Objective By analyzing the dgug-resistance of Acinetobacter baumannii got from clinic in recent 3 years to study the therapy method of pan resistant bacteria.Method Bacteria was got from sputum or trachea pipe of patients normally,identified with ATB and test 14 common antibiotic drugs by K-B method.Result All the drug-sensitive test results of 248 bacteria in 3 years show that drug-resistance rate is high(40.3%~89.5%)except for IPM,IMI and sulbactam(11.7%~15.3%),and pan resistant bacteria(resist 4 or more kinds of antibiotic drugs)is 37.1%.Conclusion Acinetobacter baumannii is the main pathogen of lower respiratory tract infection.The high picks out rate and high drug resistance get great trouble to therapy.We need to make a strict standards of asepsis operation,strengthen monitoring the drug resistance and advocate to use antibiotic drugs reasonably,so that we can prevent and control the prevalence of Acinetobacter baumannii.

OBJECTIVE To study the situation of central supply department and discuss the management of it.METHODS The hygienic monitoring results of sterile room in central supply department from 2007 to 2008 were invectigated.RESULTS The hygienic eligible rate of air,environment and objects was 91.1-97.2%.The qualified rate of sterilized packet was 99.2-100%.The eligible rate of humidity and temperature in disinfection chamber was 92.3% and 88.8%,respectively.CONCLUSIONS To consummate management measures and manage strictly sterilization procedure,assigning special person for the duty and attention to every details which easy tobe contaminated.all these measures mentioned above are the important countermeasures to quarantee environmental quality.

OBJECTIVE To discuss the effect of preventive medication for preventing incision infection before cesarean.METHODS Patients with cesarean section accepted parturients were divided in 2 groups randomly: group A(medicine before operation) and group B(no medicine before operation),and infection rate were observed after operation.RESULTS The incision infection rate of group A was 3.8%,and that of group B was 9.3%(?2=6.00,P

OBJECTIVE To investigate the pollution of venous indwelling needle and to discuss the preventive measures.METHODS A retrospective investigation was conducted on the results of germ culture of venous indwelling needle and the problems in nursing manipulation.RESULTS The total positive rate of venous indwelling needle cultures isolated from 2006 to 2007 was 20.2%,the positive rate in 2007 was lower than that in 2006(?2=7.66,P

OBJECTIVE To investigate the drug-resistance and aminoglycoside modifying enzymes (AME) in Acinetobacter baumannii (ABA) isolated from ICU. METHODS K-B method was conducted to detect the sensitivity to 14 common antibiotics of 291 strains of ABA isolated from 2005 to 2007;PCR was used to detect AME genes of partial bacteria isolated in 2005. RESULTS The drug-resistance rates of 13 kinds of antibiotics were 33.0-91.8%,but cefoperazone/sulbactam was low (12.7%). The rate of amikacin,gentamicin and tobramycin was 41.2%,61.2% and 61.5%. Twenty-three ABA strains were AME gene positive from total 27 ABA strains and the total positive rate was 74.4%.We found 21 strains with aac(3)-Ⅰ (77.8%),23 strains with aac(6′)-Ⅰ (85.2%) and 23 strains with ant(3″)-Ⅰ (85.2%). Two strains were found to have 2 kinds of AME genes,21 strains had 3 kinds of AME genes. The rest of ABA strains had not AME genes. CONCLUSIONS ABA isolated from ICU has strong drug-resistance rate and a high carrier rate,it is a critical area of preventing and controlling hospital infection.

OBJECTIVE To analyze the distribution and drug-resistance of Klebsiella pneumoniae isolated from clinic in the past two years to help doctors to use antibiotic reasonably.METHODS To detect the drug-resistance of 470 strains of K.pneumoniae to 15 kinds of antimicrobial agents were detected by K-B method,and the AmpC ?-lactamase and ESBLs were detected through the way of 3-D test.RESULTS ICU and burn department were found where had the highest isolation rate,and sputum and wound that had the highest detection rate.Sensitivity test results showed that the resistance rate of K.pneumoniae to penicillins,first and second-generation cepholosporins,fluoroquinolones and sulfamethoxazole compound was high(51.1-88.3%),and resistance rate to the third and fourth-generation cephalosporins was high,too(32.6-40.4%).All strains were sensitive to imipenem,but two of them were resistant to meropenem.ESBLs were found in 152 strains,the detection rate was 32.3%,AmpC was found in 29 strains,the detection rate was 6.2%.Both of them were found out in 21 strains.CONCLUSIONS The lower respiratory tract infection is the most common one.The ICU and wound ward are the high-risk places ward of infection.Detection rate and drug resistance are increasingly severe,clinic and laboratory should make concerted efforts to reduce nosocomial infection and strengthen information feedback.

OBJECTIVE To analyze the drug-resistance of Enterobacter cloacae isolated from clinic in the past two years.METHODS The drug-resistance by K-B method,and to perform 3-D test to detect AmpC ?-lactamase and ESBLs were detected.RESULTS One hundred and six strains of E.cloacae was detected.Burn department were the wards which had the highest detection rate.Sputum,wound,bile and drainage fluid had the highest positive rate.Sensitivity test results showed that the resistance rate to penicilins,Ⅰ,Ⅱ-generation cephalosporins and cefoxitin of E.cloacae was the highest,and the resistance rate to the third,and fourth-generation cephalosporins was 24.5-50.9%.The detection rate of ESBLs and AmpC was 27.4% and 40.6%,respectively.Twenty three strains produced both of them.CONCLUSIONS The detection rate and drug resistance of E.cloacae are increasing severely.Laboratory should pay more attention to their detections and surveillance so as to control hospital infection of E.cloacae.

0.05).In all 57 strains of germ cultured,50.9% were Gram-negative bacilli,40.3% were Gram-positive cocci,and the other 8.8% were fungi.Causes of infection included impaired immunity defense,mistake in aseptic procedure or unstrictness of skin sterilizing,inadequate drainage,etc.CONCLUSIONS Reasonable in choice of antibiotics,strictness in aseptic procedure,adequate drainage and good nursing help are the main preventive measures to prevnt drainage fluid infection after thoracic operation.

OBJECTIVE To investigate the genotyping of ?-lactamases and aminoglycoside modifying enzymes on Acinetobacter baumannii isolated in Shaoxing. METHODS Thirty nine strains of A.baumannii were isolated from hospitalized patients,and drug-resistant genes were detected by PCR. RESULTS The detection rates of ?-lactamases coding genes of TEM and OXA-23 groups were 33.3% and 51.3%,The detection rates of aminoglycoside modifying enzymes coding genes of aac(3)-Ⅰ,aac(6′)-Ⅰ and ant(3″)-Ⅰ were 64.1%,64.1% and 74.4%,respectively.The others were not found in all 39 isolates tested. CONCLUSIONS The study showed that it is more serious for A.baumannii carrying ?-lactamases and aminoglycoside modifying enzymes coding genes in Shaoxing.

OBJECTIVE To determine risk factors of crossing infection of Pseudomonas aeruginosa in ICU and to evaluate efficiency of related control measures.METHODS Clinical data of all patients hospitalized in ICU during Feb to Nov 2005 were retrospectively analyzed.These clinical data included medical records,course of diseases,types of antibiotics used and their duration,invasive medical procedures,bacteria culture results and so on.Spot circumstance of ward,measures of isolation and sterilization,asepsis conception of staffs,fulfillment of laws to prevent intra-hospital infection were examined.RESULTS Forty six patients were hospitalized in ICU during 10 months.Bacterial culture was performed in all of them.Totally 108 strains of P.aeruginosa were cultured in specimens of 24 patients,among which 83 strains(76.9%) were cultured during May to Aug 2005(21 strains cultured monthly in average).As source of specimens,52 strains were from phlegm,26 strains from suction in trachea,17 strains from wound discharge, and 13 strains from other sources.Medicine sensitivity analysis revealed that most of the P.aeruginosa cultured strains were resistant to common antibiotics,including imipenem-cilastatin and meropenem.Major causes of this epidemic might include invasive medical procedure,abuse of antibiotics,deficiency of ward circumstance,imperfect in fulfillment of measures for infection prevention.CONCLUSIONS Control measures including improving clinical circumstance,insisting asepsis conception of staffs,appropriate use of antibiotics,and stressing microbiological inspection are vital in preventing and controlling epidemic of P.aeruginosa in ICU.