Abstract:

ObjectiveTo investigate the epidemiological characteristics of nosocomial infection (NI) outbreak incidents in recent 30 years .MethodsNI outbreak occurred between January, 1980 and December, 2009 were surveyed retrospectively through literature index survey .ResultsThere were 352 cases of NI outbreak in China in recent 30 years, 7 656 persons were infected, and 341 died． The major pathogens of infection were bacteria and virus（91.48%）, the main spread routes were contact(44.32%) and iatrogenic infection(43.18%); the peak season of NI outbreak was summer(35.51%, 125/352); the major population of cases were infants (43.99%), the mortality of infants was 84.58% (192/227); general hospitals (provincial,city,countylevel) were the high area of outbreak(73.58%, 259/352); the major infection sites were intestinal tract (32.07%), lower respiratory tract (26.19%), and blood stream(14.07%); The main causes of outbreak were cross infection of health care workers’ hands, contamination of blood product, insufficient disinfection and isolation, incorrect manipulation, et al ．ConclusionThe outbreak of NI had certain regulation, preventive measures should be drawn up based on epidemiological characteristics, so as to control the outbreak of NI effectively.

Abstract:

ObjectiveTo study the pathogens in an infection outbreak after cesarean section in a hospital of Shantou, and analyze antimicrobial susceptibility of pathogens.MethodsFrom December 2009 to March 2010, 32 specimens (including focal tissue, secretion of incision and pus) were taken from 20 cesarean section patients infected with Mycobacterium abscess, and specimens were performed bacterial culture and gram staining and acidfast staining, The isolates were identified and determined the drug susceptibility on the bases of rapid growing Mycobacterium.ResultsOf 20 patients, 11 patients isolated 14 strains of rapid growing Mycobacterium , all were Mycobacterium abscess. All strains were sensitive to erythromycin, clarithromycin, azithromycin and amikacin, medium sensitive to imipenem, linezolid and gentamycin, but resistant to the other antimicrobials.ConclusionThe postoperative infection is caused by Mycobacterium abscess. Management and surveillance of nosocomial infection should be intensified to prevent the occurrence of such incident.

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ObjectiveTo investigate fungal infection and drug resistance of fungi in ICU patients with external intubation.Methods161 specimens of intubator used by 84 ICU patients in a hospital were collected, and specimens were inoculated on Candidal chromogenic medium , all strains were identified by API 20C AUX Kit,and drug sensitivity test were performed by ATB FUN3 Kit.ResultsNinetyeight (60.87%) fungus strains were isolated from 161 specimens, most of which were Candida albicans (52, 53.06%), the next were Candida tropicalis (14, 14.29%), Candida glabrata (11, 11.22%), Candida parapsilosis (9, 9.18%) , and Candida krusei (12, 12.25%). Sixty strains (61.22%) were isolated from respiratory intubator, 25(25.51%) from urethral catheter and 13(13.27%) from venous cannula. Drugresistant rate of isolated strains to 5fluorocytosine, amphotericin B, and voriconazole were all <10% , resistant rate to itraconazloe was 12.24%;resistant rate of Candida glabrata, Candida parapsilosis and Candida krusei to fluconazol were all >45%.ConclusionCandida albicans is the main fungi in infection caused by external intubation; fungal infection rate in patients undergoing respiratory intubation is high than patients undergoing the other external intubation ; All kinds of Candida have low drugresistance to 5fluorouracil, amphotericin B and fluconazole and have high drugresistance to fluconazole.

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ObjectiveTo observe the adverse drug reactions of ganciclovir in treating infants with cytomegalovirus (CMV) hepatitis, and to analyse the influencing factors. MethodsInformation of the infants who suffered from CMV hepatitis and administered with ganciclovir from January,2005 to December, 2009 was collected, and the incidence of adverse reactions was calculated. The SPSS statistical software was used to analyse the influencing factors.ResultsThe total incidence of adverse reactions during the treatment of ganciclovir was 29.46%（71/241, 95%CI: 23.70%-35.21%）,the incidence of bone marrow suppression was 22.08%（51/231，95%CI: 16.73%-27.43%）, and the incidence of liver damage was 9.71 % (20/206, 95%CI: 5.67%-13.75%). Among 71 infants with adverse reaction , 46(64.79%)had effective treatment of ganciclovir; among 170 infants without adverse reaction, 120(70.59%) had effective treatment of ganciclovir, there was no significant difference in effective rate between two groups (χ2=0.79, P=0.38). There was no correlation between adverse reaction and infants’ genders, jaundice, premature delivery, cesarean section,and infection (all P>0.05).ConclusionGanciclovir can induce the bone supression and liver damage, but the treatment effect is not affected, there is no correlated influencing factor with adverse reaction.

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ObjectiveTo investigate status of infectious diseases among public practitioners in Changping District of Peijing.MethodsPublic health information management system was adopted to analyze statistically on physical examination results of public practitioners in Changping District of Beijing in 2009.ResultsAmong 76 654 practitioners, the positive rate of HBsAg was 1.83%, employees in food and public places was 1.51% (920/61 032) and 3.09% (482/15 622) respectively; local employees and employees from the other towns was 0.74%(139/18 749) and 2.18% (1 263/57 905) respectively; male and female was 2.25%(729/32 397) and 1.52%(673/44 257) respectively; The difference in each group was statistically significant(both P＜0.01). The detection rate of active pulmonary tuberculosis was 0.12%, local employees and employees from the other towns was 0.05%(9/18 749) and 0.15% (86/57 905) respectively, the difference was statistically significant(P＜0.01). HCV and HEV antibody positive rate was 0.02% and 0.01% respectively; Suppurative or exudative skin diseases detection rate was 0.03%; typhoid/ dysentery was not found. ConclusionAmong all monitored infectious diseases ,the detection rate of HBsAg was the highest, the detection rate of pulmonary tuberculosis, purulent and exudative skin diseases were relatively low. Public practitioners should adhere to annual physical examination , the management of practitioners from the other towns should be intensified and receive vaccination .

Abstract:

ObjectiveTo study resistant mechanisms of two clinical strains of Enterobacter aerogenes (Ea293 and Ea2880)to ertapenem. MethodsThe minimum inhibitory concentrations (MICs) of antimicrobial agents were determined by microbroth dilution method, drug resistance of strains to imipenem，meropenem，and ertapenem were determined by KB test; carbapenemase was confirmed by modified Hodge test, carbapenemase genes（KPC，IMP1 group，IMP2 group，VIM）, broadspectrum and extendedspectrum βlactamases genes（TEM，SHV，CTXM1 group，CTXM2 group，CTXM9 group） were amplified by polymerase chain reaction (PCR), and sequences were analysed; Outer membrane protein (Omp) was analyzed by sodium dodecylsulfatepolyacrylamide gel electrophoresis (SDSPAGE) and the coding gene OmpE36 was amplified by PCR. ResultsAntimicrobial susceptibility test showed that Ea293 and Ea2880 were all resistant to ertapenem. Among amplified 4 carbapenemase genes and 5 broadspectrum and extendedspectrum genes, only  blaSHV and blaCTXM9 group ESBLs in Ea2880 were positive, BlaSHV DNA sequence was SHV11 type. SDSPAGE showed that compared with ertapenemsensitive isolate Ea1885, ertapenemresistant isolate Ea293 and Ea2880 lacked the protein band with 42kD which might be the outer membrane protein gene OmpE36. OmpE36 was amplified by PCR, Ea2880 appeared the excepted bands, but Ea293 didn’t. The similarity of DNA and amino acid sequences of OmpE36 of Ea2880 with the standard Enterobacter aerogenes ATCC13048 from GenBank were both 87%.ConclusionThe resistance of clinical strains of Enterobacter aerogenes Ea293 and Ea2880 to ertapenem might be associated with the loss of outer membrane protein gene OmpE36. Furthermore，Ea2880 might be associated with production of CTXM9 group ESBLs.

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ObjectiveTo report the clinical and laboratory detection data of 4 cases of rare deep infections caused by Sporothrix schenckii, Fusarium moniliforme, Penicillium marneffei and Scedosporum apiospermum. MethodsSecretion and blood specimens from patients' infected sites were taken for direct smear and culture , fungi were identified according to colony features and appearance under microscope. ResultsFour strains of filamentous fungi isolated from the wound secretion and blood specimens were Sporothrix schenckii, Fusarium moniliforme, Penicillium marneffei and Scedosporum apiospermum .ConclusionInfection caused by Sporothrix schenckii, Fusarium moniliforme, Penicillium marneffei and Scedosporum apiospermum in clinic are very rare, and the detection is also difficult. The knowledge and laboratory detection on the rare fungi infection should be strengthened to improve the level of diagnosis and therapy.

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 ObjectiveTo study the influence of different load patterns on pressure steam sterilization parameters of autoclave.MethodsThermologgers was used to measure the temperature distribution of sterilization chamber without load, the temperature time variation at the center and on the upper layer of the tested package, as well as the pressure time variation of different load patterns. The influence of different load patterns on the temperature and air expelling level inside the tested package was analyzed.ResultsLoad pattern directly acts on the temperature and air expelling level inside sterilization package. Extremely heavy load pattern may lead to the temperature inside package being lower than required sterilization temperature and remain air inside package.ConclusionLoad pattern of autoclave can influence sterilization efficacy, it is necessary to standardize the load pattern of autoclave.

Abstract:

ObjectiveTo investigate the characteristics of the distribution and drugresistance of Acinetobacter spp. in a cardiovascular special hospital.MethodsThe distribution and drugresistant rates of Acinetobacter spp. which isolated from clinical specimens from January,2006 to December,2009 were analysed retrospectively.Results409 Acinetobacter spp. were mainly isolated from sputum(75.79%),followed by blood(8.56%), the rest from others(urine,venous catheter,secretions) and accounted for 15.65%; department distribution : Acinetobacter spp. were mainly isolated from surgical ICU and accounted for 40.59%,followed by medical ICU and accounted for 37.41%,other departments(including surgery and internal medicine) was 22.00%;bacteria distribution: Acinetobacter spp. consisted of Acinetobacter baumannii(80.20%),followed by Acinetobacter lwoffii(16.87%)and Acinetobacter haemolyticus(2.93%). Acinetobacter spp. had low drugresistant rates to cefoperazone/sulbactam, piperacillin/tazobactam, ceftazidime,cefepime,gentamycin,amikacin and ciprofloxacin, drugresistant rate was 2.69%,14.18%,19.56%,15.16%,15.65%, 9.29%,and 14.18%, respectively. The percentage of drugresistant rate to imipenem and meropenem was 3.67% and 5.87% respectively, while it was over 57% to the other antimicrobial agents .ConclusionAcinetobacter spp. is one of nonfermentative bacteria in nosocomial infection, the main infection is respiratory tract infection , and shows serious drugresistance. Cefoperazone/sulbactam and carbapenems are effective antibiotics for treating infections caused by Acinetobacter spp..