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51.
对我院45例确诊为中、重度细菌感染住院患者进行了亚胺培南/西司他丁与头孢他啶疗效费用分析比较研究。结果表明:2组病例有效率、死亡率无显著性差异;头孢他啶组较亚胺培南/西司他丁组疗程明显延长。亚胺培南/西司他丁每日所需费用明显高于头孢他啶;治疗结束时,前者全部费用并未超过后者;全部住院费用无明显差异。作者认为:决定2种药物全部费用的因素,除与药物单价和每日费用有关,还与药物疗程密切相关。选用药物抗菌作用越强,用药时间即相应缩短,住院时间必然缩短;最终患者住院费用降低 相似文献
52.
53.
Ruth Ladurner Gerald Brandacher Wolfgang Steurer Stefan Schneeberger Claudia Bösmüller Martin Clemens Freund Alfons Kreczy Alfred Königsrainer Raimund Margreiter 《Transplant international》2003,16(12):885-889
Fungal infections still represent a serious complication after organ transplantation. Early diagnosis and aggressive treatment are crucial. Because of the many diagnostic problems involved, we present a case of mucormycosis--primarily affecting the paranasal sinuses with later intracranial extension--in a highly immunized recipient of a third renal transplant. Although fungal infection was suspected from various imaging techniques, only the detection of typical fungal hyphae in the infected tissue was diagnostic. Neither the blood tests and cerebrospinal fluid examinations performed nor cultures from maxillary sinus fluid were of any diagnostic help. Surgical debridement from a transnasal as well as an intracranial approach and systemic amphotericin B together with the discontinuation of immunosuppression after removal of the rejected graft were able to save the patient. This case stresses the importance of early diagnosis that can only be made from tissue biopsies and allows appropriate timely treatment. 相似文献
54.
Benoit J. M. Pirotte Alphonse Lubansu Michael Bruneau Chakir Loqa Nathalie Van Cutsem Jacques Brotchi 《Child's nervous system》2007,23(11):1251-1261
Objective The objective of this study was to evaluate whether the rigid application of a sterile protocol for shunt placement was applicable
on a routine basis and allowed the reduction of shunt infections (SI) in children.
Materials and methods Since 2001, a rigid sterile protocol for shunt placement in children using neither antibiotic-impregnated catheters nor laminar
airflow was prospectively applied at Erasme Hospital, Brussels, Belgium. For assessing the protocol efficacy before continuation,
we preliminarily analyzed the results of the first 100 operated children (43 females, 57 males, 49 aged <12 months; 115 consecutive
shunt placement/revision procedures). All procedures were performed by the same senior surgeon, one assistant, one circulating
nurse, one anesthesiologist. The sterile protocol was rigidly imposed to these four staff members: uniformed surgical technique;
limited implant and skin edge manipulation; minimized human circulation in the room; scheduling surgery as first morning operation;
avoiding postoperative cerebrospinal fluid (CSF) leak; double gloving; procedures of less than 30-min duration; systemic antibiotics
prophylaxis. We analyzed separately: (1) children carrying an increased risk of SI (n = 38) due to preoperative external ventricular drainage, CSF leak, meningitis, glucocorticoids, chemotherapy; (2) children
aged <12 months; (3) procedures for shunt revision.
Results Errors in protocol application were recorded in 71/115 procedures. They were mainly done by non-surgical staff, decreased
with time and were medically justified in some young children. Surprisingly, no SI occurred (follow-up, 4 to 70 months). One
child developed an appendicitis with peritonitis (Streptococcus faecalis) after 6 months. No SI was found. After peritonitis was cured, shunt reinsertion was uneventful.
Conclusion These preliminary results suggest that a uniform and drastic sterile surgical technique for shunt placement: (1) can be rigidly
applied on a routine basis; (2) can lower the early SI rate below 1%; (3) might have a stronger impact to reduce SI than using
antibiotic-impregnated catheters and optimizing the operative environment such as using laminar airflow and reducing the non-surgical
staff. This last issue will be evaluated further in the present ongoing protocol. 相似文献
55.
重型颅脑损伤后应激性溃疡防治与胃肠道感染的相关性及对策 总被引:14,自引:1,他引:13
目的探讨重型颅脑损伤患者应用洛赛克对应激性溃疡进行防治与胃肠道感染几率增加之间的关系及治疗对策。方法回顾近3年来我院收治的重型颅脑损伤并存活30 d以上病人176例,测定不同时间胃液pH值并分析防治应激性溃疡与发生胃肠道感染的相关性以及相应对策。结果在126例持续应用洛赛克的患者中,持续应用>7 d的患者胃肠道感染发生率明显高于持续应用≤7 d的病人。其余50例间隔应用洛赛克患者与126例持续应用洛赛克患者相比,应激性溃疡发生率无明显差别,但间隔应用洛赛克患者胃肠道感染发生率较持续应用洛赛克>7 d的患者明显下降。结论重型颅脑损伤患者应激性溃疡防治>7 d者,由于胃酸分泌严重抑制,增加胃肠道感染发生率。间隔性应用洛赛克治疗在抑制胃酸分泌,减少应激性溃疡发生的同时,可明显减少胃肠道感染的发生。 相似文献
56.
G Kellner T Popow-Kraupp C Binder I Goedl M Kundi C Kunz 《Journal of medical virology》1991,35(4):267-272
Rhinoviruses were isolated from nasopharyngeal secretions of 49 children hospitalized because of severe respiratory tract infection. The isolates were typed using 90 type-specific antisera. No obvious relation between certain serotypes and the severity of illness was found. Serum samples were drawn from all children simultaneously with the nasopharyngeal secretions and screened for the presence of type-specific neutralizing antibodies. Children aged 1 week to 6 months had higher neutralizing antibody titers and revealed a lower degree of morbidity than older children. The decline of neutralizing serum antibodies with increasing age was correlated with a higher incidence of severe disease in those aged 7-12 months. Nevertheless, also in this age group children with mild clinical courses of disease were observed despite a low concentration or an absence of neutralizing serum antibodies. This indicates that not only neutralizing serum antibodies, but other factors also influence the clinical expression of RHV-induced disease. 相似文献
57.
J. R. Zahar M. Lecuit E. Carbonnelle F. Ribadeau-Dumas X. Nassif O. Lortholary 《Clinical microbiology and infection》2007,13(3):219-221
Until recently, most reported cases of bacteraemia caused by multidrug-resistant strains of Enterobacteriacae producing an extended-spectrum beta-lactamase (ESBL) in Europe have been nosocomial in origin. However, increasing numbers of reports of community-acquired bacteraemia and urinary tract infection caused by ESBL-producing microorganisms suggest that the geographical origin of patients should be taken into account as a risk-factor for possible ESBL production. Early identification of patients at high-risk of infection with ESBL-producing microorganisms, based on their geographical origin and travel history, should help to optimise initial antibiotic treatment strategies for severe urinary tract infections in Europe. 相似文献
58.
Histoplasmosis is a fungal disease that affects humans and is caused by Histoplasma capsulatum. The presentation of the infection may be acute, chronic, or disseminated. The disseminated form has extrapulmonary manifestations which may include oral manifestation a. A patient with AIDS sought treatment and he had disseminated histoplasmosis with oral manifestations. The purpose of this case report and literature review is to emphasize the role the dental team has in the diagnosis of disseminated disease when a patient presents with oral manifestations associated with the disease. This case report is clinically relevant because it is not uncommon for oral manifestations to be one of the first signs of systemic disease. 相似文献
59.
过程管理在医院消毒灭菌中的应用 总被引:2,自引:0,他引:2
黄瑞娟 《中华医院感染学杂志》2007,17(8):967-968
目的将过程管理应用于医院消毒灭菌中,规范医院消毒灭菌工作。方法以医院感染管理相关法规为依据,对消毒灭菌流程进行调查诊断,找出流程中的关键环节,以关键环节为质控点,对工作流程进行改造并实施过程管理。结果改善了硬件设施,工作流程更为科学,提高了技术水平和工作效率,消毒灭菌合格率明显提高。结论以医院感染管理相关法规为依据,以流程中的关键环节为质控点的过程管理,有利于规范医院消毒灭菌工作,实现由经验管理、终末管理向依法管理、过程管理转变。 相似文献
60.
目的 探讨实质器官移植术后血浆中白介素18(IL-18)、白介素10(IL-10)、白介素4(IL-4)水平的检测在人巨细胞病毒(HCMV)感染中的意义。方法 对24例实质器官移植受者,用免疫组化法监测HCMV抗原血症。然后采用ELISA法测定血浆中IL-18、IL-10及IL-4的水平。结果 HCMV抗原阳性组IL-18的水平高于阴性组(P<0.01),IL-10及IL-4的水平低于阴性组(均P<0.05)。结论 血浆IL-18的水平可作为预测移植患者HCMV感染的一个有效指标,IL-10及IL-4的水平则可作为患者HCMV感染后体内免疫抑制程度的监测指标之一。 相似文献