OBJECTIVE To analyze the features of nosocomial fungal infections of inpatients in department of respi-ration ,in order to provide basis for formulating control measures of nosocomial fungal infections .METHODS Totally 67 inpatients of nosocomial fungal infections in department of respiration in 2012 were collected ,the hospi-talization duration ,underlying diseases ,season distribution ,infection sites ,and pathogenic fungi distribution were analyzed .The nosocomial infection cases were diagnosed according to the diagnosis criteria of nosocomial infections .RESULTS The infection mainly occurred in elder people with more than to years of age (74 .6% ) in winter(43 .3% ) ,the main underlying disease was pneumonia(68 .7% ) ,infection sites included 53 cases of lower respiratory tracts(79 .1% )and 14 cases of upper respiratory tracts (20 .9% ) .Candida albicans was the predomi-nant species of pathogens (79 .1% ) .CONCLUSION The prevention and control of fungal respiratory infection of elder inpatients in winter should be strengthened ,in order to reduce the nosocomial infections .

目的：了解某院住院患者医院感染现状，为制定目标监测方案及完善预防控制措施提供依据。方法采用床旁调查与病历调查相结合的方法进行医院感染现患率调查。根据《医院感染诊断标准（试行）》对医院感染病例进行诊断。结果实查住院患者2511例，发生医院感染198例，219例次，医院感染现患率为7．89％，例次现患率为8．72％。医院感染现患率最高的科室为重症监护室（45．00％，9/20）。医院感染部位以下呼吸道（46．58％，102/219）居首位。共检出病原菌269株，其中细菌226株（84．01％），以革兰阴性菌为主；真菌43株（15．99％）。调查日抗菌药物使用率为31．38％（788/2511），治疗用药病原学送检率为54．69％（373/682）。结论通过此次调查，了解了该院医院感染的真实情况，为目标监测的开展和干预措施的完善提供了可靠依据。

目的 了解2012-2013年长春地区流感病毒优势流行甲3(H3 N2)亚型流感病毒HA1基因序列的特性.方法 采用MDCK细胞分离培养流感病毒,提取病毒RNA,进行逆转录和聚合酶链式反应(RT-PCR),扩增产物用纯化试剂盒纯化后测序,用Mega 5.10软件中Neighbor Joining方法进行基因种系发生树分析.结果 (1)2012-2013年吉林省长春地区流行的H3N2亚型流感毒株核苷酸同源性为95.8％～ 100.0％,2012年流行的H3N2亚型流感毒株与WHO推荐的2011-2012年疫苗株A/perth/16/2009相比有15个氨基酸发生了变异;2013年流行的H3N2亚型流感毒株与WHO推荐的2012-2013年疫苗株A/Victoria/361/2011相比有13个氨基酸发生了变异.(2)2012年2-3月分离的毒株与2012年11月-2013年3月分离的毒株在进化树上处于两个不同的侧枝上.结论 2012-2013年长春地区流行的H3N2亚型流感毒株与WHO推荐的疫苗株A/perth/16/2009、A/Victoria/361/2011相比HA1基因已经发生了一定的变化,不同时间流行的病毒株也有差异.

目的 探讨医务人员锐器伤的发生特点及其原因,为针对性的防护措施提供参考.方法 对2010年我院医务人员锐器伤的情况进行登记、整理,分析锐器伤的职业分布、发生原因、锐器污染情况、锐器伤后的预防措施等.结果 2010年我院锐器伤登记人数为97人,锐器伤发生率为2.2％(97/4327).医生和护士锐器伤发生率分别为3.6％(37/1036)和4.4％(57/1288),明显高于护理工人及医疗垃圾处理工人(0.1％,3/2003),差异有统计学意义(P＜0.05)；医生和护士锐器伤发生率的差异无统计学意义(P＞0.05).引起锐器伤的锐器种类以头皮针最多(29.9％,29/97);锐器伤发生时所执行的操作以手术最多(35.1％,29/97).锐器病原检测乙型肝炎表面抗原阳性38例(39.2％,38/97)、丙型肝炎抗体阳性22例(22.7％,22/97)、乙型肝炎表面抗原阳性且丙型肝炎抗体阳性1例(1.0％,1/97).结论 医务人员锐器伤主要在手术中发生,病原以乙型肝炎病毒为主.建议对医务人员进行乙型肝炎疫苗的免疫接种.

目的探讨本地区近6年急性散发性戊型病毒性肝炎的临床特点。方法对2005年1月至2011年10月吉林大学第一医院收治的急性散发性戊型病毒性肝炎188例的病历资料进行回顾性分析。结果 188例戊肝中非老年组(年龄<60岁)137例,老年组(年龄≥60岁)51例;均为四季散发病例,无家庭聚集现象。临床类型急性黄疸型152例(80.85%);急性无黄疸型24例(12.77%);重型肝炎12例(6.38%)。非老年组重型肝炎5例(3.65%),无死亡病例。老年组重型肝炎7例(13.73%),死亡3例。老年组乏力、黄疸、腹水及重症肝炎发生率较非老年组明显增高,两组间比较有统计学差异(P<0.05);两组T-BIL、D-BIL、AST比较无统计学差异,ALT、ALB、CHE及凝血酶原活动度(PTA)比较有统计学差异(P<0.05)。老年组7例重型肝炎中6例发现合并抗-HBs+抗-HBc阳性。结论急性散发性戊型病毒性肝炎中,急性黄疸型比例高,老年组重症肝炎发生率高,死亡率高,其中针对抗-HBs伴随有其他抗体阳性患者,要注意隐匿性HBV感染的存在,应使用高敏感性检测方法进一步行HBV DNA检测,为临床诊治提供更好的依据。

真菌是医院呼吸科患者感染的主要病原菌之一,近年来呈现增长趋势.床单位是住院患者频繁接触的物品,极易成为真菌传播的媒介.为了更好地预防和控制医院感染,自2010年起对医院呼吸科床单位(包括被、褥、床垫等)用臭氧消毒机进行消毒,并进行了消毒前后床单位真菌菌量的检测,以及2009年(消毒前)和2010年(消毒后)住院患者发生真菌医院感染情况的监测.结果报道如下.

Objective To understand the situation of the viral etiology of the acute upper respiratory tract infection about five kinds of respiratory viral infection in Jilin province during July and December 2010.Methods Throat swab samples were collected from 456 out-patients.The method of(RT)-PCR was used to detect 5 respiratory virus in all 456 patients.The 5 respiratory viruses were influenza A virus(IVA),respiratory syncytial virus subgroup(RSV)A/B,parainfluenza virus(PIV) 1-4 type,adenovirus(ADV),human Boca virus(HBoV).Results 92 positive samples were identified,the positive rate was 20.18 percent.The positive rate of influenza virus was highest(8.11%).Conclusion Influenza virus,RSVA and ADV are the major viral pathogens leading to the acute upper respiratory tract infection in Jilin province during July and December 2010,especially Influenza virus is the first place.

OBJECTIVE To master the influenza epidemic tendency and influenza virus variation from 2005 to 2009 in the First Hospital of Jilin University,and prevent and control the nosocomial infection.METHODS Influenza epidemiologic and pathogenic data were collected and analyzed.Strict control measures of nosocomial infection were taken.RESULTS The treatment rates of influenza-like illness during 2005-2009 were1.82%,3.16%,3.05% and 2.12%,respectively.The situation of influenza cases was basically stable from 2005 to 2009,the main peaks were in Nov,Dec and Jan every year,and the main group was children.Totally 169 strains of viruses were isolated with the isolation rate of 15.79%,the predominant strain alternated.CONCLUSION The surveillance of influenza should be further strengthened,and the experience of prevention and control of nosocomial infection should be accumulated,in order to provide scientific reference for the diagnosis,treatment and control of influenza.

Objective To know six kinds of respiratory viral infection in children suffered from acute upper respiratory tract infection in Changchun area winter and spring.Methods 119 out-patients in children were selected and throat swab samples were collected,(RT)-PCR method was applied to detect six kinds of common respiratory viruses including influenza A virus(IVA),respiratory syncytial virus subgroup A(RSVA),parainfluenza virus(PIV) type 3,adenovirus(ADV),human bocavirus(HBoV) and human metapneumovirus(hMPV).Results 53 positive samples was detected,the positive rate was 44.54%,influenza virus was the highest in them(19.33%).The total detection rate of the virus between genders had statistically significant difference(χ2=7.96,P0.05).Conclusion Influenza virus is the major viral pathogen in children with acute upper respiratory tract infection in Changchun 2008 winter,male children are more susceptible to the respiratory viruses.

OBJECTIVE To explore the bacterial contamination of bed unit in common ward and disinfectant efficacy of ozone sterilizer.METHODS The samples from quilts,cotton-padded and other mattresses of 15 bed units from two common wards before and after ozone sterilizer disinfection were collected to survey the quantitative culture and identification of bacterial strains.RESULTS The bacterial contamination of bed unit was heavy,and the contamination rate was 100.0%.Opportunistic and other pathogens could be detected out.After ozone sterilizer disinfection,the quantity of bacteria significantly decreased.CONCLUSIONS The quilts and cotton-padded mattresses and then the other mattresses is heavy.are heavly contaminated.We advice that the bedding should be cleaning or replacing regularly,and bed units should be disinfected with ozone sterilizer after patients discharged.

外科手消毒剂的选择直接影响手消毒的效果.因此选择一种高效、安全、快捷并能持续杀菌的消毒液,是提高消毒效果,降低伤口感染率的重要保证.我院通过对若干手消毒剂的筛选试用,选择了洁芙柔消毒凝胶用于外科洗手,并对其消毒前后手指样本进行了细菌培养检测.

OBJECTIVE To investigate the microorganisms on the hands of nurses who are doing the intravenous infusion.METHODS Sampled the hands of nurses during the procedure of intravenous infusion randomly,and then sampled after monitoring the nurses washing their hands by the six steps hand-cleaning technique.Then cultured the samples and did the identification of bacteria.The distribution of microorganism on nurses' hands was analyzed.RESULTS During the procedure of intravenous infusion,before and after the intervention the microorganisms on the nurses' hands had evident difference and with the statistic meanings.CONCLUSIONS The handwashing compliance among nurses before working in our hospital is poor,and the hand hygiene status during the nursing procedure needs to be improved.

OBJECTIVE To search for available mode of oral apparatus′s disinfection and management.METHODS To use new ways of oral apparatus′s disinfection and management that are enhancement of recognition,normal disinfecting procedure,available disinfection room,enhancement of management,new management system,building digitizing management and so on.RESULTS To build effective system and decrease abrasion and uselessness of oral apparatus.CONCLUSIONS Effective disinfection and management are very important for prevention of the cross infection and ensuring of daily use of oral apparatus.

OBJECTIVE To study the usage of antibiotics in aseptic operation,and strengthen the management of antibiotics usage. METHODS We investgated the usage of antibiotics in aseptic operation retrospectively,then statistically analyzed. RESULTS Among all the 347 cases,343 cases were used for prophylaxis,the usage rate was 98.85%.The mean time of antibiotic therapy was 7.22 days.90.96% of the patients were treated with antibiotics for 3 days or more,53.35% of the patients were treated beyond 7 days.Ninety one patients were given antibiotics 0.5-2 hours before the operation(26.53%).There were 7 kinds of drugs used in the operation,the cephalosporin class accounted for 70.26%,moreover was third generation cephalosporin. CONCLUSIONS The prophylactic application of antibiotics in the aseptic surgery has some unreasonable phenomenon and must be strengthened.Training the doctor to use the antibiotics reasonably,and the effective surveillance management mechanism be established.

我国各大医院一般均存在患者多、内镜少、使用频繁、消毒不彻底等情况,所以必须加强对内镜的消毒与管理.按卫生部《内镜清洗消毒技术操作规范》要求,宫腔镜必须达到灭菌.作为侵入人体腔内的器械,精密度高,结构复杂,用后的消毒灭菌难度大;同时价格昂贵,医院购置有限,存在供需矛盾,影响医疗质量和医疗安全.因此寻找一种即安全、快捷又对内镜损伤小的灭菌方法尤为重要.现将我院曾经使用的几种方法进行比较.

由于老年人的机体衰老,对药物的反应与青年人不同,老年时期药物代谢动力学和药效学反应性发生了变化,药物的毒副作用也比青年人增加,加上许多人为因素,容易出现许多不良反应.所以,对于老年病人用药要加强观察与护理,使之安全有效.

OBJECTIVE To discuss the management countermeasures of disposable medical device. METHODS To strengthen the management of purchasing, checking, storing, providing, using and retrieving disposable medical device. RESULTS The rules and institutions must be cultivated and perfected, the training of persons at all level be strengthened, the duty made clear to insure the quality of purchasing product and use the disposable medical device reasonably and correctly. CONCLUSIONS Managing every link correctly is the guarantee of the safe use of disposable medical device.

甘露醇静脉输液外渗造成局部组织损伤,用0.25%普鲁卡因局部封闭,通过临床病例的治疗观察和动物实验研究,认为具有一定疗效.

目的了解我院医院感染的横断面情况.方法采用床旁和病历相结合调查方式,对全院所有住院患者进行1d的医院感染情况调查.结果调查925人,发生医院感染42人,现患率为4.54%,例次现患率为4.75%.现患率高的科室为ICU科21.43%、神经外科12.31%和传染科11.76%.医院感染部位构成中呼吸道感染居首位,其次为泌尿道感染、皮肤软组织感染、手术切口感染.年龄<2岁和>60岁为医院感染的高危人群.留置导尿、使用呼吸机、气管切开为医院感染易感因素.抗菌药物应用者588人,使用率为63.57%,其中单用药占71.26%,二联用药占26.19%.结论通过医院感染现患率调查,及时发现医院感染管理工作中存在的问题,有利于预防和控制医院感染.

目的为探讨呼吸道真菌感染的原因及预防.方法对165例呼吸道真菌感染的病例,进行回顾性分析. 结果发生呼吸道真菌感染的165例患者平均年龄65岁,均有基础疾病,所有患者均用过抗生素,16例患者应用了激素,15例患者应用了化疗药物,真菌感染以白色念球菌居多,占68.48%,及时治疗效果尚好.结论警惕真菌感染,积极治疗基础病,合理应用抗生素,及早发现和治疗真菌感染.