Objective To realize the characteristics of community-onset multi-drug resistant organism infections(MDRO-COIs).Methods A prospective investigation was conducted on patients with positive culture of Staphylococcus aureus,Enterococcus,Escherichia coli,Klebsiella pneumoniae,and Acinetobacter baumannii between July 1,2008 and June 30,2010.Results A total of 1 646 episodes of Staphylococcus aureus,Enterococcus,Acinetobacter baumannii,Escherichia coli,and Klebsiella pneumoniae infections occurred,1 148 of which were COIs,including 470(40.94%) MDRO infections;498 of which were hospital-onset(HO) infections,including 260(52.21%) MDRO infections,which was significantly higher than that of MDRO-COI rate(χ2=17.87,P=0.00).MDRO-COI pathogens were mainly from sputum or bronchial secretion(171/470,36.38%),the next was urine(166/470,35.32%),these samples accounted for 71.70% of all.Of all departments,MDRO-COI rate was the highest in intensive care unit(ICU)(64.75%).For the infection sites of COIs,respiratory MDRO infection was the highest(60.71%).Conclusion MDRO-COIs are serious,the management of patients with MDRO-COIs should be enhanced,transmission in the hospital should be avoided.

OBJECTIVE To strengthen the monitoring of nosocomial infections and implement control measures and to study the effect of the interventions in extended-spectrum β-lactamase(ESBLs)-producing Escherichia coli infections.METHODS The patients with ESBLs-producing E.coli infections from a tertiary hospital were prospectively monitored and controlled,by means of the unified investigation,the characteristics of ESBLs-producing E.coli infections and the effects of the intervention measures were studied.RESULTS Of totally 659 case-times of patients with E.coli infections investigated,ESBLs-producing E.coli were isolated from 361 case-times of patients with the isolation rate of 54.8%,the isolates were mainly isolated from the sputum,tracheal secretions,pus or wound secretions;61.2% of the patients were with community-acquired infections;before taking the interventions,the detection rate of ESBLs-producing E.coli was significantly increased,increasing from 33.0% in 2003 to 63.0% in 2006,and after taking the interventions in 2007,the detection rate decreased from 63.0% to 52.2%;the detection rate of ESBLs-producing E.coli causing hospital-acquired infection kept an downward trend,decreasing from 65.2% to 56.9%.CONCLUSION The interventions can effectively control ESBLs-producing E.coli infections,it may have difficulties in the control of ESBLs-producing E.coli causing community-acquired infections.

<正>从娩出到生后28天内的婴儿称为新生儿。新生儿非特异性和特异性免疫功能均不成熟,对细菌、病毒和真菌具有普遍易感性,是医院感染的高危人群。

OBJECTIVE To determine the epidemiology,risk factors and outcome of nosocomial infections in the RICU.METHODS Retrospective investigation was performed on the clinical data of the patients 48 hours tater after to the RICU from Jan 2010 to Dec 2010.RESULTS Nosocomial infection rate of the RICU was 30.6%(14.5 per 1000 patient days),case infection rate was 45.0%(21.3 per 1000 patient days).The most common site of infection was lower respiratory tract.The most common organism was Acinetobacter baumannii.Tumor,using over two types of antibiotics,mechanic ventilation more than seven days were the independent risk factors for the nosocomial infection.Nosocomial infection was independent risk factor for patients death.CONCLUSIONS Multi-various factors contribute to nosocomial infection in RICU.Nosocomial infection increases the risk of death in RICU patients.

OBJECTIVE To know the infection control efficacy of hospital-onset Methicillin-resistant Staphylococcus aureus infections(MRSA-HOI).METHODS We investigated the patients with positive cultures of MRSA in a general tertiary hospital from Jan 2005 to Dec 2010.We conducted a prospective investigation for the patients admitted after Jul 1st in 2008 and carried bundle measures for patients with MRSA infection or colonization.For the patients admitted before June 1st in 2008,a retrospective investigation was developed to analyze the efficacy of bundle measures.RESULTS The overall MRSA-HOI incidence rate decreased distinctly(P=0.00)from 1.22 to 0.64 per 10000 bed-days along with carrying out bundle measures in effect.There was a statistically significant decrease(P0.05) in both respiratory infections and urinary tract infections.In different departments,we achieved good control efficacy in the intensive care units with the most proportion of MRSA-HOI(40.40%).CONCLUSION Implementing contact precautions is critical for preventing the spread of MRSA in hospital.

OBJECTIVE To know the characteristics of hospital-acquired multi-drug resistant organisms infections(MDROs-HAI).METHODS We conducted a prospective investigation of the characteristics of MDROs-HAI on the patients with positive cultures of Staphylococcus aureus,Enterococcus,Escherichia coli,Klebsiella pneumoniae and Acinetobacter baumannii between Jul in 2008 and Jun in 2010.RESULTS From Jul 2008 to Jun 2010,there were totally 1646 episodes of Staphylococcus aureus,Enterococcus,Acinetobacter baumannii,Escherichia coli and Klebsiella pneumoniae infection in the hospitalized patients.Among of these 1646 infections,the MDROs infections proportion was 44.3%,and for the hospital-acquired infection,the MDROs infection proportion was higher(proportion:52.2%,P0.01).In all the departments,MDROs infection proportion of the hospital-acquired infection in intensive care unit(ICU) was the highest with 68.5%,and The MDROs infection proportion of the hospital-acquired respiratory infection was also the highest with 68.1% in all the infection sites.CONCLUSION It should pay more attention to the ICU and respiratory infection to prevention and control hospital-acquired MDROs infections.

OBJECTIVE To know the infection control efficacy of hospital-onset multi-drug resistant organisms infections(MDROs-HOI) through carrying out bundle measures in a general tertiary hospital.METHODS We investigated the characteristics of MDROs infections on the patients with positive cultures of MDROs to analyze the efficacy of bundle control measures in a general tertiary hospital from Jan 2005 to Dec 2010.We conducted a prospective investigation for the patients from Jul 2008 and carried bundle measures for patients with MDROs infection or colonization,such as hand hygiene,isolation,wearing gloves and isolation gowns,et al.For the patients from Jan 2005 to Jun 2008,a retrospective investigation was developed with the same criteria as the prospective investigation.RESULTS From Jan 2005 to Dec 2010,there were totally 2 279 episodes of MDROs infection including 1025(44.98%) hospital-onset infection(HOI) and 1 254(55.02%) community-onset infection(COI) in 243744 patients and 3 084 182 patient days.The multiple linear regression analysis showed implementing control measures could decrease the MDROs-HOI incidence rate effectively especially in the surgical departments after the exclusion of the MDROs-COI incidence rate.CONCLUSION Implementing bundle control measures is critical for preventing the spread of MDROs in hospital.

OBJECTIVE To explore the effect of scientific preventive measures against nosocomial infection of H1N1 influenza.METHODS The scientific measures,isolation,disinfection,prevention and health management of medical staffs were developed and performed.RESULTS No nosocomial infection happened in ICU during diagnosis and treatment of H1N1 influenza.CONCLUSIONS Carrying out the scientific preventive measures is the key to avoid nosocomial infection in ICU of polyclinic during the treatment of patients with critical H1N1 influenza.

OBJECTIVE:To evaluate the image of SPECT/PET (18)F-FDG in monitoring response to therapy for lymphoma patients.METHODS:A retrospective study was performed in 83 SPECT/PET studies for 70 patients with lymphoma from 1998 to 2008 in our hospital. The risk factors for survival rate were analyzed by univariate analysis.RESULTS:Forty patients received SPECT/PET after 2 - 4 cycles of chemotheraphy, the median PFS in patients with positive and negative group were 5.5 months and 15.5 months, 2-year PFS were 12.5% and 66.8%; the median OS were 12.5 months and 17 months, and 1-year OS were 28.8% and 94.1%, respectively, all being of significant difference between two groups (P = 0.003). Forty-three patients performed posttreatment SPECT/PET, the median PFS in patients with positive and negative group were 10 months and 23 months, the 2-year PFS were 23.3% and 83.2%; the median OS were 17 months and 27 months and the 2-year OS were 60.0% and 100% respectively, all being of significant difference (P = 0.001).CONCLUSION:SPECT/PET has significant value in monitoring response to therapy and predicting prognosis for patients with lymphoma.

The aim of this study was to evaluate the application value of SPECT/PET (18)F-FDG imaging in patients with lymphoma and its significance in monitoring relapse of this disease. A retrospective analysis of 71 SPECT/PET examinations was performed in patients with lymphoma diagnosed by pathologic and immunohistochemistry means from 1998 to 2008 in Peking university first hospital. The results showed that 28 patients underwent SPECT/PET before initial therapy, the accuracy of SPECT/PET and CT were 100% and 81.7% respectively. The diagnostic sensitivity of SPECT/PET and CT for foci were 85.7% and 53.5% respectively, and there was significant difference between them (p = 0.003). The diagnostic sensitivity of SPECT/PET and CT for extranodal foci were 91.3% and 56.5% respectively, there was significant difference also between them (p = 0.007). 32 patients underwent 43 SPECT/PET for monitoring relapse during follow up. The positive predictive value and negative predictive value of SPECT/PET for relapse were 100% and 92.9% respectively. The relapse were found by SPECT/PET in 6 patients more early than appearance of clinical symptoms and physical signs as well as laboratory examination, imaging examination. In conclusion, SPECT/PET has significant value in diagnosing and monitoring relapse for patients with lymphoma.

亚太地区感染控制学会(Asia Pacific society of InfectionControl)成立于1998年,由中国、澳大利亚、韩国等15个国家和地区的会员组成.由其主办的第四届亚太地区感染控制学会国际会议于2009年7月5-8日在澳门举办.

OBJECTIVE To investigate the characteristic of multidrug resistant organisms (MDROs) in hospital or community-acquired infection,so that it can approach effective infection management. METHODS Patients infected by Staphylococcus, Enterococcus, Escherichia coli, Klpneumoniae and A. baumanni were investigated in a Hospital from June 2008 to May 2009. RESULTS Among total 929 strains of bacilli from patients, 367 were MDROs infection, the detection rate of MDROs, CA-MDROs or HA-MDROs was 39.5%, 35.6% and 51.4% respectioety infection; The detection rate of MDROs from HAI patients was significantly higher than that from CAI patients (X~2 = 19.2 P=0.00). There were differences between HA-MDROs and CA-MDROs in different departments. MRSA, ESBLs-kp And PDR-AB were isolated mostly from sputum of patients, and ESBLs E. coli mostly from urine of CAI patients. CONCLUSIONS It is important to analyze the characteristic of HA-MDROs or CA-MDROs in the treatment of infection or use of antibiotics from experience. MDROs control is full of difficulties as a result of high CA-MDROs rates.