Journal Detail Information

1

Cite

Share

Impact of antimicrobial management guideline on the daily antimicrobial use rate in a general hospital

Chinese Journal of Infection Control.2014;(4):229-231,241. doi:10.3969/j.issn.1671-9638.2014.04.010

Objective To evaluate the effect of antimicrobial management guideline on the daily antimicrobial use rate in a general hospital.Methods An one-day point-prevalence survey on antimicrobial use in hospitalized patients was conducted in 2010,2011,and 2012 by means of cross-sectional investigation method.Results The daily utiliza-tion rate of antimicrobial agents in 2010,2011,and 2012 was 65.40% ,42.09% and 26.74% respectively,the rate of the submission of specimens for bacterial culture was 22.53% ,35.74% and 41.74% respectively(χ2 trend= 266.42, 29.02,respectively,bothP<0.01). The utilization rate of single drug was 83.72% ,80.27% and 93.41% respec-tively. the utilization rate of both two-drug and more than three-drug combination kept a downward tendency. The utilization rate of antimicrobial agents in several departments(digestive internal medicine,cardiovascular,hematolog-ical tumor,neurology,general surgery,orthopedics,obstetrics,pediatrics,and ophthalmology)showed a decreasing tendency(all P<0 .0 1 ).Conclusion The implementation of antimicrobial management guideline has remarkably re-duced the daily antimicrobial use rate,and increased etiological detection rate for therapeutic antimicrobial use.

2

Cite

Share

Direct economic loss due to oral infection in acute leukemia patients

Yunhong LIU ; Shuhui WANG ; Jingna WANG ; Xiaohui WU ; Yingxia LI

Chinese Journal of Infection Control.2016;15(10):785-787. doi:10.3969/j.issn.1671-9638.2016.10.016

Objective To investigate the direct economic loss caused by oral infection in patients with acute leuke-mia.Methods Acute leukemia patients with oral infection in a tertiary first-class hospital in Shandong Province be-tween January 2011 and December 2013 were investigated,the 1 :1 matched case-control method was used for com-paring hospitalization expense and length of hospital stay between oral infected (case group)and uninfected patients (control group ).Results A total of 994 patients with acute leukemia were monitored,277 had healthcare-associated infection,17 (5.56%)of whom were with oral infection.The median hospitalization expense of patients in case group and control group was￥37 327 and￥13 176 respectively,the total hospitalization expense of patients in case group was 2.83 times more than control group,difference was statistically significant (Z = -3.621 ,P <0.001).Each hospitalization expense of case group was higher than control group,especially expense for medicine, blood transfusion,laboratory examination,and therapy.The median length of hospital stay in case group and con-trol group were 17 days and 11 days respectively,rank sum test showed that difference in median length of hospital stay between two groups was statistically significant (Z =-3.627,P < 0.001 ).Conclusion Acute leukemia pa-tients with oral infection have increased hospitalization expense,prolonged length of hospital stay,and increased the financial burden.

3

Cite

Share

Clinical distribution and antimicrobial resistance of 427 Serratia marces-cens isolates

Fang YANG ; Wenen LIU ; Yiming ZHONG ; Qun YAN ; Qingxia LIU ; Hongling LI ; Yanming LI ; Mingxiang ZOU

Chinese Journal of Infection Control.2016;15(10):752-756. doi:10.3969/j.issn.1671-9638.2016.10.008

Objective To understand clinical distribution and antimicrobial resistance of clinically isolated Serratia marcescens(S .marcescens ),and provide basis for rational use of antimicrobial agents,as well as prevention and control of infection.Methods 427 S .marcescens strains isolated between January 1 ,2012 and December 31 ,2015 were analyzed,antimicrobial susceptibility testing were performed by disk diffusion method.Results 427 S . marcescens strains were mainly from respiratory tract (70.26%),among which the majority were from sputum (64.87%).S .marcescens were primarily from intensive care unit(ICU,19.44%),department of integrated tradi-tional Chinese and Western medicine(15.46%)as well as rehabilitation department (13.58%).The resistance rates of S .marcescens to cefoperazone/sulbactam,ertapenem,cefepime,ceftazidime,amikacin,imipenem,levofloxacin, and piperacillin/tazobactam were all<10%;resistance rates to ciprofloxacin,gentamicin,tobramycin,ceftriaxone, sulfamethoxazole/trimethoprim (SMZ/TMP),and aztreonam were 10%-30%.Difference in the resistance rates of S .marcescens to cefoperazone/sulbactam,ciprofloxacin,ceftriaxone,amikacin,aztreonam,and SMZ/TMP dur-ing 4 years were statistically significant (P <0.05).In 2012-2013,resistance rates of S .marcescens to cefopera-zone/sulbactam,ciprofloxacin,ceftriaxone,aztreonam,and SMZ/TMP increased obviously,then resistance rates tend to be stable,while resistance rates to cefoperazone/sulbactam decreased.Conclusion Susceptibility of S.marcescens to most antimicrobial agents are high,but resistance had increasing tendency;susceptible rates of S .marcescens to ertapenem,ceftazidime,levofloxacin,and piperacillin/tazobactam are all high,and can be used as the empirical medication for the treatment of related infection.

4

Cite

Share

Difference in antimicrobial susceptibility of common clinical pathogens to different ratios of cefoperazone/sulbactam antimicrobial disks

Lian CHEN ; Qianjun YE

Chinese Journal of Infection Control.2016;15(10):744-747. doi:10.3969/j.issn.1671-9638.2016.10.006

Objective To understand the antimicrobial resistance of common clinical pathogens to antimicrobial disks containing different ratios of cefoperazone/sulbactam,so as to provide basis for rational application of cefoper-azone/sulbactam in clinic.Methods 1 141 pathogens isolated from clinical specimens in a hospital in the first half year of 2014 were collected,disk diffusion method was adopted to detect antimicrobial activity of two kinds of cef-operazone/sulbactam disks (70/35 μg and 75/75 μg).Results Of 1 141 pathogenic strains,675 (59.16%)were En-terobacteriaceae,447 (39.18%)were non-fermentative bacteria,and 19 (1 .66%)were other gram-negative bacilli. Resistance rates of pathogens to 70/35μg and 75/75 μg cefoperazone/sulbactam antimicrobial disks were as follows:extended-spectrumβ-lactamases(ESBLs)-producing Escherichia coli (n=221)were 7.69% and 2.26% respective-ly,ESBLs-producing Klebsiella pneumoniae (n=92)10.87% and 3.26% respectively,imipenem-resistant Acineto-bacter baumannii (IRAB,n=295)54.92% and 11 .19%respectively;there were significant differences in antimicrobial activity between two ratios of antimicrobial disks(P <0.05).While antimicrobial resistance rates of ESBLs-negative Enterobacteriaceae (Escherichia coli ,n = 135;Klebsiella pneumoniae ,n =98),imipenem-sensitive Acinetobacter baumannii (ISAB,n=51),Pseudomonas aeruginosa (n=48 ),and Stenotrophomonas maltophilia (n=22)were not significantly different (all P >0.05).Conclusion Antimicrobial activity of two different ratios of cefoperazone/sulbactam antimicrobial disks to ESBLs-producing Enterobacteriaceae and IRAB is different,attention should be paid to ratios of cefoperazone/sulbactam during the treatment ,so as to achieve the desired therapeutic effect.

5

Cite

Share

Current status of occupational protection awareness and behavior among medical interns

Siyan DING ; Xiaoqing SHAO ; Yiping MAO ; Dongping ZHU

Chinese Journal of Infection Control.2016;15(10):796-799. doi:10.3969/j.issn.1671-9638.2016.10.019

Objective To understand current status of occupational protection awareness and behavior among dif-ferent professional medical interns,and provide basis for strengthening the education about occupational protection among medical interns .Methods Questionnaire survey was used to survey medical interns at the end of their clini-cal internship.Results A total of 385 cases of occupational exposure occurred during internship period,occupation-al exposure rate was 42.31 % (385/910),occupational exposure mainly occurred in nursing interns (n =190).358 (39.34%)medical interns understood self-protective antibody (hepatitis B surface antibody);difference in occupa-tional exposure rates and awareness of self-protective antibody among different professional medical interns was sta-tistically significant (all P <0.05);222 (57.66%)medical interns sustained occupational exposure more than once, 45.45% of occupational exposure occurred during the process of diagnostic and therapeutic procedure,exposure mainly occurred in the wards (32.21 %).After occupational exposure,46.75% of medical interns felt nervous, 35.06% were worried,18.18% appeared serious psychological reaction,only 14.03% sought support and help from others.Conclusion Awareness of occupational protection among medical interns is insufficient,education and awareness of occupational protection should be intensified,psychological behavioral after occupational exposure should be paid attention among medical students.

6

Cite

Share

Knowledge and attitude of nursing interns towards needle stick injury be-fore clinical practice

Hongjun DI ; Yuexian SHI ; Wei SI ; Qiuxia WU

Chinese Journal of Infection Control.2016;15(10):791-795. doi:10.3969/j.issn.1671-9638.2016.10.018

Objective To investigate nursing interns’knowledge and attitude towards needle stick injury before clinical practice.Methods In 20-23 June,2015,nursing interns who were about to start clinical practice in a hospi-tal were investigated,nursing interns’knowledge and attitude towards needle stick injury were surveyed through questionnaire.Results A total of 350 questionnaires were distributed,324 (92.57%)responded questionnaires were available.40(12.35%)questionnaires were responded by male interns,and 284(87.65%)were by female in-terns;34(10.49%)interns had bachelor degree;the mean age of interns were (20.83 + 1 .24)years old.The correct answer rates about questions related to injury occurring during needle recapping and wearing gloves were low (about 60%).About 70% of the interns gave the correct answers to questions about hepatitis B infection due to needle stick injury following hepatitis B vaccination,as well as medication after injury.Score for individual question about attitude towards needle stick injury was ≤3,the major related problems were susceptibility of blood borne diseases and recapping needles.Conclusion Needle stick injury-related knowledge and attitude among nursing interns is inadequate,including recapping needles,timely report,susceptible to infectious diseases,and so on.It is necessary for schools and teaching hospitals to strengthen the education about occupational protection among nursing interns, so as to improve the attitude and ability of professional protection.

7

Cite

Share

Therapeutic effect of clindamycin combined with compound sulfamethox-azole tablets on pneumocystis pneumonia associated with acquired immuno-deficiency syndrome

Zhong CHEN ; Gang XIAO ; Quan ZHOU ; Yan HE

Chinese Journal of Infection Control.2016;15(10):773-776. doi:10.3969/j.issn.1671-9638.2016.10.013

Objective To understand the therapeutic effect of clindamycin combined with compound sulfamethoxazole tablets on pneumocystis pneumonia(PCP)associated with acquired immunodeficiency syndrome (AIDS).Methods 97 AIDS patients with PCP in a hospital from January 2014 to March 2015 were randomly divided into control group (n=49,received compound sulfamethoxazole )and trial group(n=48,received clindamycin on the basis of com-pound sulfamethoxazole ),levels of partial pressure of oxygen in arterial blood (PaO2 ),arterial blood oxygen satu-ration(SaO2 ),serum albumin(ALB),and lactic dehydrogenase (LDH)in two groups of patients before and after treatment were recorded.Results Levels of PaO2 ,SaO2 ,ALB,and LDH between two groups of patients before treatment was not significantly different(all P >0.05).After treatment,PaO2 in control group and trial group were (73.01 ±4.62)mmHg and(84.92 ±5.34)mmHg respectively,SaO2 were (75.81 ±4.28)% and(90.86 ±5.94)%respectively,ALB were (32.62±4.41 )g/L and(43.95 ±5.03)g/L respectively,LDH were(416.53 ±30.77)U/L and(331 .58±20.86)U/L respectively,levels of PaO2 and SaO2 in trial group were both higher than control group , difference in ALB and LDH between two groups of patients after treatment were both statistically significant(both P <0.05).The total effective rate of trial group was 89.58% (n=43),which was higher than 69.39%(n=34)in control group (χ2 =6.04,P =0.014).Conclusion Clindamycin combined with compound sulfamethoxazole tablets has good therapeutic effect on AIDS and PCP,which is worthy of clinical popularization and application.

8

Cite

Share

Prevalence rate of healthcare-associated infection in patients in a tertiary first class military hospital

Haifeng LI ; Yandong ZHANG ; Lina YU ; Dongchun ZHENG ; Yue ZUO ; Liping DUAN ; Chen JIA ; Jinke SUN

Chinese Journal of Infection Control.2016;15(10):769-772. doi:10.3969/j.issn.1671-9638.2016.10.012

Objective To investigate the current situation and related risk factors of healthcare-associated infection (HAI),so as to provide evidence for making prevention and control measures of HAI.Methods On November 26, 2014,a combination method of bedside visiting and medical record reviewing was adopted to survey HAI status, pathogen examination,and antimicrobial application in all hospitalized patients in a tertiary first class military hospi-tal.Results A total of 1 657 hospitalized patients were investigated,66 patients developed 71 times of HAI,HAI rate and HAI case rate were 3.98% and 4.28% respectively.The top 4 departments with HAI prevalence rates were departments of neurosurgery (24.49%),hematology(19.05%),cadre ward(13.73%),and burn surgery (10.91 %).The top 5 HAI sites were lower respiratory tract (40.85%),urinary tract(23.94%),upper respirato-ry tract(12.68%),surgical site(9.86%),and gastrointestinal tract(5.63%).Of 66 cases of HAI,39 (59.09%) patients sent specimens for culture,a total of 48 pathogens were cultured,the major isolated bacteria was Esche-richia coli (n = 10,20.84%),followed by Staphylococcus aureus ,Klebsiella pneumoniae ,and Pseudomonas aeruginosa ,each was 7 (14.58 %)respectively.The usage rate of antimicrobial agents was 34.40%,specimen de-tection rate in patients receiving therapeutic and therapeutic+prophylactic antimicrobial agents was 59.28%.Risk factors for HAI were age <2 years old or >60 years,with respirator,tracheotomy,urinary tract catheterization, arteriovenous catheterization,hemodialysis,and surgery,difference was significant(all P <0.05).Conclusion Mo-nitoring on key departments and key sites of HAI should be strengthened,antimicrobial agents should be used rationally based on pathogenic detection results,specimen pathogenic detection rate should be improved,and effective prevention and control measures needs to be taken according to the risk factors of HAI.

9

Cite

Share

Differential diagnosis in bloodstream infection with Trichosporon asahii and Geotrichum capitatum

Xuefeng QIAN ; Jyothi KRUPAKAR ; Ye ZHAO ; Chunhua LING ; Jianan HUANG ; Cheng JI

Chinese Journal of Infection Control.2016;15(10):764-768. doi:10.3969/j.issn.1671-9638.2016.10.011

Objective To provide reference for establishing diagnosis and differential diagnosis methods of rare yeast-like fungal bloodstream infection for clinical microbiology laboratory.Methods Trichosporon asahii (T.asa-hii)and Geotrichum capitatum (G.capitatum)bloodstream infection was diagnosed and differentially diagnosed through clinical data analysis,morphological examination,biochemical reactions,and molecular biology technology. Results Two types of yeast-like fungal bloodstream infections in case 1 and case 2 both occurred in leukemia agranulocytosis phase after chemotherapy,such infections were serious and highly similar.The cultivated colonies on blood agar plates of case 1 and case 2 were performed gram stain and microscopic examination.Hyphae,arthro-spores and microconidia were visible in the former,thickness of hyphae branches and length of arthrospores were different,most presented rectangular and barrel shape;the latter can be seen hyphae with transparent septum bro-ken up into arthrospores,presented rectangular shape,did not produce blastoconidia.Identification with API 20C AUX showed that they were T.asahii and G.capitatum.The PCR product sequences were compared with NCBI, suggesting that T.asahii and G.capitatum were at sexual stage.Conclusion Comprehensive application of a varie-ty of technical methods is helpful for improving the diagnosis accuracy of bloodstream infection with yeast-like fungi, identifying Trichosporon and Geotrichum to the species level may help physicians to understand such rare fungal in-fection,choose antifungal agents rationally,and improve clinical prognosis.

10

Cite

Share

Pathogens and risk factors of peritoneal dialysis-related peritonitis

Jing WANG ; Jing LV ; Wendong LI ; Xiaolong XIN

Chinese Journal of Infection Control.2016;15(10):739-743. doi:10.3969/j.issn.1671-9638.2016.10.005

Objective To investigate the bacterial spectrum and antimicrobial resistance of peritoneal dialysis (PD)-related peritonitis,and provide evidence for rational antimicrobial use.Methods Clinical data of 120 patients with PD-related peritonitis in a hospital from January 2013 to December 2014 were retrospectively analyzed. Results 91 cases (75.83%)showed positive result in bacterial culture,93 pathogenic strains were cultured,inclu-ding 73 (78.49%)gram-positive and 13 (13.98%)gram-negative bacterial strains,the most common gram-positive bacteria was Staphylococcus epidermidis (n=38,40.86%),and the main gram-negative bacteria was Escherichia coli (n =3,3.23%).Gram-positive strains had high resistance rates to penicillin,erythromycin,and oxacillin (93.65%,69.57%,and 64.41 % respectively),while resistance rates to vancomycin and linezolid were both low (2.90% and 1 .47% respectively),and were sensitive to teicoplanin,tigecycline,and nitrofurantoin.Gram-negative bacteria had high resistance rates to cefazolin,cefuroxime,and ampicillin(50.00%,37.50%,and 37.50% respec-tively),but were sensitive to imipenem,tobramycin,and piperacillin.Resistance rates of gram-positive and gram-negative bacteria to gentamicin and levofloxacin were both low.Non-standard operation during dialysate exchange was the most common cause of peritonitis (56.67%),most peritonitis were gram-positive bacterial infection (79.41 %);while gram-negative bacteria were the main pathogens of diarrhea-induced peritonitis (52.63%).The cure rates of gram-positive bacteria, gram-negative bacteria,and negative-cultured peritonitis were 92.96%, 76.92%,and 86.21% respectively,difference was not statistically significant(χ2 =3.39,P =0.18).Conclusion Gram-positive bacteria are major pathogens in PD-related peritonitis,and are usually caused by the bacteria through dialy-sis catheter due to non-standard operation during dialysate exchange.First-generation cephalosporins are not recom-mended as empirical therapy against gram-positive bacteria,while vancomycin is still the best choice.Third-genera-tion cephalosporins and aminoglycosides are recommended as empirical therapy against gram-negative bacteria. Gentamicin and levofloxacin can be used alone as empirical therapy in special circumstances.

DISPLAY OPTIONS

Cite

Share

Cite

Share

Cite

Share

Cite

Share

Cite

Share

Cite

Share

Cite

Share

Cite

Share

Cite

Share

Cite

Share