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ObjectiveTo establish duplex polymerase chain reaction(PCR) system for fast detecting Staphylococcus aureus (S. aureus) and methicillinresistant S. aureus（MRSA）, guiding rational use of antimicrobials in clinical practice, and preventing MRSA spreading.MethodsTwo pairs of primers according to coagulase gene (Coag) and drug resistance gene (mecA) of S. aureus were designed, duplex PCR system was established and applied for amplifying Coag and mecA in 85 clinical S.aureus strains, amplification reaction result was compared with that of oxacillinsalt agar screening （OSAS） test.ResultsOf 85 clinical S.aureus isolates, 53 (62.35%) were MRSA detected by OSAS test. All 85 S.aureus isolates were detected Coag gene fragments by duplex PCR， and 53 of which were also detected mecA gene fragments, PCR results were consistent with OSAS test result for detecting MRSA.ConclusionDuplex PCR can detect Coag and mecA of S.aureus rapidly and simultaneously, and is helpful for early detection of MRSA, guidance of rational use of antimicrobial agents,and control of MRSA transmission.

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ObjectiveTo investigate the viral characteristics and epidemic trends of respiratory tract infection (RTI) in children in a hospital.Methods5 384 children who were confirmed RTI in a hospital from January to July 2012 were included in the study, nasopharyngeal secretion of children were performed detection of respiratory syncytial virus（RSV）,influenza virus A/B（FLUA/B）,parainfluenza virus 1—3（PIV1—3）and adenovirus（ADV）.ResultsOf 5 384 children, 1 834 （34.06%）were infected with virus; 1 884 isolates of virus were detected，the major virus was RSV(895 isolates，16.62%)，followed by FLUA (376 isolates，6.98%),FLUB(278 isolates，5.16%),PIV1(179 isolates，3.32%),ADV(138 isolates，2.56%),PIV3(15 isolates，0.28%), and PIV2(3 isolates，0.06%). Constituent ratio of RSV and PIV3 infection were highest in children ＜1 years of age(56.31% and 40.00% respectively), the next were in children of 1-2 years of age(27.04% and 26.67% respectively)；constituent ratio of FLUA was higher in children ＜4 years of age（16.22%-25.53%），FLUB was detected in each age group（7.19%-16.55%）；constituent ratio of PIV1 in children ＜5 years of age was 8.38%-23.46%；constituent ratio of ADV in children of 1-4 years of age was 15.94%-34.78%. Single and mixed infection accounted for 97.55% and 2.45% (45 cases）respectively, infection of PIV1 associated with other virus was the major mixed infection（25 cases），followed by RSV mixed infection （24 cases）and FLUB mixed infection（19 cases）.ConclusionRIT in children in this hospital is mainly caused by RSV, followed by FLUA, FLUB, PIV, and ADV; the positive rate of different virus in different age group is varied.

Abstract:ObjectiveTo investigate the etiology of infectious pleural effusion in children，and provide ideas and methods for the diagnosis and treatment of infectious pleural effusion．Methods165 children diagnosed with pleural effusion by chest radiography and (or) ultrasound B were admitted to a hospital from January 2011 to December 2012, their clinical and laboratory data were analyzed retrospectively．ResultsOf 165 children, 146(88.48%) were with infectious pleural effusion, including Mycoplasma infection 77 cases (52.74％), mixed infection of Mycoplasma and other pathogens 24 cases (16.44%, mixed infection with bacteria, virus and tuberculosis were 17, 6 and 1 respectively), bacterial infection 23 cases (15.75％) （12 cases were tuberculosis infection），viral infection 7 cases (4.79%), paragonimus infection 1 case (0.69%), and unidentified pathogens 14 cases (9.59%). The constituent ratio of Mycoplasma mixed infection in 1-15 years old children was 13.46%-26.32%; tuberculosis infection was highest in 7-15 years old children (19.23%); the ratio of bacterial and viral infection in children aged<1 year was 37.50% and 18.75% respectively.ConclusionMycoplasma infection is the most common cause of infectious pleural effusion in children; especially in 1-15 years old children; bacterial infection is the major cause of pleural effusion in children aged <1 year; tuberculosis infection is common in 7-15 years old children.

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ObjectiveTo explore the risk factors and economic burden of ventilatorassociated pneumonia（VAP）caused by Acinetobacter baumannii (A.baumannii).MethodsLogistic regression for 1∶1 matched casecontrol study was adopted to analyze risk factors for 33 cases of VAP caused by A. baumannii, length of hospital stay, hospitalization expense, and drug expense of two groups were compared. ResultsTracheotomy was the major risk factor for A. baumannii VAP（P=0.005，OR=65.29）. The median length of hospital stay in case group and control group were 48 and 23 days respectively. After adjusting, ttest showed that length of hospital stay in case group was significantly higher than that of control group(t=6.237，P＜0.001).The total hospitalization expense and expense of drugs in case group were both higher than those of control group(median 198 400 yuan vs 59 900 yuan P＜0.001; 97 200 yuan vs 22 300 yuan,P＜0.001）,the average expense per hospitalization day between two groups was not significantly different（P=0.085）, but the average drug expense per hospitalization day in case group was significantly higher than that of control group（median 2 160.38 yuan vs 1 321.10 yuan， P＜0.001）.ConclusionPulmonary infection can be easily developed following tracheotomy, A. baumannii is the major pathogen for VAP; pulmonary infection can increase economic burden of patients.

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ObjectiveTo evaluate the risk factors of healthcareassociated infection(HAI) in patients undergoing neurosurgical operation, and provide reference for preventing postoperative infection.MethodsClinical data of 2 496 patients undergoing neurosurgical operation were analyzed, univariate analysis and multivariate logistic regression analysis on risk factors for HAI were performed.ResultsOf 2 496 patients, 421 developed 447 episodes of HAI, HAI rate and case rate was 16.87% and 17.91% respectively; the main infection site was surgical site(42.06%，188 cases),followed by lower respiratory tract(33.56%,150 cases) and urinary tract(10.51%,47 cases). Univariate analysis showed that the related risk factors for postoperative infection were age, primary diseases, duration of operation, tracheal intubation/tracheotomy, blood transfusion, a second operation, preoperative hyperglycemia(all P＜0.05). Multivariate logistic regression analysis showed that age≥60 years old（OR 95% CI：1.19-2.06）,duration of operation ≥3 hours（OR 95% CI：1.61-2.87）, tracheal intubation/tracheotomy（OR 95% CI：2.90-5.50）, blood transfusion（OR 95% CI：1.58-2.63）, and preoperative hyperglycemia（OR 95% CI：1.52-2.79） were independent risk factors for infection in patients undergoing neurosurgical operation.ConclusionThe occurrence of HAI in patients undergoing neurosurgical operation is related to multiple factors, surveillance on HAI should be intensified.

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ObjectiveTo perform rapid and accurate active screen on methicillinresistant Staphylococcus aureus (MRSA) in patients in an intensive care unit(ICU), and provide evidence for making effective measures of controlling multidrugresistant bacterial infection.MethodsPatients who were hospitalized between November 1,2011 and April 30,2012 were in control group (79 cases, patients suspected with MRSA infection were performed MRSA detection with routine bacterial culture method), and patients who were hospitalized between June 1,2012 and November 30,2012 were in intervention group (86 cases, patients were performed active screen with MRSA chromogenic medium), MRSA detection rate between two groups was compared.ResultsThe differences in age,score of disease classification, catheterization rate between two groups were not significantly different (P>0.05); the average length of hospital stay in control group was significantly longer than that of intervention group （［20.77±7.27］d vs［18.13±6.90］d, t=2.39，P=0.02）. The detection rate of MRSA at admission to ICU in intervention group and control group was 3.80%（3/79） and 1.16%（1/86）respectively（P＞0.05）, at discharge was 5.06%（4/79）and 5.81%（5/86）respectively（P＞0.05）.ConclusionActive screen on MRSA with chromogenic medium can provide evidence for timely contact isolation，and is more effective to enforce contact precaution measures.

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ObjectiveTo investigate distribution and genotypes of human papillomavirus (HPV) infection，as well as relationship between HPV infection and female genital diseases in Fengtai District of Beijing.MethodsHPV detection was performed among 673 female patients with genital diseases in an outpatient department from September 1 to 30, 2012, the relationship between HPV genotypes and genital diseases was analyzed.Results Of 673 patients, 140(20.80%) were with positive HPV test; HPV detection rate in patients with cervicitis, cervical lesions, cervical cancer,and other inflammatory diseases （including vulvitis, vaginitis, pelvic inflammatory disease, and urinary tract infection）was 23.32%（87 cases）,38.89%（14 cases）,61.11%（11 cases）, and 11.38%（28 cases） respectively. 140 patients were detected 197 times of HPV, 13 subtypes were included（type 52,16,58、56,39,51,68,33,59,18,31,35,and 45）, the top three HPV types were ranked by HPV52（18.78%）, HPV16（16.75%） and HPV58 （11.67%）; Incidence of singleinfection was 73.57% (103 cases),double and multiple infection was 26.43%(37 cases), all HPVpositive patients with cervical cancer had double infection.ConclusionThe incidence and types of HPV infection in local female patients are regionally distributed. Survey on the incidence and distribution can provide epidemiological data for exploring effective prevention and therapy for HPVrelated diseases.

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ObjectiveTo investigate knowledge, attitude and behavior towards healthcareassociated infection (HAI) among medical students of different school years and majors, and evaluate the teaching method on the education about HAI and occupational precaution. MethodsA survey was conducted among medical students of school year 2008-2010 during their initial period of clinical practice with a simple random sampling method by specifically designed questionnaires. Results448 medical students were investigated, 421 (93.97%) effective questionnaires were received. With regard to grasping HAI knowledge, the percentage of correct answer was statistically different among students of different majors (χ2=1.62×104,P<0.05), nursing students ranked first(78.28%),and students of rehabilitation major ranked last(60.90%); the percentage of correct answer was also statistically different among students of different school years (χ2=14.62,P<0.05),students of school year 2008 ranked first (75.51%), and 2010 ranked last(70.63%). With regard to attitude, more than 90% of students realized the importance of HAI prevention and occupational precaution, there was no statistical difference in attitude among all school years (H=1.39, P>0.05), but the difference in attitude among students of different majors was significant (H=86.70, P<0.05), nursing students scored highest, 50% of whom scored >74,medical laboratory students ranked last,50% of whom scored >66. With regard to behavior, 54.46% of the students often/always showed behavior of HAI prevention and occupational precaution, the scores were statistically different among students of different school years (H=36.49,P＜0.05) and majors (H=180.32,P＜0.05),in terms of school year,50% of students of year 2008 and 2009 scored >60 and ≤55 respectively， in terms of major, nursing student got the highest average score（63.76±10.11), 8year program students scored lowest (47.94±14.35).ConclusionDuring the initial period of clinical practice, medical students demonstrate a satisfactory level of knowledge and attitude towards HAI, but their behavior need to be improved; it’s necessary to perform education about HAI knowledge as soon as possible, enhance the awareness of HAI, and improve occupational precaution among medical students, so as to reduce the occupational exposure and cross infection in hospital during the internship period.

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ObjectiveTo investigate the treatment process and infection status of health care workers(HCWs) after occupational exposure to hepatitis C virus (HCV),and provide experience in the prevention and control of occupational exposure to HCV.MethodsExposed links, treatment methods and followup results after occupational exposure to HCV among 5 HCWs were investigated. ResultsAll 5 HCWs were nurses,1 of whom developed acute HCV infection after exposure. All HCVexposed HCWs were given psychological counselling,4 HCWs were excluded from diagnosis of infection and return to normal work; the HCVinfected nurse was excluded from clinical work, received psychological support, and recovered after 1year combined antiviral therapy with pegylated interferon and ribavirin.ConclusionThe key to the recovery from acute HCV infection after occupational exposure to HCV among HCWs are timely report, surveillance of HCV RNA infection, and combined antiviral therapy with pegylated interferon and ribavirin.

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ObjectiveTo analyze the clinical diagnosis and characteristics of 261 patients with positive blood culture, as well as value of related clinical factors in the diagnosis of bacteremia.MethodsClinical data of 261 patients with positive blood culture in a hospital from October 2010 to February 2013 were analyzed retrospectively.ResultsOf 261 patients, 204(78.16%) cases of bacteremia were confirmed,but positive blood culture of the other cases (57, 21.84%) were confirmed to be caused by contamination of blood specimens. Positive blood culture result was the independent factor for bacteremia, independent factors of bacteremia in several diseases were as follows: in urinary system diseases were age ≥60 years(OR=8.87, P=0.04), temperature ≥39℃ (OR=10.98, P=0.03) and indwelling urethral catheterization (OR=11.99, P=0.02); in cerebrovascular diseases were length of hospital stay ≥10 days（OR=8.72, P=0.04） and use of central venous catheter (OR=5.46, P=0.02）;in diseases of gastrointestinal and hepatobiliary system were disorder of consciousness (OR=10.38, P=0.03） and leukocyte count ≥15.0×109/L(OR=5.58, P=0.02）.ConclusionClinical factors in the diagnostic value of positive blood culture are different among various diseases; proper clinical factors combining primary disease characteristics for correct assessment of positive blood culture result has important clinical significance.

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ObjectiveTo investigate the distribution and antimicrobial resistance of pathogens from lower respiratory tract infection in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD), and provide reference for the rational use of antimicrobial agents in clinic.MethodsSputum culture and antimicrobial susceptibility test were conducted for 200 AECOPD patients who were admitted to a respiratory disease department from January to December 2011, and antimicrobial susceptibility test results were analyzed by WHONET 5.3 software.ResultsOf 200 AECOPD patients, 85 (42.50%) had positive sputum culture, the isolation rate of gramnegative bacilli, grampositive cocci and fungi was 77.65% (66 isolates), 18.82%（16 isolates）and 3.53%(3 isolates) respectively. The top six pathogens were Pseudomonas aeruginosa (36.47%)，Klebsiella pneumoniae (11.76%)，Haemophilus influenzae (10.58%)， Acinetobacter baumannii (9.41%), Streptococcus pneumoniae（9.41%）, and Staphylococcus aureus（8.24%）. Pseudomonas aeruginosa had multiple antimicrobial resistance, the resistant rates to ampicillin,ampicillin/sulbactam, cefazolin, cefotetan,compound sulfamethoxazole, and nitrofurantoin were all 100.00%，to ceftriaxone was 93.55%；the resistant rates of Acinetobacter baumannii to ampicillin, cefazolin,and nitrofurantoin were all ＞75%；the resistant rates of Klebsiella pneumoniae to ampicillin and nitrofurantoin were both ＞60%；the resistant rates of Haemophilus influenzae to ampicillin and compound sulfamethoxazole were both ＞65%. Of 7 Staphylococcus aureus isolates，5 were methicillinresistant.ConclusionThe main pathogens in AECOPD are gramnegative bacilli,and are highly resistant to antimicrobials. Sensitive antimicrobials for gramnegative bacilli should be selected for the treatment, infection with antimicrobial resistant Staphylococcus aureus and fungi should be paid enough attention.

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ObjectiveTo investigate the colonization and clinical characteristics of multidrugresistant (MDR) bacteria isolated from intensive care unit (ICU) patients.MethodsNasal and rectal swabs of 75 patients admitted to an ICU from February 14, 2012 to March 13,2012 were screened by bacteriological surveillance.ResultsAmong 75 patients, 27 (36.00%) were detected multidrugresistant(MDR) strains;Ninetyone nasal swabs were detected 2 methicillinresistant Staphylococcus aureus (MRSA) isolates;91 rectal swabs were detected 22 isolates of extendedspectrum βlactamase(ESBL)producing Escherichia coli, 1 ESBLproducing Klebsiella pneumoniae isolate, 1 MDR Acinetobacter baumannii, and 1 MDR Pseudomonas fluorescens. Bacterial colonization rates were as follows: patients with length of hospital stay ≥3 days and <3 days was 47.37% and 32.14%, respectively, patients aged ≥60 years and <60 years was 37.29% and 31.25% respectively， patients with infectious underlying diseases and noninfectious underlying diseases was 39.22% and 29.17%，respectively. 21 MDR isolates were isolated from the specimens taken on the first day of admission,19 of which were communitycolonized bacteria, 1 was colonized at the other hospital, and 1 was colonized at the department of internal medicine in this hospital;5 isolates were isolated from specimens taken on the third day,and 1 isolate was isolated on the seventh day, all 6 isolates were colonized at ICU after 72 hours of admission.ConclusionColonization rate of MDR bacteria is high in patients in ICU, especially those aged ≥60 years and/or with infectious diseases, which should be paid attention by clinicians;surveillance should be intensified so as to avoid the outbreak of MDR bacterial infection in hospital.

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ObjectiveTo investigate protection status among close contacts of sputum smearpositive pulmonary tuberculosis (TB) patients, so as to improve the prevention and control of TB infection.MethodsOnthespot and questionnaire survey were adopted to investigate 125 persons who had close contact with 54 cases of sputum smearpositive pulmonary TB patients.ResultsThe average awareness rate of knowledge about prevention and control on TB infection among family members, colleagues, and classmates of smearpositive TB patients was 65.80%, 74.05% and 70.53% respectively, the average awareness rate among different close contacts had no statistical difference (χ2=3.96, P=0.151）.Of 125 close contacts, the percentage of persons who had implementation of management measures, environmental control (environmental ventilation, disinfection of environmental surfaces, and disinfection of patients’ sputum), and personal protection was 96.00%,64.80%,and 59.20% respectively, the qualified implementation rate of measures was 80.00%,74.90%,and 31.08% respectively; the percentage of implementing measures among different close contacts had statistical difference（χ2=29.32，P=0.002）, the qualified implementation rate of measures had no statistical difference（χ2=1.85，P=0.416）.ConclusionClose contacts of pulmonary TB patients lack selfprotection awareness, protective measures are inadequate, there is a risk of infection, education about prevention and control of pulmonary TB should be intensified.

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ObjectiveTo evaluate the best method of disinfection and storage time through comparing two different disinfection methods for oxygen humidifier bottles.MethodsFrom March to August 2012, 250 washed oxygen humidifier bottles were randomly divided into control group and experimental group,each group included 125 pieces. Control group was disinfected through immersing into “84” disinfectant containing 500 mg/L of available chlorine; experimental group was disinfected with acidic electrolyzed oxidizing water, bacterial culture results at day 1, day 7-30 and effective storage time of two groups were compared.ResultsAfter being washed, disinfected and dried, all oxygen humidifier bottles of two groups were clear and without water stain. Experimental group had no chlorine smell, but control group had chlorine smell after being immersed.Qualified rates of bacterial monitor of specimens taken at day 1 and 7-12 were all 100.00%; at day 13-30, qualified rate of bacterial monitor was 31.11%(28/90) and 43.33%（39/90） in control group and experimental group respectively（χ2=2.88，P=0.090）.ConclusionTwo disinfection methods can both achieve disinfection efficacy and be effectively stored for 12 days, acidic electrolyzed oxidizing water is perfect, fast acting, safe, nontoxic,and lowcost.

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ObjectiveTo survey the current situation of healthcareassociated infection (HAI)in psychiatric inpatients in a general hospital, analyze related factors for infection, and take preventive measures to reduce HAI rate.MethodsMedical records of 5 432 psychiatric patients in a hospital from January 1, 2009 to December 31, 2011 were analyzed retrospectively.ResultsOf 5 432 patients, 438 developed 514 times of HAI, HAI rate and case rate was 8.06% and 9.46% respectively; the major infection site was upper respiratory tract (68.29%),followed by lower respiratory tract(12.06%) and gastrointestinal tract(9.92%).The differences in HAI rates among patients with different primary diseases were statistically different（χ2=102.29，P＜0.001）, HAI rate was highest in alcoholic psychiatric patients(23.40%);with regard to season, HAI rate and case rate was highest in winter season, which was 11.82%（151 cases） and 14.02%（179 times）respectively, upper respiratory tract infection in winter accounted for 40.74%（143/351） of total upper respiratory tract infection;the difference in HAI rate in patients receiving different management modes was statistically different （χ2=59.58，P＜0.001）,the highest infection rate was in the enclosed management male ward (12.83%).ConclusionHAI rate in psychiatric patients in general hospital is high, in order to reduce the occurrence of HAI, proper measures should be taken according to the change in seasons, the susceptibility in primary diseases, and different management modes.

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ObjectiveTo explore the laboratory culture features of Brucella,and analyze positive alarming time (PAT) of Brucella detected by  BACTECTM9120 automated blood culture system．MethodsPAT of 76 Brucella isolates from clinical specimens were analyzed statistically, and compared with PAT of other pathogens.ResultsOf 76 Brucella isolates, 66(86.85%) were from blood specimen, 7(9.22%) were from bone marrow, and isolate from pus, cerebrospinal fluid and joint fluid was 1 (1.31%) for each. PAT of 76 Brucella was 72-120 h, the mean PAT of Brucella from bone marrow specimen was (84.51±8.86) h, which was significantly shorter than (98.27±10.32) h of blood specimen(t=3.39，P＜0.01）. The mean APT of Brucella from all specimens was (96.95±9.67) h, which was significantly longer than that of gramnegative bacilli (［15.43±16.56］ h),  grampositive cocci (［24.22±21.47］ h) and yeast(［50.60±26.48］ h) (t'=15.22,10.46,5.17，respectively, all P＜0.01）. ConclusionPAT of Brucella detected by  BACTECTM9120  automated blood culture system is significantly longer than other pathogens, PAT of Brucella from bone marrow specimen is significantly shorter than that from blood specimen.

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(S.aureus) isolated from a hospital.MethodsSpecimen sources and antimicrobial susceptibility test results of 520 S.aureus isolates from a hospital between January 2011 and August 2012 were analyzed.ResultsOf 520 S.aureus isolates, isolation rate of methicillinresistant S.aureus (MRSA) was 23.27%(121/520), mainly from sputum specimen (80.82%), followed by urine(33.33%), blood(25.00%) and drainage(18.31%), the detection rate was the lowest in skin and soft tissue (11.38%). Vancomycin and linezolidresistant S. aureus was not found; S.aureus was sensitive to vancomycin, linezolid,compound sulfamethoxazole and furantoin. The sensitive rates of MRSA from skin and soft tissue to gentamycin, levofloxacin, ciprofloxacin,moxifloxacin,rifampicin and tetracycline were higher than those from the other specimen sources(P<0.05), but sensitive rates to erythromycin and clindamycin were lower than those from the other specimen sources(P<0.05). MRSA was totally resistant to penicillin, MRSA from communityassociated infection was more sensitive to gentamycin, levofloxacin, ciprofloxacin,moxifloxacin， rifampicin and tetracycline than that from healthcareassociated infection (HAI) (P<0.05)， but susceptible rates to erythromycin, clindamycin and compound sulfamethoxazole were lower than that from HAI (P<0.05).ConclusionS. aureus is an important pathogen isolated from this hospital, and with high antimicrobial resistance, it is important to use antimicrobial agents rationally according to antimicrobial susceptibility test result.

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ObjectiveTo investigate the isolation trends of common pathogenic bacteria in healthcareassociated infection(HAI) in a hospital,evaluate the changes in antimicrobial resistance to quinolones and antimicrobial resistance mechanisms, and guide rational antimicrobial use.MethodsBacterial identification and antimicrobial susceptibility test were performed by Vitek32 system and KirbyBauer method respectively, and antimicrobial susceptibility test results were evaluated based on standard of US Clinical and Laboratory Standards Institute (CLSI).ResultsFrom January 2006 to December 2010, a total of 10 606 pathogenic bacteria isolates were detected, the top 5 pathogens were Escherichia coli, Staphylococcus aureus, Pseudomonas aeruginosa, Klebsiella pneumoniae, and Acinetobacter baumannii, distribution of pathogens of each year varied little. Antimicrobial susceptibility test results showed that antimicrobial resistance of these 5 pathogens to quinolones increased year by year, Escherichia coli and Klebsiella pneumoniae increased most rapidly,the resistant rate to ciprofloxacin increased from 48.72% and 48.33% in 2006 to 89.06% and 81.53% in 2010 respectively (P<0.005), the resistance to levofloxacin increased from 48.84% and 39.77% in 2006 to 80.14% and 80.64% in 2010 respectively (P<0.005); the resistant rate of Pseudomonas aeruginosa to ciprofloxacin, levofloxacin, and pefloxacin also increased year by year (P<0.005). Antimicrobial resistant rate of grampositive cocci to quinolones increased slowly.ConclusionIn the past five years, resistance of common pathogens in HAI to quinolones were increasing, monitoring on bacterial resistance should be strengthened; clinical antimicrobial use should be based on antimicrobial susceptibility test result.

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ObjectiveTo investigate the distribution and drug resistance of pathogens isolated from a general surgery department.MethodsThe category,distribution, and drug resistance of pathogens isolated from patients in a general surgery department from January 2011 to December 2012 were analyzed retrospectively.ResultsA total of 859 isolates of pathogens were isolated，563 (65.54%) of which were gramnegative bacteria,233 (27.12%) were grampositive bacteria, and 63 (7.33%)were fungi. The most common gramnegative bacteria was Escherichia coli (40.40%)， the dominant grampositive bacteria was Enterococcus faecalis (3.96%), Candida albicans was the major fungus.Most pathogens were isolated from peritoneal fluid（65.43%，562 isolates）,followed by wound or incisional secretion（10.94%，94 isolates）,sputum （9.90%，85 isolates）, and bile（6.75%，58 isolates）. Enterobacteriaceae were not resistant to imipenem and meropenem,and resistant rates to amikacin, amoxicillin/clavulanic acid,piperacillin/tazobactam and cefoperazone/sulbactam were all <20%,the resistant rates to cephalosporins were high. The resistant rate of Acinetobacter baumannii to imipenem and meropenem was 51.85% and 47.37% respectively，and to most antimicrobial agents were >60%, but to levofloxacin and amikacin were both <20%. The resistant rate of grampositive bacteria to vancomycin was <3.40%.ConclusionThe major pathogens isolated from inpatients in this general surgery department are gramnegative bacteria, survey on distribution and drug resistance of pathogens is important for the rational choice of antimicrobial agents, improvement of therapeutic efficacy,and prevention of the spread of drugresistant bacteria.

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目的通过对医务人员发生锐器伤的情况进行统计，分析发生锐器伤的危险因素，探讨改进措施，以减少医务人员锐器伤的发生。方法对2011年3月—2012年9月间发生锐器伤并登记的100名医务人员资料进行统计分析。结果发生锐器伤的100名医务人员中，护理人员占75.00%，是锐器伤发生的高危人群；工龄＜5年的医务人员是发生锐器伤的集中人群；直接用手整理物品是发生锐器伤的高危操作环节；锐器伤发生后能正确处理伤口的医务人员占69.00%。结论应加强医务人员职业暴露知识的培训，认真落实职业防护制度，规范操作，以减少锐器伤的发生。

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目的了解某院重症监护室医院感染发生情况及影响因素，为有效防治医院感染提供理论依据。方法采用前瞻性监测方法，对2011年1—12月综合ICU所有住院患者发生医院感染情况进行调查。结果169例ICU住院患者中，发生医院感染23例（13.61%），36例次（21.30%）；根据患者病情的平均严重程度进行调整后，调整日医院感染率为5.42‰，调整例次日医院感染率为10.65‰。医院感染部位以呼吸系统为主，占44.44%；呼吸机相关性肺炎、导尿管相关泌尿道感染、中心静脉置管相关血流感染率分别为27.52‰、10.67‰、5.84‰。结论 该院ICU医院感染率及器械相关感染率高, 应重视医院感染监测工作，加强对有侵入性诊疗操作患者的监护。

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目的探讨某院高压氧病区医院感染病原体种类及其耐药情况，为临床合理用药提供依据。方法对该院高压氧病区2012年1—12月收治的593例住院患者送检的标本进行病原体分离、菌种鉴定和药敏试验，并用WHONET 5.6软件进行数据汇总和统计分析。结果593例住院患者中，发生医院感染133例，医院感染率为22.43%。共分离441株病原体，包括革兰阴性（G-）菌18种，355株（80.50%）；革兰阳性（G+）菌17种，77株（17.46%）；真菌2种，9株（2.04%）。标本来源以痰液、尿液和血液为主，合计占96.15%。G-菌以铜绿假单胞菌居多，占23.58%，其对多种抗菌药物耐药率＞90%；鲍曼不动杆菌对头孢替坦、头孢唑林、头孢呋辛、氨苄西林和呋喃妥因的耐药率均达100%，对阿米卡星耐药率（37.25%）最低。葡萄球菌属对替加环素、万古霉素、利奈唑胺和奎奴普丁/达福普汀的敏感率＞95%。结论该院高压氧病区医院感染病原体耐药性较严重，应加强监测，以便预防控制病原体传播及为合理用药提供参考。

Abstract:

目的提高供应室工作人员职业防护能力，减少职业暴露的发生。方法提出品质圈活动,对供应室工作人员进行职业危害与防护相关知识培训、再造工作流程、改进供应室环境以及进行工作的节力原则和“慎独”精神的培养等。结果供应室工作人员的职业危害与防护相关知识理论考试成绩由平均83.2分上升为95.3分；近1年来供应室未发生一例针刺伤事件；复用医疗器械清洗缺陷率一年来由平均113.3次/月下降至14.8次/月。结论品质圈活动能提高供应室工作人员职业防护能力。

Abstract:

目的探讨应用康惠尓水胶体敷料预防静脉炎的效果。方法选取某院2011年6月—2012年6月应用静脉留置针输入刺激性药物的患者100例，随机分为实验组和对照组，各50例。实验组：在静脉留置针穿刺成功后，用康惠尓透明贴固定留置针，沿穿刺点静脉向近心端外贴；对照组：按常规用3M透明贴固定静脉留置针。每隔2 d消毒、更换敷料一次。比较两组患者静脉炎的发生率。结果实验组的静脉炎发生率为6.00%（3/50），显著低于对照组的28.00%（14/50），差异有统计学意义（χ2=8.575，P=0.003）；实验组均为1级静脉炎，对照组1—3级静脉炎分别为10例（71.43%）、3例（21.43%）、1例（7.14%）。结论高渗刺激性药物输注过程中，应用康惠尓水胶体敷料可使静脉炎的发生率显著降低，减轻患者的痛苦。

Abstract:

类鼻疽病（melioidosis）是由假鼻疽伯克霍尔德菌（Burkholderia psudomallei）所致的热带和亚热带地区的一种人兽共患病。因假鼻疽伯克霍尔德菌的高致病性、强抵抗力、易传播、易培养等特性，美国疾病预防控制中心将其列为B类生物恐怖剂；临床上有急性败血症型、亚急性、慢性及亚临床4种表型。急性患者可有高热、衰竭等全身症状；病菌进入血流，可形成菌血症及内脏脓肿，最后常因脓毒症死亡。慢性患者全身症状不定，可有皮肤及皮下溃疡，常类似空洞肺结核表现，其潜伏期可达数年。最近，我们从1例糖尿病肺部感染、腋窝软组织感染患者血液、骨髓等标本中分离出假鼻疽伯克霍尔德菌，现报告如下。

Abstract:

全世界约有20亿人曾感染过乙型肝炎(乙肝)病毒(HBV)，其中慢性携带者达3.5亿~4亿［1］。我国HBV慢性携带者有近半数是由围产期母婴传播所致［2-3］，而宫内感染是母婴传播的主要途径之一。 HBV宫内感染是最终发展成乙肝表面抗原(HBsAg) 慢性携带的主要原因，也是造成乙肝疫苗免疫失败的重要因素［4-5］。在HBV感染过程中，病毒抗原如HBsAg、乙肝核心抗原(HBcAg)、乙肝e抗原(HBeAg)均可诱导抗原特异性T细胞的免疫应答，这对HBV感染的控制至关重要；而慢性患者病毒感染的持续和慢性化发展，是因其HBV特异性T细胞免疫反应受损所致。既往研究［1］表明，发生HBV宫内感染的孕妇体内Th1/Th2细胞免疫失衡，即Th1细胞免疫下调，Th2细胞免疫反应增强，这是导致HBV宫内感染的主要原因之一。随着以分泌白细胞介素(IL)17为特征的辅助T细胞——Th17细胞的发现，Th17/Treg细胞的平衡作用也越来越受到人们的关注。Th17/Treg细胞间平衡的打破可能是多种疾病发生的关键因素，这将弥补既往Th1/Th2免疫效应模式的不足。近几年，维甲酸相关核孤儿受体(retinoid acidrelated orphan receptor gamma t，RORγt)作为Th17细胞的特异性转录因子也成为研究热点。本文就近几年Th17细胞及其转录因子RORγt在HBV宫内感染的相关研究进展作一综述。