目的:了解鲍曼不动杆菌感染的临床分布特点及耐药情况.方法:收集住院患者细菌学送检标本371株,剔除重复菌株.应用全自动微生物分析仪(VITEK 2 Compact型)及其相配套的药敏卡、鉴定卡开展试验.所得到的数据使用WHONET5.6软件进行统计分析.结果:临床患者感染的371例ABA中主要分布科室是ICU(44.47％)和呼吸内科(14.82％);临床各种标本类型中,痰液分离率最高,327例,占88.14％,还有尿液、血液和其他标本;鲍曼不动杆菌对替加环素、阿米卡星及多黏菌素B显示较低的耐药率,分别是14.1％、7.3％、0.5％,对碳青霉烯类抗生物耐药率大约70％.结论:鲍曼不动杆菌的分离率和耐药率已成为本地区医院内感染的重要病原菌,临床抗感染治疗应根据本地区分离菌株的体外抗菌药物敏感性实验结果为依据,选择敏感抗菌药物对其感染进行治疗.

目的 通过探讨老年患者广泛耐药鲍曼不动杆菌血行感染及其预后的危险因素,为老年患者临床防治鲍曼不动杆菌血行感染及加强和控制其感染播散提供理论依据.方法 院内血行感染鲍曼不动杆菌的老年患者100例.依据血培养及药敏实验结果分为广泛耐药组30例,非广泛耐药组70例.依据预后情况分为存活组46例,死亡组54例.收集患者一般资料、基础疾病,急性生理学及慢性健康状况(APACHE)Ⅱ评分、入院后有创检查、细菌培养及药敏实验结果、住院时间、预后状况等,采用多因素Logistic回归分析老年患者广泛耐药鲍曼不动杆菌血行感染及预后的危险因素.结果 老年患者广泛耐药鲍曼不动杆菌血行感染1个月内病死率为54.00％,其中广泛耐药组病死率为76.67％(23/30例),明显高于非广泛耐药组44.29％(31/70例,P<0.05).老年患者广泛耐药鲍曼不动杆菌血行感染的独立危险因素有合并慢性阻塞性肺疾病(COPD)及留置导管;死亡的独立危险因素有年龄、入住ICU治疗、鲍曼不动杆菌广泛耐药及合并真菌感染.结论 老年患者广泛耐药鲍曼不动杆菌血行感染后1个月内病死率显著升高,其感染与合并COPD及留置导管有关,其死亡与年龄、鲍曼不动杆菌广泛耐药、入住ICU治疗及合并真菌感染有关.因此对老年患者特别是基础疾病多且较严重的患者,应减少有创操作,加强临床管理及无菌操作观念,从而有效控制鲍曼不动杆菌感染及播散.

Objective To investigate the clinical characteristics and drug sensitivity of elderly patients with lower respiratory infection. Methods The clinical characteristics of elderly patients with lower respiratory infection were retrospective analyzed by using SPSS14. 0 software. They were all given drug sensitivity test and the results were analyzed by WHONET5. 4 software. Results 236 strains of bacteria were isolated from 624 cases. Compared to young patients, elderly patients with lower respiratory tract infection were often associated with a variety of underlying diseases, poor expectoration, atypical symptoms, complications, and poor prognosis. The main pathogenic bacteria were gram-negative bacilli, accounting for 78. 8%, which showed a high resistance to many antibiotics. Conclusion Elderly patients with lower respiratory tract infection has its own characteristics, with high bacterial resistance. They should be given comprehensive treatment.

Objective To understand the Stenotrophononas maltophilia nosocomial infection risk factors and drug resistance in order to provide the basis for rational use of antibacterial drugs.Methods The retrospective survey was used to investigate and analyze the data of 75 cases of Stenotrophomonas maltophilia infected patients in our hospital.Results The risk factors for infection with Stenotrophomonas maltophilia were patient age,with severe basic diseases,long time of hospitalization,the use of broad-spectrum antibiotics and traumatic operation.Stenotrophomonas maltophilia isolated from infection was highly resistant to Imipenem,Aminoglycosides and most β-lactam antibiotics and was sensitive to Cefoperazone/Sulbactam and Cotrimoxazole.Conclusion The Stenotrophononas maltophilia infection risk factors have no special phenomenon.This bacteria have high resistance on the majority of antibacterial drugs.So the clinical drug sensitivity test and rational use of drugs should be strengthened.

目的 调查老年患者洋葱伯克霍尔德菌(BC)感染的危险因素及耐药情况.方法 对老年BC感染病例进行回顾性分析,66例BC感染者作为观察组,53例非BC感染者作为对照组,用SPSS14.0软件分析其感染的危险因素.结果 BC感染的危险因素主要有:住院时间≥10 d、使用抗生素≥7d、气管插管及气管切开、使用抗生素≥两种、慢性支气管肺疾病、卧床和留置导尿、糖尿病、深静脉置管.其中,气管插管及气管切开、使用抗生素≥7 d、使用抗生素≥两种组间比较有统计学意义.药敏结果显示BC对氨基糖苷类及大部分β-内酰胺类抗菌药物呈高度耐药；对头孢哌酮/舒巴坦耐药率(18.2％)最低,其次为复方新诺明(21.2％)、左氧氟沙星(25.8％).结论 临床应尽量控制BC感染的危险因素,尽早根据药敏结果合理选用抗菌药物进行治疗.

OBJECTIVE To understand the clinical distribution and drug resistance of Enterococcus causing infections in elderly patients.METHODS By the means VITEK-32 type automatic microbial analyzer of French company BioMerieux and supporting GPI identification card,the identification of the strains was performed,and the antibiotic susceptibility testing was carried out using K-B method;the data processing was performed with WHONET5.4 software.RESULTS Of 136 strains of Enterococcus causing infections in elerly patients,there were 67(49.3%)strains of Enterococcus faecalis and 52(38.2%) strains of Enterococcus feces,those isolates mainly distributed in department of geriatrics,ICU,department of nephrology,and department of respiratory medicine;of the various specimen sources,66(44.1%) strains were isolated from urine,47(34.5%) strains were isolated from the sputum;the drug resistance of E.faecalis was lower than that of E.feces,but the resistance of E.faecalis to tetracycline was higher than that of E.feces,no strains of vancomycin or teicoplanin-resistant Enterococci were found.CONCLUSION Enterococci vary in drug resistance,it is necessary to choose the susceptible antibiotics for the clinical anti-infection treatment on the basis of the in vitro antibiotics susceptibility testing for the isolated strains from the local region.

目的探讨血液透析水处理系统定期消毒在减少透析用水细菌污染中的作用。方法由设备工程师每月定期1次对血液透析水处理系统用3.5 g/L过氧乙酸消毒。每月由专人定期采样监测。结果细菌、内毒素的超标率由2008年7月-2009年6月的13.89%下降到2009年7月-2010年12月的2.78%,差异有统计学意义(P<0.05)。结论定期对血液透析水处理系统消毒是减少透析用水细菌污染的重要措施。

洋葱伯克霍尔德菌(Burkholderia cepacia,)属于革兰阴性需氧非发酵菌,首次于1950年发现于洋葱根部而得名为洋葱假单胞菌,1992年归属于伯克霍尔德菌属.在自然界广泛存在,是重要的机会性致病菌.近年来临床分离率逐渐增加,已经成为医院感染的重要致病菌.本文拟了解本菌所致老年患者感染的临床分布、易感因素及其耐药情况.

目的了解嗜麦芽寡氧单胞菌(Sm)的临床分布特点及耐药情况,为临床治疗Sm感染提供依据。方法对75份分离自我院住院患者的痰液、尿液、血液、脓液等标本进行鉴定。分析其临床分布特点并进行抗菌药物敏感试验。结果 75株Sm的分布以痰液为主(65.3%);感染患者主要来自呼吸科、ICU、老年病科等。嗜麦芽寡氧单胞菌对亚胺培南、氨基糖苷类及大部分β-内酰胺类抗菌药物呈高度耐药;对头孢哌酮/舒巴坦耐药率最低,其次为复方新诺明、米诺环素、左氧氟沙星。结论 Sm的分布以痰液为主,感染患者主要来自呼吸科,Sm对多数抗菌药物具有较高的耐药性,临床治疗Sm感染应根据药敏试验结果为依据。

OBJECTIVE To investigate the drug resistance of Enterobacter cloacae isolated from hand surgery patients in our hospital,so as to guide the prophylactic and reasonable treatment in clinical practice. METHODS Analysis of the drug resistance situation of E.cloacae was made by Kirby-Bauer method from hand surgery between Jan 2007 and Dec 2009. RESULTS A total of 365 strains were isolated from Jan 2007 to Dec 2009,including 93 strains of E.cloacae,which were accounted for 25.5% of the total separation.E.cloacae showed high resistance to cephalosporins(resistance rates: 60.2%-96.8%),aztreonam(resistance rates:68.8%)and penicillin(resistance rates: 31.2%-81.7%),and medium resistance to quinolones antibiotics(resistance rates: 34.1%-43.3%),but all strains were sensitive to carbapenems. CONCLUSION More attention should be paid to the surveillance and prevention of such strains,it should reasonably choose antibiotics,on base of the result of antimicrobial susceptibility test,to reduce the drug resistant strains.

<正>半胱氨酸蛋白酶抑制剂C(Cystatin C,Cys C)又称胱抑素C,是二十世纪60年代研究发现的一种广泛分布于动物、植物和原虫生物中低分子量蛋白质,具有能从肾小球自由滤过,不被肾小管重吸收和分泌的优点,并且肾脏是其唯

Objective To know the germicidal efficacy of a binary liquid chlorine dioxide disinfectant.Method Carrier quantitative germicidal test was used to study its efficacy in killing Escherichia coli with different chlorine dioxide concentration and different contact time.Results The D value of efficacy of the solution containing chlorine dioxide 100 mg/L in killing E.coli was 1.37 min,and the concentration coefficient was 0.6582.The solution containing chlorine dioxide 100 mg/L with a 6 min contact time killed 100% of E.coli on carriers.Conclusion The binary liquid chlorine dioxide disinfectant has good efficacy in killing E.Coli.

按照《医院感染管理规范》有关规定,每6个月对紫外线灯管照射强度监测1次,以确保紫外线灯管的消毒效果.