OBJECTIVE To understand the distribution and antibiotic resistance of E.coli isolated from our hospital and offer suggestions for clinic.METHODS The antibiotic susceptibility to 21 kinds of antibiotics were tested by K-B method and analyzed by Whonet software.RESULTS The antibiotic resistance of 301 E.coli strains to ampicillin,quinolones,piperacillin,gentamicin,cefazolin,cefuroxime,ceftriaxone,ceftazidime,aztreonam,cefepime, ampicillin/sulbactam were 83.39%,69.44%,62.79%,44.19%,42.86%,36.88%,35.22%,31.23%,29.90%,29.57% and 26.91%,respectively.CONCLUSIONS E.coli isolated from our hospital show high resistance to several kinds of antibiotics.The drugs should be choosed reasonably according to their antibiotic suscepitibity results.

Objective To explore the management strategy of damage control operation(DCO) for extrahepatic bile duct injury.Methods Clinical data of 15 cases with extrahepatic bile duct injury from June 2002 to September 2007 were selected as the object of this study.Results DCO was performed in all of 15 patients,then all cases were underwent reoperation after surgery intensive care unit resuscitation.All cases survived.Two cases(13.3%) occurred biliary fistula and 1 case(6.7%) occurred intestinal fistula of colon after reoperation,2 cases(13.3%)occurred infection and disruption of incisional wound,and 1 case(6.7%) occurred acute liver function failure.All complications were cured by drainage,symptomatic and supportive treatment.The cure rate of these 15 cases was 100%.There were no stricture of bile duct and correlative complications during 28 months of median follow-up.Conclusion To increase survival rate and reduce complications,severe trauma patients with extrahepatic bile duct injury should be made positively under DCO and choose eligible operations modus.

OBJECTIVE To analyze the current situation of the hospital.and the community-acquired infections due to Staphylococcus aureus(SAU) and provide the reference for clinical reasonable use of drugs.METHODS The clinically isolated S.aureus strains during 2004-2006 were collected,cultured and identified.Their susceptibilily to 16 kinds of antibacterials was detected by K-B or MIC and WHONET5 software was used to analyze the result.RESULTS From 440 S.aureus strains,the meticillin-resisstant S.aureus(MRSA) was 260 accounting for 59.1%;the meticillin-sensitive S.aureus(MSSA) was 180 accounting for 40.9%.The resistant rate of SAU to penicillin G was the highest(85.5%),that to vancomscin was 0.CONCLUSIONS MSSA still keeps fairly good sensibility to most antibacterial medicine,but MRSA shows the multidrug resistance,except to vancomycin.For this studying the resistance mechcnism of Staphylococcus and continuously detecting the emergence of vancomycin-intermediat and vancomycin-resistante S.aureus have a significant clinicil importance.

OBJECTIVE To investigate the distribution and resistance of Pseudomonas aeruginosa isolated during Jan-Dec 2006.METHODS The clinically isolated P.aeruginosa strains were collected cultured and identified by paper diffusing method or trace dilution method(MIC),the results were evaluated according to the relevant documents of NCCLS of USA.RESULTS The in vitro susceptibility test of 244 P.aeruginosa isolates to 16 kinds of antibacterials indicated the resistance rate to SMZ was the highest(98.8%);then to minocycline,tetracycline and ticarcillin/clavulanicacid(70.1%,58.6% and 54.5% respectively).CONCLUSIONS To strengthen the continuous survezillance of drug resistance of P.aeruginosa,to sum up the resistance rules of main pathogens of departments in hospital and to reduce of production of resistant bacterica have the important significance.

OBJECTIVE To understand the antibiotic resistance of Pseudemonas aeruginosa isolated from ICU and give advices to clinicians.METHODS The antibiotic susceptibility of P.aeruginosa isolated from ICU to 12 kinds of antibiotics were tested by disc diffusion method.RESULTS The antibiotic susceptibility of 472 P.aeruginosa strains to imipenem,piperacillin/sulbactam,piperacillin,amikacin,ceftazidime,tobramycin,cefepime,ciprofloxacin,ceftriaxone,gentimicin,aztreonam and cefotaxime were 82.2%,74.94%,69.92%,64.87%,59.95%,52.93%,49.88%,49.65%,44.50%,41.92%,38.17%,and 35.60%,respectively.CONCLUSIONS P.aeruginosa isolated from ICU of our hospital is suscepitable to imipenem,piperacillin/sulbactam,piperacillin,amikacin and the cephalosporins,but show lower susceptibility to other antibiotics.

The construction of hospital administration talent echelon has become a " bottleneck" problem in the core competence construction of county-level public hospitals in ethnic regions. West China-Mabian Medical Alliance has made a preliminary exploration on the cultivation of hospital management talents in county-level public hospitals. The hospital carried out the working principle of " setting up a talent pool by post" , and gradually established a reserve talent pool with suitable scale and dynamic adjustment by providing part-time project management positions for young employees in the hospital. There were three kinds of part-time project management positions: part-time assistant to president, part-time project supervisor and part-time department management assistant. In addition, the hospital strengthened the ideological and political education, medical management theory training and practical training of the reserve talents in a planned way. The practical experience of hospital reserve management personnel training based on West China-Mabian Medical Alliance can be used for reference by other county-level hospitals.