OBJECTIVE To review the environment disinfection situation of our hospital operating room in the past three years and to discuss regulatory measurement.METHODS We carried out bacteriological monitoring of air,object surface and hands of medical personnel in operating room and made the advanced bacterial identification to distinct pathogenic bacteria and conditional ones.RESULTS A total of 478 number of times of air,652 number of times of object surface and 284 number of times of hands of medical personnel in the operating room,were detected during the past three years.Total qualification rate was 98.1%,90.2% and 96.5%,respectively,and it reflected an upward trend year by year.Staphylococcus,Escherichia coli,fungi,Acinetobacter baumannii and Pseudomonas aeruginosa were detected from the air and object surface.CONCLUSIONS Strengthening quality management of environmental disinfection,developing and implementing the various management systems,improving the precaution awareness of the operating room staff and strictly managing the people flow and object should become effective measures which guarantee the environment disinfection quality of the operating room and reduce hospital infection during surgery.

OBJECTIVE To investigate the genes associated ?-lactamases in Acinetobacter baumannii(ABA)isolated and preliminary discovery of Acinetobacter-derived cephalosporinases(ADC)-subtype in Shaoxing,Zhejiang.METHODS Eighteen ?-lactamases genes were detected by PCR,and a new ADC ?-lactamases gene fragments produced by PCR were sequenced and analyzed.RESULTS The positive rates of ADC-gene,TEM-gene and OXA-23 group-gene were 85.9%,27.1% and 58.8%,respectively.The other genes were not found in all 85 isolates tested.CONCLUSIONS There are very high positive percentages of ADC,TEM and OXA-23 group genes in A.baumannii isolated clinically and that is the important mechanism of multi-resistance.The ADC gene may be a novel subtype in lactamases(GenBank accession number:EF569590).

OBJECTIVE To investigate the resistance and the genes of quaternary ammonium compounds-resistance(qacE△1) and classⅠintegrase genes(intⅠ1)in continuously isolated Acinetobacter baumannii(ABA).METHODS K-B tests were performed to detect the susceptibility of 85 strains of ABA to 13 kinds of antimicrobial agents.The qacE△1 and intⅠ1 genes were analyzed by PCR.RESULTS The resistant rates to antimicrobial agents were between 8.2% and 81.2%.qacE△1 And intⅠ1 genes were 77.6%.CONCLUSIONS The 85 ABA strains are multiple-drug-resistant.There are very high positive percentages of qacE△1 and intⅠ1 genes in ABA isolated from Shaoxing,Zhejiang Province.

OBJECTIVE To study the antimicrobial agents resistance of Staphylococcus aureus isolated from clinic.METHODS To test the sensitivity of 20 common antimicrobial agents by K-B.MRSA was detected by cefoxitin disk;and the inducible resistance of clindamycin was detected by D-test.RESULTS The drug resistance rate of this term of S.aureus was high.Except vancomycin,minocycline,teicoplanin,nitrofurantoin and rifampin,the drug resistance rate was higher than 42.6%.From 312 strains of S.aureus 209 strains of MRSA were detected,the rate was 67.0%.The structural antimicrobial resistance rate of clindamycin was 29.5%,the detection rate of inducible resistance was 51.4%.CONCLUSIONS The antimicrobial resistance of S.aureus is increasingly severe.The high positive results of MRSA and D-test make great trouble to therapy,and should have taken more attention of clinic.

OBJECTIVE To explore the risk factors and countermeasures of burn wound infection.METHODS The data of burn patients in hospital from 2005 to 2007 were retrospectively analyzed.RESULTS From 341 burn patients 257 got infected and total infection rate was 75.4%.Investigation shows that the probability e of infection in 3 days was 12.9%,but the rate became 72.7% after 4 to 10 days.The bigger the wound area,the higher the possibility to got infected.The infection rate was 43.8% when BSA was smaller than 20.0%.When BSA was bigger than 41.0%,the rate was up to 88.0%.When BSA was bigger than 61.0%,the rate was 100.0%.Except that,antibiotics and standard medical performance were the important factors related to burn infection.CONCLUSIONS To strengthen the aseptic concept among medical staff,pay attention to the environment of hospital,and the sterilization of the materials,debridement and drainage in time,and rational usage of antibacterial drugs,are the effective countermeasures to reduce burn wound infection.

OBJECTIVE To analyze the etiological characteristics and risk factors of burn wound infection to provide scientific basis for preventive measures. METHODS The pathogens and risk factors of wound infection of burn patients were investigated. RESULTS Among 341 burn patients form Jan 2005 to Dec 2007, 257 patients were cultured positively in their wound surface with the total infection rate 86.0%. In the early period of infection, Gram-positive cocci were the main pathogens in preinfection, then Gram-negtive bacilli and fungal infection increased. Most of pathogens were opportunistic. From d4 to d10 after burn was the dangerous period of infection. Infection rate was related to the sizes of burn area. CONCLUSIONS Visiting hospital, debridement and takeing specimens to culture in time, correct antibiotics treatment, sterile environment and aseptic operation are the effective measures to reduce the wound infection.

OBJECTIVE To evaluate the present condition of bacteriological infection caused by drainage tube after modified radical mastectomy(MRM) and the prevention measure.METHODS Atotal of152 patients with drainage tube after MRM during 2005-2007 were analyzed,bacteria culture of drainage fluid from breast wound or axillary wound were taken in 24 hours after operation.The bacteria or fungi were identified with ATB bacterial analysis apparatus.RESULTS Seventy specimens from 52 patients were positive(positive rate 34.2%).Of 70 strains,40 were Gram-positive cocci,24 were Gram-negative bacilli and the other 6 were fungi.The reasons of infection included subsided immunity defense system,drainage tube application,incorrect aseptic processing or disinfection procedure,and obstruction of drainage tube.CONCLUSIONS The important prevention measures of bacteria infection through drainage tube after MRM include maintenance of aseptic environment in operating room,strict aseptic processing,fluent drainage,and proper indwelling time of drainage tube.

OBJECTIVE To study the clinical characteristics and current status of the drug resistance of Burkholderia cepacia(BCE).METHODS Drug sensitivity test was performed on BCE with K-B method isolated from clinic specimen from 2006 to 2007 and the patients′ data were analyzed.RESULTS The pathogens were mainly isolated from sputum(18 strains,39.1%) and blood(9 strains,19.6%).ICU was the common department(28 strains,60.9%);all strains of BCE were resistant to ampicillin/sulbactam.The resistance rate to 3 kinds of aminoglycosides(amikacin etc),ciprofloxacin,piperacillin and imipenem were 63.0-84.8%.The resistance to sulfamethoxazole compound,ceftazidime,cefepime piperacillin/tazobactam,cefoperazone/sulbactam and meropenem were less than 40.0%.CONCLUSIONS Serious underlying diseases,frequent invasive operation and drug abusement were the main causes of BCE infection.Meropenem,sulfamethoxazole compound,ceftazidime,piperacillin/tazobactam and cefoperazone/sulbactam could be selected to treat BCE infection.

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 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.