导尿管相关泌尿道感染病原菌分布及耐药性

目的分析重症监护室(ICU)导尿管相关泌尿道感染(CAUTI)病原菌分布及其对常用抗菌药物的耐药性。方法回顾性分析2011年1月—2014年6月ICU住院患者中发生CAUTI患者的感染病原菌,对细菌进行鉴定及药敏分析。结果共检出283株病原菌,其中革兰阴性菌192株(占67.84%),位于前3位的由高至低依次为:大肠埃希菌、肺炎克雷伯菌和奇异变形杆菌;革兰阳性菌65株(占22.97%),分别是屎肠球菌和粪肠球菌;真菌26株(占9.19%),主要是白假丝酵母菌。大肠埃希菌、肺炎克雷伯菌和奇异变形杆菌对哌拉西林、氨苄西林的耐药率均70%,鲍曼不动杆菌对头孢哌酮/舒巴坦100.00%敏感;屎肠球菌对氨苄西林和环丙沙星的耐药率分别为85.11%、80.85%。结论 CAUTI病原菌以革兰阴性杆菌为主,细菌耐药现象较为普遍,应根据药敏结果合理使用抗菌药物,减少多重耐药菌产生。     

2020—2022年西安地区三甲医院重症医学科静脉导管相关血流感染病原菌特征及耐药性分析

目的 探讨和分析重症监护室静脉导管相关血流感染病原菌分布特征及其耐药性。方法 选取2020年1月至2022年12月在西安地区3家三甲医院重症监护室进行中心静脉导管的患者为研究对象,通过临床电子病历管理系统采集重症监护室患者的基本情况并收集静脉置管部位等特征资料,由专业技术人员在无菌技术操作下对置入导管病原菌进行定量培养分离,对病原菌抗菌药物的敏感性进行测定,采用描述性分析方法对患者中心静脉导管相关性感染的病原菌分布特征及其耐药性监测情况进行分析。结果 2 781例重症监护室患者发生导管血流相关性感染265例,感染率为9.53%。共检出病原菌349株,其中革兰阳性菌218株占62.46%,革兰阴性菌117株占33.52%,真菌14株占4.01%。主要革兰阳性菌对青霉素、氨苄西林、苯唑西林、四环素以及红霉素耐药性较高,其耐药率均>70%;对万古霉素、替考拉宁、利奈唑胺较敏感;主要革兰阴性菌对氨苄西林、阿莫西林、哌拉西林、环丙沙星、左氧氟沙星、头孢唑啉、头孢呋辛、头孢噻肟以及头孢他啶均有较高耐药性,且其耐药率均>70%;对阿米卡星较敏感。结论 重症监护室静脉导管相关性感染的病原菌...     

患儿血流感染革兰阴性杆菌的构成与耐药性

目的探讨血流感染患儿革兰阴性杆菌构成及耐药性变化,为临床控制血流感染提供参考。方法对2008年8月-2014年3月532例临床诊断或疑诊为败血症(菌血症)的患儿采集静脉血标本,采用VITEK-2型全自动菌株鉴定仪进行病原菌培养、鉴定及药敏试验,并进行分析。结果送检血液标本532份,分离出病原菌114株,检出阳性率21.43%,革兰阳性菌占55.26%,革兰阴性菌占42.98%,真菌占1.76%;大肠埃希菌、肺炎克雷伯菌中产ESBLs菌株分别占44.44%、75.00%;主要感染革兰阴性菌大肠埃希菌、肺炎克雷伯菌、沙门菌属均对亚胺培南100.00%敏感,大肠埃希菌、肺炎克雷伯菌对庆大霉素、头孢唑林、氨苄西林、头孢呋辛、头孢他啶耐药率≥50.00%,沙门菌属对头孢哌酮/舒巴坦、哌拉西林/舒巴坦100.00%敏感,对氨苄西林耐药率>50.00%。结论儿科收治的血流感染患儿感染革兰阴性菌主要以大肠埃希菌、肺炎克雷伯菌、沙门菌属多见,对临床常用抗菌药物中青霉素及头孢类耐药较为普遍,在确定存在儿科血流感染时可考虑使用碳青霉烯类抗菌药物作为首选。     

1169株临床分离病原菌分布及耐药性分析

目的分析本院2014年临床检出病原菌的分布及主要病原菌耐药情况,为临床合理用药和控制医院感染提供可靠的依据。方法采用法国梅里埃ATB-New微生物鉴定仪对2014年全年临床送检的各类标本中分离的1 169株病原菌进行鉴定及药敏试验。结果检出的病原菌以革兰阴性杆菌为主,占58.7%;革兰阳性球菌次之,占31.2%,真菌占10.1%。病原菌顺序依次为大肠埃希菌、肺炎克雷伯菌、凝固酶阴性葡萄球菌、金黄色葡萄球菌、铜绿假单胞菌、鲍曼不动杆菌、阴沟肠杆菌、肠球菌属。肠杆菌科细菌对阿莫西林耐药率都达到90%以上,对哌拉西林、替卡西林、头孢呋辛耐药率达70%以上;铜绿假单胞菌对头孢噻肟、替卡西林、环丙沙星耐药率达60%以上;鲍曼不动杆菌耐药率较高,对头孢噻肟、哌拉西林、替卡西林、环丙沙星、庆大霉素耐药率达70%以上;金黄色葡萄球菌、凝固酶阴性葡萄球菌对青霉素、红霉素耐药率达90%以上。结论加强对病原菌分布及耐药性监测,及时指导临床合理应用抗生素,控制或降低院内感染的发生及多重耐药菌产生。     

COPD下呼吸道病原菌感染及耐药性分析

目的　了解慢性阻塞性肺病 (COPD)急性发作患者下呼吸道病原菌及药敏情况。方法　对 12 5例COPD患者的痰培养及药敏结果进行分析。结果　从 12 5例COPD患者的痰标本中分离出 86株细菌 ,革兰阴性菌占76 .7% ,其中铜绿假单胞菌占 2 6 .7% ,大肠埃希菌占 15 .1% ,克雷伯杆菌占 11.6 %。药敏分析发现 :革兰阴性杆菌耐药率依次为丁胺卡那 12 .2 % ,哌拉西林 2 0 .7% ,头孢他啶 2 2 .7% ,对氨苄西林耐药率为 90 .4 5 % ,铜绿假单胞菌对哌拉西林敏感。结论　COPD患者下呼吸道感染病原菌以革兰阴性杆菌为主 ,应根据药敏结果合理选用抗菌药物。     

2012-2013年儿科医院感染病原菌分布与耐药性分析

目的分析儿科住院患儿发生医院感染的部位、病原菌分布及耐药性,为临床防治医院感染提供依据。方法选择2012-2013年儿科住院患儿3 219例为研究对象,调查患儿临床资料,统计分析发生医院感染患儿的感染部位、病原菌分布及耐药性,采用Excel进行统计分析。结果医院感染156例,感染率为4.8%;感染部位以下呼吸道为主,共54例占34.6%;共分离出病原菌198株,以革兰阴性菌为主,共105株占51.5%;肺炎克雷伯菌对氨苄西林、哌拉西林和氨曲南的耐药率均>81.0%,铜绿假单胞菌对头孢唑林、头孢噻肟、头孢他啶、头孢呋辛和氨苄西林的耐药率均>73.9%。结论儿科医院感染患儿感染部位以下呼吸道为主,病原菌以革兰阴性菌居多,临床应参考药敏试验结果选择合理抗菌药物,提高临床疗效,减少耐药菌株产生。     

医院感染的临床分布及耐药性的调查分析

目的了解某院近5年来医院感染病原菌的临床分布及其对常用抗菌药物的耐药情况,以指导临床合理用药。方法收集某院2000年6月~2005年5月间临床各科患者的送检标本做微生物病原学检测和药物敏感试验。结果307株医院感染病原菌主要来源于呼吸道、胃肠道、泌尿道、血标本等。其中以革兰阴性杆菌为主,占50.81%,其次为革兰阳性菌及真菌,分别占25.41%和23.78%。耐药谱显示金黄色葡萄球菌、表皮葡萄球菌、溶血性葡萄球菌对亚安培南的耐药率超过24%,对青霉素G、苯唑西林、氨苄西林、头孢唑啉、氯霉素、红霉素的耐药率较高,达57%以上。所分离的革兰阴性杆菌对亚胺培南、阿米卡星、哌拉西林/他唑巴坦、头孢他啶、头孢噻肟、左氟沙星具有较低的耐药性,对氨苄西林耐药率最高。结论医院感染病原菌主要为条件致病菌,但仍以革兰阴性杆菌为主,真菌类感染所占比例有呈上升趋势。并应重视病原学检查及药敏结果,合理选择抗菌药物。     

2013-2018年特发性肺间质纤维化患者病原菌分布及耐药性分析

目的感染是导致特发性肺间质纤维化(idiopathic pulmonary fibrosis,IPF)患者呼吸困难加剧的主要原因,但缺乏快速诊断方法。本研究探讨特发性肺间质纤维化患者痰培养病原菌的分布特点及主要病原菌的耐药情况,对于早期治疗有重要意义。方法选择2013-02-01—2018-11-30在新乡县龙华医院住院治疗的116例特发性肺间质纤维化患者作为研究对象,对其痰培养病原菌分布特点及主要病原菌的耐药情况进行分析。结果 355次痰培养标本共培养出病原菌131株,其中革兰阴性菌88株(67.18%),革兰阳性菌10株(7.63%),真菌33株(25.19%)。革兰阴性菌中,鲍曼不动杆菌对头孢哌酮舒巴坦钠耐药率最低,为14.29%,对氨苄西林和呋喃妥因耐药率最高,均为100.00%;肺炎克雷伯杆菌对头孢哌酮钠舒巴坦钠、亚胺培南和美罗培南耐药率最低,均为9.09%,对氨苄西林耐药率最高为100.00%;铜绿假单胞菌对美罗培南、哌拉西林耐药率最低,均为11.11%,对氨苄西林、头孢呋辛酯、复方新诺明和头孢他啶耐药率最高,均为100.00%;大肠埃希菌对亚胺培南、阿米卡星和美罗培南耐药率最低,均为12.50%,对氨苄西林和哌拉西林耐药率最高,均为100.00%。主要革兰阳性菌金黄色葡萄球菌对万古霉素、替加环素和利奈唑胺耐药率均为0,而对青霉素、克林霉素、红霉素、庆大霉素、链霉素和四环素耐药率最高,均为100.00%。真菌体外耐药性试验结果显示,白假丝酵母菌对氟康唑、伊曲康唑和伏立康唑的耐药率最低,分别为0、4.00%和8.00%。结论 IPF合并肺部感染患者痰培养病原菌主要以革兰阴性菌为主,其次为真菌,革兰阳性菌检出率最低,临床治疗可根据病原菌分布特点及其耐药情况给予早期经验性抗菌药物治疗。     

医院获得性肺炎患者革兰阴性杆菌感染耐药趋势分析

目的了解医院获得性肺炎(HAP)革兰阴性杆菌耐药性及流行趋势,为临床治疗及医院感染控制提供依据。方法 2009年1月-2011年12月医院获得性肺炎患者送检标本中分离革兰阴性杆菌1 187株,经VITEK-2Compact细菌仪进行细菌鉴定,采用K-B纸片法进行药敏试验并统计分析;按CLSI标准采用WHONET5.4软件进行统计分析。结果 1 187株革兰阴性杆菌中肠杆菌科细菌673株,非发酵菌514株;2009-2011年肠杆菌科细菌对头孢哌酮耐药率为28.6%⁷7.4%,呈上升趋势,对头孢曲松、头孢他啶、头孢噻肟耐药率38.7%77.4%,呈上升趋势,对头孢曲松、头孢他啶、头孢噻肟耐药率38.7%⁸3.1%,对头孢呋辛、哌拉西林和氨苄西林耐药率45.7%83.1%,对头孢呋辛、哌拉西林和氨苄西林耐药率45.7%⁹4.6%,对亚胺培南、左氧氟沙星、阿米卡星、庆大霉素、阿莫西林/克拉维酸耐药率较低为094.6%,对亚胺培南、左氧氟沙星、阿米卡星、庆大霉素、阿莫西林/克拉维酸耐药率较低为0⁶1.1%,但呈上升趋势,2011年嗜麦芽寡养单胞菌对环丙沙星耐药率上升至41.2%,对阿米卡星41.2%61.1%,但呈上升趋势,2011年嗜麦芽寡养单胞菌对环丙沙星耐药率上升至41.2%,对阿米卡星41.2%⁵2.2%,对亚胺培南100.0%耐药。结论医院感染革兰阴性杆菌耐药严重并呈上升趋势,是导致HAP的主要原因。     

儿童中心静脉置管相关性血流感染病原菌分布及耐药性分析

目的分析儿童中心静脉置管(PICC)相关性血流感染的感染病原菌分布及其耐药性,为临床防治奠定基础。方法调查医院2009年1月-2014年1月PICC相关性血流感染患儿的临床资料72例,分析血流感染的感染病原菌分布及其耐药性,采用SPSS13.0软件进行统计分析。结果共分离鉴定98株病原菌,革兰阳性菌48株占48.98%,革兰阴性菌37株占37.75%和真菌13株占13.27%;主要革兰阳性菌对青霉素G、红霉素和氨苄西林具有较高的耐药性,耐药率为61.11%¹00.00%;主要革兰阴性菌对头孢他啶、头孢吡肟、头孢呋辛和氨苄西林高度耐药,耐药率为58.30%100.00%;主要革兰阴性菌对头孢他啶、头孢吡肟、头孢呋辛和氨苄西林高度耐药,耐药率为58.30%⁸8.89%;真菌对伊曲康唑、两性霉素B、氟康唑和氟胞嘧啶均较敏感,耐药率<20.00%;PICC留置<7d占6.9%,而>21d占50.0%,随着留置时间的增加,血流感染比例逐渐增加。结论加强PICC相关性血流感染的病原菌监测,有利于了解血流感染病原菌动态变化,掌握病原菌耐药性,指导临床合理使用抗菌药物,提高临床治疗效果。     

Trends in meningococcal disease in Italy in 1988

Meningococcal disease in Italy decreased 15% in 1988 from the previous year (290 vs. 342 cases). The decline was particularly evident in military cases (1.7/100,000 in 1988 vs. 5/100,000 in 1987) reflecting the full coverage of bivalent serogroup (A + C) meningococcal polysaccaride vaccine in army recruits, achieved since January 1988. The highest proportion of cases was seen in people older than 25 years of age (25%). Serogroup C constituted 60% of the isolates, while 19% belonged to serogroup B. The proportion of strains resistant to sulphonamides was 45%, while 15% were resistant to Minocycline and none to Rifampin. Out of the five military cases, only one (due to serogroup C) was attributable to the vaccine failure. A single coprimary case, but no secondary cases occurred among civilians. These findings are consistent with the trends reported in Italy in the previous years.     

Benzene in blood and phenol in urine in monitoring benzene exposure in industry

Determinations of benzene concentration in blood and of phenol in urine were made by head-space gas chromatography techniques on samples taken near the end of the work day from two groups of workers potentially exposed to low levels of benzene in the work-place atmosphere. Preliminary results suggest that benzene in blood is more reliable than phenol tests for assessing both exposure and uptake of benzene. Normal values of phenol in urine (10 mg/liter or less) were found in nearly all those cases in which benzene was detected in the blood.     

2015年郑州市饮用水放射性水平状况调查

目的了解郑州市不同地区、不同季节、不同水源类型的放射性水平。方法分别于丰水期和枯水期采集郑州市区黄河水源水、井水源水、丹江口水源水、出厂水和末梢水各一份;以县为单位,每单位采集出厂水、末梢水、水库水、河水、井水各1份,按《生活饮用水生活标准检验方法》(GB/T 5750.13-2006)检测饮用水中总α和总β放射性水平,依据《生活饮用水卫生标准》(GB 5749-2006)进行判定。结果丰水期、枯水期水体总α、总β放射性水平均低于国家标准限值。结论郑州市不同水源类型均处于正常的天然放射性本底水平。     

Occupational stress in nurses in psychiatric institutions in Taiwan

Nurses are known to be exposed to occupational stress. However, occupational stress is not well documented for nurses in psychiatric institutions in Taiwan. A cross-sectional study was conducted to explore the work-related stress and risk factors of nurses in psychiatric institutions in Taiwan. A structured questionnaire was distributed to nurses at five state-owned psychiatric hospitals in Taiwan in 2001. Demographic information, working environment, and personal health status were inquired. Occupational stress was assessed based on the Chinese version of Job Content Questionnaire (JCQ). General health status and mental health were evaluated by the International Quality of Life Assessment Short Form-36 (IQOLA SF-36). A total of 573 questionnaires were disseminated to nurses and 518 (90.4%) were satisfactorily completed by nurses, including 408 female full-time nurses who had been in their current work for more than 6 months. In the past one month, 17.2% of nurses reported being under significant stress often or always. Assault episodes were reported by 45.1% of nurses in the past 6 months. Among the nurses, 16.9%, 25.2%, 50.0%, and 7.8% belong to the "High strain", "Low strain", "Active", and "Passive" groups, respectively. Perceived occupational stress was associated with young age, widowed/divorced/separated marital status, high psychological demand, low workplace support, and threat of assault at work. Lower general health score was associated with low job control, high psychological demand, and perceived occupational stress. A lower mental health score was associated with low job control, high psychological demand, low workplace support, and perceived occupational stress. We concluded that nurses in psychiatric institutions are under significant stress related to work factors.     

Changes in nursing administration in supporting transplantation in Brazil

This historical and bibliographic study aimed to understand how Nursing was organized to support care in transplantation. The HISA, LILACS, BDENF, PERIENF and DEDALUS databases were consulted, and thirteen references were found, ten of which were scientific articles, two were master's dissertations and one was a doctoral thesis. The span of time chosen for study ranges from the date of the first kidney transplant in Brazil (1965), to the date of publication of the last scientific article found in the databases mentioned above (2003). After reading these articles, the ones that were similar in topic were grouped together, thus creating the thematic axis for the presentation of the results. The results showed that the Nursing profession has played an important and active role in transplants ever since the first procedure in 1965.     

2019年中国肿瘤流行病学研究进展

恶性肿瘤已成为中国居民的主要死因之一。近些年来,中国政府积极推进肿瘤预防和控制领域的研究工作,取得了很大的进步。本文简要汇总中国在肿瘤流行病学领域的研究进展,具体包括2019年的肿瘤负担、癌症危险因素及其干预、筛查和早期发现、癌症防治专项行动(2019-2022年)方案等方面,以期为我国肿瘤防治工作的有效开展提供技术支撑和理论依据。     

2012年绵阳市蔬菜中农药残留状况

目的 了解绵阳市2012年市售蔬菜中农药残留情况,为食用蔬菜监管提供依据.方法 全部样品均按照GB/T 5009-2003的方法进行农药的残留检测.依据GB 2763-2005《食品中农药最大残留限量》进行判定.结果 2012年共检测蔬菜165份,农药检出率和超标率分别为72.12％和23.64％.豆类、根茎类、叶菜类、瓜果菜类和食用菌类蔬菜检测农药残留超标率分别为8.00％、23.53％、36.00％、5.26％和27.03％,差异有统计学意义(x2=11.41,P＜0.01).不同种类农药超标率差异有统计学意义(x2 =62.42,P＜0.01).夏季和冬季蔬菜农药超标率差异无统计学意义(x2=3.44,P＞0.05).结论 绵阳市叶菜类蔬菜中农药残留情况较为严重,应采取有效措施,加强蔬菜的监督管理,从源头禁止高毒农药的使用,加大蔬菜种植、销售环节的监测,确保市民食用蔬菜的安全.