P. aeruginosa were mainly A, F, H, K, N, V, and W, which were the main epidemic strains; patients infected with A, F, H and K strains all had cross in their hospital stay； PFGE profiles of  isolates from 4 patients during different periods showed different strain patterns;  resistance rates of P. aeruginosa to ceftazidime (72.73%), piperacillin/tazobactam (70.91%), and imipenem（70.91%） were all high, resistance rate to amikacin was the  lowest(25.45%). ConclusionManagement of antimicrobial agents should be strengthened in medical institutions, HAI control measures should be strengthened, so as to prevent the transmission of multidrugresistant and extensively drugresistant bacteria in hospitals.

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ObjectiveTo investigate antimicrobial resistance of Escherichia coli (E. coli) and Klebsiella pneumoniae(K. pneumoniae), antimicrobial use density(AUD), as well as relation between antimicrobial resistance and AUD in a tertiary firstclass hospital. MethodsAntimicrobial resistance rates of clinicallyisolated E. coli and K. pneumoniae, AUD of carbapenems and quinolones, as well as relation between resistance and AUD in 20132015 were statistically analyzed.ResultsCorrelation analysis of antimicrobial resistance of bacteria and AUD showed that the decrease in resistance rate of E. coli to levofloxacin was related to the decrease in the use density of quinolones（r=0.61，P=0.03）；increase in resistance rate of K. pneumoniae to imipenem was related to the increase in the use density of carbapenems（r=0.78，P＜0.01）. ConclusionAntimicrobial use is one of the causes of bacterial resistance, management on antimicrobial use needs to be strengthened to reduce the threat of bacterial resistance to human health.

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ObjectiveTo understand the global economic burden of diseases due to needle stick injuries(NSIs), obtain relevant evidence, and prompt the relevant departments to pay attention to the precaution of NSIs. MethodsLiteratures about NSIs published from 1990 to May 2016 were searched from PubMed, ScienceDirect, EBSCOhost, Cochrane, CNKI, and Wanfang database. According to world bank inflation rate and currency rate in 2015, cost of needle stick injury in each study was adjusted to US dollars in December 2015, merge comparison analysis was performed.ResultsA total of 7 literatures were included, 3 American studies and 4 studies from Sweden, Korea, Belgium, and Taiwan Region of China respectively. Studies in mainland China only focused on the incidence of NSIs, studies about cost were not found. Two studies did not identify studied population, the remaining 5 studies were about all staff in the medical institutions. Cost analysis method: Of 7 literatures, 3 were firsthand data analysis, 4 were derived from the model. Scope of cost research：4 studies estimated the direct cost，2 calculated direct and indirect cost respectively, only 1 study estimated the summation of direct and indirect cost. The total cost per injury (direct cost + indirect cost) was $747-$2 173, direct and indirect cost were $167-$617 and $322-$455 respectively.ConclusionGlobal economic burden of NSIs is heavy and still undervalued; NSIs occur frequently in China, but attention is inadequate, research on economic burden is lacking, relevant departments should pay attention to the prevention and followup treatment process of NSIs.

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ObjectiveTo understand the direct economic burden of healthcareassociated infection(HAI) due to multidrugresistant organisms(MDROs). MethodsComputer retrieval of CNKI, Wanfang, VIP, PubMed, ScienceDirect, and Cochrane databases on literatures about economic burden of MDRO HAI at home and abroad were performed, the retrieval time was from database establishment to December 2015, systematic evaluation of the literatures was obtained. ResultsAccording to the inclusion and exclusion criteria, as well as through NewcastleOttawa Scale (NOS) for evaluating the literatures, 19 literatures were included. In 12 studies about methicillinresistant Staphylococcus aureus infection, the direct economic cost varied from $916.61 to $62 908.00; in 4 studies about MDRO Acinetobacter baumannii infection, the direct economic cost varied from $4 644.00 to $98 575.00. Direct economic cost due to extendedspectrum βlactamasesproducing Enterobacteriaceae was $2 824.14-$30 093.00. ConclusionMDRO HAI will increase economic cost of both hospitals and patients, prevention and control measures should be taken .

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ObjectiveTo evaluate systematically the effect of ventilator circuit changes on incidence of ventilatorassociated pneumonia(VAP). MethodsLiteratures about the effect of ventilator circuit changes on occurrence of VAP were searched from PubMed, Cochrane Library, CNKI, VIP, and Wanfang database, incidence of VAP in patients who received circuit changes at different intervals was compared, odds ratio (OR) and 95%CI were as effect index of the study, RevMan 5.2 software was used for data analysis. ResultsA total of 12 literatures were included, including 18 003 patients using ventilators. According to the interval of ventilator circuit changes, patients were divided into 1day group (n=191), 2day group(n=8 932), 3day group(n=228), and 7day group(n=8 652). Meta analysis showed that circuit changed every 7 days had a lower risk of VAP than that changed once every day (OR, 3.72［95%CI, 1.50，9.23］）, there was no significant difference in risk of VAP between 7day group and 2day group (OR, 1.17［95%CI, 1.00，1.37］）as well as 7day group and 3day group(OR, 0.77 ［95%CI, 0.49，1.23］）. ConclusionPatients who received circuit changes every 7 days have a lower risk of developing VAP than those who received circuit changes once per day, so change the ventilator circuit in patients with mechanical ventilation every 7 days is more reasonable.

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ObjectiveTo investigate the effect of maximal sterile barrier precaution during deep venous/arterial catheterization on preventing catheterrelated bloodstream infection (CRBSI) in patients in the department of critical care medicine. Methods996 patients who were hospitalized in Beijing Friendship Hospital and underwent deep venous/arterial catheterization from September 2011 to April 2014 were analyzed retrospectively, patients were divided into standard sterile barrier precaution group (SSB group, September 2011December 2012, n=560) and maximal sterile barrier precaution group (MSB group, January 2013April 2014, n=436) based on whether they received maximal sterile barrier precaution, incidence of CRBSI and mortality were compared between two groups. ResultsThere was no statistical difference in constitute of intubation sites between patients in SSB group and MSB group（χ2=6.750，P=0.08）. The incidence of CRBSI per 1 000 catheter days in SSB group and MSB group were 2.41‰（1.64‰-4.02‰）and 1.91‰（0‰-4.56‰）respectively，rank test revealed no significant difference（Z=-0.057，P>0.05）；24 （4.29%）patients in SSB group and 26（5.96%） patients in MSB group developed CRBSI, difference between two groups was not statistically significant（χ2=1.447，P>0.05）. The mortality in SSB group and MSB group were （18.43±5.53）% and （11.68±4.14）% respectively，independent sample ttest revealed that difference was significant（t=3.907，P<0.05）. ConclusionMaximal sterile barrier precaution did not reduce the incidence of CRBSI.

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ObjectiveTo investigate the current status of cleaning and disinfection of digestive endoscopes in the endoscope centers (rooms) of secondary and above medical institutions in Suzhou City, find the existing problems and put forward suggestion for improvement. MethodsOnthespot survey on current status of cleaning and disinfection management for digestive endoscopes in 28 medical institutions(18 tertiary medical institutions, 10 secondary medical institutions) was performed, endoscopes were selected and detected with ATP biofluorescence assay after cleaning and disinfection. ResultsAll 28 surveyed medical institutions had separate endoscope disinfection rooms, 89.29% of which had integrated endoscopic cleaning station, 17.86% had automatic endoscope washer/disinfector; 100% used multienzymatic detergent, chose the right disinfectant, monitored disinfectant concentration every day, and implemented standard disinfection time. But only 39.29% changed multienzymatic detergent for each endoscope, cleaning and disinfection personnel in 78.57% of medical institutions wore personal protective equipment correctly. 77 digestive endoscopes were detected, the qualified rate was 88.31%. ConclusionCleaning and disinfection management of digestive endoscope in secondary and above medical institutions in Suzhou City is generally standardized, there are still some problems in the manipulation procedures, relevant national regulations should be strictly complied with, efficacy of cleaning and disinfection of digestive endoscope should be further improved.

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ObjectiveTo understand current situation of fulltime healthcareassociated infection(HAI) management staff in hospitals in Xianyang, explore the causes of instability of HAI management team. MethodsStratified random sampling method was adopted, hospitals were divided into secondary and tertiary levels, then numbered according to different levels, surveyed hospitals were selected randomly, general condition, professionals, and causes of instability of 52 selected fulltime HAI management staff members in 29 secondary and above hospitals in Xianyang were surveyed. ResultsFulltime HAI management staff were mainly women, accounting for 89.13%; 54.35% of staff were aged 30-50 years; 47.83% had bachelor degree and above; 41.30% had intermediate professional titles; 65.22% were nurses；91.30% engaged in HAI management for <9 years; HAI management staff were statistically different in age and education level（both P<0.05）. 63.04% of fulltime HAI management staff engaged in nursing before engaging in HAI management work; 63.04% engaged in HAI management work according to administrative arrangement, the top three causes for instability of HAI management team were heavy workload（91.30%）, lacking enough attention of leaders（78.26%）, and low pay（63.04%）. ConclusionStructure of HAI management fulltime staff in hospitals in Xianyang is irrational, the main causes for unstable management team is heavy workload, insufficient attention paid by leaders, and low pay.

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ObjectiveTo compare the effect of different ways of water supply and whether or not drain water from waterlines for overnight on bacterial counts in dental unit waterlines(DUWLs). MethodsIn the first phase, 6 sets of DUWLs were randomly divided into 2 groups (external storage tank water supply group and municipal water supply group); in the second phase, 6 sets of DUWLs were all changed to use external storage tank and randomly divided into 2 groups (draining water for overnight group and without draining water for overnight group), bacterial count before and within one week of disinfection  between two groups at two phases were compared respectively. ResultsIn the first phase, handpiece water of DUWLs was most seriously contaminated by bacteria, the average colony count was 4 117 CFU/mL, qualified rate was 15.38%. Before disinfection, no significant difference in bacterial count were found among each groups (all P>0.05), bacterial count of DUWLs of all groups severely exceeded the standard(all >3 000 CFU/mL). Comparison of bacterial count in DUWLs from different water supply routes after disinfection was not significantly different on day 1(P>0.05), but were significantly different at day 27(all P<0.05). On the second day after disinfection, municipal water supply group began to exceed bacteria standard; on the third day after disinfection, external storage tank group began to exceed bacteria standard. Bacterial count in DUWLs after disinfection between draining water for overnight group and without draining water for overnight group was no significantly different on day 1(P>0.05) , but were significantly different on day 2-7(all P<0.05). On the fourth day of disinfection, bacterial count of without draining water for overnight group exceeded standard. On day 7 of disinfection, bacterial count in draining water for overnight group exceeded＞100 CFU/mL. ConclusionUse of external storage tank, daily change of sterile distilled water, and daily emptying water for overnight can effectively reduce bacterial count in DUWLs.

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ObjectiveTo analyze the influencing factors for fungal infection in hospitalized patients with acquired immunodeficiency syndrome( AIDS), and provide basis for taking preventive and control measures. MethodsClinical data of 112 inpatients with AIDS in a tertiary firstclass hospital from January 2010 to October 2015 were analyzed retrospectively, related risk factors were analyzed in patients with fungal infection, univariate analysis was performed by χ2 or t test, and multivariate analysis was performed by logistic regression analysis. ResultsAmong 112 AIDS inpatients, 41(36.61%) had fungal infection. Candida albicans was the main pathogen (n=52, 76.74%) and was mainly isolated from lower respiratory tract (n=29, 42.65%). Univariate analysis showed that invasive procedures, duration of antimicrobial use, combined antimicrobial use, and decreased CD4+ T lymphocyte count in peripheral blood were risk factors for fungal infection in AIDS inpatients(all P<0.05), while oral cleaning care and systemic antiviral therapy were protective factors for fungal infection(all P<0.05); multivariate analysis showed that decreased CD4+ T lymphocyte count in peripheral blood(OR,1.017［95% CI, 1.009-1.025］）and combined antimicrobial use（OR,3.975［95%CI, 1.093-14.448］） were independent risk factors for fungal infection in AIDS inpatients, while systemic antiviral therapy was independent protective factor for fungal infection(OR, 0.288［95%CI,0.099-0.841］）. ConclusionThere are many factors influencing fungal infection in AIDS patients, rational use of antimicrobial agents, systemic antiviral therapy, and increasing serum albumin concentration are main methods to prevent fungal infection, avoid unnecessary invasive procedures and application of preventive antifungal therapy for highrisk patients are also effective to prevent fungal infection.

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ObjectiveTo understand the pathogenic characteristics of intraabdominal infection after appendectomy in patients with appendicitis. MethodsClinical data of patients undergoing appendectomy in a hospital from January 2013 to December 2015 were analyzed retrospectively, pathogenic characteristics, treatment, and prognosis of patients with intraabdominal infection were analyzed. ResultsA total of 431 patients undergoing appendectomy were investigated, 38 (8.82%) developed intraabdominal infection. 36 strains of pathogenic bacteria were isolated, 34 (94.44%) of which were gramnegative bacteria, mainly Escherichia coli(n=29，80.55%）; 2 (5.56%) strains were grampositive bacteria, 1 of which was Staphylococcus aureus, and the other was Enterococcus avium. The resistance rates of 29 strains of Escherichia coli to commonly used antimicrobial agents (amoxicillin, piperacillin, ticarcillin, cefuroxime, ceftazidime, and cefalotin) were 72.41%93.10%, none of strains were found to be resistant to piperacillin/tazobactam, meropenem, imipenem, and amikacin. ConclusionEscherichia coli is the most common pathogen causing intraabdominal infection after appendectomy and it has high resistance rates to most commonly used antimicrobial agents, piperacillin/tazobactam, amikacin, and carbapenems are recommended for treating intraabdominal infection after appendectomy.

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ObjectiveTo explore the risk factors of surgical site infection(SSI) in patients undergoing selective brain tumor resection, and provide reference for clinical prevention and treatment．MethodsPatients who underwent selective brain tumor resection in the neurosurgery department of a hospital during AprilSeptember 2013 and AprilSeptember 2014 were monitored prospectively, monitoring programme and individualized questionnaire were formulated, the basic data, operation condition, postoperative symptoms/signs, laboratory test results, infectionrelated factors, and antimicrobial use in patients were collected, risk factors for infection were analyzed. ResultsA total of 205 patients were investigated, 23 (11.22%) of whom had SSI; univariate analysis showed that body mass index (BMI), NNIS score, and cerebrospinal fluid leakage were related to the occurrence of SSI(all P<0.05); logistic regression analysis showed that high NNIS score and cerebrospinal fluid leakage were independent risk factors for SSI in patients undergoing selective brain tumor resection(both P<0.05). ConclusionIncidence of SSI is higher in patients with selective brain tumor resection, corresponding preventive measures should be taken according to different risk factors including cerebrospinal fluid leakage.

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ObjectiveTo explore the clinical characteristics and risk factors of healthcareassociated infection(HAI) in patients with severe viral hepatitis, so as to provide basis for clinical prevention and treatment of HAI. MethodsClinical data of 193 patients with severe viral hepatitis and admitted to a hospital from January 2012 to November 2015 were analyzed retrospectively, clinical characteristics and risk factors for HAI in patients were evaluated, all data were statistically analyzed. ResultsAmong 193 patients, 75 developed 112 times of HAI, incidence and case incidence of HAI were 38.86% and 58.03% respectively. The main infection sites were abdominal cavity, lower respiratory tract, and gastrointestinal tract, infection rates were 33.93%, 25.00% and 16.96% respectively. A total of 58 strains of pathogens were isolated, including fungi, gramnegative bacteria, and grampositive bacteria, accounting for 53.45%, 36.21%, and 10.34% respectively. Mulvariate logistic regression analysis showed that underlying diseases, use of glucocorticoid, invasive procedure, and white blood cell count＜4.0×109/L were independent risk factors for HAI in patients with severe viral hepatitis (P<0.05). ConclusionIncidence of HAI in patients with severe viral hepatitis is high, risk factors are multiple. It is necessary to take targeted prevention measures during the treatment, so as to reduce the incidence of HAI.

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ObjectiveTo understand the current situation and characteristics of occupational exposure(OE) among health care workers(HCWs), and provide basis for making preventive measures. MethodsSelfdesigned questionnaire about OE was adopted, OE among all HCWs in a hospital in JanuaryDecember 2015 were surveyed and statistically analyzed. ResultsA total of 1 888 HCWs were surveyed, there were 304 cases of OE, the mean OE rate in the whole hospital was 16.10%; OE occurred 370 times(19.60%). Doctors, trainees，and HCWs who worked for≤1 year had relatively higher OE rates, which were 23.18%(102/440), 17.88%(49/274), and 18.34%(95/518) respectively. Sharp injury is the main OE mode, accounting for 83.24%（n=308）, sharp injuries mainly occurred before disposing the used devices and during the process of use, accounting for 37.99%(n=117) and 36.69%(n=113) respectively. Among 370 times of OE, 315 could be traced to the sources of exposure. Among the known exposure sources, OE of bloodborne pathogens accounted for 24.13% (n=76). 59 of 370 times of OE implemented complete local treatment and reporting procedures, reporting rate of OE was 15.95%. ConclusionHospital should take comprehensive measures to promote occupational safety precaution, and reduce the incidence of OE.

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ObjectiveTo analyze the occurrence of sharp injuries among health care workers(HCWs), and put forward suggestions for safety management of sharp injuries.MethodsRecorded form of sharp injuries reported in a hospital in August 2006July 2015 were analyzed retrospectively, relevant data were analyzed statistically. ResultsA total of 211 sharp injuries occurred among HCWs were reported, sharp injuries mainly occurred among nurses(n=118, 55.92%) and doctors(n=83, 39.34%); 117(55.45%）sharp injuries occurred in HCWS whose length of service was ≤5 years; the main occurrence locations of sharp injuries were surgical ward（n=67， 31.75%）, internal medicine ward（n=65， 30.81%）, and outpatient as well as emergency departments（n=33，15.64%）；the main devices causing sharp injuries were syringe needle(n=91, 43.13%）, suture needle(n=34，16.11%), and scalp needle/transfusion needle（n=27，12.80%）；the main injuryrelated manipulations were all types of injection(n=40， 18.95%）, intravenous transfusion (n=38,18.00%）, and surgical suturing/cutting (n=36，17.06%）. The main opportunities of injuries was during manipulation(treatment, examination, operation, n=109, 51.66%）. Among bloodborne pathogens contaminated devices, contaminated by HBV, HCV, and HIV were 95（76.61%），25（20.16%），and 4 cases（3.23%） respectively. There was no bloodborne pathogen infection occurred. 155（73.46%）of 211 HCWs were inoculated hepatitis B vaccine. ConclusionPrevention of sharp injuries should be focused on nurses and doctors who work for ≤5 years, HCWs in surgical ward, internal medicine ward, and outpatient as well as emergency departments. Prevention of sharp injuries during manipulations such as injection, intravenous transfusion, suturing/cutting should be intensified. Related hospital departments should improve the reporting process and intensify followup.

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ObjectiveTo analyze the characteristics of occupational exposure to bloodborne pathogens during operation, and provide reference for making the prevention and control measures. MethodsOccupational exposure to bloodborne pathogens during operation in a tertiary first class hospital between June 2016 and January 2017 were surveyed, the survey included general information about health care workers(HCWs), modes of occupational exposure, exposure sources, types of sharp injuries, manipulation and so on. ResultsA total of 100 HCWs sustained occupational exposure to bloodborne pathogens during the operation, 64（64.00%）were nurses, followed by doctors(n=30, 30.00%). The main mode of exposure were sharp injuries(n=88, 88.00%）and ocular mucosa exposure (n=10, 10.00%). The main diseases of exposure source were hepatitis B(n=36, 36.00%) and syphilis(n=11, 11.00%). The main sharp device that caused sharp injuries was transfusion system needle(n=31，35.23%），followed by syringe needle (n=24, 27.27%) and suture needle（n=14，15.91%）. The main manipulation resulting of sharp injury was intraoperative manipulation (n=31，35.23%）. ConclusionTraining about occupational exposure should be strengthened among HCWs, it is necessary to improve the record and report process of occupational exposure, strictly require HCWs, especially nurses in accordance with the standard operating procedure during the operation process, so as to reduce the occurrence of occupational exposure to bloodborne pathogen during operation.

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目的了解新型鼻镜清洗篮筐固定鼻镜进行清洗处理的清洗效果。  方法将待处理的鼻镜分为A、B两组（各12件，重复试验3次），A组采用手工刷洗预处理再放入清洗机内清洗，B组采用新型鼻镜清洗篮筐固定清洗后再放入清洗机内清洗，清洗后采用肉眼目测，10倍带光源放大镜观察和ATP生物荧光检测仪检测鼻镜的清洗合格率。  结果A、B分拣处理时间分别为（2.16±0.52）、（0.20±0.06）min，B组分拣时间短于A组，差异有统计学意义（t=66.578，P＜0.05）。采用肉眼目测、10倍放大镜观察及ATP生物荧光检测的方式观察鼻镜前端的清洗合格率，A组分别为33.33%～58.33%、25.00%～33.33%、16.67%～25.00%，B组分别为100.00%、91.67%～100.00%、83.33%～100.00%，B组清洗合格率均高于A组（均P＜0.05）。   结论在实际操作中采用新型鼻镜清洗篮筐，有助于鼻镜的关键部位得到彻底清洗，且处理时间更短，可以提高工作效率。

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目的了解老年急性脑卒中肺部医院感染患者痰标本分离病原菌及耐药情况，为临床抗菌药物合理应用提供依据。方法采用回顾性分析方法，对2011年3月—2013年9月某院干部病房年龄≥60岁的380例老年急性脑卒中患者进行医院感染的调查，对医院感染患者痰标本分离细菌进行鉴定和药敏检测。结果发生肺部医院感染54例，送检116份痰标本共分离病原菌80株，其中革兰阴性（G-）杆菌61株（76.25%），革兰阳性（G+）球菌7株（8.75%），真菌12株（15.00%），居前5位的病原菌依次是肺炎克雷伯菌、铜绿假单胞菌、鲍曼不动杆菌、白假丝酵母菌、大肠埃希菌。G-杆菌对美罗培南、亚胺培南、哌拉西林/他唑巴坦、阿米卡星等敏感率100%；G+球菌对万古霉素、利奈唑胺、替考拉宁敏感率100%；真菌对氟康唑、伊曲康唑等常用的抗真菌药敏感率100%。结论老年急性脑卒中肺部感染病原菌以G-杆菌为主，多重耐药菌株比例高，真菌感染呈上升趋势，临床上应加强病原菌监测，合理选用抗菌药物。

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术后线结排异反应属于Ⅳ型变态反应，与患者体质密切相关［1］。2015年11月医院收治了1例剖宫产术后迟发性线结排异反应合并结核分枝杆菌感染患者，现报告如下。

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革兰阴性菌是临床常见致病菌，但这些年由于各种抗生素的大规模使用，多重耐药革兰阴性菌比例逐年上升，多粘菌素作为革兰阴性菌的最后一道防线，再次引起了广泛的关注。多粘菌素B（polymyxin B）最早于1947年在Bacillus polymyxa的二次代谢产物中提取得到，1949年在B.polymyxa subsp. colistinus中得到多粘菌素E（polymyxin E）［1］。1959年作为抗菌药物用于临床，由于严重的肾毒性，而逐渐被新晋抗菌药物取代。近期，除了替加环素批准用于治疗多重耐药鲍曼不动杆菌（但该药对铜绿假单胞菌无效）外，就再无其他新研发的针对多重耐药革兰阴性杆菌感染的药物，但随着替加环素的大规模使用，耐药率也呈明显的上升趋势［2］。所以，原来的抗菌药物，如多粘菌素被再次启用，作为治疗泛耐药革兰阴性杆菌感染的最后选择。

Abstract:

为研究细菌的流行特征、追踪传染源，国内外广泛采用的方法是对相关菌株进行分型，分析菌株间的同源性关系。细菌分型方法分为表型分型和基因分型两种，表型分型主要有根据菌落形态和生化特征等的生物分型、抗菌药物药敏谱分型、血清分型、噬菌体分型，基因分型包括质粒分型、核糖体分型、染色体DNA限制性内切核酸酶图谱分析(REA)、限制片段长度多态性分析（RFLP)、脉冲场凝胶电泳分型（pulsedfield gel electrophoresis，PFGE）、随机引物PCR(APPCR)、重复片段PCR分型、多位点序列分型（MLST)等，其中PFGE是分子分型技术的“金标准”，其结果重复性好，分辨率高，易于标准化，被国内外研究者广泛接受。本文就PFGE技术及其在细菌感染性疾病中的应用进行综述。

Abstract: