OBJECTIVE To investigate the pattern of fungal isolates from hospital-acquired infection in tumor patients after chemotherapy. METHODS The clinical information of fungus isolates from 102 tumor patients after chemotherapy was investigated.We analyzed the risk factors,species and drug-resistance of isolates. RESULTS The lower respiratory tract and mouth infection accounted for 61.8% and 16.7% in 102 cases with fungal infection and 102 isolates were isolated from various clinical specimens.Among above 102 isolates,Candida albicans and C.tropicalis accounted for 71.6% and 14.7%.The resistant rate of C.albicans to fluconazole and miconazole were 96.2% and 61.4%,respectively. CONCLUSIONS Hospital-acquired infection resulted from fungi in tumor patients after chemotherapy is related to primary tumor,age,the amount of white cell and use of antibiotics.

OBJECTIVE To investigate the present situation of hand-washing among medical staff then explore more suitable hand-washing methods and monitoring measure. METHODS By surveying the hand-washing situation of 96 medical staff in our hospital through the method of sampling,the different germ eradication rate between routine soap hand-washing and disinfectant wet towel hand-wiping as well as hand-washing rate in all candidate population during practical work were observed. RESULTS The germ eradication rate after routine soap hand-washing was 86.0%,while by disinfectant wet towel wiping it was increased to 91.3%.The washing rate after above former method was 18.3% and after above two methods combined was increased to 43.6%,and after health propaganding and training was up to 60.6%. CONCLUSIONS Disinfectant wet towel hand-wiping is convenient,practical and effective which would be more suitable for clinical practice when combined with routine soap washing method.

OBJECTIVE To investigate the antibacterial activity of cefoperazone/sulbactam to Gram-negative bacilli in vitro.METHODS Gram-negative bacilli were isolated from various clinical specimens in our hospital from Jan 2004 to Dec 2007,screened by Gram-staining and oxidase test.The strain identification and the antimicrobial susceptibility test were determined by VITEK-60 Full Automated Microbiology Analyzer and slip diffusion method,respectively.The results of the survey were retrospectively reviewed.RESULTS The resistance rates of Enterobacteriaceae to cefoperazone / sulbactam were very low,the rates of Escherichia coli,Klebsiella pneumoniae and Enterobacter cloacae were 6.9%,9.2%and 12.9%,respectively;and the rates of Acinetobacter baumannii,Chryseobacterium meningosepticum,Pseudomonas aeruginosa,Stenotrophomonas maltophilia and Burkholderia cepacia were 7.7%,8.1%,20.4%,21.5% and 34.1%,respectively.CONCLUSIONS The antimicrobial activity of cefoperazone/sulbactam to Enterobacteriaceae and non-fermentation bacteria(A.baumannii,Ch.meningosepticum) is strong.The resistant rate of other Gram-negative bacteria to cefoperazone/sulbactam is less than 40 percent.In the treatment of infection caused by Gram-negative bacilli,cefoperazone/sulbactam has a very good prospect.

OBJECTIVE To investigate the antimicrobial resistance profile of Burkholderia cepacia isolated from clinical specimens in past 3 years.METHODS The B.cepacia strains were isolated from various clinical specimens by routine method from Jan 2004 to Dec 2006.In our hosptial the identification and antimicrobiol susceptibility test were determined by VITEK-32 Full Automated Microbiology Analyzer.RESULTS A total of 126 strains of B.cepacia were isolated.From them 75.14% and 15.08% of isolates were from lower respiatory tract and blood.All isolates were resistant to aminoglycosides,ampicillin,ampicillin/sulbactam,amoxicillin/CLAB,cefazolin,nitrofurantoin,and imipenem.The antibiotic resistant rates of the isolates to SMZ+TMP,cefepime,cefoperazone/sulbactam,meropenem,ceftazidime and piperacillin/tazobactam were 5.10%,16.99%,39.18%,39.61,39.65% and 48.12%,respectively.CONCLUSIONS The detection and antimicrobial resistance of the isolates of B.cepacia are increasing gradually.Multidrug resistance in the isolates of B.cepacia is serious.

OBJECTIVE To investigate the vicissitudes of antimicrobial resistance to imipenem in Gram-negative bacilli isolated from clinical specimens.METHODS Gram-negative bacilli were isolated from various clinical specimens in our hosptial from Oct 2003 to Jun 2006.The identification and antimicrobiol susceptiblity test were determined by VITEK-AMS Full Automated Microbiology Analyzer.RESULTS A total of 2045 strains of Gram-negative bacilli were isolated,including 35 species.From them 912 isolates of Enterobacteriaceae and 1120 isolates of non-fermenters accounted for 44.6% and 54.8%,respectively.The most predominant pathogens were Pseudomonas aeruginosa(21.1%),Escherichia coli(20.4%),Acinetobacter baumannii(14.2%),Klebsiella pneumoniae(9.4%),and Burkholderia cepacia(7.9%).The resistance rate of Enterobacteriaceae to imipenem was very low.The rates of Stenotrophomonas maltophilia,B.cepacia,Chryseobacterium meningosepticum,P.aeruginosa and A.baumannii to imipenem were 100.0%,98.6%,98.3%,22.3% and 20.6%.CONCLUSIONS Non-fermenters are predominant pathogens.Imipenem has high antimicrobial activity to Enterobacteriaceae in vitro,but not to non-fermenters.The resistance rates of P.aeruginosa and A.baumannii to imipenem increase gradually.

ObjectiveTo explore the feasibility and safety of preoperative cardiac rehabilitation (CR) nursing intervention in patients with severe valvular disease, and to evaluate the effect of preoperative exercise-mediated cardiac rehabilitation nursing on the clinical outcomes of patients after operation. MethodsFrom January to December of 2017, 108 patients with advanced valvular heart disease (AVHD) admitted in Department of Cardiothoracic Surgery, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School were selected based on the diagnostic standard for AVHD. The AVHD patients should not be younger than 18 years old, left ventricular ejection fraction(LVEF) less than 40%, and need repair of interventricular septal perforation, resection of ventricular aneurysm and radiofrequency ablation of surgical atrial fibrillation simultaneously. Random number method was used to divide the patients into control group and cardiac rehabilitation nursing intervention group (CR group). Mitral and aortic valve lesions were the main types of valvular lesions in the two groups, and the principles of preoperative treatment were the same. Patients in the control group received routine nursing after admission. The patients in the observation group were evaluated by 6 minute walking test (6MWT) after admission. According to the distance of 6MWT, MOTO Med nursing intervention was carried out in gradeⅠ andⅡ. Frequency was once a day, 30 minutes each time, the first movement resistance was 1 kg, and was adjusted appropriately according to the individual situation. Exercise training and aerobic training were carried out for gradeⅢ andⅣ, with emphasis on lower limb muscles, abdominal muscles and ectopectoralis once a day for 20 minutes each time. ResultsThere was no significant difference in hospital stay, ICU stay time and mechanical ventilation time between the two groups (P＞0.05). The LVEF value of CR group was significantly higher than that of control group at the early stage after operation [(42.5±6.2) vs .(31.0±4.5),P＜0.001)]. The 6 MWT (P=0.009) and self-management(Barthel) score (P=0.001) of CR group were better than those of control group. There was no significant difference in quality of life between the two groups 30 days after operation(P＞ 0.05). ConclusionsPreoperative cardiac rehabilitation nursing intervention can effectively improve the cardiac function of patients with severe valvular disease early after operation, increase the early exercise tolerance of patients after operation, improve the early self-care ability of patients after operation, and help patients recover better and faster.