OBJECTIVE To investigate the impact of multiple system diseases (MSD) on oral and maxillofacial (infections) in the elderly patients. METHODS Fourteen cases with MSD, and 8 cases with (non-multiple) (system) (diseases) (NMSD) were randomly selected. By comparison between two groups, we studied the effect of MSD (on the) elderly orofacial infections. RESULTS In etiology and infection site, their was no (difference) between two groups, (P=0.649) and P=0.552, respectively. In the surgical treatment, no difference was between two groups, P=1.000. In the medicine using to treat MSD in hospital time, MSD group was more than NMSD group, (P=0.006.) CONCLUSIONS When we treat the elderly orofacial infections, we should judge if the elderly patients have MSD.
OBJECTIVE To find out the situation of HIV occupational protection among clinical nurses.METHODS A survey of the general understanding of HIV/AIDS,the knowledge,attitude and behavior of HIV occupational protection was conducted among 160 clinical nurses.RESULTS Nurses were ideally informed about HIV/AIDS,but weren't about HIV occupational exposure.And a high occurrence of occupational skin injury was found.Only 46.8% of nurses had an common attitude towards occupational protection.CONCLUSIONS It is important to train clinical nurses in HIV occupational protection and so to promote their protection consciousness.
OBJECTIVE To investigate changes in antimicrobial resistance and the condition of producing β lactamases of Acinetobacter baumannii during the past 5 years and detect their genotype of the β lactamases encoding genes. METHODS Microdilute tests were performed to detect the susceptibility of 23 kinds of antimicrobials against 549 strains of A. baumannii isolated from inpatients between Jan 1999 and Dec 2003. Extended spectrum β lactamases (ESBLs) and AmpC enzyme were tested by three dimensional tests. Genotypes of β lactamases were analyzed by PCR and verificated by DNA sequencing. RESULTS The total susceptibility rates of 549 strains of A. baumannii to imipenem, polymyxin E, meropenem, and piperacillin/tazobactam were 96.4%, 93.0%, 92.9%, and 30.1%, respectively. The susceptibility rate to other antimicrobial agents ranged from 0.0 to 20.9%. The susceptibility rate to imipenem was more than 95.0% and remained unchanged for years. The susceptibility rate to polymyxin E and meropenem were more than 88.0% and 84.0%, respectively. From 1999 to 2003, the antimicrobial agents to whom the resistant rates increased fastest were amoxicillin/clavulanic acid, ceftriaxone, cefotaxime, piperacillin and piperacillin/tazobactam, respectively. The positive rates of ESBLs and AmpC enzyme were 30.0% and 1.7%, respectively, 48.3% of which produced ESBLs and AmpC enzyme simultaneously. The positive rates of the β lactamases encoding genes of TEM and SHV were 100.0% and 29.2%, respectively. The genotypes were TEM 1, SHV 12, SHV 48, and SHV 56, respectively. But the genes
OBJECTIVE To investigate qacE-sul1 gene resistant to the quaternary ammonium compounds (QACs) and sulphonamide compounds in Gram negative bacteria in order to provide the information of bacterial resistance to disinfectants. METHODS The minimal effective bactericidal concentration of 60 strains of Gram negative bacteria resistant to QACs was detected by diluting-counting method; the phenotype to QACs by the improved phenotype screening test,the qacE-sul1 gene of resistance to QACs and sulphonamide compounds by PCR. RESULTS The minimal effective bactericidal concentration of some Gram negative bacteria resistant to QACs was 8 times more than the recommending concentration. From 60 Gram negative bacteria strains 14 were positive by phenotype screening test; the qacE-sal1 genes of 11 strains were positive by PCR,the full sequence of some of which was registered in GenBank (Accession No. AY769739). CONCLUSIONS The bacteria of high resistance to QACs are mediated by genetic material. The improved phenotype screening test can effectively screen the bacteria of high resistance to QACs.
OBJECTIVE To investigate the causes of disease and the measures of diagnosis, prevention and treatment for pyothorax due to postoperative anastomotic leakage in esophageal and cardiac cancer surgery. METHODS The data of 42 cases of pyothorax due to postoperative anastomotic leakage in esophageal and cardiac cancer patients were analyzed retrospectively. RESULTS All cases were treated with thoracentesis. Twenty five cases were operated again,only 4 cases of them died. After that five cases died of toxic shock and exhaustion. Others had perfectly recovered from their illness. CONCLUSIONS To take more perioperative measures is the key to prevent pyothorax due to anastomotic leakage.
OBJECTIVE To investigate the disinfectants resistant gene and β lactams resistant genes in meticillin resistant Staphylococcus aureus(MRSA) with multidrug resistance isolated in Huzhou, Zhejiang Province. METHODS Twenty strains of the MRSA were clinically isolated. The disinfectants resistant gene of qacA and β lactams resistant genes of mecA and TEM of these strains were analyzed using polymerase chain reaction(PCR). RESULTS The positive rate of genes of qacA, mecA and TEM was all 100.0% in the twenty strains. CONCLUSIONS There are very high positive percentages of genes of qacA, mecA and TEM in the MRSA with multidrug resistance isolated in the 98th Hospital of PLA, and their finding of the gene in the MRSA is first reported in China.
OBJECTIVE To investigate the way of disposing infective wound. METHODS From May to Dec 2004,31 cases used Anerdian Ⅲ for dealing with infective wound.According to wetness cicatrization theory,we used the wetness dressing for local adjustment. RESULTS All the infective wounds in 31 cases were controlled within a week.The wound surface was verdure,effusion decreased evidently and no peculiar smell. CONCLUSIONS The way of using Anerdian Ⅲ for disposing infective wound and keeping wound wet obviously outgoes the traditional way of washing the wound by 3% H_2O_2 and keeping it dry.
OBJECTIVE To investigate clinical antibiotic resistance of the 2 170 stains of Gram-positive cocci, isolated from clinical specimens in the years of 1992-2001, make reasonable choices of the clinical antibiotics and provide reference for clinical anti-infection treatment. METHODS To study in accordance with The National Clinical Test Regulation of Operation. RESULTS Totally 2 170 stains of Gram-positive cocci′s average resistance rates towards VAN, CEZ, GEN, CIP, SMZ, OXA and PEN were 8.4%, 32.1%, 40.0%, 45.6%, 58.6%, 59.4% and 68.2%, respectively. In the first 7 years, Gram-positive cocci′s resistance had not been increased obviously despite some petty varieties. The increase in their resistance had been very obvious in the recent 3 years. Their resistance towards GEN had been increased most quickly, and the average resistance rate was 26.7% higher than the one in the first seven years; next towards CEZ and CIP,with the 26.5% and 25.4% higher average resistance rates. Moreover, the average resistance rate of Staphylococcus aureus towards PEN, which was the highest, reached 79.2%, and of S. epidermidis towards SMZ reached 74.2%. The average resistance rates of MRSA and MRSE were 51.1% and 68.3%, both higher than 50%. This needs our special attention. CONCLUSIONS In recent years, hospital acquired infection caused by Gram-positive cocci have an upward trend. Their resistances have also rising obviously. The strengthened supervision and reasonable advice for medicine should be given.
OBJECTIVE To strengthen the ma nagement of medical waste treatment,and to prevent nosocomial cross infection. METHODS To establish the management syste m centered by key responsible person as the first responsible person,and enhanc e the training of medical employees on medical waste knowledge.To create organi zational structure of medical waste,handle flow chart,put supervising function into effect,and adopt question feedback mechanism,make corrective measures,a nd validate the effect. RESULTS Management measures were effectiv e,and the medical waste treatment was made into a standardized system. CONCLUSIONS By strengthening the managem ent of medical waste treatment,it can ensure prevent cross infection,and impro ve the medical care quality.
OBJECTIVE To investigate the relationship between hepatitis C virus(HCV) hypervariable region 1(HVR1) quasispecies complexity and the effectiveness to interferon(IFN) therapy in patients with HCV 1b(infection.) METHODS Dynamic changes of HCV quasispecies before and after IFN therapy were(detected) by the method of heteroduplex mobility analysis(HMA).RESULTS The complexity of HVS1 quasispecies in responders was less than that in nonresponders before IFN treatment.Numbers of HMA bands of HVR1 were decreased after IFN therapy in most patients.CONCLUSIONS The low complexity of HCV HVR1 quasispecies indicates the(effectiveness) of IFN therapy in patients with HCV 1b infection.
OBJECTIVE To investigate the infection condition of meticillin-resistant Staphylococcus aureus ~(MRSA) infected in patients for adopt effective methods to its prophylaxis. METHODS Forty one cases MRSA infected in patients were analyzed retrospectively. RESULTS Infection occurred mainly in whom that were older than 60 years old, male, had been infected by several diseases. The infected inpatients were mainly in ~Departments of Neurology and Neurosurgery. The lower respiratory tract was the most frequent infection site. Nosocomial infection rate was 48.9%. The sensitivity rate of MRSA to vancomycin and teicoplanin was 100%, to amikacin was 52.4%, to gentamicin was 19.4%, the others were lower than 10%. CONCLUSIONS To ~understand the MRSA infection distribution feature in hospital in time is helpful for us to take some corresponding prophylaxis and detection measures.
OBJECTIVE To set up a multiplex PCR method to detect the Neisseria gonorrhoeae and their drug ~resistance genes to penicillin and tetracycline in the same amplification system. METHODS According to CPPB, TeM-1 and Tet-M gene sequences of N. gonorrhoeae, three pairs of primers were designed respectively, and the PCR amplification was progressed in the same system. The target DNA for CPPB, Tem-1 and Tet-M was ~150 bp, 224 bp and 316 bp, respectively. RESULTS The standard N. gonorrhoeae strain with drug resistance to penicilin and tetracycline was positive in CPPB, TeM-1, and Tet-M through the multiplex PCR. A total of 125 ~clinical specimens were tested by traditional culture, drug susceptibility tests and PCR in the sametime, the ~results demonstrated that the positive rate of N. gonorrhoeae was 20.0% and 24.8%, the penicillinase-~producing N.gonorrhoeae (PPNG) was 16.0% and ~20.8% and the tetracycline resistant N.gonorrhoeae (TRNG) was 14.4% and 19.2%, respectively. CONCLUSIONS The multiplex PCR is more ~sensitive, specific and rapid than the tranditional culture and drug susceptibility tests.
OBJECTIVE To study the distribution of the nonfermenter(NF) and the change of its resistance between 1999 and 2003 in our hospital, and instruct clinical application of antibiotics reasonably. METHODS The identification of bacteria, antibiotic susceptibility and the detection of inducible beta lactamase (IB) were done by MicroScan WalkAway 40. Extended spectrum beta lactamases (ESBLs) were confirmed by ESBLs phenotype affirmative test in accord to NCCLS. RESULTS The detective rate of the NF was 14 4%,16 6%,15 3%,18 0% and 18 8%, respectively, between 1999 and 2003. Pseudomonas aeruginosa(PA), Acinetobacter lwoffii, A. baumannii/ A. haemolyticus and Stenotrophomonas maltophilia accounted for 54 5%,10 6%,10 4% and 6 0%, respectively. The highest distribution of the NF was in the sputum. The susceptible rate of imipenem and ceftazidine to PA was higher, however, it had dropped from 80% and 79% in 2001 to 66% in 2003. The susceptible rate of cefotaxime and ceftriaxone to PA was lower(15%). The susceptible rate of sulfamethoxazole/trimethoprim to C. maltophilia was higher than the others, and rose from 75% in 1999 to 91%in 2003. The susceptible rate of A.lwoffii was higher than A.baumannii/A.haemolyticus. The incidence rates of ESBLs and IB of PA were 15 2% and 83 3%,respectively. CONCLUSIONS The detective rates of PA, A.baumannii /A.haemolyticus and C.maltophilia are gradually increased during the last five years. The resistance of the NFs, but A. lwoffii, to antibiotics is higher. The incidence of IB of PA is also higher.
OBJECTIVE To determine the genotype of β-lactamases produced by ESBLs-producing Klebsiella pneumoniae isolated from blood samples of newborn department in Shenzhen People′s Hospital.METHODS Five(ESBLs)-producing K.pneumoniae strains were isolated from blood samples of newborn department.PCR was used to detect genes SHV,DNA sequences were analyzed by the use of ABIPRISM 377 DNA sequencer.Minimal(inhibitory) concentrations(MIC) of 11 antibiotics for the isolates were determined by the agar dilution method. RESULTS Gene SHV was detected in all 5 K.pneumoniae isolates by PCR.DNA sequences showed 4 of 5(isolates) were carrying gene SHV-14,the rest isolate produced a novel SHV-type β-lactamase.This enzyme(differed) from SHV-1 at amino acid positions,Ala 134→Val and Pro 269→Leu.It was assigned the name of SHV-59(GenBank No.AY790341).CONCLUSIONS A novel β-lactamase is found in our hospital.
OBJECTIVE To strengthen the management of nosocomial infection and so to raise the level of nosocomial infection management of our hospital. METHODS Concerned with the actual status of our hospital, we established the Ten Rules of Nosocomial Infection Management according to the National Protocol of Nosocomial Infection Management and the Practical Guideline of Nosocomial Infection Management of Military Hospital. RESULTS Such work made the nosocomial infection management in our hospitals more practicable. CONCLUSIONS The Ten Rules of Nosocomial Infection Management is a significant meaningful guideline for the management of nosocomial infection.
OBJECTIVE To investigate the prevention experience of acquired lung infection (ALI) for senile patients with retained stomach tube after operation. METHODS Retrospective analysis was proceeded for all senile patients (retained) stomach tube after operation in a past decade. RESULTS Among 1 633 senile patients, 395 patients (developed) hospital infection in which 210 patients with retained stomach tube after operation developed ALI, that (occupied) (53.18%) of total patients developing hospital infection. CONCLUSIONS Long-term retained stomach tube can (increase) incidence of retrograde infection from stomach to pharynx and lower respiratory tract in sequence. (Enhancement) of prevention of respiratory tract infection for senile patients with retained stomach tube and (well-timed) (extraction) of stomach tube would effectively decrease the incidence of infection and the mortality of (senile) (patients. )
OBJECTIVE To find out some related factors of hospital infection of lower respiratory tract in patients of craniocerebral injury and provide controlling measures. METHODS The related factors of hospital infection in lower respiratory tract were retrospectively analyzed with the form of two groups including the infection group of 64 cases of lower respiratory tract infection patients in the neurosurgery department and the noninfection group of 63 cases of patients without lower respiratory tract infection randomly. RESULTS Hospital infections in lower respiratory tract were related with such factors as tracheotomy, trachea intubation, sputum aspiration, consciousness obstacle, stomach intubation, stress ulcer,general anesthesia operation, and subhypothermia treatment, and weren′t related with such factors as age, sex, and chronic disease. CONCLUSIONS These steps including no bacteria operation, clear respiratory tract, preventive sterilization and isolation. are the most effective on controlling the infection of lower respiratory tract.
OBJECTIVE To understand the ch ar acters of genotyping and antibiotic resistance of strains producing extended spe ctrum beta-lactamases(ESBLs) isolated from urinary system. METHODS ESBLs producing Escherich ia coli and Klebsiella pneumoniae strains that isolated from urine were identified by phenotypic confirmatory test.The presence of the TEM,SHV and CTX-M genes was confirmed by specific PCR assays.MICs to the isol ates were determined by the agar dilution method. RESULTS The genotype of the isolates was as follows: 85.2% CTX-M,37.0% TEM and 9.3% SHV.Near half(46.2%) of the strains carried more than one type of ESBLs gene.MIC test showed these strains were 100% susceptible to imipenem,88.9% to amikacin,70.4% to piperacillin/ta zobactam.However,the susceptibility to ciprofloxacin and ampicillin/sulbactam w as very low(25.9 and 1.9%,respectively).In addition,88.2% strains showed n onsusceptible to cefotaxime. CONCLUSIONS In our hospital,ESBLs produci ng isolates are most susceptible to imipenem,about half of the strains carry mo re than one ESBLs gene,the major genotype of ESBLs producing isolates is CTX-M.
OBJECTIVE To understand the antimicrobial resistance of Staphyalococcus causing nosocomial infections in our hospital. METHODS K-B test was used for the antibiotics susceptibility test and the results were read based on National Committee for Clinical Laboratory Standards (NCCLS). RESULTS Among 423 strains of S. aureus isolated from 1999 to 2003, there were 79 strains of meticillin-resistant S. aureus (MRSA) and 334 strains of meticillin-sensitive S. aureus (MSSA). Among 898 strains of S. epidermidis, there were 647 strains of meticillin-resistantS. epidermidis (MRSE) and 251 strains of meticillin-sensitive to clinical commonly used antibiotics,but their resistant rate to penicillin, erythromycin, azithromycin and tetracycline was over 70%. MRSAand MRSE were highly resistant to almost all commonly used antibiotics except for vancomycin. CONCLUSIONSIt is very important for rational antimicrobial therapy to survey the drug resistance of Staphylococcus. And vancomycin should be the first choice in the treatment of severe infections caused by Staphylococcus.
OBJECTIVE To evaluate the effic ac y and safety of piperacillin/tazobactam in the treatment of postoperative abdomi nal infection.METHODS Totally 140 patients with postopera tive abdominal infection were empirically treated by piperacillin/tazobactam as anti-totally inflammatory therapy.RESULTS The total effective rate was 90.6%,the bacteria eradication rate was 89.9%,the rate of adverse reactions occurri ng was 3.6%.CONCLUSIONS Piperacillin/tazobactam is a hi ghly effective,safe and low toxic agent in the treatment of postoperative abdom inal infection.
