Abstract:

ObjectiveTo investigate antimicrobial application in 56 township hospitals in Hunan Wuling mountain area. Methods13 348 outpatient prescriptions，1 288 medical records of nonoperated patients, and 280 medical records of operated patients in 56 township hospitals in Hunan Wuling mountain area were selected randomly, antimicrobial application was surveyed. ResultsAntimicrobial usage rates in outpatients, nonoperated inpatients, and operated inpatients were 53.01%, 87.97%, and 98.57% respectively, and the percentage of combined antimicrobial agents were 19.57%, 46.96%, and 39.86% respectively. The percentage of antimicrobial prophylaxis in patients undergoing type I incision surgery was 96.94%, combined antimicrobial usage rate was 36.84%. Antimicrobial use density in  hospitalized patients was 124.92 DDDs/100 patient days. 8 573 antimicrobial agents were prescribed in outpatient prescriptions of 56 hospitals, the top 5 frequently used antimicrobial agents were amoxicillin, ceftriaxone, amoxicillin/clavulanate potassium, levofloxacin, and clindamycin. ConclusionAntimicrobial agents are overused and irrationally used in township hospitals in Hunan Wuling mountain area. Health care workers should strengthen learning, conscientiously implement the relevant regulations on antimicrobial management; health administrative departments should strengthen the supervision and management on clinical application of antimicrobial agents, and promote the rational use of antimicrobial agents in township hospitals.

Abstract:

ObjectiveTo understand the distribution and antimicrobial resistance of pathogens causing wound infection in army officers and soldiers following military training injury, and provide reference for antimicrobial use in clinical antiinfection treatment. MethodsWound secretion from injured army patients who were admitted to a military hospital between January 2014 and June 2015 was performed bacterial culture and antimicrobial susceptibility testing. Results647 pathogenic bacteria strains were isolated from 1 029 wound secretion specimens , isolation rate was 62.88%, the top 6 isolated bacteria were Staphylococcus aureus（S. aureus, 29.99%, n=194）, Escherichia coli（E. coli, 19.32%，n=125）, Pseudomonas aeruginosa（19.17%，n=124），Enterococcus spp.（13.60%，n=88），Klebsiella pneumoniae(K. pneumoniae, 7.73%，n=50）, and  Acinetobacter baumannii （A. baumannii, 5.87%，n=38）. S. aureus and Enterococcus spp. had high susceptibility to vancomycin, linezolid , and daptomycin (resistance rates ≤3.41%）, 44.33% of S. aureus were methicillinresistant, 2.27% of Enterococcus spp. were vancomycinresistant . E.coli and K. pneumoniae had high susceptibility rates to piperacillin/ tazobactam (resistance rates were 1.60% and 0 respectively), except A. baumannii, resistance rates of gramnegative bacteria to carbapenems were all low (resistance rates ≤4.00%）. ConclusionMilitary clinicians should select appropriate antimicrobial agents according to antimicrobial susceptibility testing results, reduce the disability rate due to infection in trauma patients, and provide clinical support for the treatment of the wounded.

Abstract:

ObjectiveTo construct the risk model for healthcareassociated infection (HAI) with multidrugresistant organisms(MDROs) in intensive care unit (ICU).Methods836 patients who were admitted to ICU for more than 48 hours between October 2012 and September 2015 were analyzed retrospectively, logistic regression model of HAI was constructed, the model was conducted goodness of fit tests and the area under ROC curve analysis.ResultsAmong 836 patients, incidence of HAI with MDROs was 14.23%(n=119). 15 variables that were statistically significant in univariate analysis were included in logistic multivariate analysis, the results showed that the following variables entered into logistic regression equation: length of ICU stay(OR,2.493 ［95%CI,1.816-3.494］）, underlying diseases(OR,1.536 ［95%CI, 1.243-1.898］), hypoproteinemia(OR,87.211 ［95%CI,36.165-210.304］), ventilator days (OR,1.723 ［95%CI,1.399-2.121］), fever（OR,20.639 ［95%CI,3.462-123.043］）, and primary pulmonary infection (OR,0.295 ［ 95%CI,0.133-0.664］). Evaluation of model effect: sensitivity 95%, specificity 87.9%, the area under ROC curve 0.973. ConclusionLogistic regression model has a high goodness of fit in predicting HAI among ICU patients.

Abstract:

A 27yearold woman was admitted to a hospital due to intermittent fever for 20+  days and swelling pain in knee joint for 7 days. Patients was with persistent fever, the highest temperature to 40.1°C, the double knee joint swelling pain, a large number of scattered red needlelike rash were visible on  bilateral hands and legs, lymphadenectasis, splenectasis, bilateral hands interphalangeal joint and knee joint swelling pain, lymph nodes were confined to the bilateral axillary with soft texture, local tenderness, and good activity. Pathological results of left axillary lymph node showed the following finding:  fragmental lymph node tissue with incomplete structure, lymphoid follicles existed, there were diffuse histocytes, immunoblasts, and a few small lymphocytes proliferation in the reduced or disappeared area of follicular, caryokinesis could be easily seen, there were patches of necrosis foci with varied size, nucleus disintegrated, fibrinoid necrosis blood vessel with bleeding could be seen. Immunohistochemical detection showed the following results: CD3 (diffuse +); CD20 (follicular +); CD79α(follicular +); CD68 (+); EMA (-); ALK (-); CD15 (a small amount of cells +); CD30 (+), CD4 (-), CD5 (+); CD10 (-);bcl-2 (+); CD21 (+); telomerase B (-); TIA-1 (-); EBV(-)Ki-67 (+) . Through a combination of clinical and immunohistochemical detection results, the diagnosis of histiocytic necrotizing lymphadenitis was made. Patient discontinued antimicrobial drugs, after she was treated with   5% glucose 100 mL + hydrocortisone sodium succinate 200 mg intravenous drip for 3 days, patients had no fever, axillary lymph node gradually dwindled. Then patients was treated with methylprednisolone 8 mg/d, twice a day, reduced  1 tablet every two weeks, and stopped eventually. Patients was followed up for two years, repeated examination of blood routine, liver and kidney function were in the normal range, bilateral knee didn’t swell, could walk freely, there appeared no enlargement of lymph node.

Abstract:

ObjectiveTo investigate the bacterial spectrum and antimicrobial resistance of peritoneal dialysis (PD)related peritonitis, and provide evidence for rational antimicrobial use. MethodsClinical data of 120 patients with PDrelated peritonitis in a hospital from January 2013 to December 2014 were retrospectively analyzed. Results91 cases (75.83%) showed positive result in bacterial culture, 93 pathogenic strains were cultured, including 73 (78.49%) grampositive and 13 (13.98%) gramnegative bacterial strains, the most common grampositive bacteria was Staphylococcus epidermidis (n=38, 40.86%)， and the main gramnegative bacteria was Escherichia coli (n=3, 3.23%). Grampositive strains had high resistance rates to penicillin, erythromycin, and oxacillin (93.65%, 69.57%, and 64.41% respectively), while resistance rates to vancomycin and linezolid  were both low (2.90% and 1.47% respectively), and were  sensitive to teicoplanin, tigecycline, and nitrofurantoin. Gramnegative bacteria had high resistance rates to cefazolin, cefuroxime, and ampicillin（50.00%,  37.50%, and 37.50% respectively）, but were sensitive to imipenem, tobramycin, and piperacillin. Resistance rates of grampositive and gramnegative bacteria to gentamicin and levofloxacin were both low. Nonstandard operation during dialysate exchange was the most common cause of peritonitis (56.67%), most peritonitis were grampositive bacterial infection（79.41%）；while gramnegative bacteria  were the main pathogens of diarrheainduced peritonitis (52.63%). The cure rates of grampositive bacteria, gramnegative bacteria,and negativecultured peritonitis were 92.96%, 76.92%, and 86.21% respectively, difference was not statistically significant（χ2=3.39，P=0.18）. ConclusionGrampositive bacteria are major pathogens in PDrelated peritonitis, and are usually caused by the bacteria through  dialysis catheter due to nonstandard operation during dialysate exchange. Firstgeneration cephalosporins are not recommended as empirical therapy against grampositive bacteria, while vancomycin is still the best choice. Thirdgeneration cephalosporins and aminoglycosides are recommended as empirical therapy against gramnegative bacteria. Gentamicin and levofloxacin can be used alone as empirical therapy in special circumstances.

Abstract:

ObjectiveTo understand the antimicrobial resistance of common clinical pathogens to antimicrobial disks containing different ratios of cefoperazone/sulbactam, so as to provide basis for rational application of cefoperazone /sulbactam in clinic. Methods1 141 pathogens isolated from clinical specimens in a hospital in the first half year of 2014 were collected, disk diffusion method was adopted to detect antimicrobial activity of two kinds of cefoperazone/sulbactam disks (70/35 μg and 75/75 μg).ResultsOf 1 141 pathogenic strains, 675 （59.16%）were Enterobacteriaceae, 447 (39.18%) were nonfermentative bacteria, and 19 (1.66%) were other gramnegative bacilli. Resistance rates of pathogens to 70/35μg and 75/75 μg cefoperazone /sulbactam antimicrobial disks were as follows: extendedspectrum βlactamases(ESBLs)producing Escherichia coli (n=221) were 7.69% and 2.26% respectively, ESBLsproducing Klebsiella pneumoniae(n=92) 10.87% and 3.26% respectively, imipenemresistant Acinetobacter baumannii（IRAB,n=295）54.92％ and 11.19％respectively；there were significant differences in antimicrobial activity between two ratios of antimicrobial disks(P<0.05). While antimicrobial resistance rates of ESBLsnegative Enterobacteriaceae (Escherichia coli,n=135; Klebsiella pneumoniae, n=98),  imipenemsensitive Acinetobacter baumannii (ISAB, n=51), Pseudomonas aeruginosa (n=48 ), and Stenotrophomonas maltophilia (n=22) were not significantly different (all P>0.05). ConclusionAntimicrobial activity of two different ratios of cefoperazone/sulbactam antimicrobial disks to ESBLsproducing Enterobacteriaceae and IRAB is different, attention should be paid to ratios of cefoperazone/sulbactam during the treatment , so as to achieve the desired therapeutic effect.  

Abstract:

ObjectiveTo compare changes in infectious markers in blood of patients with coronary heart disease (CHD), analyze clinical diagnostic value of procalcitonin (PCT) and highsensitivity Creactive protein (hsCRP) in bacterial infection in patients with  CHD. MethodsPatients with CHD admitted to a hospital between January 2013 and December 2014 were studied. PCT, hsCRP, white blood cell (WBC), and neutrophil (NEU) count were detected before treatment and on the 5th day after treatment, differences between bacterial infected group and noninfected group, infection sites, as well as survival and death groups were compared respectively. ResultsSerum levels of PCT,hsCRP,WBC, and NEU in bacterial infected group were all significantly higher than noninfected group; PCT and hsCRP in infection of different sites were statistically significant （all P<0.001）, patients with bloodstream infection had the highest levels (［45.148±46.341］ ng/mL, ［137.000±87.367］mg/L, respectively)，followed by thoracic and abdominal infection,as well as respiratory system infection，while patients with urinary system infection had the lowest levels(［0.769±1.747］ng/mL, ［53.006±45.450］mg/L, respectively). After treatment, makers in survival group were all lower than before treatment, but in death group were all higher than before treatment. The area under the curve of PCT, hsCRP, WBC, and NEU were 0.934, 0.856, 0.782, and 0.784 respectively. ConclusionThe combined detection of PCT and hsCRP is effective for early diagnosis of bacterial infection in elderly patients with CHD, it is also helpful for assessing disease condition, curative efficacy, and prognosis.

Abstract:

ObjectiveTo understand clinical distribution and antimicrobial resistance of clinically isolated Serratia marcescens(S. marcescens), and provide basis for rational use of antimicrobial agents, as well as prevention and control of infection. Methods427 S. marcescens strains isolated between January 1, 2012 and December 31, 2015 were analyzed, antimicrobial susceptibility testing were performed by disk diffusion method. Results427 S. marcescens strains  were mainly from respiratory tract (70.26%), among which the majority were from sputum(64.87%). S.marcescens  were primarily from intensive care unit(ICU, 19.44%), department of integrated traditional Chinese and Western medicine(15.46%) as well as rehabilitation department (13.58%). The resistance rates of S. marcescens to cefoperazone/sulbactam, ertapenem, cefepime, ceftazidime, amikacin, imipenem, levofloxacin, and piperacillin/tazobactam were all＜10%; resistance rates to ciprofloxacin, gentamicin, tobramycin, ceftriaxone, sulfamethoxazole/ trimethoprim (SMZ/TMP), and aztreonam were 10%-30%. Difference in the resistance rates of S. marcescens to cefoperazone/sulbactam, ciprofloxacin, ceftriaxone, amikacin, aztreonam, and SMZ/TMP during 4 years were statistically significant (P＜0.05). In 2012-2013, resistance rates of S. marcescens to cefoperazone/sulbactam, ciprofloxacin, ceftriaxone, aztreonam, and SMZ/TMP increased obviously, then resistance rates tend to be stable,  while resistance rates to cefoperazone/sulbactam decreased. ConclusionSusceptibility of S. marcescens
 to most antimicrobial agents are high, but resistance had increasing tendency;susceptible rates of S. marcescens to ertapenem, ceftazidime, levofloxacin, and piperacillin/tazobactam are all high, and can be used as the empirical medication for the treatment of related infection.

Abstract:

ObjectiveTo investigate the current situation and existing problems of healthcareassociated infection(HAI) management in primary medical institutions in Henan Province. Methods36 primary medical institutions in 18 regions were investigated with random sampling method, development of HAI management in primary medical institutions before and after 2013 were compared. ResultsAmong 36 primary medical institutions, 31 (86.11%) had cleaning, disinfection, sterilization, and isolation systems, 13 (36.11%) implemented HAI monitoring system, 31 (86.11%) performed regular training on hand hygiene knowledge, 6 (16.67%) allocated antimicrobial management professionals. The development rates in HAI management group, hand hygiene system, training on related knowledge among staff, HAI monitoring, and antimicrobial management in 36 primary medical institutions before 2013 were all lower than those after 2013 （41.67% VS 75.00%；2.78% VS 30.56%；22.22% VS 69.44%；5.56% VS 33.33%；25.00% VS 66.67%, all P＜0.05）. ConclusionHAI management level in primary medical institutions has improved than before, but deficiencies still exists and needs further improvement.

Abstract:

ObjectiveTo investigate clinical distribution and antimicrobial resistance genes of  CTXM extendedspectrum βlactamases (ESBLs) and Klebsiella pneumoniae carbapenemases (KPCs)producing Escherichia coli (E. coli) isolated from patients with infection. MethodsMultidrugresistant E. coli (MDRE. coli) isolated from clinical specimens in a hospital in 2011-2012 were collected, minimal inhibitory concentrations (MICs) were detected by microbroth dilution method; ESBLs and KPC genes were amplified by polymerase chain reaction (PCR),  CTXM and KPC genotypes，as well as multilocus sequence types (MLST) were identified. ResultsOf 48 MDRE.coli, 45（93.75%） only produced ESBLs, 44（91.67%） carried  blaCTXM gene, 20（41.67%） of which were blaCTXM1 gene and 32（66.67%）were blaCTXM9 gene，8（16.67%）carried both genes. The following subtypes were identified through gene sequencing: CTXM14（65.91%，29/44）, CTXM55（31.82%，14/44）, CTXM15（11.36%，5/44）, CTXM3（2.27%，1/44）, CTXM24（2.27%，1/44）,and CTXM65（2.27%，1/44）. The detection rates of CTXM14+CTXM55, CTXM14+CTXM15, and CTXM55+CTXM65 were 11.36% (5/44）, 4.55%(2/44）, and 2.27%(1/44）respectively. PCR showed that 2(4.17%） ESBLs+KPCproducing strains carried blaKPC and  blaCTXM genes, sequencing analysis showed that 1 was CTXM14+KPC2，and the other was CTXM3+KPC2. ST 131 （53.66%）was the main type of MLST,  ST648, ST405, ST167, and ST1193 were also detected. ConclusionCTXM14, CTXM55 and CTXM15 are the most common genotypes of ESBLsproducing E. coli isolates, different subtypes exists, ST131 is the predominant MLST, KPC2producing  isolate of E.coli has been detected.

Abstract:

ObjectiveTo provide reference for establishing diagnosis and differential diagnosis methods of rare yeastlike fungal bloodstream infection for clinical microbiology laboratory. MethodsTrichosporon asahii (T. asahii) and Geotrichum capitatum(G.capitatum) bloodstream infection was diagnosed and differentially diagnosed through clinical data analysis, morphological examination, biochemical reactions,and molecular biology technology.ResultsTwo types of yeastlike fungal bloodstream infections in case 1 and case 2 both occurred in leukemia agranulocytosis phase after chemotherapy, such infections were serious and highly similar. The cultivated colonies on blood agar plates of case 1 and case 2 were performed gram stain and microscopic examination. Hyphae, arthrospores and microconidia were visible in the former, thickness of hyphae branches and length of arthrospores were different, most presented rectangular and barrel shape; the latter can be seen hyphae with transparent septum broken up into arthrospores, presented rectangular shape, did not produce blastoconidia. Identification with API 20C AUX showed that they were T. asahii and G. capitatum. The PCR product sequences were compared with NCBI, suggesting that T. asahii  and G. capitatum were at sexual stage.  ConclusionComprehensive application of a variety of technical methods is helpful for improving the diagnosis accuracy of bloodstream infection with yeastlike fungi, identifying Trichosporon and Geotrichum to the species level may help physicians to understand such rare fungal infection, choose antifungal agents rationally, and improve clinical prognosis.［Key words］bloodstream infection; Trichosporon asahii; Geotrichum capitatum; yeastlike fungus; differential diagnosis

Abstract:

ObjectiveTo investigate the current situation and related risk factors of healthcareassociated infection (HAI), so as to provide evidence for making prevention and control measures of HAI. MethodsOn November 26, 2014, a combination method of bedside visiting and medical record reviewing was adopted to survey HAI status, pathogen examination, and antimicrobial application in all hospitalized patients in a tertiary first class military hospital. ResultsA total of 1 657 hospitalized patients were investigated, 66 patients developed 71 times of HAI, HAI rate and HAI case rate were 3.98% and 4.28% respectively. The top 4 departments with HAI prevalence rates were departments of neurosurgery  (24.49%）,  hematology（19.05%）, cadre ward（13.73%）, and  burn surgery（10.91%）.  The top 5 HAI sites were lower respiratory tract (40.85%), urinary tract（23.94%）, upper respiratory tract（12.68%）, surgical  site（9.86%）, and gastrointestinal tract（5.63%）. Of 66 cases of HAI, 39 (59.09%) patients sent specimens for culture, a total of 48 pathogens were cultured, the major isolated bacteria was Escherichia coli (n=10, 20.84%), followed by Staphylococcus aureus, Klebsiella pneumoniae, and  Pseudomonas aeruginosa, each was 7 (14.58 %) respectively. The usage rate of antimicrobial agents was 34.40%, specimen detection rate in patients receiving therapeutic and therapeutic+prophylactic antimicrobial agents was 59.28%. Risk factors for HAI were age <2 years old or >60 years, with respirator, tracheotomy, urinary tract catheterization, arteriovenous catheterization, hemodialysis, and surgery, difference was significant(all P<0.05). ConclusionMonitoring on key departments and key sites of HAI should be strengthened, antimicrobial agents should be used rationally based on pathogenic detection results, specimen pathogenic detection rate should be improved, and effective prevention and control measures needs to be taken according to the risk factors of HAI.

Abstract:

ObjectiveTo understand the therapeutic effect of clindamycin combined with compound sulfamethoxazole tablets on pneumocystis pneumonia(PCP) associated with acquired immunodeficiency syndrome (AIDS). Methods97 AIDS patients with PCP in a hospital from January 2014 to March 2015 were randomly divided into control group (n=49, received compound sulfamethoxazole ) and trial group(n=48, received clindamycin on the basis of compound sulfamethoxazole ) , levels of partial pressure of oxygen in arterial blood (PaO2), arterial blood oxygen saturation（SaO2）, serum albumin(ALB), and lactic dehydrogenase (LDH）in two groups of patients before and after treatment were recorded. ResultsLevels of PaO2, SaO2, ALB, and LDH between two groups of patients before treatment was not significantly different(all P>0.05). After treatment, PaO2 in control group and trial group were（73.01±4.62）mmHg and（84.92±5.34）mmHg respectively，SaO2  were （75.81±4.28）% and（90.86±5.94）% respectively，ALB were (32.62±4.41)g/L and（43.95±5.03）g/L respectively，LDH were（416.53±30.77）U/L and（331.58±20.86）U/L respectively，levels of PaO2 and  SaO2 in trial  group were both higher than control group , difference in ALB and LDH between two groups of patients after treatment were both statistically significant( both P<0.05). The total effective rate of trial group was 89.58% (n=43), which was higher than 69.39%(n=34) in control group （χ2 =6.04，P=0.014）. ConclusionClindamycin combined with compound sulfamethoxazole tablets has good therapeutic effect on AIDS and PCP, which is worthy of clinical popularization and application.

Abstract:

ObjectiveTo explore the effect of ATP fluorescence detection on onsite monitoring and supervision of healthcareassociated infection management . MethodsATP bioluminescence analyzer was used to detect the contamination status of hands of health care workers(HCWs), the object surfaces, and the cleaning tools in all quarters of 2015, the detection results were timely given feedback, and improvement measures were put forward. ResultsA total of 1 294 specimens were detected, the overall qualified rate was 62.75%. The qualified rates of hands of HCWs, object surfaces, and cleaning tools increased from 54.35%, 50.30%, and 60.26% in the first quarter to 76.42%, 64.80%, and 79.52% in the fourth quarter respectively，tendency chisquare test showed that difference was statistically significant (all P＜0.05). The median of relative light unit (RLU) of hands of HCWs, object surfaces, and cleaning tools were 20.00, 85.00, and 35.00, respectively. ConclusionATP fluorescence detection for onsite monitoring and supervision for cleaning and disinfection effect can promote the continuous quality improvement of hand hygiene and environmental cleanliness. 

Abstract:

ObjectiveTo understand the genotypes of measles virus isolated from patients with measles in Beijing Xicheng District in 2014, and timely find out imported measles cases. MethodsMeasles virus nucleic acid was identified with fluorescent polymerase chain reaction (PCR), then amplified by realtime PCR (RTPCR), amplified products were sequenced and analyzed. Results82 specimens from 81 suspected measles patients in Beijing Xicheng District in 2014 were taken, 63 were throat swab specimens and 19 were urine specimens. 70 cases were positive for measles virus nucleic acid, 40 of which were obtained gene sequence through sequencing, 37 were positive culture for measles virus. The phylogenetic tree analysis showed that gene sequences of 40 measles virus isolates were belonged to the same branch as H genotype representative strain Chin9322/H1a and MVi/Hunan.CHN/0.93/7/H1 recommended by World Health Organization.  The homology of nucleotide were 98%-98.9% and 96.9%-97.8% respectively, homology of amino acid were 97.3%-99.3% and 95.3%-98% respectively. ConclusionThe main genotype of measles cases in Beijing Xicheng District in 2014 was the local genotype (H1), surveillance of measles cases should be strengthened further to control and prevent the imported measles cases.

Abstract:

ObjectiveTo investigate the direct economic loss caused by oral infection in patients with acute leukemia. MethodsAcute leukemia patients with oral infection in a tertiary firstclass hospital in Shandong Province between January 2011 and December 2013 were investigated, the 1:1 matched case  control method was used for comparing hospitalization expense and length of hospital stay between oral infected (case group) and uninfected patients(control group). ResultsA total of 994 patients with acute leukemia were monitored, 277 had healthcareassociated infection, 17 (5.56%）of whom were with oral infection. The median hospitalization expense of patients in case group and control group was￥37 327 and￥13 176 respectively, the total hospitalization expense of patients in case group was 2.83 times more than control group, difference was statistically significant （Z=-3.621，P＜0.001). Each hospitalization expense of case group was higher than control group,  especially expense for medicine, blood transfusion, laboratory examination, and therapy. The median length of hospital stay in case group and control group were 17 days and 11 days respectively, rank sum test showed that difference in median length of hospital stay between two groups was statistically significant (Z=-3.627, P< 0.001).  ConclusionAcute leukemia patients with oral infection have increased hospitalization expense, prolonged length of hospital stay, and increased the financial burden.

Abstract:

ObjectiveTo summarize the nursing experience in the prevention and control of Ebola virus disease(EVD), and provide reference for nursing practice on infection control management of further epidemic situation. MethodsPersonal experience in 53day fighting against EVD was retrospectively analyzed, nursing experience in the prevention and control of EVD was summarized by author who was one of 5th  China (Hunan) medical team members and head of nursing. ResultsThe whole medical team consisted of 40 health care workers(HCWs), none of them infected with Ebola virus; there was no cross infection among 105 HCWs of Sierra Leone, either, 100% of Ebola patients were cured. ConclusionBuilding up team work, strictly training and implementing standard working process,  focusing on infection control and management of treatment center are important factors that ensure zero infection among nursing staff during the process of diagnosis and treatment.

Abstract:

ObjectiveTo investigate nursing interns’ knowledge and attitude towards needle stick injury before clinical practice. MethodsIn 2023 June,2015, nursing interns who were about to start clinical practice in a hospital were investigated, nursing interns’ knowledge and attitude towards needle stick injury were surveyed through questionnaire. ResultsA total of 350 questionnaires were distributed, 324 (92.57%) responded questionnaires were available. 40（12.35%）questionnaires were responded by male interns，and 284（87.65%）were by female interns；34（10.49%）interns had bachelor degree；the mean age of interns were (20.83 + 1.24) years old. The correct answer rates about questions related to injury occurring during needle recapping and wearing gloves were low (about 60%). About 70% of the interns gave the correct answers to questions about hepatitis B infection due to needle stick injury following hepatitis B vaccination, as well as medication after injury. Score for individual question about attitude towards needle stick injury was ≤3,  the major related problems were susceptibility of  blood borne diseases and recapping needles.ConclusionNeedle stick injuryrelated knowledge and attitude among nursing interns is inadequate, including recapping needles, timely report, susceptible to infectious diseases, and so on. It is necessary for schools and teaching hospitals to strengthen the education about occupational protection among nursing interns, so as to improve the attitude and ability of professional protection.

Abstract:

ObjectiveTo understand current status of occupational protection awareness and behavior among different professional medical interns, and provide basis for strengthening the education about occupational protection among medical interns .MethodsQuestionnaire survey was used to survey medical interns at the end of their clinical internship. ResultsA total of 385 cases of occupational exposure occurred during internship period, occupational exposure rate was 42.31% (385/910)，occupational exposure mainly occurred in nursing interns (n=190). 358（39.34%）medical interns understood selfprotective antibody (hepatitis B surface antibody); difference in occupational exposure rates and awareness of selfprotective antibody among different professional medical interns was statistically significant (all P<0.05); 222 （57.66%）medical interns sustained occupational exposure more than once, 45.45% of occupational exposure occurred during the process of diagnostic and therapeutic procedure, exposure mainly occurred in the wards（32.21%）. After occupational exposure, 46.75% of medical interns felt nervous, 35.06% were worried，18.18% appeared serious psychological reaction, only 14.03% sought support and help from others. ConclusionAwareness of occupational protection among medical interns is insufficient, education and awareness of occupational protection should be intensified, psychological behavioral after occupational exposure should be paid attention among medical students.

Abstract:

目的 探讨血清降钙素原（PCT）在小儿细菌性肺炎早期诊断中的意义，为临床合理使用抗菌药物提供实验室依据。方法采用酶联免疫荧光法，检测某院2013年1月—2014年12月658例小儿肺炎患儿血清PCT水平。 结果658例小儿肺炎患儿，其中细菌性肺炎196例，病毒性肺炎355例，支原体肺炎107例。细菌性肺炎患儿中PCT阳性181例（92.35%），病毒性肺炎患儿中PCT阳性49例（13.80%），支原体肺炎患儿中PCT阳性9例（8.41%）。3组患儿血清中PCT阳性率比较，差异有统计学意义（P＜0.001）。细菌性肺炎患儿血清中PCT阳性率高于病毒性肺炎、支原体肺炎患儿（均P＜0.001）。结论血清PCT含量是小儿细菌性肺炎的早期敏感标志物之一，血清PCT检测有助于小儿细菌性肺炎的早期诊断和鉴别诊断，可为临床使用抗菌药物提供依据。

Abstract:

人乳头瘤病毒16型（human papillomavirus type 16，HPV16）是一类广泛感染人类上皮组织的小DNA病毒，能引起人体各种黏膜和皮肤的增生性疾病与肿瘤，与人宫颈癌的发生密切相关。疫苗接种是防治HPV16感染的有效途径之一，现有疫苗的种类包括死疫苗、减毒活疫苗、分子疫苗和DNA疫苗等，但存在一定的毒副作用，因此尚需研究新型HPV16疫苗。