NICU空气环境消毒对患者医院感染及病原菌谱的影响北大核心CSCD

目的研究神经内科重症监护病房（NICU）持续改良病房空气消毒方案对医院感染感染及病原菌谱影响,分析医院感染的危险因素。方法自2010年5月-2012年12月于某医院NICU连续制定多个空气环境消毒方案,将其中收治3~6例患者的大NICU单元作为A组,收治1~2例患者的小NICU单元作为B组,调查医院感染的危险因素,数据采用SPSS 17.0软件进行统计分析。结果 592例患者中发生医院感染146例、184例次,医院感染率24.66%、例次感染率31.08%;医院感染部位主要为下呼吸道,占75.69%;146例医院感染患者中有129例送检了病原学检查,送检率88.36%;病房空气环境及患者被服的细菌数超标、侵入性操作是NICU医院感染危险因素（P〈0.05）。结论加强NICU空气消毒是预防控制革兰阳性菌菌和真菌性医院感染的重要手段,制定优良的病房空气消毒方案和规范使用抗菌药物,是预防控制NICU医院感染和避免产生耐药性的重要措施。     

NICU空气环境消毒对患者医院感染及病原菌谱的影响

目的研究神经内科重症监护病房(NICU)持续改良病房空气消毒方案对医院感染感染及病原菌谱影响,分析医院感染的危险因素。方法自2010年5月-2012年12月于某医院NICU连续制定多个空气环境消毒方案,将其中收治3~6例患者的大NICU单元作为A组,收治1~2例患者的小NICU单元作为B组,调查医院感染的危险因素,数据采用SPSS 17.0软件进行统计分析。结果 592例患者中发生医院感染146例、184例次,医院感染率24.66%、例次感染率31.08%;医院感染部位主要为下呼吸道,占75.69%;146例医院感染患者中有129例送检了病原学检查,送检率88.36%;病房空气环境及患者被服的细菌数超标、侵入性操作是NICU医院感染危险因素(P<0.05)。结论加强NICU空气消毒是预防控制革兰阳性菌菌和真菌性医院感染的重要手段,制定优良的病房空气消毒方案和规范使用抗菌药物,是预防控制NICU医院感染和避免产生耐药性的重要措施。     

神经内科病房空气环境的微生物学特征与医院感染的关系

目的研究神经内科病房空气中的微生物学分布特征与发生医院感染的关系。方法选取2008年3~11月某医院神经内科所有住院患者1149例为医院感染监测对象,选取此病区大、小病房各1个,作为病房空气环境微生物学监测对象。结果神经内科病房不同月份空气中的微生物数量差异有统计学意义(P0.05),医院感染率各月份差异无统计学意义,医院感染部位呼吸道78.31%、泌尿道10.84%、胃肠道4.82%,病原菌中革兰阴性杆菌占53.06%,神经内科呼吸道的医院感染率与空气中细菌数量呈正相关(r=0.682,P0.05);真菌和鲍氏不动杆菌、表皮葡萄球菌等医院感染病原菌与其在空气中的月份分布具有一致性。结论神经内科病房空气中的病原菌数量是发生呼吸道医院感染的重要危险因素,空气中的真菌和表皮葡萄球菌、鲍氏不动杆菌等条件致病菌是发生医院感染的重要病原菌。     

革兰阳性菌在NICU的分布及其与医院感染的关系

目的 研究革兰阳性菌引发神经内科重症监护病房(NICU)医院感染的临床及其在病房环境中的分布特征.方法 选取2010年10月-2011年9月某三级医院NICU患者为监测对象,对其中发生医院感染患者进行病原学检查及药敏试验,同时监测NICU空气和病床单位环境的革兰阳性菌分布特征.结果 209例患者中有61例发生医院感染,感染率为29.19％;其中42例进行了病原学检测,革兰阳性菌占15.44％,均为革兰阳性球菌,以金黄色葡萄球菌为主;病房空气、枕头、被服上检出菌种的构成差异无统计学意义.结论 金黄色葡萄球菌、肺炎链球菌、溶血葡萄球菌等革兰阳性球菌是引发NICU患者下呼吸道和泌尿道医院感染的重要病原菌,病房空气和床单位环境是溶血葡萄球菌引发下呼吸道感染的重要传播途径,其对氨苄西林/舒巴坦、莫西沙星、亚胺培南、万古霉素等抗菌药物具有很高的敏感性.     

NICU患者医院感染的病原学类型与病房环境的关系

目的 研究神经内科重症监护病房(NICU)发生医院感染的病原学与病房环境因素的关系,为有效切断致病菌的传播途径提供依据.方法 选取2010年9月-2011年9月唐山市某三甲医院NICU住院患者为监测对象,监测其医院感染的发生情况,同时监测发生感染患者室内空气及床单位(枕头、被服)等环境.结果 224例住院患者中有65例发生医院感染,感染率为29.02％,感染部位以下呼吸道为主,占90.24％;感染病原菌中革兰阴性杆菌占77.01％,主要为铜绿假单胞菌和肺炎克雷伯菌,革兰阳性球菌占16.67％,主要为金黄色葡萄球菌,真菌占6.32％;感染患者病房环境主要以革兰阳性球菌为主.结论 铜绿假单胞菌、肺炎克雷伯菌、金黄色葡萄球菌等是引发NICU医院感染的主要病原菌,病房空气或床单位等环境因素是这些致病菌的重要传播途径之一,因此应加强病房环境和病床单位的消毒,以防止医院感染的传播.     

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.     

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。     

NICU发生医院感染的危险因素分析与干预措施

目的探讨NICU发生医院感染的危险因素及干预措施。方法通过前瞻性调查与回顾性调查相结合的方法对2009~2010年入住NICU共254例患者的医院感染监测资料进行统计、分析。结果 NICU共发生医院感染144例次,例次感染率为56.69%。远高于医院平均例次感染率2.93%。其中住院时间长、高龄患者是感染的高发人群;感染部位以下呼吸道为主占54.86%;共检出病原菌139株,以革兰阴性菌及真菌属为主,条件致病菌(铜绿假单胞菌、鲍曼不动杆菌)是主要的感染病原菌;侵袭性操作、滥用抗生素是医院感染发生的主要诱因。结论 NICU是医院感染的高发科室,通过缩短住院天数、加强病房管理、发扬慎独精神、重视呼吸道管理、规范无菌操作规程,严格侵入性操作指征、提高手卫生依从性、合理使用抗菌素等干预措施能有效预防医院感染的发生。     

急诊环境与留观患者医院感染发生率的关系

目的　观察急诊环境因素与同期急诊病房留观危重病患者发生医院感染之间的关系。方法　通过对我院冬春季急诊环境进行空气微生物含量、人员和物体污染状况进行监测 ,并与同期急诊病房留观危重患者发生医院感染情况及其关系进行综合分析。结果　 4人间、2人间的急诊病房和病房走廊的空气含菌量分别占前 3位 ;医务人员右手掌平均带菌量 (11.4± 3.4) CFU/ cm2 ,听诊器平均含菌量 (13.0± 4.1) CFU/ cm2 ;同期内调查留观危重病患者 493例 ,感染 97例 ,感染率 19.7% ,其中呼吸道感染占 6 1.9% ,其次为胃肠道感染和泌尿道感染 ,分别为2 0 .6 %和 14.4%。结论　冬春季急诊环境由于人员流动性大、空气闭塞、环境污染严重易导致留观患者医院感染发生率增加 ,尤其以呼吸道感染为甚 ;加强通风、消毒和提高医务人员的无菌观念 ,对于改善冬春季急诊环境污染至关重要     

神经内科病房环境的微生物分布特征及其影响因素分析

目的 分析不同等级医院神经内科病房环境的微生物学分布特征和影响因素,为神经内科病房的临床消毒和医院感染的预防提供依据.方法 监测神经内科病房内空气环境微生物分布特征,分析其影响因素.结果 同一医院大病房月平均病原菌数量均高于小病房(P<0.05),三级医院大、小病房平均微生物数量均高于二级医院的大、小病房(P<0.05);病房患者数量、医院等级是病房微生物数量的影响因素,但与月份无相关性;菌种鉴定显示G~+ 球菌占71.05%,G~+ 杆菌19.92%、G~-杆菌5.26%,G~-球菌0.38%,真菌4.51%,它们在4所医院神经内科病房的分布构成比,差异均无统计学意义(P>0.05).结论 医院等级越高、病房患者数量越多,神经内科病房的微生物数量越多;合理的病房床位设置,严格执行各种消毒制度,是预防医院感染的重要措施.     

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.     

Changes in immune function in asthma in the elderly

Asthma is an inflammatory disorder of the airway. The airway inflammation of asthma is typically an allergic inflammation characterized by cells and mediators described as a "Th2" inflammatory response. There is a growing body of evidence describing changes in the function of immune cells upon aging, a phenomenon referred to as "immunosenescence". Several studies utilizing animal models and human subjects with asthma have begun to explore age-related effects on the airway inflammation in asthma. This review explores the existing data on the presence and effects of immunosenescence or age-related changes in immune function in asthma.     

Changes in Fatty Acid Composition in Beef in Italy

Results from a study conducted in Italy concerning the updating of composition data of beef consumed in Italy are reported here. The study required a very wide sampling plan with regard to both animals and cuts to analyse. Data related to lipid composition of the most widely used type of beef consumed in Italy (young bull, 16–22 months old) show a reduction in total lipid content (which, according to the cuts, ranges between 1.8 and 10.2%) and a substantial change in fatty acid composition, with a high % of polyunsaturated fatty acids (mean 20% of total fatty acids). Such data have been confirmed by other studies conducted in Italy, and are in contrast with data reported in the tables of food composition from other countries, reporting a fatty acid composition characterized by a high fatty acid saturation degree. The occurrence of long-chain polyunsaturated fatty acid is probably due to the high ratio of phospholipids: triglycerides, occurring when the content in intramuscular lipid is very low; to the young age of animals; to the reduced activity of the rumen, where saturation of fatty acids occurs. It may be concluded that a fatty acid composition, which is particularly rich in polyunsaturated fatty acids, seems typical for Italian products.     

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.