OBJECTIVE To know the distribution and drug resistance of the ventilator-associated pneumonia(VAP) bacteria in the intensive care unit(ICU),and to provide a reasonable basis for the clinical use of antibiotics. METHODS We used the Tiek Biagnostic systems to identifly microorganisms and antibiotic susceptibility.The result of the drug sensitivity test was analyzed with SPSS13.0. RESULTS A total of 538 strains were isolated from the sputum samples of the ventilator-associated pneumonia patients in the ICU over the last 4 years,in which Gram-negative bacteria were 361(the isolation rate 69.3%).Pseudomonas aeruginosa was the most common.Gram-positive bacteria were 143(the isolation rate 26.6%),in which Staphylococcus aureus was the most common.Twenty-two strain were fungi(the isolation rate 4.1%).Most of the pathogenic bacteria maintained high sensitivity rate to imipenem,vancomycin and quinupristin/daefopristin;but the drug resistance rate to other antibiotics was high and on the rise year by year. CONCLUSIONS The pathogens types of VAP was,complex,and multi-drug resistant.We should emphasize the reasonable application of the antibiotics and strengthen the monitoring of drug resistantce,and rational use of antibiotics to improve the cure rate.

The aging process of human colonic epithelium involves a slow decline in physiological vigor and an increasing susceptibility to age-related diseases, especially, colon cancer, but the molecular mechanisms of the aging and susceptibility of aged colonic epithelium to carcinogenesis is still unclear. Identification of aging related proteins in colonic epithelium will help to reveal the molecular mechanisms of colonic epithelial aging and age-related colonic diseases. Therefore, the total proteins of human normal colonic epithelial tissues from 10 young and 10 old men were separated by two-dimensional gel electrophoresis(2-DE), respectively. PDQuest software was applied to analyze 2-DE images, the differentially expressed protein spots of colonic epithelium between young and old groups were identified by matrix-assisted laser desorption/ionization time of flight mass spectrometry(MALDI-TOF-MS), and the expression levels of partial identified proteins were determined by real-time quantitative PCR and immunohistochemistry. Well-resolved, reproducible 2-DE maps of human colonic epithelial tissues from young and old men were established, 17 aging related proteins were identified by MALDI-TOF-MS, and the differential expression levels of partial identified proteins were confirmed by real-time quantitative PCR and immunohistochemistry. The results indicate that injury of mitochondrial function and decline of antioxidant capability are important reasons for the aging of human colonic epithelium, and four differential proteins (guanine nucleotide-binding protein beta subunit-like protein, stress-70 protein, 40 S ribosomal protein SA and chloride intracellular channel protein1) may be involved in susceptibility of aged colonic epithelium to carcinogenesis.

Objective To study the role of nursing risk management in prevention of pressure sores in stroke patients. Methods From January 2016 to December 2016,1,334 stroke patients from the third section,department of neurology of our hospital were assigned as the observation group,where the nursing risk management was applied and meanwhile,another 1,295 stroke patients from the second section of the same department as the control group, where only routine nursing was applied. The two groups were compared in terms of incidence rate and treatment outcome of pressure ulcers.Result The incidence rate of new pressure ulcer and of the observation group was significantly lower than that of the control group (all P＜0.05).Conclusion The nursing risk management in the pressure ulcer prevention for stroke patients significantly reduces the incidence rate of pressure ulcers and improves the cure rate.

OBJECTIVETo understand the distribution of diarrheagenic Escherichia (E.) coli in population in Shanghai and discuss the practice model of cooperation in enteric infectious disease prevention and control between public health institution and hospital.

METHODSSentinel hospitals were assigned, standard detection and identification of diarrheagenic E. coli were conducted, incidence curve of diarrheagenic E. coli infection was drawn and epidemiologic survey and laboratory detection were conducted for suspect diarrheagenic E. coli infection outbreaks.

RESULTSA total of 7 204 stool specimens were collected from diarrhea patients in 4 hospitals during 2012-2013, in which 712 (9.9% ) were diarrheagenic E. coli positive, including 351 enteropathogenic E. coli (EPEC) strains, 292 enterotoxigenic E. coli (ETEC) strains, 32 enteroinvasive E. coli(EIEC) strains and 6 Shiga toxin-producing E. coli (STEC/EHEC) strains, as well as 31 mixed strains. EPEC infection mainly occurred in children aged 1-5 years; and all of these infections were caused by aEPEC. The incidence peak of ETEC infection was during August, the positive rate was >20%. The ETEC infection mainly occurred in infants aged 1-28 days in 2012 and in people aged 20-60 years in 2013 (P<0.05). ST was the major type (59.6%), followed by LT (27.8%) and ST/LT (12.6%). EIEC infection increased in children obviously in 2013 (P<0.01). No EHEC O157:H7 case was detected, but two EHEC O26:H11 (eae-hlyA-stx1a) cases in children were reported for the first time in Shanghai. The survey result indicated that the multidrug-resistant ETEC (STh-CS21-CFA/I-ClyA-EatA-ST2332-SHNL0005) strain causing outbreak in 15 newborns in Shanghai in 2012 was in the same clone as the strain detected in Zigong in Sichuan province.

CONCLUSIONSignificant change has occurred in diarrheagenic E. coli distribution in Shanghai in recent years, ETEC has potential risk to cause outbreak of hospital acquired infection in neonates and food borne infection. The active surveillance on ETEC and other enteric pathogens by both public health institutions and hospitals need to be improved.

Adult ; Child, Preschool ; China ; epidemiology ; Diarrhea ; microbiology ; Disease Outbreaks ; Enteropathogenic Escherichia coli ; isolation & purification ; Enterotoxigenic Escherichia coli ; isolation & purification ; Escherichia coli Infections ; epidemiology ; Humans ; Incidence ; Infant ; Infant, Newborn ; Middle Aged ; Sentinel Surveillance ; Young Adult