ABSTRACT
Objective To investigate the infection state and tendency in Tianjin Chest Hospital from 2014 to 2016,and provide scientific basis for making strategy to prevent and control nosocomial infection. Methods With bedside investigation and medical case review,one day every year was selected as the day of investigation to survey the healthcare-associated infections in our hospital during 2014-2016. Data of operative incision, infection condition, the usage of anti-bacterial agents and bacteria detection were collected and organized for further study. Results A total of 2 285 patients were investigated during 2014 to 2016, in which nosocomial infection was found in 55 cases. The total prevalence of healthcare-associated infections was 2.41%. The prevalence rates of healthcare-associated infections in each year were 2.62%,2.63% and 2.05% respectively,and no significant differences between them(χ2=0.750,P>0.05).In the three years, the highest prevalence rates were found in Department of Cardiac Surgery(13.79%),Department of Cardiac Surgery(7.48%) and Department of Endocrine (7.41%) respectively. The lower respiratory tract infection was the main infection site of nosocomial infection (61.11%-78.95%), followed by upper respiratory tract infection, urinary tract infection and blood infection. In 2014-2016, pathogenic detection rates for specimens were 77.78%, 85.71% and 88.89% from patients with nosocomial infection (χ2=0.735,P>0.05). Forty-five strains of pathogen were isolated from 2014 to 2016. The main pathogen was the gram-negative bacteria,and 32 strains were isolated during the three years,which accounted for 71.11%. Six strains of gram-positive bacteria were isolated,which accounted for 13.33%.Seven strains of fungus were isolated,which accounted for 15.56%. The predominant pathogens were Klebsiella pneumonia (10 isolates), Pseudomonas aeruginosa (8 isolates) and Acinetobacter baumannii (5 isolates). The antibiotic utilization rates were 28.40%, 29.17% and 23.74% respectively from 2014 to 2016 (χ2=7.175,P<0.05). In the three years, most of antibiotics were used therapeutically, accounting for 83.39%,14.17% received for prophylactic use,and 2.44% received for both prophylactic use and treatment (χ2=29.151,P<0.05). The rates of bacteria detection in patients who received therapeutic use were 77.02%, 74.42% and 75.77% respectively(χ2=0.306,P>0.05).Conclusion The prevalence of healthcare-associated infection of Tianjin Chest Hospital is maintained at a stable level.The monitoring and prevention of key departments,sites and predominant pathogens should be strengthen, and effective measures for preventing and controlling nosocomial infection should be formulated scientifically,so as to reduce the incidence of nosocomial infection.
ABSTRACT
Objective To establish a new determination method for the measuring of alkaline phosphatase activity (ALP) with p-acetyl phenyl phosphace (PAP-PNa_2) as substrate.Methods With the help of Vital semiautomatic analyzer,researched a continuous-monitoring procedure and set up experimental parameters.Results When using this assay,the wavelength of PAP's absorption was 325 nm and the Km of ALP was 0.376 mmol/L.The molecular extinction coefficient of PAP at 340 nm was 23 390 L?mol~(-1)? cm~(-1) and the concentration of citrate buffer was 0.438 mol/L.During the process,we found that the optimum pH of enzyme was 10.4,and the concentration of substrate was 5.0 mmol/L.The time of linear reaction was 900 seconds,and the linear range was 0-1 110 U/L.Serum total ALP were 63.1-118.3 U/ L(male) and 52.5-89.0 U/L(female),based on results from 60 heath adults.Conclusions The method is practical in its repetition and convenience,saves time and is not liable to be affected by bilirubin in serum.It is especially suited to the use of automatic analyzers.