医院空气微生物分布调查

目的了解医院各科室空气中的微生物分布,以便更好地指导临床消毒工作,预防医院感染。方法选择上午门诊高峰期,采用平板沉降法采集医院不同区域的空气样本,普通琼脂平板培养后计数菌落,革兰染色及分离鉴定,根据菌落的溶血情况、革兰染色进行判断分析;选择非医院环境的超市和学院图书馆进行对照。结果医院门诊大厅细菌总数超出国家标准的37.0%,内科病房超出国家标准15.0%;其他科室和非医院环境的空气细菌数符合国家标准,门诊大厅和病房主要以革兰阳性球菌为主。结论医院空气中的微生物多于普通公共场所,特别是人流密集的门诊区域细菌含量更高;医院有存在着发生医院感染的隐患。     

多功能空气消毒机与紫外线灯消毒对急诊病房感染控制的效果研究

目的研究多功能空气消毒机与紫外线灯消毒控制急诊病房医院感染的效果,为降低急诊病房的医院感染率提供参考依据。方法选择2011年6月-2013年6月10间急诊病房461例入住患者作为对照组,再选择同期环境结构相同的10间病房536例入住患者作为观察组,比较两组病房空气细菌总数、住院患者发生医院感染率。结果消毒前两组病房内空气细菌总数差异无统计学意义,消毒1、2、3h观察组病房空气细菌总数均显著低于对照组病房空气细菌总数(P<0.05);观察组患者感染31例,感染率为5.78%,对照组患者感染58例,感染率为12.58%,两组感染率比较,差异有统计学意义(P<0.05);观察组感染患者送检标本分离出病原菌39株,其中革兰阴性菌26株占66.67%,革兰阳性菌11株占28.20%,真菌2株占5.13%;对照组感染患者送检标本分离出病原菌64株,其中革兰阴性菌41株占64.06%,革兰阳性菌22株占34.38%,真菌1株占1.56%。结论采用多功能空气消毒机在急诊病房中运用效果优于紫外线灯,并更加安全可靠,能够有效降低急诊病房医院感染的发生率。     

四川4家三甲医院门诊大厅空气微生物调查

目的 了解三甲医院门诊大厅的微生物污染情况.方法 采用平板沉降法采集空气样本,血平板置35℃培养48 h,霉菌培养平板置26℃培养48 h后计数菌落、革兰染色及分离鉴定.结果 密闭性好、安装中央空调的门诊大厅细菌和酵母菌数量远大于空气流通性好、无中央空调的门诊大厅(P＜0.005),而前者的霉菌含量则低于后者(P＜0.005).结论 应加强医院门诊大厅的消毒,集中空调系统的卫生监管.     

沈阳市医院空气消毒的现状与管理

医院是病人集中的场所,又是病原微生物污染严重的地方,空气中所含致病微生物的浓度高于一般环境.同时,在医院还存在着健康人与患者之间的特殊接触.因此,加强医院空气消毒,减少与控制因空气污染造成的医院感染是非常必要的.有研究报道,空气中细菌总数达到800cfu/m^3以上,发生感染性疾病的可能性大大增加.《医院消毒技术规范》规定医院手术室、重症监护病房、高危易感科室（Ⅱ类环境）等空气中细菌总数控制在200cfu/m^3以下,注射室、处置室、急诊各科室（Ⅲ类环境）空气中细菌总数控制在500cfu/m^3以下为安全浓度.为使医院各类环境空气中细菌总数达到标准,定期对空气消毒,将对降低与控制医院空气污染造成的医院交叉感染起到重要作用.     

NSICU空气环境的微生物学分布特征及其影响因素分析

目的 分析神经内科重症监护病房(NSICU)空气环境的微生物学分布特征及其影响因素,从而为医院感染的控制提供依据.方法 采用空气采样的方法,监测某三甲医院NSICU空气环境微生物分布特征,分析其影响因素.结果 大病房各月份空气环境平均细菌数量,均高于小病房相应各月份空气环境平均细菌数量;在大房间中,秋季空气细菌数量明显高于冬、春、夏三季,差异均有统计学意义(均P＜0.05);而冬、春、夏季间的差异均无统计学意义;在小房间中,各季节细菌数量的差异均无统计学意义.结论 NSICU空气环境中细菌数量受患者数量的影响,且以革兰阳性菌为主,也有少量革兰阴性杆菌和真菌等重要条件致病菌,因此设立≤2张床位的小单元管理模式,强化NSICU空气中革兰阴性杆菌和真菌的消毒灭菌措施,是防控NICU发生医院感染的重要举措.     

病房空气微生物监测分析

目的　对医院旧病房、新装修后的空房和入住 3年的新建病房空气微生物进行监测 ,探讨空气质量与医院感染相关性。方法　采用自然菌沉降法对不同病房空气微生物进行采样 ,并对细菌和真菌进行分类鉴定。结果　旧病房空气微生物含量明显高于新建空房和入住 3年的房间 (P <0 .0 5 ) ,使用中的房间金黄色葡萄球菌、蜡样芽胞杆菌及不动杆菌属等条件致病菌比新建空房间增高 ,真菌比例增加尤为明显。结论　应定期维修、翻新病房 ,加强病房空气消毒及净化 ,降低室内空气微生物含量 ,减少医院感染的发生。     

肺部感染病原菌谱及耐药性分析

目的 了解医院肺部感染病原菌构成及耐药性,为临床治疗肺部感染合理选择抗菌药物提供指导.方法 采集医院172例肺部感染患者的痰标本,合格标本接种至血平板、巧克力平板、麦康凯平板进行细菌培养,细菌分离培养与鉴定参考《全国临床检验操作规程》进行,药敏试验采用纸片扩散法.结果 172例患者痰标本分离出148株病原菌,其中革兰阴性杆菌94株占63.51％,革兰阳性球菌32株占21.62％,真菌22株占14.87％;革兰阴性杆菌对氨苄西林耐药率最高,除嗜麦芽寡养单胞菌外,对亚胺培南敏感性最高;革兰阳性球菌对万古霉素的耐药率均为0.结论 革兰阴性菌为医院肺部感染的主要致病菌,且细菌的耐药性较严重,临床医师应根据药敏结果合理应用抗菌药物.     

MICU病原菌分布及泛耐药菌感染危险因素分析

目的 了解综合医院内科重症监护病房病原菌分布及泛耐药菌医院感染相关危险因素.方法 2010年1至12月内科重症监护病房收治的266例患者临床标本中分离菌株673株,经VITEK-2微生物鉴定系统鉴定;回顾性分析资料完整的泛耐药菌感染病例60例,1∶1病例对照研究,logistic多因素回归分析筛选出泛耐药菌医院感染的危险因素.结果 分离的673株病原菌中,645株来源于呼吸道标本,其次来源于尿、血、皮肤创口脓液;338株为革兰阴性杆菌,包括非发酵革兰阴性菌37.9％,肠杆菌科细菌7.4％;其次是真菌210株,均为假丝酵母菌属;革兰阳性菌125株,占18.6％,包括葡萄球菌属11.4％、肠球菌属3.7％;泛耐药菌感染的独立危险因素为有创机械通气(OR=14.820)、住院时间＞30 d(OR=9.269)及应用碳青霉烯类抗菌药物(OR=4.857).结论 内科重症监护病房病原菌以革兰阴性菌为主,非发酵菌多于肠杆菌科细菌;其次是真菌和革兰阳性球菌,假丝酵母菌多于革兰阳性球菌,屎肠球菌多于粪肠球菌;降低危险因素有助于预防和控制泛耐药菌引起的医院感染.     

荆门市某综合医院口腔科门诊环境质量调查和消毒措施评价

目的了解口腔科门诊空气质量、物体表面和医疗物品的污染状况,比较现使用消毒法消毒效果。方法监测口腔科门诊的诊室空气、综合治疗椅治疗台面和涡轮手机的进行细菌菌落总数,将结果进行统计分析。结果在开诊后数小时内,口腔科门诊空气和综合治疗椅治疗台面的细菌总数呈现不断增高趋势,当上午诊疗活动结束后检测3个诊室内空气和综合治疗椅控制面板的细菌总数远远超过开诊前,诊室内空气、物体污染较严重。使用自然通风净化法和循环风紫外线空气消毒法分别作用1 h后,3个诊室内空气细菌总数明显下降(P<0.05),但两种空气消毒方法之间比较没有明显统计学差异(P>0.05)。使用1%单过硫酸氢钾消毒液拭综合治疗椅治疗台面,作用5 min后细菌总数明显下降。涡轮手机每接诊1个病人,其表面及内部细菌总量远高于使用前,环氧乙烷消毒法可完全杀灭各类细菌。结论口腔科门诊诊室环境在诊疗过程中极易受污染而引起院内感染。现使用的消毒方法均能有效减低口腔科诊室空气、物体表面和医疗物品的细菌总数,达到国家相关标准要求。     

医疗门诊部空气细菌污染情况调查

[目的]了解门诊部空气细菌污染情况,为控制医院感染提供依据.[方法]采用平皿沉降法对门诊部20个场所空气采样,计菌落数并根据生化反应对分离菌进行鉴定、分类.[结果]门诊部大部分场所空气含菌量超过700 cfu/m3,以挂号厅、候诊厅、急诊观察室及口腔科诊室空气细菌含量最高(＞1 500cfu/m3).共分离到519株细菌,其中G+菌占79.8%,且检出金葡菌、大肠杆菌、假单胞菌、克雷伯氏菌等院内感染常见病原菌.[结论]应积极采取有效措施来降低门诊部空气细菌含量.     

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.