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ObjectiveTo construct herpes simplex virus type 2（HSV2） eukaryotic expression plasmid pCDNA3.0ICP27 and to evaluate its expression in Vero cells．MethodsThe target sequence of ICP27 gene was obtained and highfidelity amplified from HSV2 DNA. The ICP27 gene was cloned into a eukaryote plasmid pCDNA3.0 after restrictive endonucleases digestion．The pCDNA3.0ICP27 was checked and verified by double digestion and DNA sequence analysis. Vero cells were transiently transfected with pCDNA3.0ICP27 by lipofectamine 2 000 in vitro. RTPCR and Western blot analysis were employed to detect the expression of ICP27. ResultsThe 1741bp DNA fragment was obtained by DNA and cloned into pCDNA3.0. The recombinant plasmid pCDNA3.0ICP27 was subjected to sequence analysis which indicated all nucleotides were identical to the HSV2 ICP27 sequence provided by Genbank. Being transfected by lipofectamine 2 000, the expression of ICP27 in Vero cells was detected.ConclusionRecombinant plasmid pCDNA3.0ICP27 was constructed and expressed successfully in Vero cells．

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ObjectiveTo study the distribution of insertion sequence common region1(ISCR1) in local third generation cephalosporinresistant clinical strains of Enterobacteriaceae and the relationship between ISCR1 and ESBLs.MethodsAntimicrobial susceptibilities were tested by microdilution broth method;  ESBLs phenotypic confirmatory test were performed by double disk diffusion method; ISCR1 gene, SHV,TEM, and CTXMESBLs genes were amplified by PCR and analysed by singlestrand conformation polymorphism (PCRSSCP) and DNA sequencing , and the relationship between ISCR1 and ESBLs gene was detected by PCRmapping.ResultsAmong 83 strains , 17 isolates habored ISCR1 gene,6 of which were  positive  in ESBLs phenotypic confirmatory test,including 2 Escherichia coli strains（EA791,EA1367）,3 Enterobacter cloacae （EC1322,EC1342,EC553） , and 1 Klebsiella oxytoca (K386),  EA791,EC553 and K386 all contained CTXM1 ESBLs gene; EA1367 contained  both CTXM1 and CTXM9 group ESBLs gene ;EC1322 and EC1342 both contained SHV12 ESBLs gene; all  6 strains carried TEMESBL gene which were verified by PCRSSCP. PCRmapping revealed that there’s no relation between ISCR1 and ESBLs gene. ConclusionISCR1 element exist in local third generation cephalosporinresistant clinical strains of Enterobacteriaceae, the study found no evidence of direct relationship between ISCR1 and ESBLs, the element maybe play a role in horizontal transmission of other drugresistant genes.

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ObjectiveTo investigate antimicrobial resistance,genotypies and the prevalence of AmpC βlactamasesproducing and extendedspectrum βlactamases (ESBLs)producing gramnegative strains from specimens of respiratory intensive care units(RICUs) in 2 hospitals of Shenzhen.MethodsA total of 96 multidrugresistant Escherichia coli and Klebsiella pneumoniae strains were detected by threedimensional test for AmpC βlactamases and phenotypic confirmatory test based on Clinical and Laboratory Standard Institute (CLSI) criteria for ESBLs.Antimicrobial susceptibility of AmpC βlactamases and ESBLsproducing strains was detected by KirbyBauer and Etest methods.Universal primer PCR for AmpC βlactamases and ESBLs gene amplification and DNA sequencing were carried out for genotyping of these βlactamases.ResultsAmpC βlactamases, ESBLs and AmpC βlactamases combined with ESBLsproducing strains were found in 9(9.38%), 52(54.17%)and 10 (10.42%) strains,respectively.AmpC βlactamases producing strains were more susceptible to cefepime and imipenem, the resistant rate being 33.33% and 0.00% respectively. ESBLsproducing strains were more susceptible to imipenem，piperacillin/tazobactam and cefoperazone/sulbactam , the resistant rate being 0.00%, 34.62% and 19.23% respectively. AmpC βlactamases combined with ESBLsproducing strains were only sensitive to imipenem and no imipenemresistant one was found. The genotypes of AmpC βlactamases were DHA1and ACT1, the incidence being 76.92% and 26.08% respectively. ESBLs genotypes were CTXM series and SHV5, the incidence being 96.77% and 3.23% respectively.ConclusionThere are epidemic strains of plasmidmediated DHA1,ACT1 type AmpC βlactamases and CTXM,SHV type ESBLsproducing gramnegative strains in RICUs in two hospitals, they are resistant to  most  new broadspectrum βlactam antibiotics, but sensitive to imipenem.

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ObjectiveTo investigate  the disinfectantresistant gene qacE△1sul1 in clinical multidrugresistant (MDR) gramnegative bacilli.MethodsPolymerase chain reaction (PCR) was used to detect disinfectantresistant gene qacE△1sul1 in 235 isolates from clinic，including 155 multidrugresistant and 80 antimicrobial susceptible isolates. PCR products were sequenced by DNA sequencing.ResultsAmong 50 strains of  ESBLsproducing Escherichia coli, 27 ESBLsproducing Klebsiella pneumoniae, 50 MDR Pseudomonas aeruginosa, and  28  MDR Acinetobacter baumannii，disinfectantresistant gene qacE△1sul1 were detected in 37（74.00%）,24（88.89%）,46（92.00%）and 28 strains（100.00%）,respectively， the total detection rate was 87.10%; Among nonESBLsproducing antimicrobial susceptible isolates of Escherichia coli,Klebsiella pneumoniae,Pseudomonas aeruginosa, and Acinetobacter baumannii （each were 20 isolates），disinfectantresistant gene qacE△1sul1 were detected in 16（80.00%）,7（35.00%）,5 （25.00%）and 13 strains（65.00%）,respectively, the total detection rate of qacE△1sul1 gene was 51.25％.ConclusionDisinfectantresistant gene qacE△1sul1 has a high detection rate in clinical MDR gramnegative bacilli in this hospital, it is important to the rational use of disinfectant by  intensifying  the monitor on the disinfectantresistance of MDR .

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ObjectiveTo analyse hepatitis B virus（HBV） reactivation induced by glucocorticoid and the efficacy of lamivudine on the prevention and treatment of HBV reactivation in patients with HBV infection after receiving glucocorticoid therapy .MethodsOne hundred and twentysix patients with HBV infection receiving glucocorticoid treatment were divided into three groups according to serum alanine transaminase (ALT) and HBV DNA levels: 39 patients with normal serum ALT level and negative HBV DNA (group A), 60 patients with normal serum ALT level and HBV DNA level at ≥103 copies/mL(group B), and 27 patients with ALT ≥two fold of normal value upper limit and HBV DNA level ≥104 copies/mL (group C).Patients with and without lamivudine treatment were followed up by testing serum ALT and HBV DNA every three to six months for 12-18 months.ResultsFortyseven patients in group A and B did not receive lamivudine treatment, 29 of whom (61.70%) had obvious HBV DNA elevation , 31 (65.96%) with ALT elevation ,and 10 (21.28%) with liver function decompensation during glucocorticoid treatment follow up; In group A and B patients receiving lamivudine treatment, there were only 4 cases(7.69%) developed recurrence. The efficacy of lamivudine therapy in group C was only about 37.04% (10/27), which was significantly lower than that（92.31%） in patients without activation of hepatitis B (χ2=27.82,P<0.01).ConclusionGlucocorticoid therapy can induce reactivation of HBV infection, recurrence of liver inflammation and decompensation in patients with HBV infection. Lamivudine can efficiently control HBV reactivation induced by glucocorticoid in chronic hepatitis B patients.The efficacy of preventive therapy is obviously better than the delayed therapy.

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ObjectiveTo understand the distribution and drugresistance of gramnegative bactera isolated from lower respiratory tract in a hospital , so as to provide reference for antiinfection treatment in clinic.MethodsBacteria were isolated from sputum, bronchial aspiration,and pleural effusion of patients  admitted in  a hospital from January 2002 to December 2009, distribution and drug susceptibility test of bacteria  were analysed retrospectively.ResultsA total of 9 884 isolates of bacteria were isolated during 8 years, 6 358 (64.33%) of which were gramnegative bacteria . The main isolated bacteria were Pseudomonas aeruginosa(33.41%), Acinetobacter spp. (20.51%), Klebsiella spp.(19.11%) , and Escherichia coli(12.65%) . The main bacteria of Enterobacteriaceae had low resistance to carbapenems,such as meropenem and imipenem (<3%), and had relative lower resistance to amikacin(17.37%-19.58%), cefoperazone/sulbactam (10.67%-23.62%) , and piperacillin/tazobactam(13.58%-25.11%). The resistant rate of Pseudomonas aeruginosa to  carbapenems was up to 38.54% , and had relatively lower resistance to amikacin(31.50%) and minocycline(32.00%)； Acinetobacter spp. had relatively lower resistance to  carbapenems(10.47%), levofloxacin (24.64%) ,amoxicillin/clavulanic acid (24.33%), cefoperazone/sulbactam (27.00%) ,and minocycline(10.27%).ConclusionGramnegative bacteria are the major pathogens in lower respiratory tract infection  in this area, the main isolated bacteria have a rising resistance to most antimicrobial agents.

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ObjectiveTo study the distribution and antimicrobial resistance of pathogens in AIDS patients with bacterial  pneumonia.MethodsPathogens isolated from 433 AIDS patients  with bacterial pneumonia in a  hospital from January  2008 through  February  2010 were analysed .ResultsA total of 106 bacteria strains  were isolated from 433 patients, the main source was sputum (90 strains, 90.90%) , followed by pleural effusion and pneumocentesis histological samples. Of all  pathogens ,  77 strains (72.64%) were gramnegative bacilli，30 (38.96%) of which were nonfermentative bacteria, 47 (61.04%) were Enterobacteriaceae  bacteria;  28 of 106 (26.42%) were grampositive cocci , the majority were coagulase negative Staphylococcus (15 strains,53.57%); 1 of 106 (0.94%) was fungi. The ESBLs producing  rate of Escherichia coli, Klebsiella pneumoniae, and  Pseudomonas aeruginosa was 72.73%(16/22), 46.15% (6/13) and 20.83%(5/24) respectively. Antimicrobial resistant rate of Escherichia coli and Klebsiella pneumoniae to imipenem was 0.00%. Antimicrobial resistant rate of Pseudomonas aeruginosa to imipenem was 8.33%. Of all gramnegative bacilli , except for Stenotrophomonas maltophilia， antimicrobial resistant rate to the third and fourth generation cephalosporins was > 60.00% and > 53.00% respectively. The resistant rate of Stenotrophomonas maltophilia to commonly used cephalosporins was very high. MRCNS showed multidrugresistance except high sensitivity to vancomycin , there was no resistant strain to vancomycin in all MRCNS.ConclusionThe main pathogens in AIDS patients with bacterial pneumonia are gramnegative bacilli, and  drug resistance is obvious. Antimicrobial  susceptibility test result  can provide reference for clinical application of antimicrobial agents .

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ObjectiveTo emphasize the recognition of leprosy with joint symptoms or positive rheumatoid factor (RF).MethodsClinical manifestations ,laboratory results and image information of 3 cases of leprosy misdiagnosed as rheumatoid arthritis were analysed retrospectively , and the related literatures were reviewed.ResultsAmong 3 patients, 2 were male and 1 was female;2 patients showed joint symptoms, 2 were with positive RF, and 3 with increased levels of erythrocyte sedimentation rate and Creactive protein; these patients were all misdiagnosed as rheumatoid arthritis for 3-5 years.ConclusionThe possibility of leprosy should be considered when patients are with joint symptoms or positive RF complicated with skin lesions and peripheral neuropathy.

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ObjectiveTo observe the dynamic imaging change in pulmonary candidiasis and to evaluate the clinical diagnostic value of imaging for pulmonary candidiasis. MethodsThe chest Xray and/or CT imaging of 35 patients with pulmonary candidiasis were collected, the dynamic imaging change between antimicrobial therapy before diagnosis and  antifungal therapy after diagnosis was compared and analysed retrospectively.ResultsFor 35 patients receiving antimicrobial therapy before diagnosis, there were 10 cases (28.57%) with no imaging change, 18 (51.43%) with progressive imaging change and 7 (20.00%) with new imaging focuses, the total therapeutic effective rate was 0.00%, but for antifungal therapy after diagnosis, there were 29 cases with improved imaging change,  3 (8.57%) with no imaging change, 2  (5.71%) with progressive imaging change, and 1 (2.86%)  with new imaging focus, the total therapeutic effective rate was 82.86%; The difference between two treatments was statistically significant（χ2=50.07, P<0.01）.ConclusionThe observation of the dynamic imaging change in pulmonary infection of unknown origin before and after treatment is valuable for early diagnosis and treatment of pulmonary candidiasis.

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ObjectiveTo study the related factors and appropriate strategies for infections in patients with type 2 diabetes mellitus (DM)，so as to reduce nosocomial infection(NI) rate.MethodsFortyeight type 2 DM patients with NI （NI group）and 55 type 2 DM patients without NI (control group) during the same hospitalization period were selected , patients’ age at admission , fasting blood sugar, glycohemoglobin, hospital stay, immunization level, invasive procedure , antimicrobial use , and continuous subcutaneous insulin infusion in two groups were compared .ResultsPatients’ average age at admission (［62.57±14.35］ years old), fasting blood sugar(［10.26±3.68］mmol/L), glycohemoglobin(［8.38±2.95］%), and hospital stay(［21.38±10.77］days) in NI group were higher than (［44.40±12.82］ years old), (［8.96±2.92］ mmol/L), (［6.73±2.57］%) ,and (［16.24±9.62］days) respectively in  control group,there was significant difference between two groups(all P<0.05);Immunization levels in two groups were not statistically significant(P>0.05); invasive  procedure rate in NI group (16.67%) and ≥2 typies of antimicrobial usage rate (68.75%) in NI group  were both higher than those (3.64%,9.09%) of control group  respectively, continuous subcutaneous insulin infusion rate  in control group(67.27%) was higher than that of NI group(14.58%), the difference was significant(P<0.05).ConclusionMultiple factors can influence the occurrence of NI in type 2 DM patients, surveillance should be intensified , comprehensive strategies should be taken to prevent the occurrence of NI.

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ObjectiveTo investigate the clinical characteristics  of surgical site infection(SSI) in a hospital ,so as  to reduce infection rate by making  appropriate prevention and control measures .MethodsSurveillance information of SSI in  patients from January 2006 to December 2009 was analysed prospectively.ResultsA total of 22 237 patients with surgical operations were monitored , 325(1.46%)  of whom developed SSI； The top three departments with infection rates were  urologic department(2.69%), orthopedics department(2.20%), and thoracic department(1.97%); The main isolated bacteria were Klebsiella pneumoniae(19.29%), Escherichia coli(17.26%) and Staphylococcus aureus(10.66%). ConclusionMonitoring  on departments with high risk factors and  main pathogens of  SSI should be intensified , intervention   measures for SSI should be adopted , and   the incidence of SSI can be reduced effectively.

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ObjectiveTo evaluate clinical efficacy of benzylpenicillin combined with longacting antimicrobial agent in treating hard chancre. Methods130 cases of primary syphilis with hard chancre were randomly divided  into two groups. Patients were all treated with benzylpenicillin as recommended for primary syphilis in Clinical Guideline of Diagnosis and Treatment of SexuallyTransmitted Diseases issued by Chinese Center for Disease Control and Prevention. In addition to the use of benzylpenicillin, topic longacting antimicrobial agent was applied to the lesions in the experimental group. The healing time of the lesions and disease progression were observed at followups on day 7, 11, 15, and 20 of  treatment, rapidplasmareagin test (RPR) was checked on day 60.ResultsHealing time of the hard chancre in the experimental group was obviously shorter than that of  control group. The healing rate of hard chancre skin rash on day 7,11 and 15 was 57.58%, 80.30%  and 100.00% respectively in experimental group, and was 37.50%, 59.38% and 89.06% respectively in control group, there was significant difference in two groups (all P＜0.05);  The results of RPR test at 2month followup and longterm observation on the secondary syphilis showed no significant difference(P>0.05).ConclusionBenzylpenicillin in combination with longacting antimicrobial agent can shorten healing time of lesions of hard chancre and reduce transmission of Treponema pallidum.

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ObjectiveTo guide the diagnosis, prevention and control of measles through analysis of clinical features of patients with measles in different age groups and by comparing epidemiologic features of measles during different periods.MethodsClinical data of 219 patients with measles who were hospitalized  between December,2007 and May,2009 were analyzed retrospectively , and data of 150 patients with measles in the  same  hospital 5 years ago were compared.ResultsAmong 219 patients with measles, the majority (78.54%,172/219) were between 6 months5 years old, the manifestations were typical: 96.35%(211 cases) had fever, 72.99% of whom had body temperature >39℃; all patients had skin rash, skin rash presenting  at the 3rd or 4th day of the disease course mainly occurred in patients who were between 6 months5 years old , which accounting for 82.56%; 147 patients(67.12%) had mucous patch. Pneumonia was the main complication, which accounting for 73.52%; complication rate was high in children who were <5 years  old, 81.18% of complications were pneumonia. The vaccination rate of measles vaccine was only 8.22%(18 cases).ConclusionMeasles mainly occurs in children under 5 years old , clinical manifestations are typical , and incidence of complications are  high. Planned immunization in children and intensifying immunization in adults should be strengthened to reduce the incidence of measles. 

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ObjectiveTo investigate the change in immunologic function of infants with Mycoplasma pneumonic pneumonia (MPP) in the acute and recovery phase, and compare with normal healthy children. MethodsPatient’s peripheral blood was withdrawn respectively when they admitted in hospital within 2 hours in the acute phase (before receiving treatment with antimicrobial agents),  having received macrolides for 2-4 weeks and when clinical and radiographic signs significantly improved ,then all specimens were detected.ResultsCompared with healthy infants and infants  in the recovery phase, the proportion of CD4 + T cells ,CTLA–4+T cells,CD4+ /CD8+, NK cells and the level of C3,C4 in patients with acute MPP were significantly lower (P<0.05)； the proportion of CD8+T cells,B cells and the levels of IgA,IgM,IgE were significantly higher (P<0.05). The proportion of CD3+T cells and the levels of IgG were not statistically different between two groups  (P>0.05).ConclusionThe immunologic function of patients are disordered in the acute phase of MPP, and still exist a certain degree of disorder during convalescence，immunological regulatory treatment should be given to infants with MPP , so as to reduce treatment course and improve  convalescence.

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ObjectiveTo analyze the drug resistance of communityassociated methicillinresistant Staphylococcus aureus (CAMRSA) and healthcare associated MRSA(HAMRSA), so as to provide reference on empirical antimicrobial  therapy for treating MRSA infection. MethodsMRSA isolated from clinical specimens from surgical department and intensive care unit (ICU) in a hospital between January 2006 and December 2008 were analyzed retrospectively , distribution and drug resistance of CAMRSA and HAMRSA were analysed statistically.ResultsEightseven strains were from ICU , the sources were as follows: 71 strains were from sputum, 6 from throat swabs, 5 from wound secretion, 2 from blood and venipuncture tubes respectively, and 1 from pleural effusion; HAMRSA accounted for 98.85%(86/87). Fortyone MRSA strains from surgical department were all isolated from wound pus, CAMRSA accounted for 48.75%(20/41) , and showed an increasing tendency year by year, which increased from 20.00% in 2006 to 71.43% in 2008 (χ2=8.24, 0.01<P<0.025). Antimicrobial susceptibility test results showed that the resistant rates of  HAMRSA to clindamycin,tetracycline,erythromycin,ciprofloxacin,levofloxacin , and gentamycin was 98.13%,98.13%,100.00%, 100.00%,100.00% ,and 100.00% respectively, which was significantly higher than that of CAMRSA (which was 42.86%,66.70%,33.33%,0.00%,0.00% , and 4.76% respectively), there was significant difference between the two respectively(all P<0.005).ConclusionThere is an increasing tendency of CAMRSA infection in hospitalized patients , drug resistance of CAMRSA is different from that of HA MRSA , CAMRSA strains are usually susceptible to nonβlactam agents.

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ObjectiveTo realize the distribution and drugresistance of pathogens isolated from clinical samples in a cardiovascular hospital , so as to provide reference on clinical antiinfection treatment.MethodsThe data of  clinical pathogens  isolated from January to December 2009 were analyzed.ResultsA total of 1 330 pathogenic strains were isolated, including 1 044 (78.49%) gramnegative bacilli ,  215 (16.17%) grampositive cocci, and 71(5.34%) fungi.  Gramnegative bacilli mainly consisted of Klebsiella pneumoniae(308 strains),Pseudomonas aeruginosa (205 strains), Acinetobacter baumannii (138 strains), Enterobacter cloacae(122 strains) ,and Escherichia coli(105 strains). The percentage of ESBLs produced by Escherichia coli and Klebsiella spp. was 79.00% and 41.00% respectively . Imipenem was the most effective antimicrobial agents for treating gramnegative bacilli. 40.00% of Staphylococcus aureus and  98.11% of coagulase negative Staphylococcus were methicillin resistant. No Staphylococcus spp. and Enterococcus spp. strain was found to be resistant to vancomycin.ConclusionRealizing the pathogen and its drug resistance is very important to prevent and control nosocomial infections and rational  antimicrobial use for clinical treatment.

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目的了解某院泌尿生殖道感染患者病原体检出情况。方法对该院2007—2009年疑为泌尿生殖道感染患者标本的检测结果进行统计分析。结果3年6 366例就诊者中，3 533例（55.50%）检出病原体4 286株，其中652例患者同时检出2种以上病原体。各年的标本阳性率分别为：2007年52.90%(749/1 416)、2008年55.70%(1 289/2 314)、2009年56.71%(1 495/2 636)，3年间比较，差异无统计学意义(χ2=5.50, P>0.05)。检出的病原体中，支原体 2 990株(69.76%)，衣原体806株(18.80%)，普通需氧菌386株(9.01%)，淋病奈瑟菌104株(2.43%)；支原体中，解脲支原体占61.27%，人型支原体占6.46%，二者合并感染占32.27%，二者合并感染率逐年增加（χ2=6.31, P＜0.05）。结论该院泌尿生殖道感染就诊者大多检出病原体，且感染模式趋向于多样化和复杂化。

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目的了解某院就诊患者人免疫缺陷病毒（HIV）抗体初筛检测情况和分布状态。方法回顾性分析该院2005年1月—2008年12月间门诊就诊和住院的51 489例患者HIV抗体筛查检测资料。结果51 489例患者中，HIV抗体初筛阳性310例(2005年43例，2006年64例，2007年78例，2008年125例)，阳性率0.60%。男性203例，女性107例。年龄1～90岁，男性主要集中于25～44岁及55岁以上年龄段，分别占48.77%和27.59%；女性主要分布于25～34岁年龄段，占31.77%。科室分布：内科183例（59.03%）， 手术科室83例（26.78%），其他科室44例(14.19%)。结论HIV感染形势严峻，常规检测住院患者HIV抗体成为必要，对预防医源性感染、减少医疗纠纷、防止医务人员职业暴露有重要意义。

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目的了解西安市医院临床护理人员执行手卫生的效果及其影响因素，以促进手卫生质量的提高。方法按照《消毒技术规范》要求，对西安市部分专科门诊、综合医院、职工医院、三级甲等医院共116家医疗机构中从事临床护理工作的668名护理人员进行手卫生监测、比较。结果专科门诊、综合医院、职工医院、三级甲等医院临床护理人员手卫生合格率分别为67.69%（44/65）、87.50%（210/240）、71.92%（187/260）、86.41%（89/103），不同类型医院护理人员手卫生合格率差异有统计学意义（χ2=28.16，P＜0.01）。不同科室中，手术室、产房护理人员手卫生合格率最高，分别为98.37%、96.15%，其次是儿科（84.48%）、内科（75.90%）、外科（69.54%）、妇产科（68.97%）、口腔科（53.97%）。结论不同医院和科室临床护理人员执行手卫生效果参差不齐，应进一步加强对医务人员手卫生的管理，提高其手卫生依从性。

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目的调查某院医务人员手卫生的依从性现状。方法采用隐蔽式现场观察的方法，根据《医务人员手卫生规范》，对128名医务人员接触患者前后手卫生的依从性进行调查。结果128名医务人员中，接触患者前后执行手卫生者40人，手卫生依从率31.25%。手卫生依从率最高的科室为重症监护室（53.85%），其次为妇产科（36.36%）、内科（34.62%）、急诊科（25.00%）和外科（20.00%）；不同岗位间，手卫生依从率最高的是护士（48.57%），其次为医生（38.71%）、实习护士（20.83%）、实习医生（16.67%）、护工和保洁员（15.38%）。结论该院医务人员手卫生依从性不高，应加强宣教、监督和管理。

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目的了解某院医院感染的现状，发现医院感染管理中存在的问题，提出整改措施。方法采用横断面调查方法，由患者主管医生填写医院感染横断面调查个案登记表， 对2008年7月2日0∶00—24∶00间住院患者进行问卷调查。结果实查患者493例，医院感染现患率为6.49%（32/493），例次现患率为7.10%（35/493）。医院感染部位主要为下呼吸道（65.71%）、泌尿道（11.43%）、皮肤软组织（8.57%）。感染高发科室为中心重症监护室（40.00%）、神经内科（21.62%）、神经外科（12.50%）。共检出病原菌40株，主要为肺炎克雷伯菌（8株）、铜绿假单胞菌（7株）、鲍曼不动杆菌（6株）、金黄色葡萄球菌（4株）、白假丝酵母菌(3株)。日抗菌药物使用率为40.97%（202/493），治疗用药病原学送检率为21.66%（34/157）。结论该院医院感染现患率处于中等水平，感染部位以下呼吸道为主，病原菌主要是革兰阴性菌。需加强对重点科室的监控，提高病原学送检率，规范抗菌药物的使用。

Abstract:

目的探讨组长负责制在消毒供应中心管理中对工作质量及效率的影响。方法在消毒供应中心各环节设立组长岗位，实施组长负责制，通过质控检查与临床满意度问卷调查，比较组长负责制实施前后的工作质量、效率和临床满意度变化。结果实施组长负责制后，消毒供应中心清洗合格率由之前的92.00%（460/500）上升至98.60%（493/500），包装合格率由90.00%（270/300）上升至98.00%（294/300）；临床科室对消毒供应中心的满意度由85.00%（408/480）上升至97.08%（466/480），上述指标在实施组长负责制前后比较，差异均有统计学意义（均P＜0.05）。结论实施组长负责制，激发了各级护理人员的潜能，提高了工作效率和质量，使护士长工作回归到管理层面，临床服务满意度得到提升。

Abstract:

随着广谱抗菌药物及免疫抑制剂的使用，人口老龄化社会现象，抗菌药物耐药问题日益严重。和抗菌药物耐药相比，研制一种新型的抗菌药物的速度远远落后于前者。耐药的革兰阳性（G+）球菌是导致临床抗感染治疗失败的主要原因之一。达巴万星(dalbavancin)为Vicuron Pharmaceuticals公司开发的一种新型半合成糖肽类抗生素，为替考拉宁类似物A40926的衍生物，其化学结构式见图1。目前已完成了Ⅲ期临床试验，它对各类临床常见G+菌具有高度抗菌活性。达巴万星具有和替考拉宁相似的分子结构，但羧基肽基团末端的酰胺基修饰提高了达巴万星对葡萄球菌属，特别是凝固酶阴性葡萄球菌的抗菌活性；而亲脂支链和二聚体的形成提高了达巴万星的组织穿透性和与细菌细胞膜的亲和力。和替考拉宁等糖肽类抗生素一样，达巴万星通过与细菌细胞壁肽聚糖上D丙氨酰丙氨酸末端特异性结合，抑制细菌细胞壁肽聚糖的延伸和交联，阻止细胞壁合成而发挥杀菌作用。

Abstract:

铜绿假单胞菌(Pseudomonas aeruginosa，PA)是引起菌血症、泌尿系感染及多种慢性呼吸道疾病的重要病原菌,也是医院感染的主要病原菌之一。根据菌落形态及是否产生大量藻酸盐，可将PA分为黏液型和非黏液型2个型别［1］。黏液型和非黏液型菌株表现出不同的致病性和抗菌药物耐药性，是目前细菌学中非常活跃的研究领域，本文就黏液型PA及生物膜形成的研究进展作一综述。