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Objective To investigate the distribution characteristics of methicillin-resistant Staphylococcus aureus (MRSA)in a children's hospital,and provide basis for the prevention and control of MRSA infection in children. Methods Children who admitted to a children's hospital from 2011 to 2015 were analyzed retrospectively,clinical data of children,isolation of pathogens,types of specimens,and healthcare-associated infection(HAI)status were analyzed.Results From 2011 to 2015,a total of 911 children isolated Staphylococcus aureus (SA,1108 positive specimens),494 of whom isolated MRSA (599 positive specimens),54.23% of children isolated MRSA(isolation rate of specimens was 54.06%);there was no significant difference in the isolation rate of MRSA between children of different genders(P > 0.05);isolation rate of MRSA in different age groups was statistically significant(P <0.05).Isolation rates of MRSA from blood,puncture fluid,secretion,and pus were 68.97%,66.00%,55.81%, and 54.47% respectively.Isolation rate of SA and MRSA increased from 0.61% and 21.74% in 2011 to 1.40%and 75.59% in 2015 respectively,difference were both significant(both P <0.05).Incidence of SA and MRSA in-creased from 0.198% in 2011 to 2.697% and 2.119% in 2015 respectively,both showed an upward trend year by year(both P <0.05).Conclusion Isolation rate of MRSA and incidence of HAI in this children's hospital increased year by year,it is necessary to intensify management,use antimicrobial agents scientifically and rationally,timelyperform disinfection and isolation,so as to curb the emergence and spread of MRSA in hospital settings.
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Objective To understand antimicrobial resistance of Enterobacteriaceae strains and distribution charac-teristics of carbapenemase-resistant Enterobacteriaceae(CRE)in Xijing Hospital in 2015,so as to provide basis for rational use of antimicrobial agents in clinic. Methods Specimens from infected inpatients and outpatients in Xijing Hospital in January-December 2015 were performed pathogenic culture,isolation and identification. Antimicrobial susceptibility testing was performed with Kirby-Bauer method,carbapenemase confirmatory test was conducted with modified Hodge test,antimicrobial resistance of Enterobacteriaceae was statistically analyzed. Results A total of 4166 pathogenic strains were isolated in 2015,1554 (37.30% )of which were Enterobacteriaceae strains,the top 5 isolated pathogens were Escherichiacoli(E. coli),Klebsiella pneumoniae(K. pneumoniae),Enterobactercloacae (E. cloacae),Proteusmirabilis,and Enterobacteraerogenes. Of 787 E. coli strains,581(73.82% )were extend-ed-spectrumβ-lactamases(ESBLs)-producing strains;of 367 K. pneumoniae strains,182 (49.59% )were ESBLs-producing strains. E. coli and K. pneumoniae had the highest resistance rates to cefazolin,which were 93.14% and 78.48% respectively. A total of 81 (5.21% )CRE were detected,K. pneumoniae,E. cloacae,and E. coli were 41 ,27,and 13 strains respectively;strains were mainly isolated from patients in departments of neurosurgery(n=42),gastroenterology(n= 9),and neurology(n= 8). 1.02% (8/787)of E. coli and 3.27% (12/367)of K. pneu-moniae were multidrug-resistant. Conclusion Enterobacteriaceae accounted for a higher proportion of pathogenic bacteria causing HAI,the detection rate of ESBLs-producing strains remains high,the isolation rate of carbapenem-resistant Enterobacteriaceae is higher than that of last year,especially K. pneumoniae.
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Objective To investigate the distribution characteristics of methicillin-resistant Staphylococcus aureus (MRSA)in a children's hospital,and provide basis for the prevention and control of MRSA infection in children. Methods Children who admitted to a children's hospital from 2011 to 2015 were analyzed retrospectively,clinical data of children,isolation of pathogens,types of specimens,and healthcare-associated infection(HAI)status were analyzed.Results From 2011 to 2015,a total of 911 children isolated Staphylococcus aureus (SA,1108 positive specimens),494 of whom isolated MRSA (599 positive specimens),54.23% of children isolated MRSA(isolation rate of specimens was 54.06%);there was no significant difference in the isolation rate of MRSA between children of different genders(P > 0.05);isolation rate of MRSA in different age groups was statistically significant(P <0.05).Isolation rates of MRSA from blood,puncture fluid,secretion,and pus were 68.97%,66.00%,55.81%, and 54.47% respectively.Isolation rate of SA and MRSA increased from 0.61% and 21.74% in 2011 to 1.40%and 75.59% in 2015 respectively,difference were both significant(both P <0.05).Incidence of SA and MRSA in-creased from 0.198% in 2011 to 2.697% and 2.119% in 2015 respectively,both showed an upward trend year by year(both P <0.05).Conclusion Isolation rate of MRSA and incidence of HAI in this children's hospital increased year by year,it is necessary to intensify management,use antimicrobial agents scientifically and rationally,timelyperform disinfection and isolation,so as to curb the emergence and spread of MRSA in hospital settings.
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Objective To analyze the influencing factors for fungal infection in hospitalized patients with acquired immunodeficiency syndrome(AIDS),and provide basis for taking preventive and control measures.Methods Clini-cal data of 112 inpatients with AIDS in a tertiary first-class hospital from January 2010 to October 2015 were ana-lyzed retrospectively,related risk factors were analyzed in patients with fungal infection,univariate analysis was performed byχ2 or t test,and multivariate analysis was performed by logistic regression analysis.Results Among 112 AIDS inpatients,41 (36.61%)had fungal infection.Candida albicans was the main pathogen (n=52, 76.74%)and was mainly isolated from lower respiratory tract (n=29,42.65%).Univariate analysis showed that invasive procedures,duration of antimicrobial use,combined antimicrobial use,and decreased CD4+ T lymphocyte count in peripheral blood were risk factors for fungal infection in AIDS inpatients(all P<0.05),while oral cleaning care and systemic antiviral therapy were protective factors for fungal infection(all P<0.05);multivariate analysis showed that decreased CD4+ T lymphocyte count in peripheral blood(OR,1.017[95% CI,1.009-1.025])and combined antimicrobial use(OR,3.975[95%CI,1.093-14.448])were independent risk factors for fungal infection in AIDS inpatients,while systemic antiviral therapy was independent protective factor for fungal infection (OR, 0.288[95%CI,0.099-0.841]).Conclusion There are many factors influencing fungal infection in AIDS patients, rational use of antimicrobial agents,systemic antiviral therapy,and increasing serum albumin concentration are main methods to prevent fungal infection,avoid unnecessary invasive procedures and application of preventive antifungal therapy for high-risk patients are also effective to prevent fungal infection.
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Objective To investigate the occurrence of central venous catheter-related bloodstream infection(CRB-SI)in mass severe burn patients,evaluate related risk factors for infection,and effectiveness of prevention and con-trol measures.Methods In August 2014,9 cases of severe burn patients were rescued in a hospital,all patients re-ceived CVC,infection prevention and control intervention measures were performed during the whole process of catheterization.Results All patients received 30 episodes of CVC,total CVC-days were 227 days,bacterial culture for three-cavity catheters of femoral veins in 2 patients were positive,incidence of CRBSI was 8.81 ‰;1 patient was isolated Enterococcus faecium ,1 isolated both Acinetobacter baumannii and Stenotrophomonas maltophilia .2 CRB-SI patients received femoral vein catheterization,catheterization site was trauma surface,duration of catheterization were both ≥7 days,both used three-cavity catheters,and third degree burns were ≥60%,both patients were cured after timely removal of catheters and receiving of antimicrobial agents.Conclusion CVC is helpful for long term, safe and effective fluid infusion,but it can cause CRBSI;infection prevention and control intervention for patients receiving CVC during the whole process of catheterization can reduce the occurrence of CRBSI.
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Objective To evaluate the effect of selective oral decontamination (SOD)on reducing incidence of ventilator-associated pneumonia (VAP).Methods Sixty patients hospitalized in an intensive care unit (ICU)for >72 hours and with mechanical ventilation for >48 hours from January to June 2102 were selected for study,patients were ran-domly divided into trial group(n =30)and control group(n=30).All patients received cefotaxime intravenous drip for 4 days,then trial group received oropharyngeal application of tobramycin during the whole process of mechanical ventila-tion,control group topically received saline solution,the incidence and onset time of VAP ,duration of mechanical ventila-tion,length of stay in ICU,and mortality of two groups were compared.Sputum in the trachea was taken periodically for bacterial culture.Results The incidence of VAP in trial group was lower than control group (30.00% vs 63.33%);the onset time of VAP was later than control group ([9.37±6.62]d vs [5.17 ±4.72]d);Overall duration of me-chanical ventilation was less than control group ([7.63 ±6.91 ]d vs [12.26 ±9.36]d);length of stay in ICU was shorter than control group([13.56±7.22]d vs [16.79±11 .16]d)(all P 0.05).Conclusion SOD is effective for preventing and treating VAP,it can reduce the incidence of VAP,delay onset time of VAP,shorten mechanical ventilation,and reduce length of stay in ICU.