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Existing Problems and Managing Countermeasures of Disinfection and Sterilization in Hospitals

Chinese Journal of Nosocomiology.2001;11(1):1-3.

OBJECTIVE To probe into the managing countermeasures according to the existing problems of disinfection and sterilization(DS).METHODS The data come from National investigation of nosocomial infection(NI) organized by Department of Medical Administration,Ministry of Public Health at 18 hospitals in 6 Provinces and from survey of NI at hospitals in Beijing.RESULTS There are general problems of DS in hospitals.Such as the managers of hospital don′t pay attention to DS,the users are short of knowledge and their thoughts are outdated,selection of methods is not suitable,applying of disinfectant isn′t reasonable,articles of DS are polluted again and surveillance of DS is not standard, etc.CONCLUSIONS The work of DS is still poor and must be strengthened for preventing and controlling NI.

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Study of Risk Factors of Nosocomial Infection in Intracerebral Hemorrhage

Xu ZHANG ; Ji LI

Chinese Journal of Nosocomiology.2001;11(1):4-6.

OBJECTIVE In order to explore and control the risk factors of nosocomial infection in intracerebral hemorrhage.METHODS To study prospectively in 837 hospitalized patients with intracerebral hemorrhage in our hospital from Jan.1997 to June 1999. RESULTS It was showed 215 cases of the nosocomial infection were found among 837 cases with the intracerebral hemorrhage(25.8%).Among them,nosocomial lower respiratory tract infection was the highest(39.1%),the second one was the urinary tract(27.8%).Nosocomial infection was closely related with such factors as the aging,location and volume of intracerebral hematoma,disturbance of consciousness, smoking,blood sugar,invasive operation,antibiotic prophylaxis,bed-days.Whereas serum cholesterol was a protective factor.CONCLUSIONS Nosocomial infection was still a high frequent complication in intracerebral hemorrhage and it should be paid attention.This is the most important step to control nosocomial infection of intracerebral hemorrhage in the hospital.

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Clinical Study of Nosocomial Fungemia in Critical Ill Patients

Min YU ; Kanglong YU ; Zhaofen LIN ; Bingwen JING

Chinese Journal of Nosocomiology.2001;11(1):7-9.

OBJECTIVE To study the clinical characteristics,prevention and treatment of nosocomial fungemia.METHODS Fifty four consecutive patients with nosocomial fungemia were studied in clinical retrospective manner.RESULTS Sixty fungal strains were isolated from blood.Candida was the predominant pathogenic organism(86.7%),6 cases had mixed infection causing by two fungal species(11.1%).Twenty two cases had concomitant bacteremia(40.7%).Overall mortality rate was 68.5%,directly related mortality rate in treatment group was significantly lower than that in nontreatment one(28.9% vs.88.9%,χ2=11.268，P＜0.01).Effective rate of amphotericin B was 68.8%,fluconazole 70.8%,combined treatment 80.0%.CONCLUSIONS Fungal infection has become prominently fatal cause of critically ill patients.Removing predisposing factors,monitoring fungal pathogen and effective antifungal therapy are important measures to reduce the incidence and mortality of fungal infection.Fluconazole and amphotericin B are effective drugs of treating deep fungal infection.

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Clinical Research on Infectious Complications after Hematopoietic Stem Cell Transplantation

Quanshun WANG ; Bolong ZHANG ; Fangding LOU ; Qi ZHOU ; Li YU ; Haichuan LIU ; Shanqian YAO

Chinese Journal of Nosocomiology.2001;11(1):10-12.

OBJECTIVE To evaluate retrospectively the incidence and treatment of infectious complications within the first 60 days after hematopoietic stem cell transplantation,and to find more efficient anti-infective regimens. METHODS To study the incidence,pathogenic microorganism,prophylaxis,treatments of infectious complications in 150 patients accepted hematopoietic stem cell transplantation from April 1984 to March 1998 in our hospital.The results were analyzed statistically.RESULTS Incidence of infectious complications was 89.3% in all 150 cases.Three patients(2%) died of the fungal infection.The incidence of the infections was 32.5% in patients accepted treatment with imipenem or／and ceftazidine,and 15.7% in other patients without the treatment with imipenem or／and ceftazidine(P＜0.02).CONCLUSIONS The strong antibacterial prophylaxis can′t reduce the incidence of infection,and may increase the chance of fungal infection.

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Clinical Characteristics of Spontaneous Bacterial Peritonitis(SBP) in Patients with Severe Type of Viral Hepatitis

Xingfeng REN ; Ya GE ; Guiming JIN

Chinese Journal of Nosocomiology.2001;11(1):13-14.

OBJECTIVE To investigate clinical characteristics of spontaneous bacterial peritonitis(SBP) in patients with severe type of viral hepatitis.METHODS A retrospective review of 120 cases of SBP associated with severe type of viral hepatitis was performed.RESULTS Clinical manifestations were as follows:fever 85.0%,abdominal tenderness 51.6%. 63.3% of the total white blood cells count in the ascitic fluid under 0.5×109／L,85.0% of polymorphonuclear cell ratio above 0.50.The positive culture of the ascitic fluid 24.2%,whereas 42.9% of the isolated microorganisms were Escherichia coli.CONCLUSIONS Clinical manifestations in SBP may be non-specific or absent.The total white blood cells count in the ascitic fluid are often under criteria for diagnosis.E.coli was the most common culture isolate.PMN ratio is the reliable parameter for the diagnosis of SBP.

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Study of the Antimicrobial activity in vitro of Domestic Mezlocillin／Sulbactam and Other Three Antimicrobials

Peilan WANG ; Qingfeng LIU ; Youning LIU ; Rui WANG

Chinese Journal of Nosocomiology.2001;11(1):15-17.

OBJECTIVE The antimicrobial activity in vitro of mezlocillin／sulbactam(MLBT),piperacillin／tazobactam(Tazocillin,TZXL),mezlocillin(MLXL) and ticarcillin／clavulanic acid(Timentin TMT) against 179 clinical isolates was studied.METHODS MICs were determined by agar dilution method.RESULTS The antimicrobial activity in vitro of MLBT against clinical bacteria was 1-2 times higher than that of MLXL.In vitro,MLBT has higher susceptibility than MLXL against Escherichia coli which have higher rate producing β-lactamase,such as Enterobacter species,Acinetobacter species,et al.,and has higher susceptibility than TMT against Enterobacter and other G- bacillus(P＜0.01).MLBT and TZXL have similar antibacterial spectrum and activity susceptible rate.MIC50 of TZXL was 1-2 times lower than that of the MLBT,but there were no siginficant differences. CONCLUSIONS The antimicrobial spectrum and antimicrobial activity in vitro of MLBT were similar to that of TZXL.

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In vitro Antibacterial Activity of Home-made Rifamycin against Meticillin Resistant Staphylococcus and Other Pathogens of Clinical Isolates

Xiuzhen ZHANG ; Dongke CHEN ; Yunjian HU ; Tianzhi XUAN

Chinese Journal of Nosocomiology.2001;11(1):18-20.

OBJECTIVE The in vitro activity of home-made rifamycin was investigated.METHODS Minimal inhibitory concentrations(MICs) were determined by agar dilution method using multipoint inoculator.RESULTS The results indicated that MIC50 and MIC90 of rifamycin against MRSA and MSSA were similar to vancomycin. The values were 1 and 2 mg／L, respectively. Rifamycin against MRSE was 4 times stronger than vancomycin.The value of MIC50 was 0.5 mg／L.The MIC50 of rifamycin against S.pneumoniae,Branhamella catarrhalis,and Listeria monocytogenes were 8,128 and 4 times lower than vancomycin, respectively.CONCLUSIONS There are good antibacterial activity of home-made rifamycin against meticillin resistant Staphyloccocus and the most species of clinical isolates,so can be used the infective diseases by MRSA and MRSE.

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Distribution and Resistance of Pathogenic Bacteria in Urinary Tract Infections in Yanbian Region

Yuji SONG

Chinese Journal of Nosocomiology.2009;0(13):-.

OBJECTIVE To master the distribution and resistance of the isolates from adult urinary tract,in order to make correct treatment plan,and elvaluate the effect of treatment measures. METHODS The bacteria were isolated from meidstream urine of 441 urinary tract infection patients from Nov 11,2006 to Aug 8,2007,and the resistance of bacteria was detected. RESULTS The total number of isolated pathogenic bacteria was 100. Among them,the Gram-negative bacteria,Gram-positive bacteria and fungi were 65 (65%),22(22%) and 13 (13%),respectively. The top three of Gram-negative bacteria were Escherichia coli (41%),Enterobacter cloacae (12%),and Klebsiella pneumoniae (5%). 58.5% E. cloacae and 60% K. pneumoniae could produce extended spectrum ?-lactamases (ESBLs). The most of bacteria were multi-resistant to antibiotics,but all of isolated Gram-negative bacteria were sensitive to imipenem and 4.5% strains of Gram-positive bacteria were resistant to vancomycin. CONCLUSIONS The resistance of pathogenic bacteria is serious,so their resistance and administration of antibiotics must be monitored and controlled.

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Nosocomial Pulmonary Acquired Infection of Craniocerebral trauma after Operation:Survey Analysis and Nurseing

Xiuqing JIANG

Chinese Journal of Nosocomiology.2009;0(13):-.

OBJECTIVE To analyze the morbility of nosocomial pulmonary acquired infection and related factors after operation of head injury,and inquire into effective countermeasures. METHODS By methods of retrospective investigation,280 patients in hospital form Jan 2005 to Jan 2007 operated for craniocerebral trauma had investigated on mortality rates of pulmonary infection and related factorsRESULTS The rates of pulmonary infection was 18.2% in 280 patients,the death rate was 38.7% in infected group. and group 13.7% in uninfected. The risk factors of nosocomial pulmonary infection were lower immunity among elderly patients,long-time in hospital,general anesthesia intubation,trachea incision and the use of respiraters. CONCLUSIONS The mortality and morbidity rates of pulmonary infection are both higher for the head injury patients. It's important to prevent infection. According to the main risk factors,to take corresponding protection measures,comprehensive supervision,and emphasis enhencing prevention and control;meanwhile to improve the quality of treatment and nurse,and reduce morbility and death rates of pulmonary infection.

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Ventilator-associated Pneumonia Following Severe Craniocerebral Trauma and Its Clinical Characteristics

Guoqiang WU ; Zhaoyang LI ; Wanxian L

Chinese Journal of Nosocomiology.2009;0(13):-.

OBJECTIVE To explore the characteristics of the pathogens in ventilator-associated pneumonia (VAP) following severe craniocerebral trauma. METHODS The 220 cases with severe craniocerebral trauma were analyzed retrospectively. RESULTS The incident rate of VAP was 24% in these patients. A total of 169 pathogens were isolated,including 146 ( 86%) strains of bacteria and 23 (14%) fungal isolates. The main Gram-negative bacteria (114 strains) were Pseudomonas aeruginosa,Escherichia coli,Klebsiella pneumoniae,etc. The Gram-positives (32 strains) were Staphylococcus aureus and twenty-four (75%) of them were meticillin-resistant. CONCLUSIONS The incident rate of VAP is high following severe craniocerebral trauma. Most of the isolated pathogens are drug resistant. These cases have mixed infection occurred commonly. To prevent and treat VAP,we should pay attention to disinfection and aseptic manipulation,and make the rational use of antimicrobial agents.

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