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ObjectiveTo detect the protective role of high mobility group box1 protein (HMGB1) antibody in  concanavalin A(ConA)induced liver injury in mice.MethodsThe healthy male Balb/c mice were grouped into control group (saline injection), model group(ConA injection) and experimental group(ConA+HMGB1 antibody injection). After 6 hours of injection, mice blood was collected for detecting alanine transaminase (ALT) and HMGB1,liver tissue was used to do HE stain, Tunel, and immunofluorescence detection.ResultsPathological inflammation in experimental group was slighter than model group. The levels of ALT and HMGB1 in mice serum were （52.00±8.34）U/L and （7.54±0.53）ng/mL in control group，（5 551.50±1 445.74）U/L and （18.06±1.65）ng/mL in model group，（1 977.40±654.89）U/L and (10.77±0.71）ng/mL in  experimental group, respectively; the expression levels of HMGB1 mRNA and HMGB1  (relative value) in liver tissue were 1.886±0.253 and 0.086±0.028  in control group，4.718±0.341 and 0.268±0.043 in model group，3.005±0.331 and 0.116±0.008  in  experimental group, respectively; the expression levels of ALT and HMGB1 in serum, as well as HMGB1 mRNA and HMGB1 in liver tissue of experimental group were all lower than model group(all P＜0.001). Apoptosis and HMGB1 migration  in the liver cell (normalized) were 1±0 and 1±0 in control group, 4.67±0.33 and 4.50±0.22 in model group，2.67±0.21 and 2.33±0.21 in experimental group, respectively; apoptosis and HMGB1 migration in liver tissue of experimental group were both lower than model group（both P＜0.001）.ConclusionHMGB1 antibody can improve the pathological injury of liver tissue, and protect mice liver against the injury induced by ConA.

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ObjectiveTo understand teicoplanin concentration in cerebrospinal fluid (CSF) during intravenous infusion in patients following neurosurgery operation, and evaluate whether drug concentration can be increased if bloodbrain barrier was damaged, and effect of continuous pump of drug on drug concentration in CSF.MethodsThe postneurosurgical surgery patients with surgical site/ventricular drainage were enrolled in the study, patients were divided into routine administration group(a dose of teicoplanin of 400 mg/12 h was administered for 30 min) and continuous administration group (a dose of 400 mg teicoplanin was administered for 30 min followed by a continuous infusion of 200 mg/6 h). CSF specimens were collected at respective time points of administration, teicoplanin concentration in specimens was measured.ResultsFor routine administration group, drug concentration in CSF was（0.004±0.0123）mg/L immediately after teicoplanin was bumped, the peak concentration was (0.712±1.028)mg/L after 1hour bumping, then concentration decreased gradually, which were （0.254±0.222）,（0.173±0.152）, and （0.355±0.207）mg/L at 12,18, and 24 hours of bumping respectively. For continuous administration group, drug concentration in CSF was（0.017±0.020））mg/L immediately after teicoplanin was bumped, the peak concentration reached （0.587±0.255）mg/L after 4hour bumping, then concentration were （0.429±0.416）,（0.325±0.254）,（0.476±0.686）,and （0.318±0.464）mg/L at 6,12,18, and 24 hours of bumping respectively, teicoplanin concentration was relatively stable 6 hours later, which were （0.318±0.464）mg/L（0.476±0.686）mg/L. The area under the curve during 24 hours (AUC024) in routine administration group and continuous administration group were 5.590 mg/ L·h and 9.082 mg/L·h respectively. For two groups of patients, teicoplanin concentration only at the area near peak value achieved 50% minimum inhibitory concentration(MIC50) for coagulase negative staphylococcus (CNS), but the time for achieving concentration higher than CNS MIC50 was far less than 50% of total administration time; teicoplanin concentration in CSF of both groups of patients didn’t achieve MIC50 for Staphylococcus aureus.ConclusionAfter continuous infusion of teicoplanin, drug concentration in CSF can be increased compared with routine administration group,but still can’t achieve the effective MIC; the increase of blood drug concentration is benefit to drug concentration in CSF, it is necessary to increase the dose appropriately to achieve clinical effectiveness.

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ObjectiveTo analyze the significance of time to positivity（TTP） of blood culture in differentiating bloodstream infection(BSI) from contamination during blood withdrawal.MethodsClinical data and TTP of blood culture in patients hospitalized in different departments from November 2013 to November 2014 were compared retrospectively, role of TTP in differential diagnosis of BSI was evaluated.ResultsOf 2 605 blood culture specimens, 137 were positive for blood culture，78(56.93%) of which were pathogenic bacteria and 59(43.07%) were contaminated bacteria, coagulase negative staphylococcus had the highest contamination rate（75.76%），while Escherichia coli had the lowest contamination rate（12.50%）. TTP of pathogenic bacteria was shorter than that of contaminated bacteria (［13.86±8.19］ h vs ［40.72±20.96］h, P＜0.05). Of pathogenic bacteria, Enterococcus had the earliest TTP (［10.20±8.00］h),followed by Escherichia coli（［11.12±3.91］ h）, Staphylococcus aureus（［12.22±5.08］h）, Klebsiella pneumoniae（［14.72±10.45］ h）, the other gramnegative bacteria（［16.11±12.97］ h）,and coagulase negative staphylococci（［16.42±5.74］ h）, fungi had the latest TTP （［29.04±3.67］h ）. TTP of gramnegative bacteria was ≤16.59 h, sensitivity and specificity of BSI were 84.09% and 100.00% respectively; TTP of grampositive bacteria was ≤20.96 h, sensitivity and specificity of BSI were 96.77% and 94.44% respectively.ConclusionCombination of TTP of blood culture and other clinical indications can provide reference for early differentiating isolated pathogenic bacteria from contaminated bacteria.

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ObjectiveTo improve the cleaning quality of reusable medical instruments continuously through root cause analysis, reduce healthcareassociated infection(HAI) and the wear and tear of instruments.MethodsThe major factors influencing the cleaning quality of instruments were analyzed and clarified by fishbone diagram, continuous quality improvement was carried out based on 5 terminal factors, the rate of rusting, stain, repeated cleaning, damage, and clinical department satisfaction before and after the implementation of continuous improvement were compared.ResultsThe qualified rate of instrument clean increased from 94.24% before implementing measures to 97.60% after implementing measures, the rate of rusting, stain, repeated cleaning, damage decreased from 3.39%, 2.37%, 5.76%,and 2.08% to 1.55%, 0.85%, 2.40%, and 0.48% respectively, there were significant difference among different groups(all P＜0.001); the score of satisfaction rate to central sterile supply department elevated from(93.87±3.87) before implementing measures to (98.08±0.59) after implementing measures（t=6.80，P＜0.001）.ConclusionRoot cause analysis is important in improving cleaning quality of reusable instruments continuously, as well as reducing HAI and the wear and tear of instrument, it can save medical cost.

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ObjectiveTo investigate the incidence of surgical site infection(SSI) following clean incision breast surgery under nonlocal anesthesia, and evaluate risk factors for SSI.MethodsClinical data of 3 327 patients who underwent clean incision breast surgery under nonlocal anesthesia in 22 hospitals in Fujian Province were surveyed retrospectively, SSI and risk factors were analyzed.ResultsAmong 3 327 patients, 1 502（45.19%）were with malignant tumors, the average duration of surgery were （101.18±8.04）minutes; a total of 24 cases of SSI occurred, incidence of SSI was 0.72%；253（7.60%）patients received preoperative antimicrobial prophylaxis, 62.66% used antimicrobial agents within 0.5-2 hours before surgery. The main pathogenic bacteria was Staphylococcus aureus. Univariate and logistic regression analysis revealed that malignant tumor, diabetes mellitus,and use of immunosuppressants were all risk factors for SSI (all P＜0.05).ConclusionSSI following clean incision breast surgery under nonlocal anesthesia is well controlled, risk factors for SSI should be evaluated before operation, comprehensive preventive measures should be taken to reduce the incidence of SSI.

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ObjectiveTo explore the etiologies of fever of unknown origin(FUO) and methods for confirming diagnosis in patients at a hospital, and provide reference for clinical diagnosis and treatment of FUO.MethodsPatients with FUO admitted to a hospital between January 2008 and July 2014 were performed clinical diagnosis with methods of serology, bacteriology, molecular biology, bone marrow aspiration, tissue biopsy, and diagnostic therapy, the etiologies and final diagnosis of 224 patients were analyzed retrospectively.ResultsOf 224 FUO cases, 189(84.38%) eventually got confirmed diagnosis, 35 (15.62%) were not confirmed. The percentage of infectious diseases, connective tissue diseases, malignant tumor, and other diseases were 50.45%,18.75%, 9.82%, and 5.36% respectively. Among infectious diseases, the major pathogens were bacteria, followed by virus. The major connective tissue diseases were systemic lupus erythematosus and  polyarteritis nodosa; the main malignant tumor was hematological tumor, lymphoma was the main form. Among 189 patients with confirmed diagnosis, 30.16% and 24.34% were performed pathogenic and pathologic detection respectively, and 20.11% were performed the other (comprehensive) methods.ConclusionInfectious diseases, connective tissue diseases, and tumor are major etiologies of FUO.

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ObjectiveTo evaluate the risk factors for surgical site infection(SSI) following ankle joint and Pilon fracture surgery, and provide theoretical basis for the prevention of postoperative SSI.MethodsClinical data of patients who underwent ankle joint and Pilon fracture surgery in a hospital between June 2005 to May 2013 were surveyed retrospectively, risk factors for SSI were analyzed.ResultsAmong 356 patients with ankle joint and Pilon fracture surgery, 22 developed 25 times of SSI, SSI rate was 6.18%, case infection rate was 7.02%. Univariate analysis showed that elderly patients（＞60 years old）, history of diabetes, preoperative calcaneal traction, perioperative irrational antimicrobial use, incision type, and long duration of operation （＞3 h）were risk factors for SSI following ankle joint and Pilon fracture surgery （all P＜0.05）.Multivariate logistic regression analysis showed that the independent risk factors for SSI were incision type(OR, 3.58［95%CI, 3.24-12.07］), history of diabetes(OR, 2.75［95%CI,1.54-4.75］), duration of operation(OR, 2.15［95%CI,1.32-3.64］), and patients age(OR, 1.68［95%CI,1.25-2.37］).ConclusionOccurrence of SSI following ankle joint and Pilon fracture surgery is related to multiple factors, corresponding prevention and control measures should be taken to reduce the occurrence of SSI.

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ObjectiveTo explore the isolation and antimicrobial susceptibility of Mycoplasma from urogenital tract, and provide the basis for rational clinical treatment.MethodsUrogenital tract specimens from 57 904 outpatients in a hospital between 2008 and 2014 were performed Ureaplasma urealyticum (Uu) and Mycoplasma hominis(Mh) culture, identification, and antimicrobial susceptibility testing.ResultsOf 57 904 patients with urogenital infection，21 614 (37.33%) had positive culture for Mycoplasma, isolation rate of Mycoplasma in female and male were 42.14% （18 917/44 889）and 20.72% （2 697/13 015）respectively; Mycoplasma was mainly isolated from population of 21-40 years old; Uu≥104 CFU/mL and Mh<104 CFU/mL mixed infection was common(69.35%). The resistance of Mycoplasma to doxycycline, josamycin, and tetracycline were all low(<10%); resistance rates of Mh to doxycycline, erythromycin, clarithromycin, and roxithromycin were all significantly higher than Uu （all P<0.05）.ConclusionMycoplasma infection/carriage rate in female outpatients is significantly higher than male outpatients, antimicrobial profile of Uu is different from Mh, josamycin and doxycycline can be as the first choice for treatment of nongonococcal urethritis (cervicitis) caused by Mycoplasma.

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ObjectiveTo realize the isolation of multidrugresistant organisms (MDROs) from ward environment, and provide evidence for clinical prevention and control of MDRO transmission.MethodsPatients with MDRO infection in a stomatology hospital from September 2012 to July 2014 were as trial group, 12 randomly selected patients without MDRO infection were as control group, environmental object surface in patients’ ward were taken specimens and performed culture, isolated organisms were identified and performed antimicrobial susceptibility testing.ResultsOf 44 patients with MDRO infection, 13 patients’ surrounding environment were detected MDROs, the total detection rate was 29.55%（13/44）. The detection rate of methicillinresistant Staphylococcus aureus(MRSA)， multidrugresistant Acinetobacter baumannii(MDRAB)，and methicillinresistant Staphylococcus epidermidis(MRSE) were 45.45%（5/11）， 66.67% （2/3）and 66.67%（6/9） respectively. Detection rates of MRSA from nasal cavity and hands of MRSAinfected patients were 72.73% and 54.54% respectively， from nasal cavity and hands of patients’ caregivers were 36.36% and 18.18% respectively. The difference in bacterial count between trial group and control group was not significantly different (all P＞0.05).ConclusionIsolation rate of MDROs from ward environment of MDROinfected patients is higher than that of nonMDROinfected patients, monitoring, cleaning and disinfection for MDROinfected patients’ surrounding environment should be strengthened, so as to prevent the spread of MDROs in hospital.

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ObjectiveTo understand antimicrobial resistance and homology of carbapenemresistant Klebsiella pneumoniae (CRKP) from an intensive care unit (ICU).Methods11 CRKP isolates from patients and environment of an ICU in a hospital were performed antimicrobial susceptibility testing, the homology of CRKP was analyzed by randomly amplified polymorphic DNA (RAPD) method.ResultsOf 11 CRKP isolates, 8 were from patients, and 3 from environment, the main specimen was sputum(n=6, 54.55%). Antimicrobial susceptibility testing results revealed that 10 (90.91%) CRKP isolates were resistant to ciprofloxacin; 11 isolates were susceptible to compound sulfamethoxazole, intermediate to imipenem, and resistant to other antimicrobial agents(100%). All 11 CRKP isolates had 3 bands, and were divided into two types: (type Ⅰ, n=10; type Ⅱ, n=1).ConclusionAntimicrobial resistance of Klebsiella pneumoniae in ICU is serious, CRKP isolated from ICU patients and environment are of the same clone. Cleaning, disinfection, and monitoring of ICU environment should be strengthened, which is helpful for reducing, timely warning of multidrugresistant organisms, and reducing healthcareassociated infection.

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ObjectiveTo realize current status of healthcareassociated infection (HAI) in a neonatal intensive care unit(NICU) of a hospital, and evaluate the effect of comprehensive intervention measures.MethodsHAI in NICU was monitored, targeted intervention measures were implemented, incidence of HAI before and after intervention was compared.ResultsThe implementation rates of intervention measures at intervention stage was higher than that of preintervention stage,  the difference was significant(all P＜0.001). Incidence of HAI at intervention stage was lower than that of preintervention stage(5.64%［46/816］ vs 13.45% ［46/342］，χ2 =20.12，P＜0.001). The main infection site  was lower respiratory tract (38.04% ［35/92］).  Incidence of ventilatorassociated pneumonia and catheterrelated bloodstream infection after intervention were both lower than preintervention stage (0.38‰  vs 3.30‰, 0.12‰  vs 1.18‰,respectively). The main isolated pathogens before and after intervention were both grampositive bacteria, accounting for 58.09% and 51.16% respectively.ConclusionRoutine HAI monitoring can reflect the weak links in infection control practice,  HAI can be controlled effectively by carrying out  intervention measures.

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ObjectiveTo investigate the contamination of clinically used tablet computers, and compare the effectiveness of three cleaning and disinfection methods.MethodsThe front and back surfaces of tablet computers were wiped and detected by handheld adenosine triphosphate (ATP) fluorescence detector, the study was divided into baseline stage and cleaning and disinfection stage. During baseline stage, the tablet computers in use were directly wiped, during cleaning and disinfection stage, the tablet computers were wiped by normal salinemoistened gauze, alcoholmoistened gauze, and wet napkin.ResultsDuring baseline stage: 20 tablet computers were wiped, the qualified rate was 0, the median of relative light unit (RLU) of ATP detection was 218.00. During cleaning and disinfection stage, 10 tablet computers were wiped in each cleaning and disinfection group, and the qualified rate of normal salinemoistened gauze, alcoholmoistened gauze, and wet napkin groups were 50.00%, 0, and 60.00% respectively, the median RLU of ATP detection were 28.50,79.00, and 29.00 respectively. Except comparison between salinemoistened gauze and wet napkin groups (P=0.97), multiple comparison of RLU of ATP detection among the other groups were significantly different （all P＜0.001）.ConclusionContamination of medical tablet computers are serious, wet napkin wiping is an ideal method for cleaning and disinfection, but the frequency for cleaning and disinfection needs to be further studied.

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ObjectiveTo evaluated the impact of obesity on surgical site infection (SSI)  following colorectal cancer surgery.MethodsA total of 215 patients undergoing radical surgery for colorectal cancer in a hospital between January 2008 and December 2013 were investigated retrospectively, 100 patients were with body mass index (BMI) ≥25 kg/ m2 (obesity group) and 115 patients with BMI＜25 kg/ m2 (normal weight group), the intraoperative and postoperative indicators and surgical complications were compared between two groups.ResultsIn obesity group, 72（72.00%） patients had intraoperative blood loss of ＞60 mL, 58（58.00%） patients’ duration of surgery was ＞220 min , 20 （20.00%）of whom developed postoperative SSI; in normal weight group, 30（26.09%） patients had intraoperative blood loss of ＞60 mL, 20（17.39%） patients’ duration of surgery was ＞220 min, 8（6.96%）of whom developed postoperative SSI. Intraoperative blood loss and  incidence of SSI in obesity group were both significantly higher than normal weight group, duration of surgery and postoperative length of hospital stay were both longer than normal weight group（both P<0.05）.ConclusionIncidence of SSI in colorectal cancer patients is high. Obesity, long duration of surgery, and more bleeding are high risk factors for SSI in colorectal cancer patients.

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ObjectiveTo explore the application of bundle strategies in the management of multidrugresistant organisms(MDROs).MethodsFrom July 1,2013, bundle intervention measures were applied in the management of MDROs from inpatients in a tertiary firstclass hospital, the implementation of isolation measures for MDROinfected/colonized patients were monitored, AprilJune 2013 was preintervention group, JulySeptember 2013 was the first stage of intervention, OctoberDecember 2013 was the second stage of intervention, the qualified rate of each measure and incidence of  MDRO infection per 1 000 patientdays before and after intervention were compared.ResultsFrom April to December 2013, a total of 3 430 nonrepetitive isolates were detected. The qualified rate of doctors’ order “contact isolation ” before intervention and in the second stage of intervention were  78.14% and 95.95% respectively; the qualified rate of hanging bedside isolation signs, providing bedside quickdrying hand disinfectant, and patients wearing blue wristbands before intervention were 52.70%, 66.89%, and 87.16% respectively，and in the second intervention stage were all 100.00%. The qualified rate of disinfection of medical supplies and environment, as well as patients’ bed assignments before intervention were 23.65% and 15.54% respectively, in the second stage were 79.79% and 77.66% respectively. Health care workers’ awareness rate of hand hygiene knowledge, hand hygiene compliance rate, and  hand hygiene correct rate  before intervention were 69.70%,45.76%, and 76.35% respectively; in the second stage were 90.23%, 87.50%, and 94.58% respectively；the qualified rate of implementation of each isolation measure before intervention and in different stages after intervention were all significantly different(all P<0.01). The incidence of MDRO infection per 1 000 patientdays before intervention, in the first and second intervention stages were 3.24‰, 2.63‰, and 2.20‰ respectively.ConclusionAfter the monitoring and intervention in MDROs with bundle management strategies, the qualified rate of each measure improved, incidence of MDRO infection per 1 000 patientdays decreased.

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ObjectiveTo evaluate the effect of comprehensive intervention measures on reducing the bacterial colonization of the intensive care unit (ICU) bedside notebook computer keyboards and mice.MethodsAccording to bacterial contamination of ICU bedside notebook computer keyboards and mice, comprehensive intervention measures were taken (including wiping computer keyboards and mice with alcohol twice a day, intensifying hand hygiene, and monitoring handwashing compliance), specimens of keyboards and mice were taken, bacterial detection results were analyzed. ResultsBefore intervention, bacterial counts of keyboards and mice of 8 specimens were all ＞5 CFU/cm2,detection rate of Bacillus subtilis was 64.71%，Micrococcus, coagulase negative staphylococcus, Acinetobacter baumannii, and Klebsiella pneumoniae were 17.65%-58.82%, Escherichia coli and Acinetobacter calcoaceticus were both 5.88%. After comprehensive intervention measures were taken, bacterial counts of only two specimens of keyboards and mice were ＞5 CFU/cm2,the qualified rate of monitoring result after intervention was significantly higher than before intervention (88.24% vs 52.94%; χ2=5.10，P＜0.05）.ConclusionComprehensive intervention measures can significantly reduce bacterial count on ICU bedside notebook computer keyboards and mice, and decrease the occurrence of healthcareassociated infection.

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ObjectiveTo investigate the detection of multidrugresistant organisms(MDROs) in a hospital, evaluate the efficacy of multidisciplinary team(MDT）on management of MDROs, and provide guidance for effective control on MDRO infection.MethodsFrom October 2013 to September 2014, compliance to comprehensive intervention measures in clinical departments in different stages as well as detection of MDROs from patients were compared respectively.ResultsCompliance to comprehensive intervention measures showed an overall upward trend from the fourth quarter of 2013 to the first, second, and third quarters of 2014, difference was statistically significant （all P＜0.001）.From the fourth quarter of 2013 to the third quarter of 2014, the percentage of the major MDRO strains in the same species of bacteria were: methicillinresistant Staphylococcus aureus(MRSA) 52.34%,45.45%, 48.95%, and 26.25% respectively；carbapenemresistant Acinetobacter baumannii （CRAB）64.42%,63.07%,59.87%,and 43.09% respectively；multidrugresistant Pseudomonas aeruginosa (MDRPA) 42.11%,41.82%,29.33%, and 17.52% respectively；the detection rate of MRSA,CRAB, and MDRPA showed an overall downward trend, difference among different stages were statistically significant （all P＜0.001）. Detection rates of carbapenemresistant Enterobacteriaceae (CRE) and vancomycinresistant Enterococcus (VRE) were both low (＜5%), difference among different stages were not statistically significant （all P＞0.05）.ConclusionMDT on management of MDROs is helpful for reducing the emergence and spread of MDROs.

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ObjectiveTo detect bacterial content on surface of mobile phones of health care workers (HCWs) by adenosine triphosphate (ATP) bioluminescence assay.MethodsHCWs in departments of internal medicine, surgery, medical laboratory, and administration were randomly selected, 50 in each department, field detection on bacterial content on surface of mobile phones of HCWs was conducted, the relevant data were recorded.ResultsA total of 200 mobile phones were detected, 33 mobile phone surface were qualified, the qualified rate was 16.50%. Qualified rate of mobile phone surface of HCWs in different departments as well as mobile phone disinfected by different modes were different（χ2=13.46, 10.24, respectively，both P＜0.01）; difference in qualified rate of mobile phones of different types, different service life, and different protective case were all not significant （χ2=4.37,1.87, 0.25 respectively，all P＞0.05）.ConclusionThe qualified rate of bacterial content on surface of HCWs’ mobile phone is low, the awareness of hand hygiene of HCWs should be strengthened, regular cleaning and disinfection on the mobile phone can effectively reduce bacteria on the mobile phone surface.

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目的探讨基层医疗机构消毒供应中心（CSSD）现状及区域化集中管理的可行性。方法采用随机抽样的方法抽取重庆市某区18所基层医疗机构，自行设计调查问卷，采用现场查看、访谈和问卷调查相结合的方法对其进行调查。结果18所基层医疗机构中有15所乡镇卫生院和3所民营医院，均未完全实行集中管理，建筑布局和流程均不合格；15所医疗机构CSSD灭菌设备配置合格，合格率为83.33%；CSSD制度与人员配备的合格率均为0；仅1所医疗机构CSSD职业防护物品配备齐全且进行过相关培训，合格率为5.56%；18所基层医疗机构中有16所（88.89%）愿意接受集中消毒供应服务。结论基层医疗机构的消毒供应存在严重问题。上级卫生行政主管部门急需规划建立区域化CSSD，建议将整改后不能达标的医疗机构纳入区域化集中管理，提高器械清洗、消毒及灭菌质量，降低医院感染发生率，保障医疗安全。

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目的了解基层医院微生物实验室现况，探讨区域化县市级微生物实验室建立的可行性。方法采用现场考察和问卷调查相结合的方法，对某县级市的28所医疗机构进行调查，调查各医院微生物实验室基础设施、实验设施及专业人才等情况。结果共发放调查问卷28份，收回28份。调查二级医院4所，乡镇中心卫生院18所（其中二级建设医院3所），民营医院6所；现场考察医院25所。仅有2所医院能进行血培养检验，3所能进行需氧菌培养，均不能进行厌氧菌、苛养菌的培养等。结论大部分基层医院均不可进行微生物检验，急需建立区域化微生物实验室，从而减少各医院的成本投入，达到资源共享和技术共享。

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目的评价医院感染信息化对降低医院感染漏报率的效果。方法2012年前某院医院感染监测一直采用传统监测方法，2012年开始应用医院感染实时监控系统，调查2011—2013年每年7—12月医院感染病例，比较医院感染实时监控系统应用前后漏报率。结果2011—2013年每年7—12月医院感染漏报率分别为12.12％、8.16％、4.55%，3年同期医院感染漏报率比较，差异有统计学意义（χ2=8.02，P＜0.05）。结论医院感染信息化管理方式可有效降低医院感染漏报率。

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目的了解鲍曼不动杆菌（AB）的临床分布，以及普通科室与重症监护病房（ICU）AB的耐药差异。方法应用WHONET 5.4对某院2013年1—12月临床科室所有送检标本分离出AB的标本来源、科室分布及耐药情况进行统计分析。结果全院共分离AB 876株。AB检出科室主要为ICU（592株，67.58%），其次为外科（164株，占18.72%）。ICU检出AB标本来源主要为痰（440株，占74.33%），普通科室主要为分泌物（122株，占39.44%）。除头孢曲松外，ICU与普通科室检出的AB对抗菌药物耐药率比较，差异均有统计学意义（均P＜0.05）。结论AB感染/定植主要发生于ICU患者，尤其以呼吸道感染为主，其次为手术切口、创面的感染，AB对常见抗菌药物较高的耐药性需引起临床重视。

Abstract:

目的了解某市食品中食源性致病菌污染状况，确定高危食品，为预防和控制食源性疾病提供科学依据。方法采用主动监测的方法，随机采集2014年该市有代表性的农贸市场、食品超市、餐饮店、学校及个体摊贩12类食品，对其进行食源性致病菌监测。结果266份食品样品中，24份阳性,总检出率9.02%。共检出5种24株食源性致病菌，其中调理肉制品检出率最高（46.15%）,其次为预制动物性水产品（13.33%），酱及酱制品、加工坚果与籽类、餐饮店和饮品店自制饮料及食用冰等未检出食源性致病菌。24株食源性致病菌中铜绿假单胞菌检出率最高，达12.50%(3/24)；其后依次为单核细胞增生李斯特菌［5.33%（8/150）］、副溶血性弧菌［5.00%（2/40）］,蜡样芽孢杆菌［4.69%（6/128）］和金黄色葡萄球菌［3.33%（5/150）］。结论主动监测有利于掌握市售食品中食源性致病菌污染状况，为实现高危食品的预报和危险性评估提供科学依据。

Abstract:

目的探讨品管圈（QCC）对提高重症监护病房（ICU）护士手卫生依从性的效果。方法2013年6—12月应用QCC管理模式对ICU 56名护士手卫生行为进行管理，通过现状调查，找出手卫生依从性低的要因，采取有效措施进行持续质量改进。结果护士对手卫生知识的认知率由QCC活动前的65.74%提升至活动后的95.45%（P＜0.001），手卫生依从率由活动前的33.33%提升至活动后的80.18%（P＜0.001）；护士在接触患者前、接触患者后、接触患者周围环境后手卫生依从率由活动前的32.93%、15.19%、24.62%，分别提升至活动后的71.43%、73.08%、79.66%，差异均有统计学意义（均P＜0.05）。结论应用QCC进行持续质量改进，可有效提高ICU护士手卫生意识及其依从性。

Abstract:

禽流感病毒有6个内部基因来自于H9N2，部分血凝素（hemagglutinin，HA）和神经氨酸酶（neuramidinase，NA）基因源自H7N3和H1N9。禽流感病毒能够感染人类，可能与HA和NA基因发生了Q226L和E627K关键位点突变有关，这两个突变被认为是病毒适应人类气道上皮的表现。此外，H7N9具有哺乳动物流感病毒的特性，如HA蛋白与哺乳动物细胞器结合，PB2蛋白基因突变等［1］。人类感染后缺乏特异性临床表现，很难早期诊断，患者死亡的原因多为多器官功能衰竭综合征和单纯急性呼吸衰竭。虽然临床观察认为神经氨酸酶抑制剂可能具有抑制H7N9病毒复制的能力，但是目前无大规模临床资料证实其疗效确切。本文就人感染禽病毒疫苗及预防控制的研究作一综述。