• ZHANG Ting-ting , MIAO Jiao-jiao , QIANG Yu-jun , LI Xiu-wen , PENG Xian-hui , ZHANG Wen , HAN Na
•2019, 18(9):797-802. DOI: 10.12138/j.issn.1671-9638.20195128
Abstract:Objective To understand the distribution and diversity of tetracycline resistance genes in human, animal and environmental micro-ecology in different countries. Methods Metagenomic sequencing data of 2 036 micro-ecological specimens from different sources were identified tetracycline resistance genes, distribution and mechanism of tetracycline resistance genes from different sources, different countries and different sites of human body were studied. Results Among 2 036 specimens, detection rate of tetracycline resistance genes was 44.70% (n=910), with the highest detection rate in human specimens (78.99%, 880/1 114), followed by animal specimens (40.98%, 25/61). A total of 28 kinds of tetracycline resistance genes were detected, 248 specimens were detected at least 10 kinds of tetracycline resistance genes, human specimens were detected all 28 kinds of tetracycline resistance genes, animal specimens were detected 6 kinds of tetracycline resistance genes. Among 28 tetracycline resistance genes, 10 coding ribosomal protective protein genes were found, 5 of which (tetQ, tet32, tetW, tetO, tetM) were detected in more than 50% of human specimens, and 4 were detected in animal specimens with a detection rate of more than 16%. 338 human specimens had national information (China, Denmark, Spain, the United States and Japan), analysis on drug resistance genes showed that tetO, tetQ and tetW were detected in 5 countries; specimens from China were matched 24 tetracycline-resistant genotypes, among which tet32, tet40, tetO, tetQ and tetW were detected in all Chinese specimens. Among the distribution of tetracycline resistance genes in micro-ecology of different sites of human body, intestinal tract had the richest distribution of drug resistance genotypes, 26 kinds of tetracycline resistance genes were matched to intestinal specimens, detection rates of tetQ, tetW, tetO, tet32 and tet40 were more than 70%. Conclusion There are a large number of tetracycline resistance genes in human and animal micro-ecology, which threaten the public health and ecological environment, and need to be paid more attention.
• HUANG Zhen , XU Zhi-chao , ZHANG Bo , WANG Hong-yan , CHEN Zhong , BAI Bing , PAN Wei-guang , LI Gui-qiu , XU Guang-jian , YU Zhi-jian , DENG Qi-wen , LI Duo-yun
•2019, 18(9):803-807. DOI: 10.12138/j.issn.1671-9638.20194378
Abstract:Objective To understand the in vitro susceptibility of cethromycin, a ketolide antibiotic, to clinically isolated methicillin-susceptible Staphylococcus aureus (MSSA) and relationship of different molecular types of MSSA with minimum inhibitory concentration(MIC) value of cethromycin. Methods 118 strains of MSSA isolated from different clinical specimens in Nanshan Hospital of Shenzhen from 2011 to 2015 were collected, MIC values of cethromycin and other 9 commonly used antistaphylococcal agents against MSSA were determined by broth dilution method and Kirby-Bauer method. Multilocus sequence typing (MLST) technique was used to classify them into different genotypes, relationship of MSSA type and MIC values of cethromycin to MSSA was observed. Results MSSA was sensitive to linezolid, vancomycin, furantoin, teicoplanin, and amoxicillin/clavulanic acid, 2 strains were intermediate to cethromycin, and 21 strains were resistant to cethromycin, resistance rate was 19.5%, resistance rate to erythromycin was as high as 60.2%. MSSA was divided into 32 ST types, and 20 strains were new ST types, the top three ST types were:15 ST7 (12.7%), 12 ST188 (10.2%) and 12 ST59 (10.2%). Conclusion Resistance of MSSA to macrolide antibiotics is severe, and cethromycin is more effective than erythromycin in treating MSSA. ST7, ST188, ST59 and ST398 are the main MLST of MSSA strains isolated from this hospital.
• ZHAO Kai , YAO Xiao-long , WANG Jun-wen , ZHANG Hua-qiu , NIU Hong-quan
•2019, 18(9):808-813. DOI: 10.12138/j.issn.1671-9638.20194452
Abstract:Objective To investigate the clinical characteristics and treatment of brain abscess in elderly patients. Methods Clinical data of elderly patients with brain abscess treated in neurosurgery department in a hospital from January 2008 to December 2016 were collected, clinical characteristics, treatment methods and prognosis were analyzed. Results A total of 64 elderly patients who underwent operation for brain abscess, including 14 cases (21.9%) with fever, 9 cases (14.1%) with a definite history of infection, 6 cases (9.4%) with meningeal irritation sign, laboratory examination indicated that 11 cases (17.2%) might be infected. The average time from onset to consultation was (43.3±20.4) days. Imaging findings were lesions of cystic (17 cases), cystic-solid (38 cases) or solid (9 cases). Enhanced scan showed no obvious envelope in 9 cases, thin wall(<2 mm) in 11 cases, and thick wall(>2 mm) in 44 cases; lesion envelope showed circular enhancement or inhomogeneous enhancement. 48 cases underwent abscess resection and 16 cases underwent abscess puncture. Two weeks after operation, the Glasgow outcome scale(GOS) was 1 point (death) in 4 cases, 2-3 points in 11 cases and 4-5 points in 49 cases. Except for 4 cases of death and 6 cases of loss to follow-up, the other 54 patients were followed up for an average of (25.7±16.4) months, GOS were 1 point in 2 cases, 2-3 points in 1 case, and 4-5 points in 51 cases. Conclusion Elderly patients with brain abscess lack symptoms of systemic infection, clinical symptoms of intracranial hypertension are not obvious, interval between onset and first consultation is long, imaging manifestations show brain abscess with typical thick-walled cystic-solid mass and circular enhancement, individualized treatment principle should be followed, and good prognosis can be obtained.
• ZENG Ting , ZENG Ling , CAO Xian-wei , DENG Qiong , ZHANG Jie
•2019, 18(9):814-818. DOI: 10.12138/j.issn.1671-9638.20195350
Abstract:Objective To analyze the resistance characteristics, main epidemic clones and biofilm formation ability of carbapenem-resistant Acinetobacter baumannii (CRAB) in a hospital, and provide reference for better prevention and control of CRAB infection. Methods 32 non-repetitive CRAB strains were collected from the hospital, antimicrobial susceptibility was detected by automatic microbiological analysis system, biofilm formation ability was detected by crystal violet staining, polymorphism of CRAB clones was analyzed by pulsed-field gel electrophoresis (PFGE). Results Resistance rate of 32 CRAB strains to tetracycline was the lowest (68.6%) and to other antimicrobial agents were all>78%. PFGE homology results showed that 32 CRAB strains could be divided into 9 different clone types (type A-I), each clone type consisted of 1-9 strains, the main prevalent clones were type A (n=9) and type E (n=7). Of 32 CRAB strains, 14 (43.8%) had biofilm formation ability and were weakly positive; there was no significant difference in biofilm formation ability among different clones (χ2=6.636, P=0.659). With the enhancement in biofilm formation ability, antimicrobial resistance rate increased in varying degree, but only gentamicin resistance rate between biofilm formation strains and biofilm non-formation strains was significantly different(χ2=4.879, P<0.05). Conclusion There are different clonal transmission of CRAB in this hospital, mainly type A and E, enhancement in biofilm formation ability can increase the drug resistance of strains.
• JIA Hui-xue , ZHAO Yan-chun , JIA Jian-xia , ZHAO Xiu-li , YAO Xi , HU Mei-hua , ZHANG Ran , QIAN Jing-jing , PENG Xue-er , LI Liu-yi
•2019, 18(9):819-823. DOI: 10.12138/j.issn.1671-9638.20195352
Abstract:Objective To explore the evaluation methods of hand hygiene(HH) compliance. Methods HH compliance rate of health care workers(HCWs) in clinical technical departments of a hospital from 2011 to 2018 was investigated by direct observation method, consumption of HH supplies, including detergent and alcohol-based hand rub in all departments of hospital during the same period were investigated, HH opportunities per bed-day were calculated. Concealed survey combined with consumption of HH supplies was adopted to calculate HH opportunities per bed-day. Directly observed HH compliance rate was adjusted and Hawthorne effect was analyzed. Results HH compliance rate surveyed through direct observation method in 2011-2018 increased year by year (χ2=11 712.41,P<0.01), from 38.17% to 94.46%. According to the amount of consumption of alcohol-based hand rub and detergent each time, opportunities of HH per bed-day were estimated to be 12.41 in 2011 and 22.37 in 2018; consumption of alcohol-based hand rub and detergent per bed-day had good correlation with HH compliance rate (r values were 0.82 and 0.79, respectively, P<0.05). The adjusted HH compliance rates were 36.87%-69.10%, which were 1%-43% different from that of direct observation. Conclusion Consumption of HH supplies and HH compliance rate have good guiding significance for the correct evaluation on HH, and can avoid over-evaluation of HH compliance rate.
• LI Zhan-jie , CHEN Wen-sen , LIU Cheng-cheng , ZHANG Xiang , LIU Gen-yan , ZHANG Yong-xiang , LIU Yun , LI Song-qin
•2019, 18(9):824-829. DOI: 10.12138/j.issn.1671-9638.20195351
Abstract:Objective To perform epidemiological survey on aggregated cases of surgical site infection (SSI) after radical thyroidectomy for thyroid cancer, provide evidence for prevention and control of healthcare-associated infection(HAI). Methods Epidemiological survey was conducted on SSI patients after radical thyroidectomy for thyroid cancer in a tertiary first-class hospital between April 27, 2019 and June 7, 2019, intervention measures were given, efficacy of prevention and control was evaluated. Results There were 4 cases of SSI after radical thyroidectomy for thyroid cancer in this hospital during a short period of time, secretion cultures of surgical sites of 2 cases were methicillin-resistant Staphylococcus aureus (MRSA), and antimicrobial susceptibility profile was consistent. Surgeons, nurses and workers in the operation group were sampled (nasal cavity, forehead and hand), and the surface of environmental objects in the dressing room, treatment room and related bed units were also sampled, MRSA was isolated from the nasal cavity and hand specimens of surgeon C, susceptibility profile was consistent with MRSA cultured from the secretion of surgical site of patients. Intervention measures were given, operation qualification of doctor C was suspended, and mopirocin was used for decolonization, re-examination 10 days later, no MRSA was cultured, within one month after decolonization, no related infection cases were found, which confirmed the effectiveness of prevention and control measures. Conclusion Non-effective decolonization of MRSA can lead to aggregation of SSI, clinical departments should be encouraged to report infection events on their own initiative to reduce the risk of infection.
• ZHANG Yin , TANG Yi , WANG Yi-chen , YE Zhen-xia , WANG Wen-liang , LIU Yi-qing , TENG Pei-min , ZHANG Yi-bo , WANG Qun , MI Chen-rong
•2019, 18(9):830-834. DOI: 10.12138/j.issn.1671-9638.20195353
Abstract:Objective To compare the terminal disinfection effect of different dosage of hydrogen peroxide vapor (HPV) on burn intensive care unit(BICU). Methods A 110 m3 empty ward in department of burn and plastic surgery of a hospital was selected as the test location. Bacillus subtilis var. niger spore tablets were placed at 15 points without shielding (0, 1, 2, 3, 4 m away from the disinfector, each point was divided into upper, middle and lower planes) and 15 points (same position) in the uncovered sterile test tube, hydrogen peroxide indicator tape was placed at each point of uncovered sterile test tube and non-shielding point. The amount of hydrogen peroxide was calculated according to the size of ward (8 g/m3 and 12 g/m3, respectively). After 5 hours of disinfection, change in color of chemical indicator tape was observed, spore tablets were placed in broth culture tube, result was observed after culture. Data was analyzed using SPSS 20.0 statistical software. Results When 8 g/m3 hydrogen pero-xide was used for disinfection, the peak concentration was 255.9 g, the time to reach peak concentration was 1 hour and 48 minutes; when 12 g/m3 hydrogen peroxide was used for disinfection, the peak concentration was 337.6 g, the time to reach peak concentration was 2 hour and 26 minutes. When disinfection time of two disinfection dosages reached 8 hours, the concentration of ward was basically the same. Under the condition of non-shielding, chemical indicator tape of two kinds of disinfection dosage all changed color, but could not completely change color in uncovered sterile test tube. When disinfection dosage of hydrogen peroxide was 8 g/m3 and 12 g/m3, positive rates of the non-shielding specimens were 6.67% and 2.67% respectively, with no significant difference (P>0.05), and disinfection effect was not significantly different among different points (all P>0.05). Conclusion Change in color of chemical indicator tape can be used as a preliminary evaluation of disinfection effect in clinic. When using HPV for terminal disinfection, it is necessary to expose the items as far as possible, disinfection time and dosage should be determined according to the actual situation, disinfection effect of different points in the ward is basically the same.
• ZENG Ling , DENG Qiong , LIU Yang , ZHANG Jie , ZENG Ting , CAO Xian-wei
•2019, 18(9):835-841. DOI: 10.12138/j.issn.1671-9638.20195354
Abstract:Objective To understand the molecular characteristics and main epidemic clone types of methicillin-resistant Staphylococcus aureus (MRSA) in different regions of Jiangxi Province, explore the possible competitive advantages of epidemic clone, provide information for the subsequent study on mechanism. Methods Clinical isolates of MRSA from 11 hospitals in 11 cities of Jiangxi Province between January 2017 and December 2018 were collec-ted, MRSA strains identified by mecA+femB double polymerase chain reaction (PCR) were included in study, molecular typing was performed by spa, SCCmec, pulsed-field gel electrophoresis (PFGE) and multilocus sequence typing (MLST), virulence genes of Panton-Valentine leukocidin (PVL) were detected by PCR method. Results The main types of spa were t437 (74 strains, 31.22%) and t030 (32 strains, 13.50%); there were significant differences in spa types among different regions, except for t030 in Nanchang region, t437 was the dominant type in other regions. SSCCmec IVa was the dominant type (66.67%), SCCmec Ⅲ accounted for 15.19%; except for SCCmec Ⅲ in Nanchang (59.38%), SCCmec IVa was the dominant type in other regions. The dominant clone types detected by PFGE and MLST were ST239, ST59, ST1 and ST338; and the dominant clone groups were CC239, CC59 and CC1. A total of 32 strains (13.19%) of PVL-positive bacteria were detected, the highest detection rate of PVL was found in Yingtan region (29.63%, 8/27), followed by Jingdezhen region (26.32%, 5/19). Conclusion ST59-MRSA-IVa-t437 is the predominant epidemic clone type in Jiangxi, and there is a certain degree of clonal dissemination among different regions. ST239-MRSA-Ⅲ-t30 is the secondary dominant epidemic clone type, which is mainly found in Nanchang and sporadic in other regions. The main type of PVL-positive strains in Jiangxi is ST59-MRSA-t437-IVa.
• WANG Fang , SUN Qi-mei , LIU Xin , JIANG Xue-jin , SONG Shu-xia , SHAO Fang-fei , SONG Li-xia , SUN Ji-hua
•2019, 18(9):842-847. DOI: 10.12138/j.issn.1671-9638.20195355
Abstract:Objective To understand the difference in economic loss between carbapenem-resistant Acinetobacter baumannii(CRAB) and carbapenem-susceptible Acinetobacter baumannii(CSAB) healthcare-associated infection(HAI), and improve health care workers' awareness on the prevention and control of CRAB infection. Methods Patients with Acinetobacter baumannii infection in the intensive acre unit(ICU) of a tertiary first-class hospital from October 2012 to September 2018 were studied and divided into CRAB group and CSAB group according to susceptibility of Acinetobacter baumannii to carbapenems, two groups were matched according to 1:1 matching standard, paired rank sum test was used to analyze the direct economic loss of two groups of patients. Results Forty-six pairs were matched, the median hospitalization expense of CRAB group and CSAB were 179 192 yuan and 82 314 yuan respectively, difference between two groups was 96 878 yuan; the median length of hospital stay of CRAB group and CSAB group were 49 days and 27 days respectively, difference between two groups was 22 days; difference in total hospitalization expense and length of hospital stay between two groups were both significant (both P<0.05). The main direct economic loss of patients with CRAB HAI were western medicine fee (29 246 yuan), material fee (19 465 yuan) and treatment fee (12 872 yuan), accounting for 63.6% of direct economic loss. Conclusion CRAB HAI can lead to prolonged length of hospital stay and increase hospitalization expense, so it is essential to reduce the incidence of CRAB HAI.
• YE Qing , XU Ya-qing , LEI You-rong , DENG Min , CHENG Yu-jia
•2019, 18(9):848-853. DOI: 10.12138/j.issn.1671-9638.20195357
Abstract:Objective To analyze the growth law, research hotspots and frontier of relevant literatures on healthcare-associated infection(HAI) training in China, and explore its development direction. Methods Based on China National Knowledge Infrastructure (CNKI) database, Excel table was employed to analyze the law of literature growth, and CiteSpace visualization software was introduced to identify the hotspots and frontier of domestic research on the training of HAI by means of co-occurrence network analysis on key words. Results A total of 1 267 articles were included in analysis, literature publication has gone through three stages:the initial stage (1991-2003), the growth stage (2004-2013) and the stable stage (2014 and beyond), the main publications were Chinese Journal of Nosocomiology, Journal of Traditional Chinese Medicine Management and Chinese Journal of Infection Control. A total of 131 nodes and 387 connecting lines were identified by key word co-occurrence network. The hotspots of identified research were "compliance", "hand hygiene", "operating room", "healthcare-associated infection", "health care worker", "pre-job training" and "cleaners", with the centrality values ≥ 0.30. These research hotspots present certain evolution rules with "knowledge training" and "primary medical institutions" as the recent frontier. Conclusion The development of HAI training research in China is closely related to the development of national HAI management. The training system for non-professional personnel needs to be improved in the future, and the research on training system and effect evaluation for full-time personnel needs to be strengthened.
• LIU Si-di , DOU Qing-ya , YI Liang , YIN Jin , LI Jie , HUANG Xin , HUANG Xun
•2019, 18(9):854-858. DOI: 10.12138/j.issn.1671-9638.20194359
Abstract:Objective To investigate the bacterial contamination of medical ultrasound probes in a hospital, explore the disinfection effect of different disinfection methods on ultrasound probes, and provide reference for cleaning and disinfection of medical ultrasound probes. Methods 274 specimens of common ultrasound probes and gynecolo-gical transvaginal ultrasound probes in a tertiary first-class hospital were taken and grouped according to different sampling time, common ultrasound probes were taken specimens before and after wiping with common tissue paper as well as after disinfection following touching patients; transvaginal ultrasound probes were taken specimens after removal of disposable protective sheath and after disinfection following mucosa-touching examination for patients. According to different disinfection methods, two groups were also divided:group A was disinfection wet wipes group (compound double-chain quaternary ammonium salt disinfection wet wipes), group B was ultrasound probe sterilizer group, the total number of bacteria was calculated and identified respectively. Results A total of 174 specimens of common ultrasound probes were taken, the average bacterial colonies before and after wiping with common tissue paper, as well as after disinfection following touching patients were 1.61×104, 1.57×103, and 2.41 CFU/piece respectively, there was significant difference in the average bacterial colonies at three different sampling times (P<0.05); a total of 100 gynecological transvaginal ultrasound probe specimens were taken, the average bacterial colonies of probes after removing disposable protective sheath and after disinfection following touching patients' mucosa were 13.20 and 0.24 CFU/piece respectively, there was significant difference in the average colonies between two sampling times (P<0.05). After probes were disinfected by disinfection wet wipes and ultrasound probe sterilizer, the average bacterial colonies of common ultrasound probes were 5 and 0 CFU/piece respectively, transvaginal ultrasound probes were 0.40 and 0 CFU/piece respectively, there were no significant difference between two disinfection methods (both P>0.05); no pathogen was detected after ultrasound probes were disinfected. Conclusion Both double-chain compound quaternary ammonium salt disinfection wet wipes and ultrasound probe sterilizer have good disinfection effect on ultrasound probes, which can be recommended for use in ultrasound diagnosis and treatment department.
• HU Shi-yun , WU Jie-jiao , YANG Xue-song , QIN Gui-ying , DAI Hong-yan , ZHONG Ming , QIU Long-min
•2019, 18(9):859-862. DOI: 10.12138/j.issn.1671-9638.20195356
Abstract:Objective To explore the direct economic loss due to healthcare-associated infection(HAI) in patients with liver failure, so as to make policy makers and health care workers have an intuitive understanding of the harm of HAI. Methods Patients with liver failure in a tertiary first-class general hospital in Guizhou Province from December 2009 to December 2014 were analyzed, according to 1:1 ratio, patients with HAI were in case group, while those without HAI during the same period were in control group, length of hospital stay and medical cost were compared by paired rank sum test, SPSS 17.0 software was used to perform statistical analysis. Results 276 cases of liver failure were collected, 23 of which were matched effectively. The results showed that the average length of hospital stay of liver failure patients complicated with HAI was 11 days longer than that of patients without HAI (P=0.01), and the average medical cost were 22 980.01 yuan more (P=0.01). The top three cost in case group from high to low were medicine (40.25%), material (20.32%) and blood transfusion (13.90%), in control group were medicine (60.13%), laboratory detection (14.57%) and blood transfusion (7.25%). Conclusion The average length of hospital stay of liver failure patients complicated with HAI is longer than that of patients without HAI, and the average medical cost is higher, which increases the economic burden of patients.
• LIU Jun , FEI Chun-nan , JI Xue-yue , LIU He , SONG Jia , GUO Yu-ting
•2019, 18(9):863-866. DOI: 10.12138/j.issn.1671-9638.20194518
Abstract:Objective To explore the cleaning and disinfection effect of wipes with different material on the surface of environmental object. Methods Cleaning and disinfection of the same object surface were set up control group and experimental group (4 groups), experimental group 1 was wiped with ultrafine fiber cloth+detergent, experimental group 2 with common cotton cloth+detergent, experimental group 3 with ultrafine fiber cloth+disinfectant, and experimental group 4 with common cotton cloth+disinfectant; another control group and experimental group (group A and B) were also set up, group A was wiped with disposable disinfection wet wipes containing 2 000 mg/L double-chain quaternary ammonium salt disinfectant, group B was wiped with ultrafine fiber cloth+detergent, control group didn't take any wiping measures, 50 specimens were collected from each group, the total number of bacterial colonies, qualified rate, and average clearance rate of bacteria of each group were calculated. Results A total of 400 specimens were taken. The qualified rates of experimental group 1, 2, 3, and 4 were 90.00%, 66.00%, 98.00%, and 92.00% respectively; the qualified rates of ultrafine fibre cloth+detergent and ultrafine fibre cloth+disinfec-tant were both higher than that of common cotton cloth, difference were both statistically significant (both P<0.05). Bacterial clearance rates of ultrafine fibre cloth combined with detergent and disinfectant were 91.99% and 94.00% respectively; bacterial clearance rates of common cotton cloth combined with detergent and disinfectant were 64.07% and 90.00% respectively. After wiping the surface of hospital environmental objects with superfine fibre cloth combined with detergent and disposable disinfection wet wipes, the average clearance rates were 91.00% and 92.01% respectively. Conclusion Ultrafine fiber material has better disinfection and cleaning effect, application of this material can reduce the use of disinfectant, not only conducive to environmental protection, but also reduce clinical workload.
• WANG Li-bo , FENG Lin-lin , YANG Yun-hai , CONG Shu-nan , SUN Li-ping
•2019, 18(9):867-871. DOI: 10.12138/j.issn.1671-9638.20195134
Abstract:To study the effect of packaging methods on sterilization efficacy of infectious waste sterilized by vertical pressure steam sterilizer, verify its biological safety, and provide basic data for formulating technical guidelines for treatment of infectious hazardous waste in hospital laboratories in China. Methods Two vertical pressure steam sterilizers in infectious waste disposal room of microbiology laboratory of a hospital were selected as observation objects, experimental bacteria was Bacillus thermophilus bioindicator (ATCC6767), experimental material included glass test tubes (cotton ball sealing), glass plate and plastic bags for medical waste, experiment were divided into non-packaging group, open packaging group for medical waste plastic bags and sealing packaging group for medical waste plastic bags, statistical analysis of experimental results was performed through treatment effect test and safety verification test. Results Culture result of biological indicators showed that sterilization effect could all be achieved when bioindicators were in non-packaging group sterilized at 121℃ for 20 minutes and 132℃ for 5 minutes,in open packaging group at 121℃ for 60 minutes, and in sealing packaging group at 121℃ for 105 minutes. Whether the plastic bags were open or sealed, setting the temperature at 132℃ for 5 minutes sterilization could melt plastic bags of medical waste. Conclusion Infectious wastes packaged in the open package at 121℃ for 65 minutes sterilization and in sealed package at 121℃ for 110 minutes sterilization is recommended, sterilization procedure at 132℃is not recommended.
• YANG Li , PENG Wei-jun , XIE Hong-yan , LAI Xiao-quan , LIANG Yan-fang
•2019, 18(9):872-876. DOI: 10.12138/j.issn.1671-9638.20194512
Abstract:Objective To explore the application efficacy of plan-do-check-act (PDCA) cycle in hospital environmental hygiene supervision and management. Methods PDCA tools were adopted to supervise and manage hospital environmental hygiene, isolation rates of methicillin-resistant Staphylococcus aureus (MRSA) and multidrug-resis-tant(MDR) Acinetobacter, as well as qualified rate of ATP fluorescence detection before and after the implementation of supervision mode were compared. Results After the implementation of PDCA cycle supervision mode, isolation rate of MDR Acinetobacter, overall isolation rate of MRSA and MDR Acinetobacter on the surface of environmental objects in two departments were both lower than those before intervention (0.96% vs 8.04%; 6.73% vs 15.18%, respectively), with statistical significance (both P<0.05). Before intervention, a total of 17 strains of MDROs were isolated, 7 strains of MDROs were isolated from bedside instruments, and 2 strains were isolated from ground, dairy appliances and ward bed respectively; after intervention, a total of 7 strains of MDROs were isolated, 2 strains were isolated from bedside instruments and ground respectively. Qualified rate of ATP detection on environmental surface after intervention was higher than before intervention (82.61%[38/46] vs 58.33%[28/48], χ2=8.451,P=0.004). Conclusion Applying PDCA cycle supervision mode, active finding out problems and strictly controlling process management can effectively reduce the isolation rates of MRSA and MDR Acinetobacter on the surface of hospital environmental objects, ensure medical environmental hygiene and maintain medical safety.
• WU Jie , ZENG Fan-hui , LIU Hai-na
•2019, 18(9):877-881. DOI: 10.12138/j.issn.1671-9638.20194509
Abstract:Objective To understand the basic situation and sources of pressure of full-time staff in healthcare-associated infection(HAI) management in a city of Henan Province. Methods A stratified random sampling method was used to classify hospitals into secondary and tertiary hospitals according to the level of hospitals, all were public hospitals, secondary and tertiary hospitals were numbered, target hospitals were investigated by random sampling, the general situation, profession, full-time HAI management personnels matching, willing to continue to work in HAI management and sources of pressure of full-time staff in HAI management were investigated. Results A total of 44 full-time staff in HAI management in 17 secondary and tertiary general hospitals were investigated. Full-time personnels mainly received college education(43.18%); professional titles were mainly intermediate titles(63.64%); profession was mainly nursing(81.82%); service years in HAI management were 5 to 10 years(47.73%); the highest proportion of age was 40-50 years old (34.09%). Only 4 full-time personnels matching met the requirements(23.53%). Thirty full-time staff (68.18%) were willing to change their jobs, 40-50 years old were the most(86.67%), followed by 30-39 years old (78.57%). Among the main sources of pressure of full-time staff in hospitals of different levels, the top five were:high work pressure (95.45%), extensive management (81.82%), insufficient attention of hospital leaders (72.73%), few full-time staff (61.36%) and difficult promotion of professional titles (50.00%). Conclusion The irrational structure of the full-time staff in HAI management, high work pressure, extensive management and insufficient leadership attention are the main sources of pressure of full-time staff in HAI management in this city.
• LI Chun-hui , WU An-hua
•2019, 18(9):882-887. DOI: 10.12138/j.issn.1671-9638.20195358
Abstract:Human enterovirus (HEV) belongs to the enterovirus genus of Picornaviridae family, it is an important human pathogen, as a common opportunistic infectious pathogen, it can infect people of all ages, the morbidity in infants is significantly higher than that of adults. HEV is highly infectious and can cause epidemics and outbreaks. HEV includes Poliovirus, Coxsackievirus A, Coxsackievirus B, Echovirus(EchoV) and new enterovirus. HEV can cause encephalitis (meningitis), bronchitis, myocarditis, hand-foot-and-mouth disease, flaccid paralysis, type 1 diabetes mellitus and other diseases, serious infection caused by EchoV, especially that acquired by newborns in hospitals, often leads to outbreaks and epidemics. In recent years, outbreaks of infection caused by EchoV in China have occurred from time to time, which is highly infectious. In 2019, EchoV infection among newborns in a hospital in Guangdong Province resulted in 5 fatal cases, with serious consequence and great influence. This paper reviews the characteristics of EchoV infection and the key points of healthcare-associated infection(HAI) prevention and control, so as to provide help for diagnosis and treatment of infection as well as prevention and control of HAI.
•2019, 18(9):888-892. DOI: 10.12138/j.issn.1671-9638.20194491
Abstract:The emergence of "superbugs" resistance will bring us into "the post-antimicrobial era". In the face of the increasingly serious bacterial resistance, finding new antimicrobial agents and therapy options has become an urgent problem to be solved. This paper elaborates in detail the advantage of bacteriophage therapy by consulting a large number of successful cases of bacteriophage therapy at home and abroad, fully illustrates that bacteriophage lysis of drug-resistant strains for bacterial disease therapy is an effective method, points out advantage and disadvantage of bacteriophage therapy technology, and puts forward the future development direction.
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