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ObjectiveTo understand department distribution, pathogens, and antimicrobial resistance of postoperative lower respiratory tract infection(LRTI), provide evidence for formulating prevention and treatment measures. MethodsFrom March 15, 2016 to December 31, 2016, monitored data of LRTI in the crosssectional survey of National Healthcareassociated Infection Surveillance Network(NHAISN) were collected and analyzed. ResultsA total of 1 057 361 hospitalized patients in 1 588 hospitals were surveyed, 12 827 cases of LRTI occurred, 2 275 of which were postoperative LRTI, accounting for 17.74% of LRTI. Most LRTI occurred in patients in surgery departments (n=1 700 cases, 74.73%), followed by general intensive care unit (n=372 cases, 16.35%); among departments of surgery, prevalence rate of LRTI was highest in patients in department of neurosurgery (2.34%), followed by department of thoracic surgery (1.71%). A total of 1 163 strains of pathogens were isolated, gramnegative bacteria accounted for 83.66%; the top 5 pathogens were Pseudomonas aeruginosa (20.29%), Klebsiella pneumoniae (19.69%), Acinetobacter baumannii (19.69%), Escherichia coli (6.53%), and Staphylococcus aureus (5.85%). Among pathogens causing postoperative LRTI, isolation rates of methicillinresistant Staphylococcus aureus, imipenem/meropenemresistant Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, and Acinetobacter baumannii were 64.15%, 8.00%, 14.19%, 29.14%, and 62.58% respectively, isolation rate in nonoperative LRTI infection were 76.03%, 8.85%, 15.51%, 39.67%, and 70.13% respectively; resistance rate of Pseudomonas aeruginosa to imipenem/meropenem and Acinetobacter baumannii to cefoperazone/sulbactam were both higher in postoperative LRTI than in nonpostoperative LRTI(the latter were 47.17% vs 63.68%), difference were both significant(both P<0.05). ConclusionIncidence of postoperative LRTI is highest in department of neurosurgery, gramnegative bacteria are the predominant pathogens, resistance of pathogens is serious, but antimicrobial resistance in partial strains are lower than nonpostoperative LRTI.

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ObjectiveTo investigate the causes of clustered event of acute hemorrhagic conjunctivitis(AHC) in the ophthalmology department of a hospital, and provide basis for comprehensive prevention and control of healthcareassociated infection(HAI). MethodsAHC occurred in the ophthalmology department of a hospital from January to November 2016 were investigated retrospectively, onsite epidemiological and environmental hygienic investigation was carried out. Hand hygiene compliance among health care workers(HCWs) in this department during JanuaryAugust 2016(before supervision)  and SeptemberNovember 2016 (after supervision) were surveyed. Hands of HCWs, instruments for routine diagnosis, and frequently touched object surface were taken sampling by ATP fluorescence rapid detector, bundle intervention strategies for HAI prevention and control were formulated. ResultsA total of 11 patients developed AHC from August 4, 2016 to September 17, 2016, 9 of whom were inpatients, and 2 were outpatients; 3 HCWs had AHC. Eye secretion was taken only from two patients in ward I, virological examination confirmed that it was caused by adenovirus infection. ATP examination showed that the qualified rate of HCWs’ hand hygiene and hygiene of environmental object surface were 28.57% and 34.38% respectively. Compliance rates of hand hygiene of HCWs before and after supervision were 50.00% and 78.52% respectively, difference was statistically significant (χ2=4.89, P=0.03). During the supervision period, the implementation rate of disinfection for equipment such as slit lamp, tonometer, and other common equipment was 76.64%. After the implementation of bundle intervention strategies, no case of hemorrhagic conjunctivitis was found in the ophthalmology department since midOctober. ConclusionGood hand hygiene and environmental cleaning and disinfection are still important means of infection prevention and control, timely and feasible bundle intervention strategies can effectively control the outbreak or epidemic of infection.

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ObjectiveTo analyze the relationship between multilocus sequence typing(MLST) and sources of specimens as well as antimicrobial susceptibility of Candida albicans(C. albicans), and explore the relationship among strains and their molecular epidemiological characteristics. MethodsC. albicans isolated from neonatal department in a hospital from April 2015 to May 2015 were collected, in vitro susceptibility testing was carried out by a kit, strains were typed by MLST, homology and molecular epidemiological characteristics of strains were analyzed. ResultsA total 15 C. albicans strains were isolated from 4 children and 1 health care worker, these strains were divided into 3 sequence types (ST) through MLST, 13 of which were ST 1997, and the other 2 were ST 1359 and ST 1933 respectively. Phylogenetic analysis of strains was carried out by eBURST software. ST 1997, ST 1359, and ST 1933 were in Group 13， Group 1，and Group 20 respectively, C. albicans isolated from peripheral blood and peripheral venous catheter of the same patient belonged to the same clone. ConclusionThere is an outbreak of C. albicans bloodstream infection in the neonatal department, corresponding preventive and control measures should be formulated to strengthen the management of healthcare associated infection in neonatal department.

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ObjectiveTo systematically evaluate the effect of low molecular weight heparin (LMWH) on the prognosis and bleeding risk  in patients with sepsis. MethodsCochrane Library Databases， PubMed，Embase，VIP Data，Wanfang Data，China National Knowledge Infrastructure（CNKI），and China Biology Medicine disc（CBMdisc）between January 1995 and September 2017 were retrieved, retrieved literatures were about randomized controlled clinical trial of LMWH for treatment of sepsis. According to inclusion and exclusion criteria, literatures were screened, extracted, and conducted quality evaluation, RevMan 5.3 software was used to perform Meta analysis. Results1 016 patients in 19 studies were included in Meta analysis. 28day mortality was compared among 19 studies and found that LMWH could reduce 28day mortality in patients with sepsis (RR=0.52，95％CI［0.43-0.63］，P<0.001)；subgroup analysis included 2 studies, which showed that LMWH could reduce 28day mortality in patients with sepsis combining acute lung injury(RR=0.40，95％CI［0.21-0.75］，P=0.004)；4 studies compared the length of stay in intensive care unit (ICU) and found that LMWH had no obvious effect on length of stay in ICU (MD=-0.84，95％CI［1.95-0.26］，P=0.14)；15 studies compared effect of LMWH on APACHE Ⅱ score and found that LMWH could reduce the APACHE Ⅱ score of patients with sepsis after 7 days(MD=-0.64，95％CI［0.93-0.34］，P=0.00)；4 studies compared the effect of LMWH on the incidence of disseminated intravascular coagulation (DIC) and found that LMWH could reduce the incidence of DIC in patients with sepsis (RR=0.34，95％CI［0.18-0.67］，P=0.002)；12 studies compared the effect of LMWH on bleeding and found that LMWH could increase the risk of bleeding in patients with sepsis (RR=2.74，95％CI［1.60-4.71］，P=0.00). ConclusionLMWH can reduce 28day mortality and improve the prognosis of patients with sepsis, but can increase the incidence of bleeding.

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ObjectiveTo comprehensively evaluate the quality of healthcareassociated infection(HAI) management in a tertiary firstclass hospital in Tianjin City from 2012 to 2016, understand control status of HAI, and provide an objective basis for the evaluation of HAI management. MethodsData of HAI management in a tertiary firstclass hospital in Tianjin from 2012 to 2016 were collected, analytic hierarchy process (AHP) method was adopted to calculate each dimension weight of the index system, Topsis method was adopted to comprehensively evaluate HAI management. ResultsThe evaluation of HAI management quality in this hospital was the best in 2013(C=0.6012), and worst in 2015(C=0.3937), which was consistent with the actual situation of hospital.ConclusionAHPTopsis method is used to comprehensively evaluate the quality of HAI management, the results are true and credible, it has a certain guiding role in evaluating the quality of HAI management and innovation of HAI management methods.

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ObjectiveTo explore risk factors for peripherally inserted central catheterrelated bloodstream infection（PICCCRBSI）in patients with tumor. MethodsPatients with PICC and had accessible complete information from central venous catheter registry database in a tertiary firstclass hospital in Jingzhou City between February 2015 and February 2017 were chosen. 48 tumor patients with PICCCRBSI were performed 1∶1 matched casecontrol study, the main risk factors were screened through logistic regression analysis. ResultsThere were 1 357 patients with PICC, 698 were recruited in the study, 48 cases had PICCCRBSI, incidence was 6.88%; the total PICC days were 13 953 days, incidence was 3.44 per 1 000 catheter days. No.of puncture ≥3(OR=2.05), positioning of chest Xray (OR=4.23), and without timely maintenance (OR=2.17) were independent risk factors for PICCCRBSI.ConclusionPICCCRBSI is related to No. of puncture, positioning  method and maintenance frequency, the occurrence of PICCCRBSI can be decreased by reducing the No. of puncture, positioning by electrocardiogram (EKG) during catheterization process, and timely maintenance.

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ObjectiveTo understand the clinical distribution and antimicrobial resistance characteristics of clinically isolated carbapenemresistant Klebsiella pneumoniae (CRKP) and carbapenemresistant Escherichia coli （CREC）. MethodsClinically isolated Klebsiella pneumoniae and Escherichia coli from a hospital between January 2010 and December 2016 were analyzed retrospectively, isolation of CRKP and CREC were conducted statistical analysis. ResultsFrom 2010 to 2016, a total of 310 carbapenemresistant Enterobacteriaceae (CRE) isolates (268 were CRKP strains and 42 were CREC strains) were collected, isolation rate of CRKP increased from 1.33% in 2010 to 12.70% in 2016, showing an increasing trend year by year (χ2=123.73, P< 0.01); isolation rate of CREC was relatively stable, were all about 1.00% from 2010 to 2016. Most specimens were respiratory tract specimens (45.49%) and from intensive care unit (31.93%). Antimicrobial susceptibility testing showed that except resistance rates of CRKP and CREC were slightly lower to amikacin (80.60% and 38.10% respectively),  resistance rates of CRKP to most commonly used antimicrobial agents, such as third generation cephalosporins, fourth generation cephalosporins, βlactamase/lactamase inhibitors, and quinolones were all＞90%, resistance rates of CREC to above antimicrobial agents were all about 80%, resistance rate of nonCRE strains was lower than that of CRE strains (P<0.01). ConclusionDuring the past 7 years, detection rate of clinically isolated CRKP increased rapidly, were almost resistant to commonly used antimicrobial agents, which should be paid close attention.

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ObjectiveTo investigate risk factors for pulmonary infection(PI) in patients with acute fatty liver of pregnancy (AFLP). MethodsClinical data of AFLP patients in a tertiary hospital from January 2015 to December 2017 were analyzed retrospectively, patients with PI were in infection group, and those without PI were in control group. Age, gestational age at onset of PI, time from onset to delivery, mode of delivery, total bilirubin (TBIL), alanine aminotransferase (ALT), aspartate aminotransferase (AST), serum creatinine (Scr), and prothrombin time (PT) were conducted univariate analysis. ResultsA total of 28 AFLP patients were collected, 10 patients who didn’t conform to the inclusion criteria were excluded, 18 AFLP patients were included, among whom 10 were with PI and 8 were control cases. Univariate analysis showed that serum TBIL level and PT in infection group were both higher than control group (P<0.05), levels of ALT and AST in infection group were lower than those in control group (P<0.05).ConclusionLiver function is a key factor affecting PI in patients with AFLP, improving liver function is the key to prevent and control PI in patients with AFLP.

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ObjectiveTo analyze clinical characteristics of patients with brucellosis. MethodsClinical and epidemiological data of patients with brucellosis and admitted to a tertiary general hospital in Hunan Province from January 2014 to March 2018 were analyzed retrospectively. ResultsFrom January 2014 to March 2018, a total of 32 patients were diagnosed with brucellosis, the number of confirmed cases in 2017 was the most(n=12, 37.5%). The age of onset was concentrated on 14-60 years (n=23, 71.9%), 29(90.6%) patients lived in rural areas. 19 patients had definitely contacted with cattle and sheep. 16 cases (50.0%) were initially diagnosed in the infectious diseases department, and 12 (37.5%) were initially diagnosed in the spine surgery department. The main clinical manifestations and abnormal findings were as follows: fever (n=29, 90.6%), lumbago and leg pain (n=18, 56.3%); among 20 patients with spinal imaging examination, 5 (25.0%) had damage in lumbar vertebra or sacral vertebra, 7(35.0%) had soft tissue lesion around the vertebral body, 21(65.6%) had lower hemoglobin, and 9(28.1%) had thrombocytopenia; 62.5% (15/24) of patients had elevated procalcitonin, 96.7%(29/30) had elevated Creactive protein, and 74.2% (23/31) had accelerated erythrocyte sedimentation rate. 21(62.5%) patients were treated with doxycycline plus rifampicin, 30 patients completed followup, and 29 patients recovered. ConclusionClinical manifestations of brucellosis are diverse, patients with fever of unknown origin, especially those with fever and lumbago and leg pain after contacting cattle and sheep should consider the possibility of brucellosis, so as to avoid missed diagnosis and misdiagnosis.

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ObjectiveTo explore risk factors for hospitalacquired pneumonia (HAP) and ventilatorassociated pneumonia (VAP) in patients undergoing emergency surgery, provide evidence for reducing the incidence of healthcareassociated infection(HAI).MethodsClinical data of patients undergoing emergency and selective surgery in a hospital from January 2014 to December 2016 were surveyed retrospectively, incidence and distribution of pathogens of HAP and VAP after surgery were analyzed, risk factors for HAP and VAP in patients undergoing emergency surgery were analyzed.ResultsA total of 3 526 patients who underwent emergency surgery were selected, 123 cases of HAI occurred, HAI case rate was 3.49%; 55 cases of HAP and 20 cases of VAP occurred among patients undergoing emergency surgery. 6 904 patients underwent selective surgery, 192 cases of HAI occurred, HAI case rate was 2.78%； 53 cases of HAP and 17 cases of VAP occurred among patients undergoing selective surgery; HAI case rate, incidences of HAP and VAP in the emergency surgery were all higher than those of selective surgery, difference were all statistically significant (all P<0.05). Gramnegative bacteria were the main pathogens isolated from patients with HAP and VAP after surgery. Sex (male), age (≥60 years), coma, tracheotomy/tracheal intubation, mechanical ventilation, combined use of antimicrobial agents, oral care, history of staying in ICU, and the number of surgery≥2 times were independent risk factors for HAP in patients undergoing emergency surgery (all P<0.05); coma and the number of surgery≥2 times were independent risk factors for VAP in patients undergoing emergency surgery (both P<0.05).ConclusionIncidences of HAP and VAP are higher in patients undergoing emergency surgery, each has its own independent risk factors, targeted prevention and control measures should be taken according to the relevant risk factors.

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ObjectiveTo understand distribution of pathogens and risk factors of multidrugresistant organism (MDRO) infection in patients with diabetic foot ulcer(DFU), and provide reference for effective clinical prevention and treatment of MDRO infection in patients with DFU. MethodsPatients with DFU and admitted to department of endocrinology and department of orthopedics in a tertiary firstclass general hospital between January 2011 and September 2016 were surveyed. Occurrence of diabetic foot infection was surveyed retrospectively, risk factors for MDRO infection were analyzed by univariate and multivariate logistic regression analysis. ResultsA total of 135 patients with DFU were surveyed, 122 strains of pathogens were isolated, 75 (61.48%) of which were gramnegative bacteria, 42(34.43%) were grampositive bacteria, and 5(4.10%) were fungi. Among 117 isolated strains, 76 were MDRO strains (64.96%), 22.37% of which were Escherichia coli, 17.11% were Staphylococcus aureus, and 15.79% were Pseudomonas aeruginosa. Univariate analysis suggested that 7 risk factors for MDRO infection in patients with DFU were history of antimicrobial use, antimicrobial treatment course＞10 days, combined more than 2 kinds of antimicrobial use, No. of hospitalization＞2 times per year due to wound at the same site, combined with osteomyelitis, neuroischemic wound, and Wagner grade 3-5(P＜0.05）. Multivariate logistic analysis revealed that independent risk factors for MDRO infection in patients with DFU were history of antimicrobial use, antimicrobial treatment course＞10 days, No. of hospitalization＞2 times per year due to wound at the same site, combined with osteomyelitis, neuroischemic wound, and Wagner grade 3-5(P＜0.05）.ConclusionPrevention is the priority of MDRO infection in patients with DFU, monitoring of degree of focal infection and change in pathogens should be paid attention, antimicrobial agents should be used rationally according to susceptibility of pathogens, bacterial resistance needs to be reduced as much as possible.

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ObjectiveTo explore the application of bundle management in the prevention of catheterassociated urinary  tract infection (CAUTI) in stroke patients, so as to reduce the incidence of CAUTI in stroke patients. MethodsStroke patients who were admitted to the department of neurology of a hospital and with indwelling urinary catheter between January 2016 and May 2017 were selected, patients who were admitted between January and August 2016 were as control group (adopting routine urinary catheter maintenance method), between September 2016 and May 2017 were as trial group (adopting bundle management measures). The implementation rate of urinary catheter maintenance measures, urinary catheter indwelling time, urinary catheter contamination rate, and incidence of CAUTI were compared between two groups of patients.ResultsA total of 60 patients were enrolled in the study, 30 were in control group, and 30 in trial group. The implementation rate of catheter maintenance measures in trial group was higher than that in control group (92.55% vs 71.74%, P=0.000). The implementation rates of catheter maintenance measures in trial group on the third, tenth, and seventeenth day were 94.64%, 89.13%, and 91.30% respectively, and control group were 78.55%, 67.87%, and 54.89% respectively, there were significant difference between two groups (both P<0.05). Catheter indwelling time in trial group was shorter than control group (［9.67±3.54］ d vs ［12.40±6.52］ d, P<0.05); contamination rate of urinary catheter in trial group was lower than control group (13.33% vs 50.00%, P<0.05); incidence of CAUTI in trial group was lower than control group (3.33% vs 26.67%, P＜0.05）. ConclusionBundle management can improve the implementation of urinary catheter maintenance measures, establish feedback mechanism, continuously improve quality, combined with bladder function training and rehabilitation, it can shorten catheter indwelling time, reduce urinary catheter contamination, and reduce the incidence of CAUTI in patients.

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ObjectiveTo explore the effect of meticulous nursing intervention and multidisciplinary team(MDT) collaboration on the compliance and correctness of wearing masks of tuberculosis(TB) patients going out for checkup. MethodsTB patients in the tuberculosis department of a hospital from October 2015 to December 2016 were investigated. OctoberDecember 2015 was pre intervention group（without intervention）, JanuaryDecember 2016 was postintervention group, meticulous nursing intervention and MDT collaboration were adopted, wearing status of medical surgical masks and awareness of TB prevention and control measures in TB patients going out for checkup before and after intervention were compared. Results799 TB patients were admitted in hospital, 160 cases were in pre intervention group and 639 in postintervention group. Before intervention, mask wearing rate and correct mask wearing rate were 50.63% and 86.42% respectively; after intervention, mask wearing rate and correct mask wearing rate were 95.31% and 98.52% respectively. Wearing rate and correct wearing rate of masks of TB patients at different seasons before and after intervention were compared, difference were both statistically significant (χ2=222.94, 38.512，respectively, both P=0.000）. After intervention, patients’ awareness of tuberculosis and prevention and control measures were both higher than before intervention, difference were both statistically significant (both P<0.001). ConclusionMeticulous nursing intervention and MDT collaboration can improve the wearing rate and correct wearing rate of masks in TB patients going out for checkup.

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ObjectiveTo explore the incidence and pathogens causing healthcareassociated infection(HAI) in donation after cardiac death(DCD) kidney transplant recipients, provide theoretical basis for formulating corresponding prevention and control measures. MethodsTargeted monitoring on HAI in DCD kidney transplant recipients from January 2014 to December 2016 was studied prospectively, incidence and pathogenic characteristics of HAI in DCD kidney transplant recipients were analyzed. ResultsFrom January 2014 to December 2016, 313 DCD kidney transplant recipients were monitored, 63 patients had 48 times of HAI, HAI rate and HAI case rate were 15.34% and 20.13% respectively. HAI rate in 2016, 2014, and 2015 were 10.11%（19/188）， 28.57%（14/49），and 19.74%（15/76）respectively, HAI rates were statistically significant among different years（P＜0.05）. The top three infection sites were lower respiratory tract (22/63, 34.92%), surgical site (16/63, 25.39%), and blood system (11/63, 17.46%). A total of 42 strains of pathogens were isolated, mainly gramnegative bacteria (n=27, 64.29%), followed by fungi (n=9, 21.43%) and grampositive bacteria (n=6, 14.28%); the top three pathogens were Klebsiella pneumoniae (n=9, 21.43%), Candida tropicalis (n=7, 16.67%), and Escherichia coli (n=5, 11.90%). Among 42 strains of pathogens, 15(35.71%) were multidrugresistant organisms(MDROs), 10(66.67%) of which were gramnegative bacteria, mostly were carbapenemresistant Enterobacteriaceae(n=4) and Acinetobacter spp.(n=3); 5 strains (33.33%) were grampositive bacteria, mainly were methicillinresistant Staphylococcus aureus(n=3). ConclusionHAI incidence in DCD kidney transplant recipients is high, comprehensive intervention measures should be taken to strengthen prevention and control of lower respiratory tract infection, surgical site infection, and bloodstream infection. Prevention and control of MDRO infection should be strengthened, antimicrobial use strategy should be improved to reduce the emergence of carbapenemresistant strains.

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ObjectiveTo understand current situation of construction and management as well as problems existing in the maintenance and management of clean operating rooms in Yunnan Province, provide basis for health administration department to standardize the construction and use management of clean operating rooms. MethodsA total of 135 secondary and higher general hospitals in whole province were surveyed by questionnaires, comprehensive performance of clean operating rooms was sampled for detection. ResultsOf 135 hospitals, 80.00% have built clean operating rooms, there was no significant difference in the constituent ratios of clean operating rooms in hospitals of different levels and different number of beds (P＞0.05). Clean operating rooms in 81.48% of hospitals had speciallyassigned persons to be responsible for daily maintenance of purification of airconditioning system, some hospitals didn’t replace primary, middle, and high efficiency filters as required, there was no significant difference in the maintenance of purification of air conditioning system between tertiary and secondary hospitals (P>0.05), 92.45% of hospitals carried out the monitoring of sediment bacteria, 37.96% of hospitals entrusted thirdparty agents to carry out comprehensive monitoring on clean operating rooms. Comprehensive monitoring results of 81 clean operating rooms in 34 hospitals showed that none were all qualified for 8 detected indexes, there was no significant difference in detection indexes between tertiary and secondary hospitals (P>0.05); there was significant difference in dust particle count between filter replacement group and nonreplacement group (P<0.05). ConclusionThere are discrepancies between No. of construction, cleanliness level of clean operating room, and hospital size as well as actual demand in Yunnan Province, maintenance and management in the established clean operating rooms is universally insufficient, it is necessary for hospitals and all levels of health administration departments strengthen management and supervision, standardize the construction, maintenance and management of clean operating rooms.

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ObjectiveTo understand microbial contamination and management of medical refrigerators in medical institutions in Hongkou District of Shanghai. MethodsA questionnaire survey was conducted to understand the refrigerator management system of various medical institutions, hygienic sampling on refrigerator surface was performed, bacterial colony forming unit was calculated and microbial species were identified. ResultsA total of 71 medical refrigerators in 71 departments of 13 medical institutions were investigated, tertiary, secondary, first level, and private medical institutions were 30, 21, 10, and 10 sets respectively. Of 71 departments, 63.38%（45/71）established medical refrigerator management system; only 25.35% (18/71) of medical refrigerators used digital temperature control system; 28.17% (20/71) used telephone/short message alarming; in terms of staff training, 49.30% (35/71) of departments conducted refrigerator management training, 15.49% (11/71) didn’t record the operation condition of refrigerators, 80.28% (57/71) regularly disinfected refrigerators. Of 71 medical refrigerators, the total number of colonies on surface of 2 refrigerators exceeded 10 CFU/cm2, which was from clinical laboratory and outpatient pharmacy; 27 refrigerators were isolated fungus, 5 isolated Staphylococcus aureus, and 4 isolated Acinetobacter baumannii; coliform group was not found in all refrigerators. Fungus was isolated on surface of medical refrigerators in pharmacy, laboratory, and general wards, Staphylococcus aureus and Acinetobacter baumannii were isolated from surface of refrigerators in pharmacy and general wards, one refrigerator in intensive care unit was detected fungus, and another was detected Staphylococcus aureus. ConclusionManagement of medical refrigerators in medical institutions is not sufficient, perfect management system for different levels, different departments, and different use condition of refrigerators should be formulated, monitoring and recording of temperature should be strengthened, measures and frequency of cleaning and disinfection of medical refrigerators should be clarified.

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ObjectiveTo understand direct economic loss due to healthcareassociated infection(HAI) with multidrugresistant Acinetobacter baumannii(MDRAB). Methods65 hospitalized patients with MDRAB  in a tertiary firstclass general hospital in Chongqing City between September 2014 and August 2016 were as case group, a 1∶1 matched casecontrol study was adopted, 65 hospitalized patients without HAI during the same period were selected as control group, direct economic loss due to MDRAB HAI was analyzed and compared. ResultsThe median of hospitalization expense, medicine proportion, and length of hospital stay in case group were 167 579.56 yuan, 37.40%, and 52 days respectively, while those in control group were 59 386.77 yuan, 31.85%, and 27 days respectively, the average direct economic loss due to MDRAB HAI was 108 192.79 yuan, mainly for fees of medicine, nursing, treatment, and laboratory detection, the proportion of medicine was the highest; the average extension of length of hospital stay due to MDRAB HAI was 25 days; each expense in case group was higher than that of control group, difference were all statistically significant (all P<0.05). ConclusionEconomic loss due to MDRAB HAI is serious, proportion of medicine is increased, and length of hospital stay is prolonged, prevention and control should be paid attention.

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假膜性肠炎（pseudomembranous enterocolitis，PMC）是一种主要发生于结肠，也可累及小肠的急性肠黏膜坏死、纤维素渗出性炎症，黏膜表面覆有黄白或黄绿色假膜［1］。PMC治疗方法有限，病情易反复。现将我科粪便菌群移植（fecal microbiota transplantation，FMT）成功治疗复发性重度PMC １例报告如下。

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针灸是中国传统医学的一个重要组成部分，据世界卫生组织（WHO）统计，目前已有103个会员国认可并使用针灸，其中29个国家设立了相应法律法规，18个国家将针灸纳入医疗保险体系［1］。针刺疗法作为一种侵入性治疗手段，其安全性已受到了WHO及许多国家卫生管理部门的关注，特别是在针刺器具、医者手指、针刺部位、治疗场所的消毒方面均有具体的规定或建议。由于美国具有除中国之外最为严格和完善的针灸执业资格准入和执照考试的规范体系［2］，本文就中美两国针刺消毒规范进行比较。

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