Objective To understand the history and current situation of digestive endoscope cleaning and disinfec-tion in domestic medical institutions.Methods Questionnaire survey was used to investigate and analyze the history and current situation of digestive endoscope cleaning and disinfection in medical institutions in some provinces and cities in China.Results A total of 278 medical institutions in 11 provinces and cities of China participated in the in-vestigation,78,175,and 278 institutions filled out complete information in 1986,2005,and 2015 respectively.The personnels participated in cleaning consisted of doctors,nurses and workers,the combination of nurses and workers increased from 2.56% in 1986 to 23.74% in 2015.In 1986,100% of medical institutions used storage water for di-gestive endoscope cleaning;in 2005 and 2015,all used running water for cleaning,besides,30.29% of medical in-stitutions used filtered water or purified water for cleaning,in 2015,50.72% of medical institutions used filtered water,17.63% used purified water for cleaning.In 1986,no cleaning enzyme were used,in 2015,98.92% of med-ical institutions used enzyme for cleaning;in 1986,irrigation of digestive endoscopy channel was performed with simple rinsing(94.87%),in 2015,enhanced irrigation (34.53%)and automatic irrigation (53.24%)were the main rinsing modes.In 2005 and before,>90% of digestive endoscope cleaning and disinfection were not recorded or manually recorded,in 2015,36.33% of institutions used information traceability system.Conclusion The staffing of digestive endoscope cleaning in domestic medical institutions,quality of cleaning water,selection of high efficien-cy disinfectant,monitoring and recording of digestive endoscope cleaning and disinfection in domestic medical insti-tutions were greatly improved compared with 1986 and 2005,cleaning and disinfection gradually standardized,disin-fection and sterilization methods of digestive endoscope tend to be diversified.

Objective To analyze the medical environmental distribution characteristics of carbapenem-resistant Klebsiella pneumoniae (CRKP).Methods On April 25 and August 29,2016,random sampling was performed be-fore cleaning and disinfecting the surrounding of patients who isolated CRKP in a hospital,sampling were mainly object surfaces and medical devices.Distribution characteristics of CRKP were analyzed.Results The number of environmental sampling in surgical intensive care unit(SICU),respiratory ICU(RICU),and emergency ICU(EICU) were 90,41,and 56 respectively.CRKP was not found in SICU and RICU specimens;6 strains of CRKP were iso-lated in EICU,the isolation rate was 10.71%.In April 2016,103 specimens were taken,and 6 strains of CRKP were isolated,isolation rate was 5.83%,which was higher than in August of 2016(P <0.05).There were no sig-nificant differences in isolation rates of CRKP among different specimens and different responsible persons (all P >0.05).Conclusion Key departments,such as EICU,should be intensified cleaning and disinfection,so as to re-duce the spread of CRKP in the medical environment.

Objective To evaluate the effect of three methods on detecting cleaning efficacy of suction luminal de-vices in pediatric department,and find out a proper detection method for such devices.Methods Random number table method was adopted to take samples of suction lumen devices after cleaned in central sterile supply department in January-April 2016,visual observation with the aid of magnifying glass,jieli strip detection method,and ATP bi-oluminescence assay were adopted to detect cleaning efficacy of outer surface,screwed connection,and inner wall of lumen devices,the qualified rates of cleaning detected by three methods were compared.Results The qualified rates of suction lumen devices after cleaned detected by visual observation with the aid of magnifying glass,jieli strip de-tection method,and ATP bioluminescence assay were 99.00%,91.00%,and 71.50% respectively,qualified rates of cleaning detected by three methods were statistically significant(χ2 =71.545,P <0.001),pairwise comparison showed a significant difference (both P <0.0167);qualified rates of cleaning of the outer surface of lumen detected with three methods were all 100.00%;qualified rates of cleaning of screwed connection were 100.00%,98.00%, and 97.00% respectively(χ2 =5.695,P >0.05);qualified rates of cleaning of inner wall were 99.00%,92.00%, and 72.00% respectively(χ2 = 72.634,P < 0.01 ),pairwise comparison were all significantly different(all P <0.01).Conclusion The cleaning quality of the outer surface and screwed connection of pediatric suction lumen de-vices can be assessed by visual observation with the aid of magnifying glass,cleaning quality of the inner wall of lu-men can be detected by ATP bioluminescence method,when condition is limited,Jieli strip method can be used for routine detection,supplemented by ATP bioluminescence detection on a regular basis.

Objective To understand healthcare-associated infection(HAI)in group burn/trauma patients,and explore its risk factors.Methods HAI occurred among 25 hospitalized patients with group burn/trauma during a bus deflagration event on May 12,2014 were monitored and analyzed.Results Of 25 burn/trauma patients,7 de-veloped 10 times of HAI,incidence and case incidence of HAI were 28.00% and 40.00% respectively;the main in-fection sites were wound and lower respiratory tract,accounting for 60.00% and 30.00% respectively.30 strains of pathogens were isolated from 7 patients with HAI,including 16 strains (53.34%)of gram-negative bacteria,13 strains(43.33%)of gram-positive bacteria,and 1 fungus (3.33% ).Risk factors for HAI were large burned area, high degree of inhalation injury,arteriovenous catheterization,urinary tract catheterization,tracheotomy,use of ventilator,and surgery.Conclusion Incidence of HAI is high in the group burn/trauma patients,corresponding in-tervention measures should be formulated according to the risk factors,so as to reduce the occurrence of HAI.

Objective To study the changing trend of prevalence rates of healthcare-associated infection (HAI) and antimicrobial use in hospitalized patients in medical institutions of Hubei Province,and provide a scientific basis for improving HAI management.Methods The cross-sectional survey results of HAI in Hubei Province in 2010, 2012,and 2014 were analyzed.Results The prevalence rates of HAI in 2010,2012,and 2014 were 3.48%(1526/43909),3.03%(1919/63320),and 2.86%(2174/76145)respectively,which showed a downward trend,differ-ence was statistically significant(χ2 =36.44,P <0.01).Antimicrobial usage rate decreased from 54.29% (23838/43909)in 2010 to 41.02% (31238/76145)in 2014,difference was statistically significant(χ2 =2194.09,P <0.01).Among patients receiving therapeutic use of antimicrobial agents,the specimen detection rate increased from 30.49% (4297/14091)in 2010 to 52.13% (10556/20248)in 2014 (χ2 =1593.98,P <0.01).Conclusion The prevalence rate of HAI showed a downward trend in Hubei Province,cross-sectional survey on antimicrobial use showed a gradual decrease.

Objective To investigate the changes in distribution and antimicrobial resistance of pathogens causing bloodstream infection in a hospital in 2012-2015.Methods Pathogenic bacteria isolated from blood culture in a hospital microbiology laboratory between January 2012 and December 2015 were collected and divided into 2012-2013 group and 2014-2015 group,distribution characteristics,constitute,and antimicrobial susceptibility of two groups were compared.Results Gram-negative bacteria were the main pathogens isolated during two periods,ac-counting for 54.96% and 54.66% respectively,there was no significant differences in pathogen distribution between two groups (P >0.05).Gram-positive cocci had a high sensitivity to vancomycin and linezolid,resistant rates were both 0;resistance rates of coagulase negative staphylococci to oxacillin were all >80%,resistance to penicillin was also >90%;Enterobacteriaceae was highly sensitive to imipenem and meropenem,but resistance strains had ap-peared;Acinetobacter baumannii was sensitive to minocycline during two periods,resistance rates were 35.90% and 34.55% respectively,resistance rates to other antimicrobial agents were also high (>75%).Conclusion The iso-lation rate of drug-resistant pathogenic strains causing bloodstream infection is high,monitoring on bacterial resistance is helpful for guiding rational use of antimicrobial agents in clinic.

Objective To investigate the inhibitory effect and mechanism of soybean-derived Bowman-Birk inhibi-tor (BBI)on LPS-induced expression of inflammatory cytokines in intestinal epithelial cells.Methods Cytotoxicity effect of LPS and BBI on intestinal epithelial cells was analyzed by MTT assay.Intestinal epithelial cells were pre-treated with BBI,followed by LPS stimulation,expression of inflammatory cytokines(TNF-α,IL-1β,IL-8,and MCP-1)was detected by quantitative real-time polymerase chain reaction;the activation of NF-κB was measured by pNF-κB-luc system and Western Blot.Results The maximum concentration of LPS (10000 ng/mL)and BBI (1000 μg/mL)had no cytotoxicity effect on intestinal epithelial cells.LPS could potently up-regulate the expression of inflammatory cytokines(TNF-α,IL-1β,IL-8,and MCP-1 ),the up-regulation was positively correlated to the concentration of LPS;LPS-induced expression of inflammatory cytokines in intestinal epithelial cells could achieve the highest level,then decreased over time.The up-regulation of LPS on inflammatory cytokines in intestinal epi-thelial cells had dose-time effect;when intestinal epithelial cells were pretreated by BBI for 6 hours,the inhibitory effect of BBI on LPS-induced expression of inflammatory cytokines in intestinal epithelial cells was most obvious, and had dose-time effect.Conclusion BBI can potently inhibit LPS-induced expression of inflammatory cytokines through inhibiting NF-κB in intestinal epithelial cells.

Objective To explore the role of infection control nurses in healthcare-associated infection(HAI)man-agement,and provide basis for HAI management.Methods Through setting up infection control nurses in clinical departments of the whole hospital,clarifying their responsibilities and duties,training,and supervising them,the effect of infection control nurses on HAI management was observed.Results A total of 67 infection control nurses were set up in the clinical departments of the whole hospital,HAI management knowledge among health care work-ers (HCWs)in 26 departments improved significantly,scores of HAI management knowledge among HCWs in April and December was compared,difference was statistically significant (Z = - 2.193,unilateral P = 0.014). Hand hygiene compliance rate of HCWs improved from 83.35%(1817/2180)in April to 89.53% (2002/2236)in December,difference was statistically significant(χ2 =36.13,P <0.01).A total of 56670 hospitalized patients were monitored from April to December 2015,the total length of hospital stay was 411164 days,utilization rate of three catheters was 27.18%,three catheter-related infection rate was 0.74‰.The median scores of supervision on HAI management in clinical departments improved from 95.30 in May to 97.70 in September(P <0.05).Conclusion Setting up infection control nurses is of great significance to strengthen the HAI management organization and pro-mote the quality of HAI management.

Objective To understand effect of application of disposable shoe covers on the culture result of air-borne bacteria in intensive care unit (ICU).Methods According to Hygienic standards for disinfection in hospi-tals (GB 15982-2012)and Technical standards for disinfection in medical institutions (WS/T 367-2012),the col-ony forming units of bacteria in ICU air were detected for 15 consecutive days when disposable shoe covers were used and unused,bacterial culture results were analyzed.Results The number of patients,number of visitors, temperature,and humidity in ICU when disposable shoe covers were used and unused were not significantly differ-ent (all P >0.05).The total number of bacterial colonies in ICU air when using disposable shoe covers was (median ± interquartile range:[1.20±2.20]CFU/15 min.·Φ9 cm.plate),which was significantly higher than air when disposable shoe covers were not used(median ± interquartile range:[0.60±1.10]CFU/15 min.·Φ9 cm.plate), difference was statistically significant(P <0.05).The qualified rate of bacterial culture result of air when disposable shoe covers were not used was higher than that when disposable shoe covers were used (96.67% vs 86.67%,P <0.05).Conclusion The use of disposable shoe covers can not improve ICU air quality.

Objective To investigate the distribution characteristics of methicillin-resistant Staphylococcus aureus (MRSA)in a children's hospital,and provide basis for the prevention and control of MRSA infection in children. Methods Children who admitted to a children's hospital from 2011 to 2015 were analyzed retrospectively,clinical data of children,isolation of pathogens,types of specimens,and healthcare-associated infection(HAI)status were analyzed.Results From 2011 to 2015,a total of 911 children isolated Staphylococcus aureus (SA,1108 positive specimens),494 of whom isolated MRSA (599 positive specimens),54.23% of children isolated MRSA(isolation rate of specimens was 54.06%);there was no significant difference in the isolation rate of MRSA between children of different genders(P > 0.05);isolation rate of MRSA in different age groups was statistically significant(P <0.05).Isolation rates of MRSA from blood,puncture fluid,secretion,and pus were 68.97%,66.00%,55.81%, and 54.47% respectively.Isolation rate of SA and MRSA increased from 0.61% and 21.74% in 2011 to 1.40%and 75.59% in 2015 respectively,difference were both significant(both P <0.05).Incidence of SA and MRSA in-creased from 0.198% in 2011 to 2.697% and 2.119% in 2015 respectively,both showed an upward trend year by year(both P <0.05).Conclusion Isolation rate of MRSA and incidence of HAI in this children's hospital increased year by year,it is necessary to intensify management,use antimicrobial agents scientifically and rationally,timelyperform disinfection and isolation,so as to curb the emergence and spread of MRSA in hospital settings.