Objective To determine the distribution and antibiotic resistance of hospital - associated pneu-monia(HAP) in senile patient,and the high risk factors of HAP,pathogenic bacterium and prognosis,so as to instruct the clinic prevention and treatment. Methods Patients with age over 60 years old,who were diagnosed of HAP with confirmed pathogens. Pathogens were identified, then the antibiotic resistance was determined by Kirty-Baucer disk dif-fusion assay. High risk factors of HAP, pathogenic bacterium and prognosis were analyzed by Logistic regression analy-sis. Results The first 10th pathogens of HAP patients were pseudomonas aeruginosa( 16.1% ),staphylococcus au-reus( 14.6% ) ,klebsiella pneumonia( 10.2% ), escherichia coil (8.8%) ,staphylococcus hemolyticus (7.3%). MR-SA accounted for 90% in staphylococcus aureus. The drug resistance of pseudomonas aeruginosa to imipenem was 29.5%. The high risk factors of HAP were acute brain accident, hypoalbuminemia, tracheal intubation or mechanical ventilation, rennal failure,COPD, gastric tube, anaemia,liver disfunction,long length of stay ( all P < 0.05 ). The mor-tality of senile HAP was 29.2%. Conclusion There are high antibiotic resistance and high mortality of HAP in se-nile patients. Measures should be taken to modify the risk factors.

Objective To construct a new molecular biological method for the analysis of microbial species in lower respiratory tract infections based on 16S rRNA gene by denaturing high-performance liquid chromatograph(DHPLC).Methods The universal primer set was analyzed basing on the highly conserved regions of 16S rRNA gene.DNA amplicons of lower respiratory tract were analyzed by DHPLC to generate peak profiles respectively.The incorporation of 40-bpGC clamp into the amplification primet was essential to effectively discriminate genetic differences identification.Results The primers could only amplify bacterial 16S rRNA.Bacterial of amplicons which incorporation of a 40-bpGC clamp were effectively discriminated genetic differences in DHPLC.The results of clinical isolares identification showed 100%according with the traditional method.Conclusion DHPLC has not only high accuracy,but also is a convenient,rapid and high-through technique for the discrimination bacteria.It has potential value in the detection of lower respiratory pathogenic bacteria.

Purpose/Significance To quantitatively analyze and evaluate 26 health informatization construction policies issued at the national level,so as to provide basis for improving related policies.Method/Process Based on the policy modeling consistency(PMC)index model,a health informatization construction policy evaluation index system is constructed,which includes 9 first-level indicators and 36 second-level indicators.Appling it to the evaluation of various policy texts,and the health informatization construction policies are analyzed in a holistic and concrete way.Result/Conclusion The overall score of the health informatization construction policies is ex-cellent.2 policies are at the perfect level,80.6％of policies are at the excellent level,and there are no bad level policy texts.However,the driving force of the policy and the balance of policy recipients need to be further improved.

OBJECTIVE To investigate the antimicrobial resistance of hospital-and community-acquired pathogens collected from 10 teaching hospitals located at different areas in China in 2006.METHODS According to the study protocol,the strains of Streptococcus pneumoniae,meticillin-susceptible Staphylococcus aureus(MSSA),Escherichia coli and Klebsiella pneumoniae were collected and sent to the central lab for reidentification and susceptibility testing.The minimal inhibitory concentrations(MICs) of antimicrobial agents against Str.pneumoniae were determined by Etest method and MICs of antimicrobial agents against S.aureus,E.coli and K.pneumoniae strains were determined by agar dilution method.WHONET5.4 software was used to analyze the data.RESULTS Among 353 Str.pneumoniae strains,74.2% were penicillin-susceptible(PSSP),9.6% were penicillin-intermediate(PISP) and 16.2% were penicillin-resistant(PRSP).Strains from different hospitals showed different sensitivity to penicillin.Among ?-lactam antibiotics,cefuroxime showed the lowest susceptibility rate of 0%(for PRSP) to 76.7%(for PSSP).The susceptibility rate to ceftriaxone and amoxicillin-clavulanic acid was 98.1% and 98.9% in PSSP group,61.8% and 64.7% in PISP group,and 15.8% and 10.5% in PRSP group.The ESBLs rate was 56.2% among 267 Escherichia strains and 42.7% among 206 K.pneumoniae strains.For ESBLs-producing strains,the susceptibility rates to cefotaxime and ceftriaxone were low and the rate to ceftazidime was relatively high among ?-lactam antibiotics.73.4% MSSA strains produced ?-lactamase.?-Lactam antibiotics tested showed high susceptibility against MSSA strains.The susceptibility rate was 98.9-100%.The susceptibility rate to ciprofloxacin and levofloxacin was 80.8% and 88.1%,separately.CONCLUSIONS Fluoroquinolones show high susceptibility against Str.pneumoniae.Ceftriaxone and amoxicillin-clavulanic acid have relatively high susceptibility among ?-lactams.For MSSA and non-ESBLs-producing E.coli and K.pneumoniae strains,?-lactams show high susceptibility.For ESBLs-producing E.coli and K.pneumoniae strains,the susceptibility rates to cefotaxime and ceftriaxone are low and that to ceftazidime,cefepime and cefoperazone-sulbactam are relatively high.