ABSTRACT
Objective To understand the infectious pathogens distribution and drug resistance in the surgical departments of our hospital from 2007 to 2011 to provide the basis for the anti-infective therapy in the surgical patients.Methods TheVitek automatic microbial identification system was used to identify bacteria and fungi.The Kirby-bauer (KB)method was used to study the antibi-otic resistance in the pathogens isolated from the patients in the surgical departments.Results 1218 strains of pathogens were iso-lated,including 669 strains(55%)of Gram-negative bacteria,440 strains(36%)of Gram-positive bacteria and 109 strains (9%)of fungi.The top five of bacteria in turn were Escherichia coli in 182 strains(15%),Pseudomonas aeruginosa in 171 strains (14%), Staphylococcus aureus in 105 strains (9%),Klebsiella pneumoniae in 86 strains (7%)and Enterococcus faecalis in 61 strains(5%). Among 283 strains of Escherichia coli,Klebsiella pneumoniae and proteus mirabilis,the detection rate of ESBLs producing strains was 29.7%.Methicillin-resistant Staphylococcus aureus(MRSA)accounted for 63% of Staphylococcus aureus.The resistance rates of Staphylococcus and Enterococcus to multiple antibacterial drugs were above 50%.Enterobacteriaceae bacteria were more sensi-tive to carbapenems as well as compound antibacterial drugs containing enzyme inhibitor.The lowest resistance rate of Acinetobact-er to cefoperazone/sulbactam was 21.1%.Pseudomonas aeruginosa showed the most sensitive to compound antibacterial drugs con-taining enzyme inhibitor and its lowest resistance rate to cefoperazone/sulbactam was 17.4%.Conclusion The drug resistance phe-nomenon in the pathogens isolated from the surgical patients are relatively serious,this study provides some basis for the preventive antimicrobial drugs use in the perioperative period and the empirical medication in the infection therapy.
ABSTRACT
OBJECTIVE To raise the sci-tech components of the infection control work guided by evidence-based medicine.METHODS To apply the basic principle of evidence-based medicine in the actual work and carry on the argument and analyses. RESULTS The implement of these measures under the guidance of evidence-based medicine could raise the level of the infection control work effectively,which included consult rule of the Hospital Infection Committee,collection of information in network,evaluation and analysis of the examination result of clinical microbiological laboratory,integreted and individualized dynamic monitoring method and diversity and whole process intervention measure.CONCLUSIONS The infection control work guided by evidence-based medicine can reduce the occurrence of the hospital infection effectively.
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OBJECTIVE To investigate the methods of promoting nosocomial infection administration in laminar airflow(LAF) operation department,based on the theory of air microbe and object surface microbe. METHODS To begin with the construction standard of LAF operation department,to discuss difficult,complicating,professional and legal characteristics of nosocomial infection administration of LAF operating room. RESULTS It was a solid base of promoting nosocomial infection administrition to specify strictly the standard for the LAF operation department built;it was a vital link of promoting nosocomial infection administrition to take part in inspecting the engineering quality of LAF operation department;it is an effective means of LAF nosocomial infection administrition to carry out the supervision and control to the LAF operation department daily;it was the essense of promoting nosocomial infection administrition to make efforts to innovate the modern administration pattern in LAF operation department. CONCLUSIONS The management of hospital infection in the LAF operation department must emphasize the comprehensive measure of the all-directional germ control,make standard of decontamination of air conditioning guarantee system and carry out the whole process supervision.
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OBJECTIVE To assess the clinical effectiveness of antibiotic combined therapy for febrile neutropenia as an empirical treatment.METHODS We analyzed bacterial epidemiology form Jan 2001 to Feb 2003 and performed a study in 202 neutropenic febrile patients after chemotherapy or(HSCT).Three groups were divided.In first group(84 cases) carbapenems and vancomycin were used.In second group(78 cases)and in third group(40(cases)) used cephalosporin or quinolone.RESULTS Carbapenems plus vancomycin were with response rate of 93%,and(without) vancomycin were only 66%.Cephalosporin or quinolone was with response rate only of 30%.(CONCLUSIONS) Strong antibiotic with vancomycin is effective for treating patients with neutropenia and fever(under) limited bacterial epidemiology.