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ObjectiveTo realize antimicrobial resistance and carrying status of  OXA carbapenemase among imipenemresistant Acinetobacter baumannii （IRAB）isolated from patients of Hohhot, so as to provide guidance for the prevention and control of healthcareassociated infection(HAI) caused by multidrugresistant Acinetobacter baumannii.  Methods49 IRAB isolates from 3 tertiary firstclass hospitals in Hohhot between January and December 2012 were collected,  antimicrobial susceptibility testing was performed by KirbyBauer disk diffusion method, four genotypes（blaOXA51like,blaOXA23like, bla OXA24like, bla OXA58like )  of  OXA carbapenemase were detected by polymerase chain reaction (PCR). ResultsAll 49 isolated IRAB strains were found to be highly resistant to antimicrobial agents（81.63%100.00%）except to minocycline（8.16%）;  blaOXA51like  was identified in 49 strains（100.00%），42(85.71%）of which also carried blaOXA23like gene ，blaOXA23lik and blaOXA51like were both found in three hospital, bla OXA24like and  bla OXA58like  weren’t found. ConclusionIRAB strains present multidrug resistance, resistant to minocycline is the lowest;  blaOXA23like is the main drugresistance mechanism of IRAB in Hohhot.

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ObjectiveTo understand clinical characteristics of primary pulmonary cryptococcosis (PPC), so as to provide reference for clinical diagnosis and treatment. MethodsClinical data of 32 patients who were confirmed PPC  by pathological diagnosis in a hospital from January 2008 to June 2014 were analyzed retrospectively.ResultsAll 32 cases were communityacquired infection , 26  male and 6 female (age between 17 and 62 years old, the average age was （35.53 ± 11.29）.  Among 32 patients, 8 had underlying diseases, 2 were parturients, 4 were carpenters, 5 were pigeon keepers,3 were seafood  transport drivers,  and 10 lived in humid environment. Imaging findings：Solitary or multiple nodules and cluster shape(n=21），lobar consolidation(n=2），diffuse patchy shadow on bilateral lung (n=5），pulmonary cavity(n=3），and diffuse and mixed lesions (n=1）. Pathological confirmation: diagnosis through percutaneous  lung biopsy(n=23），thoracoscopic surgery(n=7），and thoracotomy(n=2）. Prognosis: 30 were cured，and 2 had marked effect. ConclusionPPC is commonly occurs in young and middleaged immunocompetent persons, the onset is occult, clinical manifestations and imaging features lack  specificity,  can be  easily misdiagnosed or omitted diagnosis, diagnosis is difficult, lack rapid diagnostic method in clinical practice, invasive pathological biopsy can be used as the basis of diagnosis; there is a controversy on therapy, adverse reaction of fluconazol is mild, and has good therapeutic effect.

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ObjectiveTo explore the change trend and antimicrobial resistance of pathogens causing infection in extensive burn patients, and provide reference for clinical prevention and treatment.MethodsSpecimens from 9 extensive burn patients who were admitted to a hospital at the same time were performed pathogenic culture and antimicrobial susceptibility testing, change trend and antimicrobial susceptibility of pathogens were observed.ResultsThe main specimen was wound secretion, accounting for 93.81%. The major pathogens causing infection were Acinetobacter baumannii (44.85%), Staphylococcus aureus (32.47%), Pseudomonas aeruginosa (12.37%), and Klebsiella pneumoniae (5.15%). With the prolongation of hospital stay, pathogens changed from one kind to multiple strains, and from susceptibility to resistance,multidrug resistance,and extensive drug resistance. ConclusionIt is difficult to avoid infection in burn patients, timely realizing the changes of pathogens causing infection and antimicrobial resistance play an important role in the control of infection.

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ObjectiveTo investigate the management of prevention and control of catheterrelated bloodstream infection (CRBSI) in intensive care units (ICUs) of tertiary hospitals in a city, and explore stategies. MethodsData about CRBSI prevention and control as well as quality management were collected and surveyed by selfdeveloped questionnaires.  ResultsOf ICUs in 8 hospitals, the incidence of CRBSI was 4.81‰, case infection rate was 5.02‰. 6（75.00%） hospitals had standard operating instruction for the prevention and control of CRBSI, 2 (25.00%) hospitals had maintenance record on central venous catheter, and 2(25.00%) hospitals implemented maximum sterile barrier and catheterization combination strategy, none hospital adopted antiinfective dressing and chlorhexidine bathing.ConclusionThere are many problems in the standard operating instruction and implementation of measures for the prevention and control of CRBSI in ICUs of tertiary hospitals in this city, which needs to be improved.

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ObjectiveTo analyze the distribution and antimicrobial resistance of pathogens isolated from department of hematology during the past three years.MethodsPathogenic strains isolated from patients hospitalized in a hematology department between January 2011 and December 2013  were collected, antimicrobial susceptibility testing was performed by KirbyBauer disk diffusion method or automatic system, antimicrobial susceptibility testing results were judged according to American Clinical and Laboratory Standards Institute 2011, data were analyzed by WHONET 56 software.ResultsA total of 462 clinical isolates were collected in 2011—2013, including 161 grampositive cocci isolates, 279 gramnegative bacilli, and 22 fungi. Of Staphylococcus spp, detection rate of methicillinresistant coagulase negative Staphylococcus（MRCNS）and methicillinresistant Staphylococcus aureus (MRSA) was 81.37％ and  62.50％respectively. The resistant rate of Staphylococcus spp. and Enterococcus spp. to linezolid was 1.69% and 3.57% respectively, resistant rate of Staphylococcus spp. to teicoplanin was 3.39%, vancomycinresistant grampositive coccus was not found.  Enterobacteriaceae strains Escherichia coli and Klebsiella pneumoniae were highly susceptible to carbapenems, the sensitivity rates were 97.56%—98.88%; while nonfermentative gramnegative bacilli Pseudomonas aeruginosa and Acinetobacter baumannii  strains were obviously resistant to carbapenems,the resistance rates were 38.71%—64.00%.ConclusionAntimicrobial resistance of major pathogenic strains from hematology department is high, antimicrobial agents should be used according to pathogenic distribution characteristics and antimicrobial susceptibility testing results, healthcareassociated infection control should be strengthened to reduce antimicrobial resistant rate

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ObjectiveTo investigate the distribution characteristics and antimicrobial resistance of carbapenemresistant Acinetobacter baumannii  (CRAB), and to guide effective clinical prevention and rational antimicrobial  use.MethodsData about clinically isolated CRAB between January 2009 and December 2013 were analyzed retrospectively, distribution and antimicrobial resistance were analyzed by WHONET 5.5 software.ResultsA total of 888 Acinetobacter baumannii strains were isolated,421  of which were CRAB, the isolation rate was 47.4%, the isolation rates in 2011, 2012 and 2013 were all about 50.0%; CRAB strains were mainly isolated from sputum (73.4%) and mostly distributed in intensive care unit(ICU) (61.3%), followed by neurosurgery department(12.4%). CRAB presented highly antimicrobial resistance. Except cefotaxime and cefatriaxone, resistant rates of CRAB to the other detected antimicrobial agents(ceftazidime, cefepime, cefoperazone / sulbactam,aztreonam, imipenem, amikacin, gentamycin, minocycline, chloramphenicol, levofloxacin, ciprofloxacin, and compound sulfamethoxazole) were all higher than nonCRAB isolates( all P≤0.01), Compared with nonCRAB isolates, The resistant rate of CRAB to cefoperazone/sulbactam was the lowest(<15%), followed by minocycline, resistant rates to other antimicrobial agents were all >80.0%. ConclusionSurveillance of CRAB should be further strengthened. It is necessary to focus on the control and prevention of healthcareassociated infection in ICU patients and respiratory system. ［Key words］Acinetobacter baumannii; carbapenemase; carbapenemresistant antibiotic; carbapenemresistant Acinetobacter baumannii; drug resistance,microbial;healthcareassociated infection

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ObjectiveTo  investigate department distribution and antimicrobial resistance of mucoid Klebsiella pneumoniae(K. pneumoniae),so as to provide reference  for rational antimicrobial use and control of healthcareassociated infction.Methods80  K.pneumoniae isolates from clinic in JanuaryDecember 2013 were collected, mucoid  strains were selected, bacterial identification and antimicrobial susceptibility testing were performed by VITEK2 Compact identification system.ResultsA total of 28 mucoid K.pneumoniae isolates were obtained,  strains were mainly from respiratory specimens, the main departments were neurosurgical department. Susceptibility rates of mucoid K. pneumoniae to imipenem, piperacillin / tazobactam, ceftazidime,ciprofloxacin, and amikacin was 96.43%,96.43%,89.29%,92.86%, and 96.43%, respectively,nonmucoid K. pneumoniae  to above antimicrobial agents was 78.29%,78.29%,69.08%,72.37%, and 78.29% respectively.ConclusionAntimicrobial susceptibility rates of mucoid  K. pneumoniae are significantly higher than nonmucoid strains in vitro, biofilm should be considered in clinical therapy, antimicrobial agents should be chosen rationally.

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ObjectiveTo analyze the risk factors of postoperative infection in patients with skin and soft tissue expander (SSTE) implantation, and provide scientific evidence for making intervention strategies.MethodsQuestionnaires were made, relevant data were obtained through medical record reviewing and telephone inquiry, and casecontrol method was used to conduct statistical analysis.ResultsA total of 532 patients were with SSTE  implantation, 22 (4.14%) of whom had infection, and 14 infected patients were included in this research. Univariate logistic regression analysis indicated that there were significant difference in the number of the embedded expanders (OR=1.58,95%CI: 1.20-2.32), the implantation site(OR=1.75,95%CI :1.30-2.32), living circumstances of patients(OR=1.87,95%CI:1.84-2.65), and whether expanders were regularly disinfected(OR=2.66,95%CI:1.76-4.32)（all P<0.05）. Multivariate logistic regression analysis found that living circumstances of patients(OR=1.55,95%CI: 1.15-2.25) and whether expanders were regularly disinfected (OR=3.66,95%CI: 2.86-3.22)were two main factors entering the regression equation（both P<0.01）.ConclusionLiving circumstances of patients and whether expanders are regularly disinfected are main risk factors of postoperative infection in patients with SSTE embedding. Knowledge education on preventing infection among patients and main caregivers should be strengthened,postdischarge continuous nursing system should be established.

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ObjectiveTo evaluate the effect of plandocheckact (PDCA)  cycle method in improving disinfection efficacy of object surface in intensive care unit ( ICU).MethodsOn the basis of management of healthcareassociated infection (HAI) and prevention of multidrugresistant organisms, disinfection efficacy of object surface in an ICU was intervened, data about surface object specimens taken before, during, and after intervention, HAI in patients, as well as detection of MDROs  were collected.ResultsThe total qualified rate of specimens taken before, during, and after intervention  was 58.24%, 76.74%, and 88.71%，respectively, there was an increased tendency,the difference was significant （χ2=17.41，P=0.009）; the incidence of HAI was 3.72%,2.42%, and 1.78%，respectively, there was a decreased tendency（χ2=6.03，P=0.039）， case infection rate was 4.36%,2.75%, and 2.37% respectively，there was a decreased tendency（χ2=7.24，P=0.046）；detection rate of MDROs was 34.03%,27.45%, and 14.05%，respectively, there was a decreased tendency （χ2=33.84，P=0.007），the percentage of patients who were detected MDROs and HAI caused by MDROs showed a decreased tendency（χ2=6.14, 6.02，both P<0.05）.ConclusionThe implementation of PDCA cycle can effectively improve disinfectant efficacy of ICU object surface, and reduce the incidence of MDRO HAI.

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ObjectiveTo explore the main sites, pathogen distribution and risk factors of healthcareassociated infections (HAI) in children with acute leukemia, and provide scientific evidence for  prevention and treatment.MethodsData  of 828 children with acute leukemia admitted to a hospital in 2011-2012 were collected, infection site, pathogen distribution and risk factors of infection were analyzed.ResultsOf 828 patients, 184 cases and 196 times of HAI occurred with the incidence of 22.22% and 23.67%, respectively. HAI occurred mostly in respiratory tract (52.56%). A total of 96 pathogenic strains were isolated, among which gramnegative and grampositive bacteria accounted for 58.33%(n=56) and 29.17%(n=28) respectively. Univariate analysis revealed that risk factors for HAI were leukemia remission induction chemotherapy,  hospital stay ≥30 days, peripheral leukocyte count (WBC) ≤3×109/L， granulocyte count ≤0.5×109/L, and acute nonlymphocytic leukemia. Multivariate analysis revealed that hospital stay ≥30 days was independent risk factors for HAI.ConclusionChildren with acute leukemia have a high incidence of HAI, infection mainly occurs in respiratory system, and gramnegative bacteria are major pathogens. The incidence of HAI is correlated with remission induction chemotherapy,long length of hospital stay, low WBC, low number of neutrophils, and acute myeloid leukemia.

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ObjectiveTo evaluate the characteristics and  risk factors for healthcareassociated infections(HAI)  in patients with liver cirrhosis, so as to make effective strategies to prevent and control the occurrence of HAI.  MethodsClinical data of  hospitalized patients with liver cirrhosis in a hospital from January to December 2013 were collected,occurrence of HAI, distribution of pathogens，and risk factors were analyzed.ResultsOf 507 patients with liver cirrhosis,48 (9.47%) had HAI，the main infection site was intraabdominal （31.25%）；48 specimens(100.00%) were sent for bacterial culture; a total of 43 isolates of pathogens were detected，isolation rate of gramnegative bacteria, grampositive bacteria,and fungi was 58.14% (n=25）, 23.26%（n=10）, and 18.60% (n=8）respectively；the incidence of HAI were different among cirrhosis patients with different age,  length of hospitalization, white blood count, albumin levels,the grade of liver function, invasive procedure, complications, prophylactic use of antimicrobial agents respectively (all P<0.05%).  ConclusionThe incidence of HAI in patients with liver cirrhosis is high, risk factors for HAI are multiple, corresponding intervention measures  should be formulated according to the risk factors, so as to reduce the occurrence of HAI.

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ObjectiveTo evaluate application effectiveness of  quality control circle (QCC) in increasing the face mask wearing rate of hospitalized pulmonary tuberculosis (TB) patients.MethodsNine nurses in department of tuberculosis formed a ‘circle’,   the  theme of ‘improving the face mask wearing rate of hospitalized pulmonary TB patients’ was established, rectification measures were formulated and implemented, face mask wearing rates of patients before and after implementing QCC activities were analyzed statistically.ResultsThe face mask wearing rate of hospitalized pulmonary TB  patients after implementing  QCC activities  was higher than that before implementing  QCC activities (87.50% ［147/168］ vs 65.54%［116/177］, P<0.05). The abilities of every ‘circle member’ have been improved in the following aspects: problemsolving skills, sense of responsibility, communication skills, selfconfidence, team working, enthusiasm, qualitycontrol techniques, and cooperation abilities,the total average score increased from 23.78 before implementing QCC to 33.78 after implementing QCC.ConclusionQCC activities can not only improve the face mask wearing rate of hospitalized pulmonary TB patients, but also enhance circle members’ qualitycontrol skills and team spirit.

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ObjectiveTo understand healthcareassociated infection(HAI) in a maternal and child health care hospital, so as to provide scientific evidences for further targeted surveillance.MethodsA crosssectional survey was performed by bedside visiting and medical record reviewing.ResultsOf 768 hospitalized patients, 9(1.18%) had HAI, the top 3 highest prevalence rates were found in obstetrical intensive care unit (9.09%), neonatal intensive care unit (5.80%) and gynecological department II(2.22%). Antimicrobial usage rate was 30.34%(n=233), 134 of which (57.51%) were prophylactic use, 165 were monotherapy(70.82%). A total of 5 pathogenic bacteria were isolated, the number of Streptococcus agalactiae,Klebsiella pneumonia, Enterococcus faecalis, and Staphylococcus saprophyticus was 2,1,1, and 1 respectively, except Streptococcus agalactiae, the other 3 strains were multidrugresistant organisms(MDROs).ConclusionSurveillance on MDRO infection should be paid much attention, the occurrence of MDRO infection should be reduced through targeted and bundle intervention.

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ObjectiveTo investigate hand hygiene status of health care workers (HCWs) in a hospital, and provide guides for improving hand hygiene compliance．MethodsHand hygiene intervention was adopted in a hospital between 2012 and 2014, hand hygiene compliance among HCWs and healthcareassociated infection in patients between August 1 and August 31 of each year were investigated and analyzed statistically. ResultsIn 2102-2014, hand hygiene compliance rate of HCWs was 59.55%，62.13%,and 65.16% respectively, which showed a increased trend (χ2=10.018, P=0.002), HAI rate was 2.13%，1.48% and 1.06% respectively, which showed a decreased trend (χ2=82.377, P<0.001); hand hygiene compliance rate of doctors was lower than nurses  （57.97% vs 65.97%）; Of different hand hygiene moments, hand hygiene compliance rate was the lowest before touching a patient（41.32%）, and highest after body fluid exposure （76.47%）. ConclusionComprehensive hand hygiene intervention in this hospital has achieved preliminary results, improvement of HCWs’ hand compliance is helpful for preventing HAI.

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ObjectiveTo improve microbial specimen detection rate before therapeutic antimicrobial use.MethodsA system of selective targeted management by clinical department was established, before management was as control group(JulySeptember 2013), after management was as intervention  group(OctoberDecember 2013), microbial specimen detection in patients before antimicrobial use was compared between before and after management.ResultsOf all hospitalized patients, 11 254 received therapeutic antimicrobial agents, 3 426  were sent specimens for microbial detection, the specimen detection rate was 30.44%; specimen detection rate in control and intervention group was  28.80% and 31.89% respectively ，the difference was significant（χ2=12.71，P＜0.05）.3 716 patients(46.61%) received restrained antimicrobial  therapy, and 1 418 (79.20%) received special antimicrobial therapy, compared with control group, the difference were both significant(χ2=32.86,19.31，respectively, both P＜0.05）.ConclusionApplying selective targeted management can improve microbial specimen detection rate before therapeutic use of antimicrobial agents.

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目的探讨新生儿发生下呼吸道感染的危险因素，为临床预防控制新生儿医院感染提供依据。方法采取回顾性调查的方法收集2012年1月—2013年1月入住某妇幼保健院新生儿科的105例下呼吸道感染新生儿的相关信息，并与同时期在该科室住院的无下呼吸道感染的105例新生儿对比，采用单因素和多因素logistics回归分析新生儿下呼吸道感染的危险因素。结果新生儿下呼吸道感染的发生与分娩方式（剖宫产 OR=4.89, 95%CI : 1.60~14.91）、羊水浑浊（OR=4.83, 95%CI : 1.82~12.80）及侵入性治疗（OR=5.17, 95%CI : 2.12~12.63）有关。结论剖宫产、羊水浑浊及侵入性治疗是新生儿发生下呼吸道感染的危险因素，应针对这些因素采取相应的干预措施，加强呼吸道管理，降低新生儿下呼吸道感染发生率。

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目的探讨清洁消毒维护与培训对移动式循环风紫外线空气消毒机消毒效果的影响。方法选取某院现行使用的20台移动式循环风紫外线空气消毒机，进行清洁消毒维护与培训前后分别对20间Ⅲ类环境的普通病房进行空气消毒并采样，干预前后共收集空气样本400份，比较干预前后细菌消亡和空气采样合格情况。结果干预前空气中细菌消亡率（57.98±11.43）%，干预后为（77.72±8.77）%；干预前病室消毒后空气采样合格率为97.00%，干预后为100.00%。细菌消亡率和消毒后空气采样合格率干预前后比较，差异均有统计学意义（均P<0.05）。结论对移动式循环风紫外线空气消毒机定期进行清洁消毒维护，并对设备管理人员进行相关知识的培训，能够提高空气消毒机的空气净化和消毒效果。

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目的了解医院多重耐药菌(MDRO)的分布和耐药情况，为临床制定有效的干预措施、合理使用抗菌药物、减少感染和细菌多重耐药的发生提供科学依据。方法对某院2013年1—12月住院患者细菌培养结果进行回顾性分析。结果临床分离489株MDRO，其中大肠埃希菌占24.54%，鲍曼不动杆菌占20.25%，大多数MDRO仅对1种或几种抗菌药物敏感。结论MDRO在医院分离率较高，合理使用抗菌药物、减少侵入性操作、加强病区消毒隔离对控制MDRO在医院的传播有重要意义。

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为做好中华人民共和国卫生行业标准《可重复使用医用织物洗涤消毒技术规范》的起草、编制工作，该规范编制小组部分专家于2013年10月28日—11月2日赴美国进行了专题工作学习、交流，现将美国重复使用医用织物洗涤消毒方面的管理理念与做法，以及对我国制定相应卫生行业标准的借鉴与启示报告如下。

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蝇蛆病是由蝇类幼虫感染人体或脊椎动物的组织器官所形成的一种疾病。蝇蛆利用寄主死的、活的组织为食，蝇蛆症会导致寄主出现生理障碍，严重者可造成患者死亡。2014年9月本院收治1例鼻腔蝇蛆病患者，现将该病例的诊疗情况报告如下。

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自然环境和医疗设备中普遍存在细菌生物被膜，往往引起难见治疗成效的慢性感染，探索和开发新的药物以防止细菌生物被膜的形成和/或破坏已形成的生物被膜引起了研究人员极大兴趣。本文就细菌D氨基酸的生成及其在调节生物被膜解离过程中的作用进行综述。