无菌手术间空气细菌污染监测

对无手术和有连续手术历时２－４ｈ的３个手术间进行空气细菌含量监测。结果：无手术的手术间于消毒后６ｈ内均无菌落生长，１２ｈ、２２ｈ平均菌落数为１０６ｃｆｕ／ｍ＾３。有手术的手术间于消毒后４ｈ内无菌落生长，６ｈ后空所细菌含量严重超标，在采取相应措施后，达到了标准，提示应重视手术时间长或连续手术的手术间空气的消毒。     

实验室空气细菌污染监测与预防

检验科是医院内大部分病源微生物、标本汇集的地方，患者分泌物、排泄物及一次性用品处理不当都严重污染空气，某些原因可致空气污染而散播全院，实验室空气细菌污染监测，作为预防医院污染尤为重要，2000年我院实验室空气监测情况如下。 1 方法 采用平板暴露、自然沉降法。采样时每个房间分别放置5个取样点，四角和中央将普通营养琼脂平皿盖打开，暴露15min盖好，放37℃温箱24h培养。 2 结果 各实验室每季度不定时抽样调查1次，一、四季度各科室合格率为100%，其它季度合格率分别是80%、40%(见附表)。 附表 实验室空气细菌检测cfv/m3 实…     

幼儿园空气中细菌总数监测分析

自2009年12月—2010年1月对某企业所属幼儿园寝室空气中作为细菌学评价指标[1]的细菌总数进行了监测,现将监测结果分析如下。1资料与方法1.1一般资料选择某企业所属幼儿园寝室空气中作为细菌学评价指标的细菌总数进行监测。1.2方法根据《公共场所卫生监测技术规范》在8所幼儿园随机选择了79个寝室采样监测寝室空气,监测项目为细菌总数。以梅花点方式确定监测点采用沉降法采样,在关闭寝室门窗、室内无风的情况下,将普通琼脂培养基平皿放置于距离地面0.5~1.0 m的床或桌子上,暴露于空气中5 m in送检验室,将平皿放在37℃恒温箱中培养48 h,观察细菌总数报结果。1.3评价标准参照GB/T 188     

院内感染-空气细菌监测与药敏试验结果分析

笔者于2003年采用标准平板沉降法 ,对我院13个重要科室及病房进行了空气细菌监测 ,并对分离的菌株做出菌种鉴定 ,同时采用NCCLS推荐K -B法对分离的部分菌株进行药敏试验。结果显示 ,13例空气微生物细菌监测超标率为15 38 % ,共检出大肠杆菌、聚团肠杆菌、肺炎克雷伯菌、表皮葡萄球菌、四联球菌、八叠球菌、枯草杆菌、霉菌、丙链、草绿色链球菌、酵母菌11种细菌。药敏试验表明 ,5株表皮葡萄球菌耐药率为复方新诺明80 % ,青霉素、氨苄青霉素、庆大霉素、头孢唑林、头孢拉定、头孢哌酮为20 % ;3株大肠艾希氏菌的耐药率分别是复方新诺明、氨…     

医院空气中细菌监测取样条件标准的探讨

目的:通过应用沉降法监测医院空气中的细菌时,对取样高度、暴露时间、平板的直径及放置等条件与结果的分析,探讨医院空气中细菌监测取样条件的标准.方法:将营养琼脂平板培养基打开盖,暴露于手术室不同高度,待一定时间后培养24小时.结果:计算平板培养基上的平均菌落数及细菌数,随采样高度的增加细菌数量则减少.暴露时间在15分钟以后...     

空气净化器在产房空气中的杀菌效果评价

经空气传播是引起感染的重要途径，因为未经净化处理的空气为微生物气溶胶，许多微生物常以尘埃、皮屑、飞沫等粒子为载体而悬浮在空气中，其中有些是致病菌。空气中病原性细菌污染程度往往与感染率关系密切。有调查表明，空气中浮游细菌数在700cfu/m^3以上时，就有经空气传播引起感染的危险性。在产房这个特殊的环境中，分娩可致产妇机体抵抗力下降，增加产褥感染的机会。     

高压氧舱空气细菌污染状态监测

<正>1材料与方法1.1实验条件高压氧舱(HBO)为烟台冰轮高压舱有限公司YC 3800/0.3-36Ⅶ舱三舱七门式氧舱,直径3.6 m,体积160 m3;入舱患者情况:常规治疗舱容纳治疗8人,患者采取坐位;重症治疗舱(ICU舱)容纳治疗卧床4张,陪舱人员4人,总共也8人,患者多为气管切开等重症患者;HBO的治疗条件:治疗压为1～2.4 ATA,氧浓度控制在21.5%,舱内温     

医院手术室与产房内的空气消毒与监测

控制和预防院内感染的发展是当前医院质量管理的重要课题。空气是传播疾病的重要媒介,空气细菌污染直接影响医院的治疗质量。本文主要对面积相同而工作条件不同的3个手术室及2个产房在规定时间内进行微生物监测。     

长江客轮客舱空气细菌含量调查及评价

按《GB9673—88》标准规定,用平皿沉降法对重庆长江轮船公司所属客轮开展客舱空气细菌含量调查及相关因素探讨,随机抽查22艘客轮(占该公司客轮总数的66.6％),采样330件次,合格251件次,合格率为76.06％,平均细菌含量(Cfu/m~3)4159.4个/M~3,空气中细菌含量受舱位级别、季节、CO浓度等因素的影响,方差分析有显著性意义。     

细菌耐药性监测在临床微生物检验中的应用价值分析

目的探究细菌耐药性监测在临床微生物检验中的应用价值分析。方法随机抽取2013年11月～2016年11月在我院临床所收集的尿标本、血液标本、痰标本及分泌物标本中分离出的500例致病菌株实行细菌耐药性监测,在临床微生物检验中进行菌种分布情况和细菌耐药性检测结果分析。结果 500例致病菌株中,其中革兰阳性菌为148株、革兰阴性菌为352株。其中凝固酶阴性葡萄球菌检出率最高,其次为铜绿假单胞菌、大肠埃希菌。变形杆菌对氨苄西林耐药性最高为92.09%,肠杆菌属对头孢唑林的耐药性最高为42.78%,金黄色葡萄球菌中MRSA对青霉素和氨苄西林耐药性均达到100%,凝固酶阴性葡萄球菌中MRCNS(甲氧西林凝固酶阴性葡萄球菌(MRCNS)及MSCNS对青霉素及氨苄西林耐药性分别为100.00%、100.00%、96.72%及89.89%,肠球菌属对头孢唑林的耐药性最高为32.48%。结论在细菌耐药性逐渐升高及多重耐药菌株生成的现状下,细菌耐药性监测在临床微生物检验中显得尤为重要,通过监测使得细菌耐药性变化形势被准确的掌握,进而给予患者适当适量的药物进行临床治疗,最大程度上减少抗生素的过度使用,具有较高的临床价值。     

灭菌制剂洁净室空气菌落数测定方法的探讨

本文针对灭菌制剂百级层流和万级乱流洁净室,采取琼脂平板暴露法,考察平板暴露时间、细菌培养时间、霉菌测定、空气净化时间以及洁净室状态对洁净室空气菌落数的影响。结果表明:洁净室空气净化30min,平板暴露30min,细菌培养48h,霉菌培养72h,以生长细菌与霉菌平均菌落数之和为洁净室空气菌落数,能客观地反映洁净室生物微粒沉降密度。该方法适宜医院灭菌制剂洁净室空气菌落数的测定。     

2015-2018年四川地区无菌体液细菌的分布及耐药性分析

目的 对四川省细菌耐药监测网成员单位2015-2018年度无菌体液(未包括血液)的细菌分布及耐药情况进行统计分析，为本省临床合理应用抗菌药物提供依据。方法 按照监测方案，采用标准纸片扩散法、E-test法或自动化仪器检测法，依据美国临床实验室标准化研究协会(CLSI)2018年标准，用WHONET 5.6软件进行数据分析。结果 2015-2018年间四川地区无菌体液共分离出29754株非重复的细菌，其中革兰阳性菌11351株，占38.1%，革兰阴性菌18403株，占61.9%。无菌体液中最常见的细菌依次为大肠埃希菌、肺炎克雷伯菌、金黄色葡萄球菌、屎肠球菌和表皮葡萄球菌。耐甲氧西林金黄色葡萄球菌(MRSA)和耐甲氧西林凝固酶阴性葡萄球菌(MRCNS)的检出率分别为28.3%和63.9%。MRSA和MRCNS对绝大多数测试药物的耐药率均显著高于甲氧西林敏感株(MSSA和MSCNS)。屎肠球菌中分别检出0.5%(9株)对利奈唑胺耐药和2.2%(40株)对万古霉素耐药的菌株，粪肠球菌中发现1.7%(22株)对利奈唑胺耐药和0.3%(4株)对万古霉素耐药的菌株。耐万古霉素屎肠球菌(VRE)由4%降至1.8%，而耐利奈唑胺屎肠球菌由1.3%降至0。无菌体液标本中产ESBL大肠埃希菌和肺炎克雷伯菌的检出率分别为45.8%和25.6%，大肠埃希菌和肺炎克雷伯菌对碳氢霉烯类仍然保持较高的活性。非发酵菌对碳青霉烯类抗生素耐药率较高，其中鲍曼不动杆菌对亚胺培南的耐药率已大于65%。结论 四川地区无菌体液分离细菌对常见抗菌药物的耐药率部分仍呈增长趋势，尤其是耐碳青霉烯肺炎克雷伯菌。对万古霉素耐药的屎肠球菌分离率较高。非发酵菌特别是鲍曼不动杆菌的耐药形势严峻。应充分利用本地细菌耐药监测结果进行感控管理，促进抗菌药物合理应用。     

尘肺合并社区获得性肺炎患者病原菌分布及抗菌药物使用合理性评价

目的分析并对尘肺合并社区获得性肺炎(CAP)患者病原菌分布以及抗菌药物使用合理性进行评价。方法选取90例既往无其他慢性呼吸道疾病史的尘肺合并CAP患者作为研究组,另选同期90例既往无慢性呼吸道疾病史的CAP患者作为对照组。比较两组患者病原菌及耐药菌情况;白细胞、中性粒细胞百分比、C反应蛋白、白细胞介素-6、降钙素原升高情况;抗菌药物的使用情况。结果对照组培养出病原菌6株,4株杆菌,2株球菌(肺炎链球菌),无真菌,无耐药菌;研究组培养出病原菌18株,14株杆菌,1株球菌,3株真菌,其中耐药菌3株,占病原菌的16.67%。研究组病原菌占比20.0%高于对照组的6.67%,差异具有统计学意义(χ^2=6.923,P<0.05);两组病原菌中,耐药菌占比比较,差异无统计学意义(χ^2=1.143,P>0.05)。研究组C反应蛋白、白细胞介素-6升高率用药前后差值分别为54.44%、58.89%,均高于对照组的35.56%、36.67%,差异均具有统计学意义(P<0.05);两组白细胞、中性粒细胞百分比、降钙素原升高率用药前后差值比较,差异无统计学意义(P>0.05)。两组口服、静脉滴注、单用、联用抗菌药物情况比较,差异无统计学意义(P>0.05);研究组用药疗程>10 d占比52.22%高于对照组的27.78%,差异具有统计学意义(P<0.05)。研究组一、二代头孢菌素的总使用率32.22%低于对照组的50.00%,差异具有统计学意义(χ^2=5.875,P<0.05);研究组三代头孢菌素加酶抑制剂总使用率33.33%高于对照组的8.89%,差异具有统计学意义(χ^2=16.145,P<0.05)。结论尘肺合并CAP患者抗菌药物品种选择、疗程基本合理,但仍需加强抗菌药物培训管理工作,充分发挥临床药师在抗菌药物应用中的作用,规范、合理、个体化、精准化使用抗菌药物,为患者更好地服务。     

Evaluation of Using Dogs to Predict Fraction of Oral Dose Absorbed in Humans for Poorly Water-Soluble Drugs

Dogs have been widely used to study the oral absorption of a drug in drug discovery. However, there has been no quantitative validation of using dogs to predict the fraction of oral dose absorbed (Fa) in humans (Fa_h) for poorly water-soluble drugs. Here, we report the results of using dogs for quantitative Fa_h prediction, focusing on poorly water-soluble free acid and neutral drugs. The Fa values of 4 acidic and 1 neutral proprietary compounds were measured in humans and dogs. Extensive literature survey was also performed to increase the number of Fa data. Fa_h and Fa in dogs (Fa_d) were then compared at equivalent body weight–normalized doses. In the case of neutral compounds, Fa_d was found to be similar to Fa_h. In the case of acidic compounds, Fa_d significantly overestimated Fa_h in most cases. A difference in intestinal pH was suggested as the main reason for this discrepancy. In conclusion, the use of dogs would not be appropriate to predict Fa_h for acidic compounds, but more work is required to know about neutral compounds.     

Evaluation of safety and tolerance of microencapsulated Lactobacillus reuteri NCIMB 30242 in a yogurt formulation: A randomized,placebo-controlled,double-blind study

Probiotic organisms have shown promise in treating diseases. Previously, we have reported on the efficacy of microencapsulated Lactobacillus reuteri NCIMB 30242 in a yogurt formulation at lowering serum cholesterol levels in otherwise healthy hypercholesterolemic adults. This study investigates the safety and toxicology of oral ingestion of microencapsulated L. reuteri NCIMB 30242 in a yogurt formulation. A randomized group of 120 subjects received a dose of 5 × 10¹⁰ CFU microencapsulated L. reuteri NCIMB 30242 in yogurt (n = 59) or placebo yogurt (n = 61) twice/day for 6 weeks. Clinical chemistry and hematological parameters of safety were analyzed. Fecal samples were collected at these time points for the analysis of deconjugated bile acids. The frequency, duration and intensity of adverse events (AEs) and clinical significance of safety parameters were recorded for both groups. No clinically significant differences between the probiotic yogurt and placebo yogurt treated groups were detected in either the blood clinical chemistry or hematology results and there was no significant increase in fecal deconjugated bile acids (P > 0.05) between treated and control groups. The frequency and intensity of AEs was similar in the two groups. These results demonstrate the safe use of this formulation in food.     

A real-time and modular approach for quick detection and mechanism exploration of DPIs with different carrier particle sizes

Dry powder inhalers (DPIs) had been widely used in lung diseases on account of direct pulmonary delivery, good drug stability and satisfactory patient compliance. However, an indistinct understanding of pulmonary delivery processes (PDPs) hindered the development of DPIs. Most current evaluation methods explored the PDPs with over-simplified models, leading to uncompleted investigations of the whole or partial PDPs. In the present research, an innovative modular process analysis platform (MPAP) was applied to investigate the detailed mechanisms of each PDP of DPIs with different carrier particle sizes (CPS). The MPAP was composed of a laser particle size analyzer, an inhaler device, an artificial throat and a pre-separator, to investigate the fluidization and dispersion, transportation, detachment and deposition process of DPIs. The release profiles of drug, drug aggregation and carrier were monitored in real-time. The influence of CPS on PDPs and corresponding mechanisms were explored. The powder properties of the carriers were investigated by the optical profiler and Freeman Technology four powder rheometer. The next generation impactor was employed to explore the aerosolization performance of DPIs. The novel MPAP was successfully applied in exploring the comprehensive mechanism of PDPs, which had enormous potential to be used to investigate and develop DPIs.     

Novel approach for real-time monitoring of carrier-based DPIs delivery process via pulmonary route based on modular modified Sympatec HELOS

An explicit illustration of pulmonary delivery processes (PDPs) was a prerequisite for the formulation design and optimization of carrier-based DPIs. However, the current evaluation approaches for DPIs could not provide precise investigation of each PDP separately, or the approaches merely used a simplified and idealized model. In the present study, a novel modular modified Sympatec HELOS (MMSH) was developed to fully investigate the mechanism of each PDP separately in real-time. An inhaler device, artificial throat and pre-separator were separately integrated with a Sympatec HELOS. The dispersion and fluidization, transportation, detachment and deposition processes of pulmonary delivery for model DPIs were explored under different flow rates. Moreover, time-sliced measurements were used to monitor the PDPs in real-time. The Next Generation Impactor (NGI) was applied to determine the aerosolization performance of the model DPIs. The release profiles of the drug particles, drug aggregations and carriers were obtained by MMSH in real-time. Each PDP of the DPIs was analyzed in detail. Moreover, a positive correlation was established between the total release amount of drug particles and the fine particle fraction (FPF) values (R² = 0.9898). The innovative MMSH was successfully developed and was capable of illustrating the PDPs and the mechanism of carrier-based DPIs, providing a theoretical basis for the design and optimization of carrier-based DPIs.