OBJECTIVE To investigate the status and risk factors of nosocomial infections in geriatric department and to lay down the intervention strategy.METHODS Prospective monitoring and retrospective investigation were carried out to analyze 218 cases of nosocomial infection in geriatric department.RESULTS The lower respiratory tract infection was the main one in geriatric department(69.4%),which was followed by urinary tract infection(22.5%).The risk factors included old ages,prolonged hospitalization,using broad spectrum antibiotics widely,severe underlying illness,invasive operating manipulation and so on.CONCLUSIONS General intervention strategy should be adopted to control the nosocomial infections in geriatric department in order to cut down the infection rate and increase the rate of curing.

The bactericidal activity of serum and cere brospinal fluid (SBA and CBA)of ceftroiaxone (CTRX), cefotaxime(CTX) cefuroxime(CFR) in the patients undergoing surgery of skull and brain were studied by means of microdi luted method. The results showed antibacterial activity of CTRX against, enterobactericeae in vitro or in serum and cerebrospinal fluid (CSF) was the highest, it is suggested that the schadule of CTRX per 12hr may be used in prevention and treatment of serious infections after surgery of skull and brain.The bacteria The SBA and CBA of CFR were less ,but its antibacterial spectrum was wide and bactezi cidal activity of CTX against gram positive strains and enterobactericeae in sencm and CSF were higher, CTX may be used in treatment of infections of nervous system caused by mixed bacteria, the cost was lower, so CFR may be selected in the moderate infections. The CBA was a synthesized guide reflexing the antibactieral activity and penetration into barrier, so it is impostand reference to select antibiotics of infection after surgery of skull and brain.

OBJECTIVE To probe into the managing countermeasures according to the existing problems of disinfection and sterilization(DS).METHODS The data come from National investigation of nosocomial infection(NI) organized by Department of Medical Administration,Ministry of Public Health at 18 hospitals in 6 Provinces and from survey of NI at hospitals in Beijing.RESULTS There are general problems of DS in hospitals.Such as the managers of hospital don′t pay attention to DS,the users are short of knowledge and their thoughts are outdated,selection of methods is not suitable,applying of disinfectant isn′t reasonable,articles of DS are polluted again and surveillance of DS is not standard, etc.CONCLUSIONS The work of DS is still poor and must be strengthened for preventing and controlling NI.

OBJECTIVE In order to explore and control the risk factors of nosocomial infection in intracerebral hemorrhage.METHODS To study prospectively in 837 hospitalized patients with intracerebral hemorrhage in our hospital from Jan.1997 to June 1999. RESULTS It was showed 215 cases of the nosocomial infection were found among 837 cases with the intracerebral hemorrhage(25.8%).Among them,nosocomial lower respiratory tract infection was the highest(39.1%),the second one was the urinary tract(27.8%).Nosocomial infection was closely related with such factors as the aging,location and volume of intracerebral hematoma,disturbance of consciousness, smoking,blood sugar,invasive operation,antibiotic prophylaxis,bed-days.Whereas serum cholesterol was a protective factor.CONCLUSIONS Nosocomial infection was still a high frequent complication in intracerebral hemorrhage and it should be paid attention.This is the most important step to control nosocomial infection of intracerebral hemorrhage in the hospital.

OBJECTIVE To study the clinical characteristics,prevention and treatment of nosocomial fungemia.METHODS Fifty four consecutive patients with nosocomial fungemia were studied in clinical retrospective manner.RESULTS Sixty fungal strains were isolated from blood.Candida was the predominant pathogenic organism(86.7%),6 cases had mixed infection causing by two fungal species(11.1%).Twenty two cases had concomitant bacteremia(40.7%).Overall mortality rate was 68.5%,directly related mortality rate in treatment group was significantly lower than that in nontreatment one(28.9% vs.88.9%,χ2=11.268，P＜0.01).Effective rate of amphotericin B was 68.8%,fluconazole 70.8%,combined treatment 80.0%.CONCLUSIONS Fungal infection has become prominently fatal cause of critically ill patients.Removing predisposing factors,monitoring fungal pathogen and effective antifungal therapy are important measures to reduce the incidence and mortality of fungal infection.Fluconazole and amphotericin B are effective drugs of treating deep fungal infection.

OBJECTIVE To evaluate retrospectively the incidence and treatment of infectious complications within the first 60 days after hematopoietic stem cell transplantation,and to find more efficient anti-infective regimens. METHODS To study the incidence,pathogenic microorganism,prophylaxis,treatments of infectious complications in 150 patients accepted hematopoietic stem cell transplantation from April 1984 to March 1998 in our hospital.The results were analyzed statistically.RESULTS Incidence of infectious complications was 89.3% in all 150 cases.Three patients(2%) died of the fungal infection.The incidence of the infections was 32.5% in patients accepted treatment with imipenem or／and ceftazidine,and 15.7% in other patients without the treatment with imipenem or／and ceftazidine(P＜0.02).CONCLUSIONS The strong antibacterial prophylaxis can′t reduce the incidence of infection,and may increase the chance of fungal infection.

OBJECTIVE To investigate clinical characteristics of spontaneous bacterial peritonitis(SBP) in patients with severe type of viral hepatitis.METHODS A retrospective review of 120 cases of SBP associated with severe type of viral hepatitis was performed.RESULTS Clinical manifestations were as follows:fever 85.0%,abdominal tenderness 51.6%. 63.3% of the total white blood cells count in the ascitic fluid under 0.5×109／L,85.0% of polymorphonuclear cell ratio above 0.50.The positive culture of the ascitic fluid 24.2%,whereas 42.9% of the isolated microorganisms were Escherichia coli.CONCLUSIONS Clinical manifestations in SBP may be non-specific or absent.The total white blood cells count in the ascitic fluid are often under criteria for diagnosis.E.coli was the most common culture isolate.PMN ratio is the reliable parameter for the diagnosis of SBP.

OBJECTIVE The antimicrobial activity in vitro of mezlocillin／sulbactam(MLBT),piperacillin／tazobactam(Tazocillin,TZXL),mezlocillin(MLXL) and ticarcillin／clavulanic acid(Timentin TMT) against 179 clinical isolates was studied.METHODS MICs were determined by agar dilution method.RESULTS The antimicrobial activity in vitro of MLBT against clinical bacteria was 1-2 times higher than that of MLXL.In vitro,MLBT has higher susceptibility than MLXL against Escherichia coli which have higher rate producing β-lactamase,such as Enterobacter species,Acinetobacter species,et al.,and has higher susceptibility than TMT against Enterobacter and other G- bacillus(P＜0.01).MLBT and TZXL have similar antibacterial spectrum and activity susceptible rate.MIC50 of TZXL was 1-2 times lower than that of the MLBT,but there were no siginficant differences. CONCLUSIONS The antimicrobial spectrum and antimicrobial activity in vitro of MLBT were similar to that of TZXL.

OBJECTIVE The in vitro activity of home-made rifamycin was investigated.METHODS Minimal inhibitory concentrations(MICs) were determined by agar dilution method using multipoint inoculator.RESULTS The results indicated that MIC50 and MIC90 of rifamycin against MRSA and MSSA were similar to vancomycin. The values were 1 and 2 mg／L, respectively. Rifamycin against MRSE was 4 times stronger than vancomycin.The value of MIC50 was 0.5 mg／L.The MIC50 of rifamycin against S.pneumoniae,Branhamella catarrhalis,and Listeria monocytogenes were 8,128 and 4 times lower than vancomycin, respectively.CONCLUSIONS There are good antibacterial activity of home-made rifamycin against meticillin resistant Staphyloccocus and the most species of clinical isolates,so can be used the infective diseases by MRSA and MRSE.

OBJECTIVE To explore the issues and weakness of hospital infection management at clean operating sector . METHODS Effective preventing and controlling measures of hospital infection, sterilization, isolation , and aseptic technique recommended by WHO were utilized in order to improve investigation and management . RESULTS Quality control was formed in the practice process when sterilization and aseptic technique was performed in routine work at clean operating sector. CONCLUSIONS Hospital infection can be prevented and controlled effectively, patients′ safety coefficient can be improved, and operative infection rate can be lowered when the methods stated in this paper are performed strictly.