Objective To understand the homology of clinical isolates from patients with carbapenem-resistant Klebsiella pneumoniae(CRKP)infection and isolates from environment in a medical institution.Methods One CRKP strain isolated from a patient in this hospital and 4 strains of Klebsiella pneumoniae(K.pneumoniae)isolated from patient's surroundings were collected,susceptibility of 5 strains to commonly used antimicrobial agents was detected,production of carbapenems in 5 strains were detected by modified Hodge testing and carbapenem inactivation method(CIM),homology analysis was performed by pulsed-field gel electrophoresis(PFGE).Results Antimicrobial susceptibility testing results showed that 5 strains of K.pneumoniae(1 from patient,4 from the patient's ward surroundings,including hands of nursing aides,solution bottle opening,handle for lifting and dropping bed,and bedrail)were all resistant to other antimicrobial agents except to cephamycin and aminoglycosides.The modified Hodge testing and CIM confirmed that 5 strains all produced carbapenemases;PFGE results showed that electrophoretogram of CRKP isolated from solution bottle opening of ward,bedrail,and handle for lifting and dropping bed were the same as CRKP isolated from patient,while electrophoretogram of CRKP isolated from hands of nursing aides had 2 different bands,there was a close relationship between the strains.Conclusion The same type of CRKP were isolated from patient and his surroundings,it is necessary to implement healthcare-associated infection(HAI)control system,isolate infected patient,and strengthen environmental cleaning and disinfection,so as to avoid the outbreak of HAI.

Objective To understand the change of transient bacteria on surface in clinical ward before and after terminal disin‐fection ,provide the basis for controlling of hospital infection .Methods Surface samples were collected before and after terminal dis‐infection in infected patch of our hospital ,and then bacterial in the samples were cultured and identified .Compared changes about number and type of samples bacterial ,distribution of common clinical pathogenic bacteria before and after of the terminal disinfec‐tion .Results The surface colony number < 10 CFU /cm2 accounted for 63 .54% after terminal disinfection ,compared with the dis‐infection before 56 .29% ,increased 7 .25 percentage points .Surface sampling microorganism detecting rate decreased by 6 .74% . Surface average bacteria colony had different degree decreased before and after disinfection ,except the bed frame and quilt cover . Water tap ,which was the largest amount of bacteria surface ,followed by the bedside table .Before and after disinfection ,the mainly common microorganism was environment bacteria in infected patch ,including coagulase negative staphylococcus ,gram positive ba‐cilli ,Micrococcus ,Acinetobacter spp .Clinical common pathogenic bacteria mainly isolated from the department of brain surgery (9 .49% ) ,department of hepatology(8 .76% ) ,department of dermatology (8 .76% ) ,department of pediatrics (8 .03% ) ,emergency department (7 .30% ) .Pathogenic bacteria living areas were mainly the bedside table (21 .17 % ) ,water tap (18 .25% ) ,bed rest (12 .41% ) .Conclusion Terminal disinfection could effectively reduce the number of bacteria in the infected patch ,improve the ward environmental sanitation quality ,it have an important significance in the prevention of hospital infection control .

Objective To evaluate the diagnostic value of MSCT in Solitary Pulmonary Nodules (SPN) with different pathologic types .Methods Four-five SPN with pathological findings including 16 benign cases and 29 malignant cases were retrospectively an-alyzed ,and performed with MSCT scanning .Observation of the distribution ,morphology and internal characteristics of SPN by post-processing technique were done ,and the results were compared with pathological findings .Results Among 45 SPN ,the benign nodules included 6 cases of inflammatory pseudotumor ,4 cases of tuberculoma ,3 cases of hamartoma ,2 cases of cryptococcus and 1 case of hemangioendothelioma ,and the malignant nodules included 21 cases of adenocarcinoma ,3 cases of squamous carcinoma ,2 ca-ses of small cell carcinoma and 3 cases of alveolar cell carcinoma .Average diameter of benign nodules was 2 .1 cm ,and 2 .6 cm for the malignant nodules .All SPN ,including 5 cases in the inner zone ,12 in the medial zone and 28 in the lateral zone ,the percentages with malignant signs at the corresponding parts were 40% (2/5) ,50% (6/12) ,75% (21/28) ,there was significant difference be-tween distributions(P<0 .05) .The distributions of malignant nodules in the upper and lower lung lobe had no significant difference (P>0 .05);the incidences of leaf sign ,burr sign ,pleural indentation sign ,cavitas and bronchial air sign ,blood vessels cluster sign of malignant nodules were higher than that of the benign nodules(P<0 .05) ,and the inflammatory pseudotumor and adenocarcinoma owned similar characteristics ;the incidence of calcification in tuberculoma and hamartoma was high ,while cavitas in tuberculosis and lung cancer were high .Conclusion MSCT can sufficiently display the distribution ,morphology and internal characteristics of SPN , and can help make qualitative diagnosis of benign and malignant SPN ,providing great practical value in clinical treatment .