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cleaning and disinfection.Results All 28 surveyed medical institutions had separate endoscope disinfection rooms, 89.29% of which had integrated endoscopic cleaning station,17.86% had automatic endoscope washer/disinfector;100% used multi-enzymatic detergent,chose the right disinfectant,monitored disinfectant concentration every day, and implemented standard disinfection time.But only 39.29% changed multi-enzymatic detergent for each endo-scope,cleaning and disinfection personnel in 78.57% of medical institutions wore personal protective equipment correctly.77 digestive endoscopes were detected,the qualified rate was 88.31%.Conclusion Cleaning and disin-fection management of digestive endoscope in secondary and above medical institutions in Suzhou City is generally standardized,there are still some problems in the manipulation procedures,relevant national regulations should be strictly complied with,efficacy of cleaning and disinfection of digestive endoscope should be further improved.
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Objective To explore the cleaning status and cleaning quality of dental handpieces in various types of medical institutions in Suzhou City.Methods On October 26-31, 2015, dental clinics in the whole city were sampled according to cross-sectional survey and proportional sampling method, the cleaning quality of dental handpieces in each clinic was detected by ATP bioluminescence assay.Results 72 medical institutions, 201 handpieces, 402 samples in 10 administrative regions of the city were sampled, 42 samples was unqualified, unqualified rate was 10.45％, unqualified rate of cleaning of dental handpiece surface was higher than waterline of dental handpiece(17.91％ vs 2.99％, P<0.05).Cleaning quality of dental handpieces in different grades of medical institutions was different(P<0.05), tertiary medical institutions were all ualified, medical institutions without grade was 14.45％.According to the classification based on name of different medical institutions, cleaning quality of handpieces was statistically significant(P<0.05), cleaning efficacy of dental handpieces in department of stomatology of public hospitals was best(unqualified rate was 4.31％), while private dental clinics had the worst cleaning efficacy(unqualified rate was 13.81％).Conclusion Education and training of dental handpieces cleaning in the whole city should be strengthened, especially the management of cleaning of dental handpieces in low grade and private dental clinics.
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Objective To understand the cleaning quality of dental handpieces in Suzhou City, analyze the relevant factors that influencing cleaning effect.Methods A cross-sectional study was performed with the proportional system sampling method, questionnaires were adopted to investigate the cleaning location, cleaning method and process of dental handpieces, the ATP fluorescence detection method was conducted to detect cleaning quality.Results In 10 administrative regions of this city, a total of 72 medical institutions were selected, 25 were public medical oral diagnosis and treatment institutions, 47 were private clinics.Cleaning effect of automatic handpiece cleaning machine was better than traditional manual cleaning (unqualified rate :3.95% vs 11.96%, P0.05).The quality of cleaning of handpieces could be improved if waiting time of cleaning ≤30 minutes, enzymes were used during cleaning, and purified water was used at the end rinse(all P<0.05);whether there was drying process and used lubricant, difference were both not significant.Conclusion Using automatic handpiece cleaning machine, cleaning personnel with adequate knowledge, cleaning waiting time ≤30 minutes, enzyme use during the cleaning process, and purified water use at the end rinse can improve the quality of cleaning of dental handpieces.
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Objective To investigate the carriage and homology of carbapenemase genes of multidrug-resistant Acinetobacterbaumannii (MDRAB)in Wujiang area.Methods A total of 44 non-duplicated MDRAB isolated from patients in 3 general hospitals in Wujiang area from January 2010 to December 2013 were collected. Minimum inhibitory concentrations (MICs)were detected,carbapenemase genes OXA-51,OXA-23,OXA-24,OXA-58, IMP,TEM,SHV,and GES were amplified with polymerase chain reaction(PCR),homology of strains was detec-ted with pulsed-field gel electrophoresis (PFGE).Results 44 MDRAB strains were mainly collected from sputum (93.18% ),mainly distributed in intensive care unit (ICU),department of respiratory diseases,and department of neurosurgery,accounting for 45.45% ,27.27% ,and 13.64% respectively;MDRAB were both sensitive to minocy-cline and polymyxin B,resistance rates to piperacillin,ampicillin/sulbactam,ceftazidime,gentamicin,amikacin, and ciprofloxacin were all 100.00% ,resistance rates to imipenem and meropenem were both 97.73% . 44 MDRAB strains were all detected OXA-51,OXA-23 and TEM genes,12 strains were positive for GES gene,1 strain was positive for OXA-58 and SHV respectively,OXA-24 and IMP genes were not found ;MDRAB were divided into 7 types of G-A,which included 19,3,9,3,1,4,and 5 strains respectively,type A was mainly from two large gen-eral hospitals in Wujiang area (Wujiang First People’s Hospital and Shengze Hospital),type B,D and E strains were not detected in Wujiang First People’s Hospital,type E strain was only 1 isolate and was from Yongding Hos-pital,the other types were sporadically distributed.Conclusion Multidrug resistance of clinically isolated Acineto-bacterbaumannii is serious in Wujiang area,OXA-23 and TEM genes are major causes of multidrug resistance in Acinetobacterbaumannii,the main types are A and C,which present clonal spread.
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Objective To explore drug resistance and distribution of multidrug-resistant(MDR)Mycobacterium tuberculosis (M.tuberculosis)in a county-level hospital,so as to strengthen the prevention and control of health-care-associated infection with M.tuberculosis .Methods Specimens with positive sputum smear were performed M. tuberculosis culture and drug resistance testing,and distribution of MDR tuberculosis patients in the departments before isolation were investigated retrospectively.Results Of 488 patients with tuberculosis,254 were positive for sputum smear,122 M.tuberculosis strains were isolated from positive sputum smear patients,120 isolates were per-formed drug susceptibility testing,results revealed that 86 isolates were drug-resistant strains,46 of which were monodrug-resistant,40 were MDR.Of MDR strains,16 were all resistant to isoniazide,rifampicin,streptomycin, and ethambutol.The percentage of monodrug-resistance,MDR,pandrug resistance was 9.43%,8.20%,and 3.28% respectively.Medical imaging department,ultrasound department,and respiratory disease department were the main units of M.tuberculosis exposure.Conclusion The percentage of MDR M.tuberculosis is high among M. tuberculosis ,surveillance should be intensified,so as to prevent the transmission in hospital.
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Objective To investigate the drug resistance and risk factors of hospital-acquired pneumonia (HAP) induced by imipenem-resistant Acinetobacter baumannii.Methods Clinical data on 114 patients with Acinetobacter baumannii-related HAPs admitted in Wujiang First People' s Hospital in Suzhou during January 2013 and December 2014 were retrospectively analyzed.According to the results of drug sensitivity test,patients were divided into imipenem-resistant group and non imipenem-resistant group.Drug resistance to 20 commonly used antibiotics was observed in two groups,and multivariate Logistic regression analysis was performed to identify the risk factors of imipenem-resistant Acinetobacter baumannii infection.Results Among 114 strains ofAcinetobacter baumannii,66 strains (57.89％) were imipenem-resistant and 48 strains (42.11％) were non-imipenem-resistant.The resistance rates to β-lactams,quinolones and aminoglycosides were significantly higher in imipenem-resistant group than those in non-imipenem-resistant group (P ＜ 0.01),and no tigecycline-resistant strain was found in both groups.Univariate analysis showed that acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score ≥ 15,plasma level of albumin ≤ 25 g/L,intensive care unit (ICU) stay,indwelling gastric tube,deep venous catheterization,establishment of artificial airway,mechanical ventilation time ≥ 7 d,use of broad-spectrum antibiotics ≥ 14 d and combined use of antibiotics were risk factors of imipenem-resistant Acinetobacter baumannii related HAP (x2 =13.06,6.86,25.40,15.09,17.87,21.46,17.94,6.91 and 10.10,P ＜0.01).Multivariate Logistic regression analysis revealed that establishment of artificial airway [OR =72.014,95％ confidetial interval (CI):19.566-265.061,P ＜ 0.01],and use of broad-spectrum antibiotics ≥ 14 d (OR =3.892,95％ CI:1.092-13.879,P ＜ 0.05) were independent risk factors of imipenem-resistant Acinetobacter baumannii related HAP.Conclusion Imipenem-resistant Acinetobacter baumannii strains are highly resistant to most antibiotics.Strict control of invasive procedures and long-term combined use of antibiotics may reduce the occurrence of imipenem-resistant Acinetobacter baumannii related HAPs.
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Objective To establish the quality standard for Xuanshi Texiao Yaoshui(mainly composed of Radix Sophorae Flavescentis,Cortex Pseudolaricis,etc).Methods Radix Sophorae Flavescentis and Cortex Pseudolaricis were identified by TLC.The content of oxymatrine was determined by HPLC.Symmetry C18 column(4.6 mm? 250 mm,5 ? m)with mobile phase of methanol-water-triethylamine(40:60:0.04)was used.The detective wavelength was 220 nm.Results TLC for Radix Sophorae Flavescentis and Cortex Pseudolaricis was specific .HPLC for oxymatrine had a good separation with other components,and the linear range of oxymatrine was 0.60～ 1.80 ? g and recovery rate was 99.34 %(RSD =0.71 %).Conclusion This method can be used to control the quality of Xuanshi Texiao Yaoshui.