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Objective:To investigate the causes of the outbreak of Candida Pelliculosa catheter-related bloodstream infection in the neurosurgical intensive care unit (ICU), find out the source of infection and the route of transmission, and provide evidence for the prevention and control of nosocomial infection. Methods:An epidemiological investigation and environmental hygiene monitoring were made in patients with Candida Pelliculosa catheter-related bloodstream infection who received treatment in March and April 2019 in Houma People's Hospital, China. Comprehensive measures were taken to control the outbreaks of Candida Pelliculosa catheter-related bloodstream infection. Results:There were four patients with Candida Pelliculosa catheter-related bloodstream infection in the ICU of Neurosurgery Department of Houma People's Hospital, China. Eight samples were collected from these four patients. Ten strains were isolated and identified positive for Candida Pelliculosa. Drug sensitivity test revealed identical results: the minimum inhibitory concentration (MIC) of 5-fluorocytosine, amphotericin B, fluconazole, itraconazole and voriconazole was ≤ 4 mg/L, ≤ 0.5 mg/L, < 1 mg/L, ≤ 0.12 mg/L and ≤ 0.06 mg/L, respectively. No target bacteria were detected from the environment. Candida Pelliculosa infection was not observed after taking comprehensive control measures such as strengthening hand hygiene supervision in medical staff and thorough disinfection of the environment. Conclusion:Poor hand hygiene compliance in medical staff in neurosurgical ICU and non-sufficient environmental disinfection may be the main causes for the outbreak of Candida Pelliculosa catheter-related bloodstream infection.
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Objective To explore the implementation styles on the therapeutic effects on the neurosurgical intensive care unit (NICU) patients. Methods Patients were enrolled during February 3, 2015 to February 3, 2016. The key point time was August 3, 2015 when the treatment in our NICU was fully implemented by NICU professional doctors. Based on this time point, all the enrolled patients were divided into non-NICU professional doctor implementing (NNPDI) group and NICU professional doctor implementing (NPDI) group. Thus non-NICU professional doctors and professional doctors were the leaders of diagnosis and treatment in tow groups. The length of hospital stay, complications, prognosis and other therapeutic outcomes were compared between two groups. Results The length of hospital stay was longer in NPDI group than that in NNPDI group (P0.05). The proportion of referral to other wards and fatality rate were both lower in NPDI group than those in NNPDI group (P0.05). Conclusion The NICU professional doctor implementing may be contribute to, at least in part, the improving of prognosis of NICU patients without obvious advantages in most complications. The level of professional management remains to be improved.
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Objective To compare the effects of Chinese herbal fumigation and ultraviolet light exposure on air disinfection in neurosurgical intensive care unit.Methods The floors and the tables in the rooms of ICU were all disinfected using 0.02%84 disinfectant.The air disinfection was performed in the rooms using Chinese herbal(elsholtziae,ramulus cinnamomi,forsythia suspense,flos caryophylli)fumigation as the experiment group and those using ultraviolet light exposure as the control group,both for 30 times.The two disinfection methods were compared before air disinfection,at hours 0,1,2,4,8 and 12 in terms of bacteria tests.Results The air quality on natural bacteria in both groups met the standard of Class Ⅱ Environmental Health Criteria at hour 0,l after air disinfection,without significant difference between the two groups at each time point(P>0.05).In the control group,the bacteria began to grow in number one hour after ultraviolet light exposure and overgrew two hours after air disinfection.In the experiment group,the bacteria grew less,never exceeding the standard level at all time points.The disinfection effect of the experimental group was all significantly better than that of the control group at the time points of 2 h,4 h,8 h,12 h(P<0.05 or P<0.01). Conclusions Chinese herbal fumigation is superior to the UV light irradiation disinfection.It is safe and harmless even in case of medical staff working in the unit.
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Neurointensive care arose from the specific growth of the various therapeutic methods in neuroscience, similar to the formation of specific units in other specialties. The progress of the neurological intensive treatment is more recent and because of the high frequency of pathologies in this area it became necessary to structure this specialty in terms of theoretical and physical aspects. In this text, a commentary on the chronology of this development is set out briefly and objectively.
O neurointensivismo surgiu a partir do crescimento específico das diversas formas terapêuticas em neurociências, à semelhança da formação de unidades específicas em outras especialidades. O progresso do tratamento neurológico intensivo é mais recente e, em virtude da alta frequência das patologias nessa área, tornou-se necessária a estruturação dessa especialidade do ponto de vista teórico e físico. Neste texto, um comentário à cronologia desse desenvolvimento é exposto de maneira breve e objetiva.