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Stenotrophomonas maltophilia Pneumonia:An Analysis of Clinical Features and Antibiotic Susceptibility of 31 Cases

Chinese Journal of Nosocomiology.2006;0(12):-.

OBJECTIVE To analyze and summarize the clinical features and distribution of antibiotic susceptibility of Stenotrophomonas maltophilia pneumonia.METHODS We statistically analyzed the clinical data of thirty-one cases of S.maltophilia pneumonia,and determined drug susceptibility of this bacteriaum,using K-B methods.RESULTS Twenty-six out of 31(83.87%) cases were old age patients.All Patients were with underlying diseases,while 17(54.84%)cases had chronic obstructive pulmonary disease history and 15(43.39%) cases were with immunodeficiency.Out-of hospital infection and nosocomial infection were 10(32.26%) cases and 21(67.74%),respectively.The clinical symptoms were mainly cough and expectoration(100.00%),17(54.84%) cases had fever,and 24 cases(77.42%) had dyspnea.Chest X-ray showed different-degree shadow on lungs.Besides compound sulfamethoxazole,ciprofloxacin,minocycline and amikacin were susceptive(71.41-45.00%),the drug susceptibility test showed,that the microbe was resistant to lots of antibiotics(28.57-100.00%).CONCLUSIONS The risk factors of S.maltophilia pneumonia are ageing,underlying diseases and immunodeficiency.Early choosing susceptive antibiotics and drug sensitivity test would improve the prognosis.

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Management of Disposable Medical Article in Blood Purified Center

Mengping HE

Chinese Journal of Nosocomiology.2006;0(08):-.

OBJECTIVE To prevent and control infection in hospital and enhance the disposable medical article management. METHODS Special training methods were enhanced for the staff in blood purified center of our hospital to improve their ability.And relative rules and regulations were enacted to enhance the management of the disposable medical articles. RESULTS The disposable medical articles management was standardized and systematized.From Jan 2004 to Dec 2005,all the used disposable medical articles were collected by the center of blood purification in Anzhen Hospital.Effectively prevented them from dispersing to the outside and reduce the incidence of infection.The rate up to standard in the examination about the hospital infections knowledge was 100%,and the rate of correct operation was 98%. CONCLUSIONS The key points to guarantee the medical system safety and the healthy condition of the patients and medical staff include reconstruction in minds,clear responsibility,effective management and reasonable use of the disposable medical articles.

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Comparison of Bactericidal Activity in cerebrospinal Fluid of Three Cephalosporins in Patients undergoing Surgery of Skull and Brain

Rui WANG

Chinese Journal of Nosocomiology.1994;0(04):-.

The bactericidal activity of serum and cere brospinal fluid (SBA and CBA)of ceftroiaxone (CTRX), cefotaxime(CTX) cefuroxime(CFR) in the patients undergoing surgery of skull and brain were studied by means of microdi luted method. The results showed antibacterial activity of CTRX against, enterobactericeae in vitro or in serum and cerebrospinal fluid (CSF) was the highest, it is suggested that the schadule of CTRX per 12hr may be used in prevention and treatment of serious infections after surgery of skull and brain.The bacteria The SBA and CBA of CFR were less ,but its antibacterial spectrum was wide and bactezi cidal activity of CTX against gram positive strains and enterobactericeae in sencm and CSF were higher, CTX may be used in treatment of infections of nervous system caused by mixed bacteria, the cost was lower, so CFR may be selected in the moderate infections. The CBA was a synthesized guide reflexing the antibactieral activity and penetration into barrier, so it is impostand reference to select antibiotics of infection after surgery of skull and brain.

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Prevention of Hospital Infection in Senile Patients with Long-term Central Vein Catheterization

Liping ZHANG ; Mulin WU

Chinese Journal of Nosocomiology.2006;0(05):-.

OBJECTIVE To explore the prevention mesures of hospital infection in aged patients with long-term central vein catheterization.METHODS The clinical data of 26 aged patients with long-term central vein catheterization from Mar 2005 to Oct 2006 were analyzed retrospectively.RESULTS Among 26 aged patients with long-term central vein catheterization,no related hospital infection occurred with average 7 d hospitalization.Swelling in upper extremities was observed in 5 patients.CONCLUSIONS The mesures,such as aseptic procedure for changing transfusion device periodically and using effective filter can effectively prevent the infection.

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Genotypes of ?-Lactamases Multi-drug Resistant Genes of Pseudomonas aeruginosa and Type Ⅰ Integrating Enzyme Genes

Shuping ZHAO

Chinese Journal of Nosocomiology.2006;0(12):-.

OBJECTIVE To investigate genes associated with the drug-resistance of ?-lactamases antibiotics in Pseudomonas aeruginosa(PAE) and type Ⅰ integrating enzyme gene isolated from clinical patients.METHODS The drug-sensitivity for 16 antibiotics were detected by the disc agar diffusion(DAD) and microdilution.To ditect the related drug-resistence genes TEM,SHV,OXA-10,PER,VEB,GES,CARB,IMP,VIM,SPM,GIM,DHA,F-OX,MOX,CTX-M9,CTX-M1 and outer membrane protein gene oprD2 and 18 main drug resistance genes of typeⅠ integrating enzyme gene and others with PCR method.RESULTS Resistant rates of 34 multidrug resistant P.aeruginosa(MRPA)strains for amikacin,ceftazidime,ciprofloxacin,cefoperazone/sulbactam,cefepime,imipenem,levofloxacin,piperacillin/tazobactam,aztreonam,piperacillin and tobramicin were 14.7%,29.4%,61.8%,67.6%,70.6%,73.5%,76.5%,76.5%,79.4%,91.2% and 94.1%,respectively,with 100.0% for others antibiotics.The positive diagnosis rates of gene encoding extended-spectrum ?-lactamases FOX,IMP,DHA,and VIM were 23.5%,11.8%,11.8% and 5.9%,24(70.6%) were deleted in outer membrane protein gene oprD2,other ?-lactamase genes were absent in all isolates,the type Ⅰ integrating enzyme gene intⅠ1 was positive in 34 strains.CONCLUSIONS P.aeruginosa carries various ?-lactamases genes in clinical PAE patients,and the deletion ratio of oprD2 gene is high,type Ⅰ integrating enzyme exists largely in MRPA.

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Hospital-acquired Infections:An Investigation of 78 829 Patients

Menghua ZHANG

Chinese Journal of Nosocomiology.2006;0(12):-.

OBJECTIVE To study the causes of hospital acquired infections in the general hospitals and provide the reliable evidence to prevent and control the hospital acquired infections.METHODS By means of retrospective investigation,we observed 78829 patients with hospital acquired infections collected from May 2004 to Apr 2006 in our hospital.RESULTS The hospital acquired infection rate was 3.07%,the most cases were with respiratory infection,accounted for 59.07%,mainly with G-bacteria accounted for 49.73% and caused by primary malignancy,accounted for 18.05%.CONCLUSIONS The high risk factors of hospital acquired infections are immunosuppression,more invasive examinations and treatments and long-term using antibiotics.

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Hospital Disinfection Quality Surveillance Analysis:10 Year Results and Impact Factors

Bin WU

Chinese Journal of Nosocomiology.2006;0(09):-.

OBJECTIVE To learn about the state of disinfecting quality and its impact factors of our hospital in recent 10 years.METHODS According to GB15982-1995 and GB15981-1995 the sampling and surveillance were carried out to the objects concerned for disinfecting in the hospital.RESULTS It showed ascent trend in its entirety for the qualified rate of sample surveillance(70.53-96.34%).The qualified rates of applying disinfecting liquid,medical treatment necessities and pressure steam sterilizer were also higher in the surveillance each year.CONCLUSIONS The lows and regulations correlated with disinfection and operating technological specification have become more and more perfect and flawless,supervision and management also have been intervened and strengthened,and the level of the consciousness and knowledge of disinfection among the staff have had elevation,all these have elevated the disinfection job of the hospital in quality.

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Nosocomial Infections in Geriatric Department:Status and Intervention Strategy

Lan YU ; Xiangqun CHENG

Chinese Journal of Nosocomiology.2006;0(09):-.

OBJECTIVE To investigate the status and risk factors of nosocomial infections in geriatric department and to lay down the intervention strategy.METHODS Prospective monitoring and retrospective investigation were carried out to analyze 218 cases of nosocomial infection in geriatric department.RESULTS The lower respiratory tract infection was the main one in geriatric department(69.4%),which was followed by urinary tract infection(22.5%).The risk factors included old ages,prolonged hospitalization,using broad spectrum antibiotics widely,severe underlying illness,invasive operating manipulation and so on.CONCLUSIONS General intervention strategy should be adopted to control the nosocomial infections in geriatric department in order to cut down the infection rate and increase the rate of curing.

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Report on the 13 Cases of Nosocomial Urinary Infection by Flavobacterium

Yuesheng CAO

Chinese Journal of Nosocomiology.1994;0(01):-.

Between 1988-1991,13 stains of Flavobacterium were isolated from urine of patients in hospital.The result showed that the strains were gradually increased from year to year.The Flavobacterium was gram-negative,weakly fermentatively saprophytic bacilli,could colonized.These patients had serious underlying disease,such as trauma,diabetes mellitus,congenital heart discase etc.They were immunocompromised and easily infected.Most of the patients had been produced dysbiosis because they had used high doses of antibiotic therapy.The bacteria resistant to many antibiotics and sensitivity test of drug didn't uniformity with the clinical effect so that treatment is very difficulty.Prevention and treatment of the nosocomial infection by this bacteria is important.

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Analysis of Drug Resistance of Common Gram-negative Bacilli in Clinic with VITEK-AMS

Jie PENG

Chinese Journal of Nosocomiology.1994;0(04):-.

The procedure of routine bacteria-detective methode are very complicated, so are MIC methods for drug detection.The results of drug sensitive test with disk diffusion are not stable.However,the Auto Microbic System VITEK AMS has made it possible to carry out bacterial identification, drug-sensitive test and MIC detection rapidly and accurately. The results of AMS of 382 clinically isolated Gram-negative bacilli showed that the strains contianed P.aeruginosa (32.5%), K. pneumoniae(18.6%), E. coli(16.5%), A.calcoaceticus(13.1%) E.claocae(12%), E. aezogenes(4.2%), Proteus mirabilis(3.1%), and multiresist tstains were common in them. The resistant rate of the above strains to two to six antibiotics were 84.1%~100%, 67.6-100%, 59.2-99.2%, 52.1-95.9%, 40.8-89.5%, respectively. All above strains had the lowest resistance to Amikacin and the highest to Ampicllin. It is significant that clinical doctors should choose right antibiotics according to the accurate results of AMS.

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