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ObjectiveTo understand biofilmforming ability of Acinetobacter baumannii(A. baumannii) in clinical isolates, and evaluate the effect of biofilm formation on antimicrobial resistance. MethodsA total of 47 A. baumannii clinical isolates were collected, biofilmforming ability was detected by crystal violet staining assay, the minimal inhibitory concentration(MIC) of 12 kinds of antimicrobial agents to  biofilmforming isolates were detected when the isolates were in planktonic or biofilm formatted condition; biofilmforming ability of positive isolates at different culture condition (shaking or stable) and on different materials(glass tube or polypropylene plastic centrifugal tube) were detected. ResultsThirteen isolates (27.66%) exhibited biofilm formation. In planktonic condition, antimicrobial resistance rates of these isolates were all <35%, no isolates shown resistance to polymyxin and tigecycline, in biofilm formatted condition, resistance rates to tigecycline was 15.38%，resistance rates to the other antimicrobial agents were all 100%. Of 13 tested isolates, ≥10 isolates shown higher absorbance in the shaking condition than in the stable condition, ≥10 tested isolates shown higher absorbance in polypropylene plastic centrifugal tube than in the glass tube. ConclusionThe resistance of A. baumannii to antimicrobial agents is greatly changed after the formation of biofilm, which may results in the failure of antimicrobial therapy for infection.

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ObjectiveTo investigate the distribution and antimicrobial resistance of Pseudomonas aeruginosa (P. aeruginosa) from intensive care units(ICUs) and general wards of a hospital, and provide scientific basis for rational use of antimicrobial agents in clinic. MethodsIdentification and antimicrobial susceptibility testing of clinically isolated bacteria in this hospital in 2016 were performed by VITEK 2 Compact automatic microbial analysis system, difference in antimicrobial resistance of P. aeruginosa between ICUs and general wards was compared.ResultsThe tested specimens were mainly sputum in both ICUs and general wards, accounting for 78.7% and 66.5% respectively. There was no significant difference in the isolation rate of P. aeruginosa between ICUs and general wards (11.7% vs 11.0%, P>0.05). P. aeruginosa isolated from ICUs had the highest resistance rate to aztreonam (73.8%)，resistance rates to piperacillin/tazobactam, cefoperazone/sulbactam, ceftazidime, imipenem, and meropenem were all up to more than 50%; P. aeruginosa detected in general wards had the highest resistance rate to aztreonam(59.6%), followed by piperacillin/tazobactam and imipenem, accounting for 48.0% and 44.3% respectively；resistance rates of P. aeruginosa isolated from ICUs to 12 kinds of antimicrobial agents were all higher than those of general wards(P<0.05). ConclusionResistance rate of P. aeruginosa from ICUs is higher than that in general wards, which should be paid attention, antimicrobial agents should be selected for clinical treatment of infection according to the results of antimicrobial susceptibility testing result.

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ObjectiveTo investigate clinical distribution, capsular serotyping, molecular typing, virulence gene carriage, and antimicrobial susceptibility of hypervirulent Klebsiella pneumoniae (hvKP) strains isolated from a hospital in Hainan Province in 2016.MethodsKlebsiella pneumoniae(K. pneumoniae) isolated from the hospital between January and December 2016 were analyzed retrospectively, hvKP strains were selected through string test, antimicrobial susceptibility testing was performed and compared with classic K. pneumoniae(cKP); capsular serotyping, virulence genes, and drug resistance genes of hvKP strains were detected with polymerase chain reaction, molecular typing was performed with pulsedfield gel electrophoresis (PFGE) and multilocus sequence typing.ResultsA total of 84 hvKP strains were isolated, the main specimen source was sputum(45 strains); K1 and K2 were the major capsular serotypes of hvKP, while ST23, ST65, and ST86 were the main sequence types of hvKP. The carriage rates of rmpA, aerobatin, allS, kfuBC, and cf29a in hvKP were 90.48%, 96.43%, 42.86%, 66.67%, and 53.57% respectively, all of them were statistically higher than those of cKP strains, PFGE found that allS was positive only among K1 strains; most antimicrobial resistance rates of hvKP were lower than those of the cKP.ConclusionSputum is the main specimen source of hvKP, especially K1 serotype; more than 90% of hvKP strains carry rmpA and aerobatin genes, allS gene only exists in K1 type hvKP.

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ObjectiveTo investigate drug resistance genes and epidemic characteristics of βlactamase carried by carbapenemresistant Acinetobacter baumannii(CRAB) in the respiratory intensive care unit(RICU) in a hospital.MethodsClinically isolated CRAB from RICU patients in OctoberDecember 2015 were collected. Five drug resistance genes (KPC2, IMP, VIM, NDM1, OXA23) were specifically amplified by polymerase chain reaction (PCR), amplified products were performed agarose gel electrophoresis and sequencing analysis, the homology was analyzed with pulsedfield gel electrophoresis (PFGE). ResultsA total of 22 CRAB strains were isolated in OctoberDecember 2015, 19 (86.36%) of which were isolated from sputum. The resistance rate of 22 CRAB strains to compound sulfamethoxazole was 59.09%, resistance rate to minocycline was 9.09%, all were sensitive to polymyxin B, resistance rates to other antimicrobial agents were more than 80%. Three kinds of resistance genes KPC2, IMP and NDM1 were not found by PCR amplification, positive rates of VIM and OXA23 were both 100%. PFGE homology analysis revealed that 22 strains were divided into 13 different types, each type contained 15 strains, 9 types（69.23%） contained only 1 strain respectively, the other 4 types (30.77%) contained 25 strains. A5, A7, and A8; A9, A11, A14, A19 and A22; A4, A10 and A12; A16 and A18 were of the same type respectively. ConclusionThe main types of βlactamaseresistant genes of CRAB in RICU are VIM and OXA23. Homology analysis shows a small parts are of the same clone strains, which reveals epidemic of a small scale.

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ObjectiveTo explore the drugresistant genotypes and homology of carbapenemresistant Klebsiella pneumoniae (CRKP). Methods38 strains of clinically isolated CRKB in a hospital between September 2015 and February 2016 were collected, drug resistance genes were detected with polymerase chain reaction (PCR), homology of strains was analyzed with pulsedfield gel electrophoresis (PFGE). ResultsAll 38 strains were from intensive care unit(ICU) and surgical intensive care unit(SICU), accounting for 39.48% and 34.21% respectively. 38 strains all harboured drug resistance genes blaKPC and blaSHV , 6 strains harboured blaCTX. PFGE revealed that strains were divided into types A, B, C, and D, type C was predominant（65.78%，25/38）. Of type A strains, strains 14, 15, and 16 carried drug resistance genes blaKPC2, blaSHV, and blaCTXM15 respectively, these strains were all isolated from SICU patients, strains 14 and 15 were isolated on the same day, strain 16 was isolated on the following week; of type C strains, homology of strain 10, 18, 25, and 28 was 100%. strian 10 and 18 were isolated from ICU patients, strains 25 and 28 were isolated from patients in division I of neurology ICU( both were transferred from ICU), and both were isolated during patient hospitalization in ICU, the isolation time only differed for one day.ConclusionThe main drugresistant genotypes of CRKB in this hospital are mainly blaKPC and blaSHV,  there is epidemic of clone strains in this hospital.

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ObjectiveTo understand the microbiological and clinical features of bloodstream infection(BSI) with high virulent Klebsiella pneumoniae(hvKP). MethodsThe strains and clinical data of 159 patients with Klebsiella pneumoniae (K. pneumoniae) BSI at the Second Hospital of Dalian Medical University from April 2013 to March 2016 were collected. Statistical analysis was performed using SPSS 19.0 software. Results35.22%（56/159）of patients were with hvKP BSI, K1 and K2 serotypes in hvKP BSI accounted for 51.79% and 26.79% respectively. The main source of hvKP BSI was liver abscess（n=26，46.43%），the classic type of K. pneumoniae (cKP) BSI was primary bacteremia（n=41，39.81%）. Difference in different types of infection between two groups of patients was statistically significant（χ2=57.782，P＜0.001），89.29% of hvKP BSI was communityassociated infection(CAI), and 73.79% of cKP BSI was healthcareassociated infection(HAI). Difference in underlying diseases between two groups of patients was statistically significant（χ2=36.532，P＜0.001），50.00% of hvKP BSI patients had diabetes, 45.63% of cKP BSI patients had malignant tumor. Icidence of septic shock in hvKP BSI patients was higher than that of cKP BSI patients（32.14% vs 8.74%; χ2=14.096，P＜0.001）. The proportion of ESBLsproducing of hvKP and cKP were 5.36% （3/56）and 47.57%（49/103）respectively，difference was statistically significant（χ2=29.375，P＜0.001).  Klebsiella pneumoniae carbapemase(KPC)producing hvKP was not found. Resistance rates of hvKP to ceftazidime, ceftriaxone, cefepime, aztreonam, gentamicin, levofloxacin, and compound sulfamethoxazole were all lower than cKP(all P<0.05). ConclusionhvKP BSI is common in CAI, infection sources and underlying diseases are difference from cKP BSI, hvKP BSI is prone to cause septic shock. Both laboratories and clinicians should pay attention to hvKP infection and the change trend of antimicrobial resistance.

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ObjectiveTo understand infection status, clinical and epidemiological features of respiratory tract infection(RTI) with human Bocavirus（HBoV） in children in Wuhan area. MethodsA total of 968 hospitalized children with acute RTI between January and December 2016 were recruited in the study. Sputum specimens were collected by sterile negative pressure suction method. HBoV, respiratory syncytial virus, adenovirus, A/Btype influenza virus, and parainfluenza virus I/II/III were detected, the prevalence and clinical features of HBoV infection were analyzed. ResultsAmong 968 cases, 75(7.75%) were positive for HBoV. The detection rates of HBoV in boys and girls were 5.68% and 2.07% respectively, there was no significant difference in the detection rate of HBoV between different genders（χ2=2.083，P=0.140）；53 (70.67%) HBoVpositive children were<1 year old, 63（84.00%） were<3 years old, there was significant difference in the detection rate among all age groups(χ2=4.60，P=0.043）. The detection rates in spring, summer, autumn, and winter were 9.78%, 5.29%, 2.86%, and 5.20% respectively； except September and October, HBoV was found positive in the other months, detection rate was highest in March (33.33%）. 17 cases were simple HBoV infection and 58 were mixed infection, the main clinical diagnosis of HBoV was bronchopneumonia（n=26, 34.67%）. The main clinical features of HBoV cases were fever（81.33%）, cough（77.33%）, and wheezing (77.33%). ConclusionHBoV is one of the important pathogens causing RTI in hospitalized children in Wuhan area, HBoV infection can occur throughout the year , the peak season are spring and summer, there is no difference between different genders. The most common clinical diagnosis of HBoV in hospitalized children is bronchopneumonia, the main manifestations are fever, coughing, and wheezing.

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ObjectiveTo evaluate the effect of galactomannan(GM) test combined with CD4+ T lymphocyte detection on early diagnosis of invasive aspergillosis (IA) in patients with acquired immunodeficiency syndrome (AIDS).Methods197 AIDS patients who were suspected with IA in a hospital from January 2014 to December 2016 were analyzed retrospectively, they were divided into confirmed IA group (n=35), clinically diagnosed IA group (n=96, suspected cases), and nonIA group(n=66), sensitivity and specificity of GM test and GM test combined CD4+T lymphocyte counting for diagnosing IA were compared.ResultsIn confirmed IA group, clinically diagnosed IA group, and nonIA group, the medium values of GM (minimum, maximum) were 1.29（0.65，1.84）pg /mL, 0.91（0.36，1.23）pg /mL, and 0.11（0.28，0.72）pg /mL respectively, CD4+T lymphocyte counting were 45（29，69）cells/μL, 79（35，99）cells/μL, and 89（59，158）cells/μL respectively, GM value and CD4+T lymphocyte counting among three groups were significantly different(all P＜0.05）. The sensitivity and specificity of single GM test for diagnosing IA in AIDS patients were 64.9% and 72.7% respectively; sensitivity and specificity of two consecutive GM test within one week for diagnosing IA were 72.5% and 95.5% respectively; sensitivity and specificity of GM test combined CD4+T lymphocyte counting were 86.3% and 90.9% respectively.ConclusionGM test has better diagnostic value for IA in AIDS patients, continuous GM test and GM test combined CD4+ T lymphocyte counting will further improve the clinical diagnostic value for IA.

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ObjectiveTo evaluate the detection value of serum (1,3)βD glucan (Gtest) and galactomannan(GMtest) combined with sputum fungal culture in the early diagnosis of invasive fungal infection(IFI) in intensive care unit(ICU) patients. MethodsInpatients with high risk factors for IFI in the ICU of the Affiliated Hospital of Xuzhou Medical University between January 2015 and December 2016 were chosen, they were divided into 3 groups according to the diagnostic criteria of IFI: IFI group(including confirmed and clinically diagnosed cases), suspected IFI group, and nonIFI group. The results of serum Gtest, GMtest, and sputum fungal culture in three groups of patients were analyzed, early diagnostic value in IFI with combined three tests was evaluated. ResultsA total of 264 ICU patients were investigated, IFI group, suspected IFI group, and nonIFI group were 56, 43, and 165 cases respectively. Among 56 cases of confirmed IFI, 46, 39, and 34 were positive for Gtest, GMtest, and fungal culture respectively. The sensitivity, specificity, positive predictive value, and negative predictive value of combined three detection were 98.2%, 82.4%, 65.5%, and 99.3% respectively, positive likelihood ratio, negative likelihood ratio, and Youden index were 5.58, 0.02, and 0.98 respectively. The sensitivity and negative predictive values of combined three detection were both higher than those of single Gtest, GMtest, and sputum fungal culture(all P<0.05); but specificity and positive predictive value of combined three detection were not significantly different from single Gtest, GMtest, and sputum fungal culture(all P>0.05). ConclusionThe combination of Gtest, GMtests, and sputum fungal culture can improve the sensitivity of early diagnosis of IFI in ICU patients, and guide the clinicians in the early treatment of IFI.

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ObjectiveTo investigate HIV seroconversion in HIVnegative partners or lovers among HIV serodiscordant couples. MethodsChina National Knowledge Infrastructure(CNKI), Wangfang data, and PubMed were retrieved, literatures about HIV seroconversion in HIVnegative partners or lovers among HIV serodiscordant couples were included in the study, Meta analysis was performed by R software. ResultsThere were 11 literatures were included in the study, Meta analysis showed that HIVnegative partners’ or lovers’ overall seroconversion rates among HIV serodiscordant couples in China was 1.0/100 personyear; in different economic levels and epidemic areas, HIVnegative partners’ or lovers’ seroconversion rates were both 1.0/100 personyear. ConclusionThe HIVnegative partners’ or lovers’ seroconversion rates among HIV serodiscordant couples in China are not high.

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ObjectiveTo explore the therapeutic efficacy of levofloxacin combined with antituberculosis drugs and thoracic catheterization for the treatment of tuberculous pleuritis. MethodsPatients who were admitted to Departments of Infectious Diseases of Hanzhong Central Hospital and Ankang Central Hospital between February 2014 and August 2016 for initial treatment of tuberculous pleuritis were included in the study, they were divided into groups A, B, C and D. Group A received 2HRZE+7HR regimen combined with conventional drainage; group B received 2HRZE+7HR regimen combined with thoracic catheterization； group C received 2HRZEV+7HR regimen combined with thoracic catheterization；group D received 2HRZEV+10HR regimen combined with thoracic catheterization. groups B, C and D received thoracic catheterization, normal saline 20mL and urokinase 100,000U were given through the drainage tube. ResultsA total of 172 patients with newly diagnosed tuberculous pleurisy were received for treatment. There were 45, 53, 38, and 36 cases in group A, B, C, and D respectively. The total effective rate of therapy for pleural effusion in group A was lower than that in group B(64.44% vs 90.57%, χ2=9.863，P＜0.05）；after two month therapy, total effective rate of therapy for pleural effusion in group B was lower than that in group C (18.87% vs 39.47%, χ2=4.716，P＜0.05）；at the end of therapy, total effective rate in group C was lower than that in group D (60.53% vs 83.33%, χ2=4.731，P＜0.05）. ConclusionFor initial treatment of patients with tuberculous pleuritis, 2HRZEV+10HR antituberculosis regimen combined with thoracic catheterization and urokinase infusion can significantly improve the clinical symptoms and recovery rate of tuberculous pleuritis, facilitate drainage of pleural effusion and prevent pleural thickening, adhesion and encapsulation.

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ObjectiveTo evaluate the distribution and antimicrobial resistance of pathogens in neonates. MethodsBlood culture specimens from hospitalized neonates in the neonatal intensive care unit (NICU) of a maternal and child heath hospital between January 1, 2013 and December 31, 2015 were investigated retrospectively, blood culture and antimicrobial susceptibility testing results were analyzed with WHONET 5.6 software.ResultsA total of 255 strains were isolated from blood culture specimens, including 219 strains（85.88%） of gramnegative bacteria, 29 strains（11.37%） of grampositive bacteria, and 7 strains（2.75%） of fungi. The isolated bacteria were mainly Klebsiella pneumoniae (n=157), Escherichia coli (n=35), and Streptococcus B (n=13). Resistance of Escherichia coli to ampicillin and piperacillin were 97.14% and 94.29% respectively, all were sensitive to cefoxitin, imipenem, meropenem, ertapenem, and amikacin. Resistance rates of Klebsiella pneumoniae to piperacillin, cefazolin, and cefuroxime were 93.63%, 87.90%, and 85.35% respectively, but was sensitive to amikacin. Resistance rates of the main gramnegative bacteria to enzyme inhibitor (amoxicillin/clavulanic acid, ticarcillin/clavulanic acid), cephalosporins (ceftazidime, cefoxitin), and sulfonamides (sulfamethoxazole compound) increased, difference were all statistically significant (all P<0.01).ConclusionKlebsiella pneumoniae and Escherichia coli are the major pathogens causing bloodstream infection in NICU, and resistance rates to a multiple antimicrobial agents are high, empirical medication for antiinfection treatment should be combined with local data.

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ObjectiveTo evaluate the efficacy of infection prevention and control measures on the management of rational use of antimicrobial agents.MethodsPatients who were admitted in a hospital from 2011 to 2015 were as the research object, a series of infection prevention and control intervention measure were taken,  efficacy of intervention measures were evaluated.ResultsAfter the implementation of comprehensive intervention measures, compliance rate of hand hygiene increased year by year, from 38.17% in 2011 to 87.16% in 2015, difference was statistically significant （χ2＝48.50, P＜0.05）. Incidence of healthcareassociated infection dropped from 1.45% to 1.06%, difference was statistically significant （χ2＝42.50, P＜0.05）； antimicrobial use density in 2011-2015 were 63.1, 44.4, 40.0, 40.8, and 40.5 respectively, which showed a decreasing tendency. ConclusionEffective infection prevention and control measures have obvious effect on promoting management of rational use of antimicrobial agents, it is helpful for reducing the clinical use density of antimicrobial agents.

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目的探讨标准化病人（SP）模拟教学联合以问题为基础的学习（PBL）教学模式在传染病学临床教学中的教学效果。方法选取某医学院2010、2011级临床医学本科五年制学生，按自然班随机分为对照组（传统教学组）、PBL教学组、SP组及SP+PBL组。学期结束时，对学生进行闭卷理论考试、技能操作考试和不记名问卷调查。结果四组学生理论考试成绩差异无统计学意义（P＞0.05）。在临床技能考核中，SP+PBL组学生成绩高于对照组及PBL组（P＜0.05）；SP+PBL组与SP组比较，差异无统计学意义（P＞0.05）。在问卷调查中，四组之间在是否有利于激发学习兴趣、提高自主学习能力、培养团队精神问题中，差异无统计学意义（均P＞0.05）；SP+PBL组学生在培养临床思维能力、提高知识理解及掌握程度、提高医患沟通能力等方面高于对照组及PBL组（P＜0.01）。结论SP+PBL教学法相对于传统教学及单纯的PBL教学法而言，更适合在传染病学临床教学中应用。

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目的通过根因分析法（RCA）查找乳腺、甲状腺手术切口感染的根本原因。方法2016年3—4月某院乳甲外科发生3例手术部位感染，采用RCA查找造成切口感染的根本原因，管理者针对根本原因采取措施，继续追踪4个月查看术后手术部位感染情况。结果通过RCA查找到此次手术部位感染的根本原因为：科室对患者术后管理的机制落实不到位、科室绩效分配不合理，以及科室未严格执行进修、实习人员的带教制度。针对根本原因采取措施后，该科5—8月未再发生感染病例。结论RCA从根本上查找到此次乳腺、甲状腺手术切口感染的根本原因，针对原因，采取的控制措施有效。

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目的采用医院感染主动监测系统调查某院医务人员手卫生现状，探讨信息化手段对提高手卫生依从性的作用。方法自2015年起采用医院感染主动监测系统对该院医务人员手卫生情况进行监测，2014年采用普通观察法，对比采用信息化监测前后医务人员的手卫生依从性、洗手消毒剂消耗情况。结果2014、2015年各观察医务人员应执行手卫生为2 016、3 275次，实际执行手卫生1 139、2 297次，依从率分别为56.50%、70.14%，2015年手卫生依从性高于2014年，差异有统计学意义（χ2=4.551，P＜0.05）。2015年护士依从率最高（85.30%），工勤员最低（54.34%）。手卫生依从性较差人群（工勤员）第一季度手卫生依从率为50.00%，对其加强重点培训后，第二季度手卫生依从率提升至52.17%，第三季度持续提高，第四季度手卫生依从率达60.32%。2015年全院手消毒剂人均日消耗量与2014年相比明显增加，其中2015年每月人均日消耗量平稳上升。结论采用医院感染主动监测系统能及时发现问题，明确手卫生依从性较弱的人群，并进行针对性改进，提高医务人员整体手卫生依从性。

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目的观察殡仪人员手卫生行为模式，提出切实可行的干预措施，改善殡仪人员手卫生状况。方法采用现场观察和采样检测相结合的方法对国内9个殡仪馆90名一线遗体防腐整容工手卫生行为及洗手效果进行调查，选取一线遗体防腐整容工20名，进行为期1周的行为干预试验，评价干预效果。结果9个殡仪馆手控式水龙头配备率为100%，均未配备感应式或脚踏式水龙头，均未配备感应式干手设施。殡仪人员采取手卫生的方式为流水或肥皂洗手，洗手率为100%，55.56%的殡仪人员采用六步洗手法洗手，80.00%的人员洗手不规范;90名殡仪人员洗手后手细菌平均数为（180.51±209.23） CFU/cm2，高于洗手前（154.95±271.95） CFU/cm2，差异有统计学意义（F=0.173，P=0.036）。干预前殡仪职工手卫生依从率为26.99％（95/352）,培训后殡仪职工手卫生依从率为57.32%(227/396),差异有统计学意义（χ2=24.56，P＜0.001）。殡仪人员按六步洗手法洗手后用干手纸巾擦手和使用快速手消剂均能降低手细菌总数（均P＜0.05）。结论殡仪人员手卫生状况不佳，提高殡仪人员的消毒卫生防护知识，规范其六步洗手法、开关水龙头、干手等行为，能有效改善殡仪人员手卫生状况。

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目的分析烧伤科住院患者连续5年医院感染情况，为加强医院感染管理提供依据。方法回顾性调查某院2011年1月—2015年12月烧伤科的住院患者，调查内容包括是否发生医院感染、医院感染部位、病原学送检情况。应用SPSS统计软件进行数据分析。结果2011年1月—2015年12月共有住院患者6 721例，721例（845例次）发生医院感染，医院感染发病率为10.73%，例次发病率为12.57%。医院感染发病率呈逐年下降趋势（χ2趋势=122.040，P＜0.001），由2011年的17.67%下降至2015年的6.00%。医院感染部位以烧伤创面为主（758例，89.70%），其次为下呼吸道（34例，4.02%）、上呼吸道（20例，2.37%）。2011—2015年烧伤科医院感染患者烧伤面积均以≤20%为主（85%以上）。烧伤面积≤20%、21%~40%、41%~60%的各组患者医院感染发病率均呈下降趋势（χ2趋势值分别为84.141、83.655、23.867，均P＜0.001）。烧伤面积越大的患者医院感染发病率越高（χ2趋势=811.054，P＜0.001）。烧伤科2011—2015年医院感染病原菌主要为金黄色葡萄球菌（204株）、铜绿假单胞菌（77株）和肺炎克雷伯菌（61株）、肠球菌属（55株）、鲍曼不动杆菌（51株）。结论该院医院感染发病率呈逐年下降趋势，烧伤创面感染依然是烧伤科医院感染的主要部位，对于烧伤面积＞40%的患者应重点防控，建议加强抗菌药物的合理使用，以减少耐药菌感染的发生。

Abstract:

假鼻疽伯克霍尔德菌（Burkholderia pseudomallei，BP）导致的类鼻疽病，是热带感染性疾病，病死率高达25.0%~50.0%［12］。该菌引起的感染有地域性，主要集中在热带地区，海南地区有流行分布报道［3］。类鼻疽病临床表现多样，可致急性和慢性感染，急性感染主要是败血症，慢性感染以化脓性感染为主，易出现误诊误治［45］，给医生的诊治带来困难。本文从腮腺炎患者脓液分离出1株假鼻疽伯克霍尔德菌，文献报道少见，现将诊治经验报告如下。

Abstract:

近二十年来，随着造血干细胞移植、器官移植、侵袭性操作、化疗药物和免疫抑制剂等的广泛应用，导致临床患者免疫功能下降，出现深部真菌感染的风险随之增加。深部真菌感染的比例逐年增加，其中曲霉菌感染比例仅次于假丝酵母菌，位居第二位。侵袭性曲霉病（invasive aspergillosis， IA）不仅给患者带来身体上的痛苦，还增加了患者的经济负担。截至目前，尚未有完善的标准指南用来防治IA，环境因素、患者自身的基础疾病、免疫功能下降等危险因素可以增加IA的发病风险，因此，分析引起IA的相关危险因素尤为重要。本文从IA的危险因素及防控措施方面进行以下综述，旨在为控制IA的发生提供支持依据。

Abstract:

金黄色葡萄球菌（Staphylococcus aureus，SA）是骨科术后引起手术部位感染（surgical site infection，SSI）最常见的病原体，且仍有不断升高的趋势；其中，耐甲氧西林金黄色葡萄球菌（methicillinresistant Staphylococcus aureus，MRSA）感染引起的危害最大。SA在正常人群的定植较为普遍，探讨SA与骨科SSI的关系，采取有效的干预措施，从而降低SA（尤其是MRSA）引起的SSI对提高患者预后及降低医疗成本具有重要意义。本文对SA定植的流行病学、SA定植对骨科SSI的影响及去定植的干预效果做以下综述。