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Role of immunoglobulin in treating chronic obstructive pulmonary disease with fungal infection

Chinese Journal of Infection Control.2014;(5):281-283. doi:10.3969/j.issn.1671-9638.2014.05.007

Objective To explore the clinical effect of intravenous immunoglobulin(IVIG)on chronic obstructive pulmonary disease(COPD)and fungal infection.Methods Seventy-two COPD patients with fungal infection were randomly and equally divided into conventional and intervention group.Patients in conventional group were treated with common schedule for COPD plus antifungal agents;patients in intervention group received 1 0 g/d IVIG besides routine therapy.Length of hospital stay and prognosis were recorded,and therapeutic effectiveness were evaluated. Results The effectiveness rate of intervention group was significantly higher than that of conventional group ([88.89%,32/36]vs [66.67%,24/36]);the average length of hospital stay was significantly shorter than conven-tional group ([12.62±7.51]d vs [20.81±6.92]d),and mortality was lower than conventional group ([5.56%, 2/36]vs [22.22%,8/36]),the differences were statistically significant (P<0.05).Conclusion IVIG for treating COPD with invasive pulmonary fungal infection can improve therapeutic efficacy,shorten length of hospital stay and decrease mortality rate.

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Spatio-temporal distribution characteristics of syphilis in Mainland China, 2005-20 1 1

Xiaodan YI ; Baosen ZHOU

Chinese Journal of Infection Control.2014;(5):257-262. doi:10.3969/j.issn.1671-9638.2014.05.001

Objective To investigate the spatio-temporal distribution characteristics of syphilis epidemic in Main-land China in 2005-2011.Methods Geographic information system was established based on the data of syphilis epidemic and demographic information from online reporting system of 3 1 provinces,municipalities and autonomous regions of Mainland China from 2005 to 2011,global indication of spatial autocorrelation(GISA),local indication of spatial autocorrelation (LISA),and spatial-temporal cluster analysis were conducted by GeoDa 0.95i and SaTScan 9.1 .1 software,high risk areas of spatial-temporal distribution of syphilis were determined.Results The number of syphilis in Mainland China in 2005-2011 were 1 841 217 cases,annual incidence was 20.07/100 000,suggesting a sign of obvious cluster distribution.Except 2011,GISA coefficient Moran’s I were statistically different.Accord-ing to LISA analysis,Jiangsu,Shanghai,Zhejiang and Fujian lay in high-high region in 2005-2009,Chongqing lay in high-low region in 2006-2008,and in 2011,no area was found in high-high region.Spatio-temporal cluster anal-ysis showed that the most likely cluster was in Shanghai and Zhejiang (2009-2011);the secondary cluster distribu-ted in five areas,including Guangdong,Guangxi and Hainan (2009-2011),Xinjiang (2009-2011),Liaoning and Jilin (2010-2011),Gansu,Ningxia,Shaanxi,Sichuan,Chongqing,Shanxi and Inner Mongolia (2011),Beijing and Tianjin (2008-2010).Conclusion Significant spatio-temporal cluster pattern is found for the distribution of syphilis in mainland China,which can be meaningful for pertinent control.

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Economic loss of healthcare-associated infection in hospitalized children with acute respiratory infection

Xiufen ZHENG ; Yaru XU ; Huirong ZHAO ; Hongliang DENG ; Yan WANG ; Yao YU ; Jing LI

Chinese Journal of Infection Control.2014;(7):428-430. doi:10.3969/j.issn.1671-9638.2014.07.014

Objective To study direct economic loss of healthcare-associated infection (HAI)in hospitalized children with acute respiratory infection (ARI),and the influence in satisfaction degree of children’relatives.Methods Clinical data of 1 039 children with ARI in a pediatrics ward between April 1,2012 to March 31,2013 were analyzed retrospective-ly.50 patients with HAI were in case group and 50 patients without HAI were in control group.The difference in medical cost and the degree of satisfaction of children’s relatives were compared between two groups.Results Medical cost of pa-tients in case group was significantly higher than control group([P 25 - P 75 :￥3 095.54 - ￥4 779.48]vs [P 25 -P 75 :￥1 744.14-￥2 382.07],Z =5.89,P <0.01).The expenses in medicine,laboratory examination,diagnosis and treatment,and nursing in case group were all higher than control group,there were significant differences between two groups(all P <0.01 );Hospitalization day of case group was significantly longer than control group ([P 25 -P 75 :9 d-15 d]vs[P 25 -P 75 :6 d-8 d],Z =5.79,P <0.01 ).Satisfaction degree of patients’relatives in case group was significantly lower than control group (Z =8.22,P <0.01).Conclusion HAI occurred in ARI children can increase medical cost,prolong length of hospital stay and decrease satisfaction degree of patients’relatives.

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Drug resistance genes of 16S rRNA methylase in Klebsiella pneumoniae

Chunmei YE ; Wenen LIU

Chinese Journal of Infection Control.2014;(7):389-392. doi:10.3969/j.issn.1671-9638.2014.07.002

Objective To investigate antimicrobial susceptibility of Klebsiella pneumoniae (K .pneumoniae )to aminoglycosides and detection of 16S rRNA methylase genes in K .pneumoniae .Methods Ninety-six non-repetitive clinical K .pneumoniae isolates were collected from Xiangya hospital of Central South University from January to Ju-ly 2009,minimal inhibitory concentrations (MICs)of gentamycin,amikacin and tobramycin were determined by agar dilution method ;genotype of 16S rRNA methylase genes (armA,rmtA,rmtB ,rmtC,rmtD ,npmA)were detec-ted by polymerase chain reaction(PCR).Results MIC50 of amikacin,gentamycin and tobramycin was 256μg/mL, 512μg/mL and 512μg/mL respectively;and MIC90 were all>512μg/mL;antimicrobial resistance rate was 21 .88%, 63.54%,and 41 ,67% respectively.68 isolates (70.83%)were resistant to at least one kind of antimicrobial agent, 21 isolates(21 .88%)were resistant to three kinds of antimicrobial agents.22 isolates(22.92%)carried armA,but rmtA,rmtB ,rmtC,rmtD and npmA were not detected;of 22 isolates harboring armA 16S rRNA methylase genes, 17(77.27%)were highly resistant to gentamicin,amikacin and tobramycin,the homology of armA positive isolate and armA (FJ410928.1 )was 100%.Conclusion armA 16S rRNA methylase gene harbored in K .pneumoniae plays an important role in aminoglycoside resistance.

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Antimicrobial resistance characteristics and mechanisms of imipenem-re-sistant Pseudomonas aeruginosa

Guowei DONG ; Jie GUO

Chinese Journal of Infection Control.2014;(7):385-388. doi:10.3969/j.issn.1671-9638.2014.07.001

Objective To investigate antimicrobial resistance characteristics and mechanisms of imipenem-resistant Pseudomonas aeruginosa (P .aeruginosa)isolated from clinical specimens.Methods Bacterial strains were identi-fied by BD Phoenix 100 automatic microbial analysis system,antimicrobial susceptibility testing was performed by Kirby-Bauer method;Carbapenemase genes (IMP ,VIM ,OXA,GES )and outer membrane protein gene oprD2 were detected by polymerase chain reaction.Results Resistant rates of imipenem-resistant P .aeruginosa strains to ami-kacin was the lowest (8.33%);resistant rates to gentamicin and tobramycin were<20%;resistant rates to the third and fourth generation cephalosporins,aztreonam,meropenem,compound sulfamethoxazole and minocycline were all>60%,and all strains were resistant to ampicillin/sulbactam.The positive rate of OXA-17 gene was 2.78%(n=1 ),deletion rate of oprD2 was 38.89%,the other drug-resistant genes were not detected.Conclusion Except aminoglycosides,resistance of imipenem-resistant P .aeruginosa to other antimicrobial agents is serious;resistance of P .aeruginosa to imipenem may be due to lacking of OprD2 and production of carbapenemases.

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Reporting of epidemic of notifiable infectious diseases in a general hospital between 2007 and 2011

Liping SUN ; Yunhai YANG ; Xiuhua LIANG

Chinese Journal of Infection Control.2014;(7):431-433. doi:10.3969/j.issn.1671-9638.2014.07.015

Objective To study the reporting status of notifiable infectious diseases in a general hospital,grasp epidemiological characteristics and patterns,and provide scientific basis for the preventive measures of infectious diseases.Methods Epidemic data of notifiable infectious diseases reported by a hospital in 2007 -2011 were ana-lyzed statistically.Results Reporting rate of notifiable infectious diseases was 0.40%(15 386/3 852 327)in 2007-2011 ,and were statistically different among each year (χ2 =94.93,P <0.01),the major age of reported cases were 14-45 years(46.70%),the main transmission routes were blood and sex (60.68%),followed by respiratory tract (33.06%).The reporting rates among different months were statistically different(χ2 =487.60,P <0.01 ),April ranked first for five consecutive years(0.53%),followed by December(0.51 %)and May(0.48%).The main repor-ted infectious diseases included viral hepatitis(42.82%),varicella(20.06%),syphilis(16.96%),rubella(5.41 %), and pulmonary tuberculosis(3.75%).Conclusion Bloodborne diseases,sexually transmitted diseases,and infec-tious respiratory diseases are the stress in the prevention and control of infectious disease,management should be in-tensified.

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Difference in hand hygiene idea of varied educational systems

Bo LIU ; Songqin LI ; Weihong ZHANG ; Suming ZHANG ; Ping XU ; Wensen CHEN

Chinese Journal of Infection Control.2014;(7):421-424. doi:10.3969/j.issn.1671-9638.2014.07.012

Objective To analyze the present medical teaching textbooks and practice skill guidelines,and explore the profound causes of poor hand hygiene idea among doctors.Methods Three sets of unified textbook series used for domestic medical colleges and universities and two sets of manipulation skill guidelines were studies.Statistical method was conducted to analyze whether concepts and methods of hand hygiene,hand-washing and antiseptic han-drubbing were included in these teaching textbooks;as to eight aseptic manipulation skills,coverage of knowledge, steps of hand-washing and antiseptic handrubbing in manipulation skill guidelines were also analyzed.Results The mentioning rate of hand hygiene,hand-washing and antiseptic handrubbing in 8-year and 5-year program teaching textbooks were both 0 ,in nursing teaching textbooks was 1 00 % ;as to 8 aseptic manipulation in 2 sets of skill practice guidelines,mentioning rate of hand washing was 37 .50 % ,and method and steps of antiseptic handrubbing were both 0 .Conclusion School teaching and skill assessment are the basis,it is difficult to form the right idea by only relying on continuing education without basic education.Hand hygiene should be stressed in the written of teaching textbooks,guidelines should be written following the newest progress,so as to form the correct idea of hand hygiene among doctors.

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Monitor and management of in-use disinfectant

Jinping DU

Chinese Journal of Infection Control.2014;(7):418-420. doi:10.3969/j.issn.1671-9638.2014.07.011

Objective To monitor the quality of in-use disinfectant,evaluate the causes of exceeding of bacterial content standard,and put forward the corresponding management measures.Methods According to the different management methods,disinfectant specimens were divided into experimental group(n =210,from August 2012 to July 2013)and control group (n=190,from August 2011 to July 2012);in-use disinfectant in experimental group was contained with ground-glass stoppered bottles,in-use disinfectant in control group was contained with stainless bottles and ground-glass stoppered bottles,biological monitor results of two groups were compared.Results Quali-fied rate of biological monitor result in experimental group was 100.00% (201/201 ),and in control group was 90.00%(171/190),there was significant difference between two groups(χ2 =21 .13,P <0.05).Conclusion Impro-ving management method can increase the qualified rate of biological monitoring result of in-use disinfectant,and en-sure the safety and effectiveness of disinfection.

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Surgical site infection in five patients

Qian XIANG ; Jiayu WU ; Daoqiong WEI ; Zhonghua ZHOU ; Min DAI ; Yu LV

Chinese Journal of Infection Control.2014;(7):415-417. doi:10.3969/j.issn.1671-9638.2014.07.010

Objective To investigate the possible causes of surgical site infection(SSI)in neurosurgical patients in a hospital during a short period of time.Methods Medical data of 135 neurosurgical operative patients from February 1 to March 15,2013 were reviewed,the possible risk factors for SSI were analyzed retrospectively with case-control study.Results Of 135 operative neurosurgical patients,5 (3.70%)developed SSI.Case-control study showed that the ratio of the run of the fifth operating room and undergoing of secondary operation was 4.07 (95%CI :0.52 -36.65)and 18.00(95%CI :2.00 -180.00)respectively.The difference between each surgeon special SSI rate and the average SSI rate in 2012 (2.54%[17/669])was not significantly different (P >0.05).Bacterial detection of en-vironmental specimens of the fifth operating room showed that except anesthetic cuff exceeded standard,the others were met the national requirements,and the isolated bacteria from anesthetic cuff was coagulase negative Staphylo-coccus ,which was not related with pathogens in infection.Conclusion “The secondary surgery”is the key risk fac-tor for SSI of neurosurgical patients.

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Etiology and clinical characteristics of infectious mononucleosis-like syn-drome

Shengping XIAO ; Simao FU ; Yuling LIU ; Guilan WANG ; Xiaohong HUANG

Chinese Journal of Infection Control.2014;(7):408-410. doi:10.3969/j.issn.1671-9638.2014.07.008

Objective To analyze the etiology and clinical characteristics of infectious mononucleosis-like syndrome (IMLS).Methods Eighty-seven children with IMLS in a hospital from January 2006 to September 2013 were per-formed pathogenic detection,then clinical features were summarized and analyzed.Results The top 5 pathogens in IMLS were Mycoplasma pneumoniae (MP,n=20 ),cytomegalovirus (CMV,n=13),simplex herpes virus(HSV, n=11),Chlamydia (CP,n=11),and parvovirus B19 (Hpv B19,n=9 ),clinical manifestations of all kinds of dis-eases were similar,but the occurrence rates were slightly different.MP infection were mainly fever,hepatospleno-megaly,and lymphadenopathy,and most were associated with respiratory complications(including laryngitis,bron-chitis,and pneumonia),CMV infection were also showed fever and hepatosplenomegaly,but the latter was more ob-vious;rubella patients didn’t appear skin rash,but the other symptoms were obvious.Conclusion Etiologies of in-fectious mononucleosis-like syndrome are varied,MP infection is most common,the next is CMV.Pathogens should be ascertained to provide theoretical basis of treatment.

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