2011—2015年细菌性腹膜炎病原菌分布及耐药性

目的了解细菌性腹膜炎病原菌分布及耐药状况,为临床抗感染治疗提供实验室依据。方法收集徐州医科大学附属医院2011—2015年细菌性腹膜炎患者腹腔积液培养分离的病原菌,对其进行细菌鉴定和药敏试验,分析病原菌分布和耐药情况。结果共收集菌株491株,其中革兰阴性杆菌291株（59.26%）,革兰阳性球菌196株（39.92%）,真菌4株（0.82%）,排名居前5位的病原菌分别为大肠埃希菌（30.14%）、凝固酶阴性葡萄球菌（12.22%）、金黄色葡萄球菌（10.39%）、肺炎克雷伯菌（8.55%）和屎肠球菌（6.52%）。大肠埃希菌、肺炎克雷伯菌、鲍曼不动杆菌和铜绿假单胞菌对亚胺培南的耐药率分别是4.90%、31.04%、77.28%和26.27%。耐甲氧西林金黄色葡萄球菌（MRSA）检出率为56.02%,耐甲氧西林凝固酶阴性葡萄球菌（MRNCS）检出率为70.02%。结论引起细菌性腹膜炎的病原菌以革兰阴性杆菌为主,大肠埃希菌占首位;病原菌耐药情况严重,应该加强抗菌药物的规范使用,减少耐药菌株的产生。     

血液系统疾病医院感染临床分离菌株分布与耐药性分析

目的 分析血液病住院患者医院感染临床分离菌的分布及其耐药现状.方法 收集2005年1月-2007年12月住院血液病患者临床分离菌株,采用微量稀释法进行药敏试验.结果 共检出病原菌431株,革兰阳性菌170株(39.5%),革兰阴性菌194株(45.0%),真菌67株(15.5%);革兰阳性菌中屎肠球菌占6.3%;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)检出率分别为71.4%和35.8%,未检出对耐万古霉素葡萄球菌和肠球菌;血液科最常见革兰阴性菌中依次为大肠埃希菌14.6%、肺炎克雷伯菌7.7%、铜绿假单胞菌5.6%、嗜麦芽寡养单胞菌5.1%、鲍氏不动杆菌4.9%;大肠埃希菌和肺炎克雷伯菌ESBLs的检出率分别为17.5%和9.1%;2007年检出泛耐药铜绿假单胞菌2株.结论 血液病患者合并医院感染病原菌以革兰阴性菌为主,应合理使用抗菌药物,防止多药耐药株与泛耐药菌株的出现,降低医院感染发生率.     

4668株呼吸道感染病原菌的耐药性研究

目的了解医院呼吸道感染病原菌的分布及耐药性,为临床合理用药提供依据。方法收集2012-2014年送检的29352例痰液和咽拭子标本,采用VITEK-2 Compact辅以K-B纸片法对病原菌进行鉴定和药敏试验,采用WHONET5.6进行分析。结果共分离出4668株病原菌,革兰阴性杆菌占72.1%,革兰阳性球菌占27.9%;检出率前5位的菌依次是铜绿假单胞菌、大肠埃希菌、肺炎克雷伯菌、金黄色葡萄球菌和鲍曼不动杆菌。MRSA检出率为56.1%,产ESBLs的大肠埃希菌和肺炎克雷伯菌检出率为34.8%和15.1%。多重耐药鲍曼不动杆菌分离率为44.7%。铜绿假单胞菌和鲍曼不动杆菌对多粘菌素、阿米卡星的耐药率低;大肠埃希菌和肺炎克雷伯菌对亚胺培南和美洛培南100%敏感,对阿米卡星耐药率均5%;未发现耐万古霉素和替考拉宁的金黄色葡萄球菌。MRSA对所有药物的耐药性均高于MSSA,其中5种药物的耐药率经分析差异有统计学意义(P0.01)。结论医院呼吸道分离菌以革兰阴性杆菌为主,应重视对细菌的耐药性监测,以促进临床合理用药。     

2006—2007年Mohnarin门急诊患者病原菌耐药性监测

目的 了解我国门急诊患者分离菌对抗菌药物的耐药状况.方法 采用纸片法、MIC法或E-test法测定病原菌药物敏感性,使用WHONET5.4软件进行数据分析,对卫生部全国细菌耐药性监测网(Mohnarin)所属84所三级甲等医院2006年6月1日-2007年5月31日门急诊来源的病原菌药物敏感性进行分析.结果 共分离病原菌8815株,包括革兰阳性菌3270株(37.1%),革兰阴性菌5358株(60.8%)和真菌187株(2.1%);其中大肠埃希菌分离最多,共2276株(25.8%),其次为凝固酶阴性葡萄球菌(CNS)1404株(15.9%)、铜绿假单胞菌725株(8.2%)、金黄色葡萄球菌(SAU)689株(7.8%)和肠球菌属638株(7.2%);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36.8%和73.9%,低于同期整体病原菌耐药监测水平,未发现耐万古霉素金黄色葡萄球菌和耐万古霉素凝固酶阴性葡萄球菌;粪肠球菌和屎肠球菌中分别有1.3%和3.8%对万古霉素耐药,2.1%和3.2%对替考拉宁耐药;链球菌属主要对大环内酯类与克林霉素耐药,β-溶血性链球菌(β-SHA)与酿脓链球菌对左氧氟沙星耐药率＞30.0%;嗜血菌属对氨苄西林耐药率＞30.0%;大肠埃希菌和肺炎克雷伯菌ESBLs的阳性率分别为21.4%和11.0%,低于同期整体监测水平;铜绿假单胞菌对阿米卡星、亚胺堵南、头孢他啶的耐药率＜30.0%.结论 我国门急诊来源病原菌以大肠埃希菌、CNS、铜绿假单胞菌和SAU多见;儿童以革兰阳性菌为主,成人则以革兰阴性菌为主;门急诊来源MRSA的发生率、大肠埃希菌和肺炎克雷伯菌ESBLs的阳性率均较同期整体水平偏低.     

腹部手术切口感染病原菌分布与耐药性调查

目的 探讨腹部手术切口感染病原菌的分布及耐药性.方法 采集伤口分泌物进行细菌培养,分离病原菌并进行鉴定;用琼脂扩散法(K-B法)做药物敏感试验,对病原菌耐药率进行分析.结果 病原菌以革兰阴性杆菌为主,占76.9%;其中分离率最高的为大肠埃希菌(24.9%)、铜绿假单胞菌(17.6%)、肺炎克雷伯菌(17.2%),耐甲氧西林金黄色葡萄球菌(MRSA)检出率为40.0%;产超广谱β-内酰胺酶(ESBLs)大肠埃希菌和肺炎克雷伯菌检出率为45.2%;以上病原菌均检测出较高的耐药率.结论 必须采取切实的防治对策,预防与控制腹部手术切口感染.     

外科感染性标本的病原菌分析

目的 探讨医院外科感染性标本的病原菌分布及耐药性,指导临床合理选择抗感染药物.方法 采集感染性标本进行细菌培养,采用常规方法分离病原菌并进行鉴定;用琼脂扩散法(K-B法)进行药物敏感试验.结果 322株外科感染性标本分离的病原菌巾,金黄色葡萄球菌(SAU)、大肠埃希菌(ECO)、铜绿假单胞菌(PAE),分别占第1、2、3位,占总数的25.2%、15.8%、13.0%;耐甲氧西林金黄色葡萄球菌(MRSA)检出率为32.1%;耐甲氧西林凝固酶阴性葡萄球菌(MRCNS)检出率为33.3%;产ESBLs大肠埃希菌和肺炎克雷伯菌检出率为34.5%;各种病原菌均产生了不同程度的耐药性,但万古霉素对革兰阳性球菌敏感率为100.0%;亚胺培南对革兰阴性杆菌敏感率为19.0%～100.0%.结论 外科感染病原菌耐药性各异,临床应根据细菌培养的结果合理使用抗菌药物,避免耐药菌产生与流行.     

某院近5年痰标本分离病原菌及耐药性分析

目的了解某院近5年呼吸科呼吸道感染患者痰标本主要病原菌分布及耐药性变化,为临床感染控制和指导合理用药提供依据。方法常规培养分离细菌,应用VITEK2和Phoenix100全自动细菌鉴定分析仪鉴定菌株;药敏试验采用K-B纸片扩散法,按美国临床实验室标准化协会(CLSI)发布的标准操作。结果 2009—2013年该院呼吸科住院患者痰标本共分离病原菌1 829株,其中革兰阴性杆菌1 442株(78.84%),革兰阳性球菌387株(21.16%)。主要革兰阴性杆菌为鲍曼不动杆菌(21.76%)、铜绿假单胞菌(18.70%)、肺炎克雷伯菌(11.70%)、大肠埃希菌(7.16%);主要革兰阳性球菌为金黄色葡萄球菌和屎肠球菌,分别占11.76%和4.70%。产超广谱β-内酰胺酶(ESBLs)大肠埃希菌和肺炎克雷伯菌检出率为61.83%和34.45%。鲍曼不动杆菌对阿米卡星、亚胺培南和美罗培南的耐药率均70%;铜绿假单胞菌对头孢吡肟和头孢他啶的耐药率分别为22.22%和51.46%,对亚胺培南和美罗培南的耐药率分别为49.71%和49.42%。金黄色葡萄球菌中出现了对利奈唑胺耐药的菌株,对呋喃妥因的耐药率6.0%,5年中耐甲氧西林金黄色葡萄球菌(MRSA)的检出率为88.37%;2013年,肠球菌属对利奈唑胺、替考拉宁的耐药率均为4.35%,对万古霉素的耐药率达8.70%。结论该院呼吸科呼吸道感染患者主要感染病原菌为鲍曼不动杆菌、铜绿假单胞菌、肺炎克雷伯菌、大肠埃希菌和金黄色葡萄球菌,对临床多种常用抗菌药物的耐药率均较高,呈现多药耐药现象。     

山东省101所医院重症监护病房患者分离细菌及耐药性特征

目的了解山东省重症监护病房(ICU)细菌分布及耐药情况。方法收集2014年山东省101所医院ICU及106所医院普通病房(非ICU)分离细菌的药敏数据,进行统计分析。结果共收集细菌24 458株,革兰阴性菌占80.37%,革兰阳性菌占19.63%。ICU分离居前5位的细菌依次为:肺炎克雷伯菌、鲍曼不动杆菌、铜绿假单胞菌、大肠埃希菌、金黄色葡萄球菌。来源于ICU的大肠埃希菌、肺炎克雷伯菌、阴沟肠杆菌、黏质沙雷菌对碳青霉烯类药物、哌拉西林/他唑巴坦、头孢哌酮/舒巴坦、阿米卡星耐药率高于非ICU来源菌株(均P0.01)。ICU分离鲍曼不动杆菌、铜绿假单胞菌、葡萄球菌属细菌对常用抗菌药物耐药率高于非ICU菌株(P0.05)。ICU分离鲍曼不动杆菌对亚胺培南和美罗培南耐药率分别为78.0%、79.0%;铜绿假单胞菌对前述药物耐药率分别为25.5%、21.6%,对其他常用抗菌药物的耐药率30.0%。ICU耐甲氧西林金黄色葡萄球菌(MRSA)检出率为39.7%,高于非ICU的26.0%(P0.05)。结论 ICU分离细菌耐药情况比较严重,应依据药敏结果指导抗菌药物合理应用,防止耐药菌感染扩散。     

手足创伤患者感染病原菌分布及耐药性分析

目的 分析手足创伤患者感染的病原菌及其耐药性,为临床合理选用抗菌药物提供依据.方法 对2005～2008年手足创伤感染标本分离出的病原菌,采用纸片扩散法(K-B法)进行药敏试验,对病原菌耐药率进行分析.结果 分离出242株病原菌,革兰阴性杆菌163株,占67.4 0%,主要为铜绿假单胞菌、大肠埃希菌、阴沟肠杆菌、肺炎克雷伯菌和鲍氏不动杆菌;革兰阳性球菌79株,占32.6%,主要为金黄色葡萄球菌和肠球菌属;大肠埃希菌和肺炎克雷伯菌的超广谱β-内酰胺酶(ESBLs)检出率分别为53.8%和40.9%,耐甲氧西林金黄色葡萄球菌(MRSA)检出率为24.1%.结论 手足创伤患者感染的病原菌以革兰阴性杆菌为主,检出率最高的是金黄色葡萄球菌,主要致病菌常为多药耐药,应加强病原菌的监测,指导临床合理用药,减少耐药菌株的产生.     

临床常见病原菌分布与耐药性研究

目的了解医院常见病原菌分布及耐药性,为临床合理选用抗菌药物提供依据。方法选取2008年1月-2012年12月14 227株病原菌,鉴定采用VITEK微生物分析仪,药物敏感性试验采用BIOMIC药敏测定仪,耐药性分析采用WHONET5.4软件。结果在14 227株临床分离菌中革兰阴性菌8 257株占58.0%,革兰阳性菌3 187株占22.4%,真菌2 783株占19.6%,最常见的菌种依次为铜绿假单胞菌、大肠埃希菌、金黄色葡萄球菌、鲍氏不动杆菌、肺炎克雷伯菌,铜绿假单胞菌在高压氧科检出较高,鲍氏不动杆菌在ICU检出较高,大肠埃希菌、肺炎克雷伯菌和金黄色葡萄球菌在内科病区检出较高;除大肠埃希菌主要检自尿标本外,上述4种菌主要检自痰标本;耐甲氧西林金黄色葡萄球菌(MRSA)和凝固酶阴性葡萄球菌(MRCNS)检出率分别为70.6%、73.7%,金黄色葡萄球菌对利奈唑胺和万古霉素的敏感性最好,未发现耐药株,对呋喃妥因敏感性次之,耐药率为0.9%。结论加强细菌耐药性监测,推动临床抗菌药物的合理使用。     

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.