3261例老年患者医院感染分析及对策

目的　探讨老年人医院感染状况 ,以采取有效措施降低医院感染率。方法　对我院 3 2 61例老年住院患者进行回顾性调查分析。结果　 3 2 61例中 2 1 2例发生医院感染 ,感染率为 6 .5 % ,以下呼吸道感染为多 ,占 49.5 % ;其次为泌尿道感染 ,占 2 2 .0 % ;胃肠道感染占 1 6 .5 % ;皮肤感染占 6 .6 % ;其他感染占 5 .2 %。结论　老年患者抵抗力低下 ,不合理使用抗生素以及住院时间延长 ,是造成医院感染的主要因素 ,因此应加强老年患者的护理 ,提高其自身防御能力 ,严格加强感染管理制度及医院感染监测 ,合理使用抗生素 ,以有效地降低医院感染的发生。     

肾移植术后肺部真菌感染的诊治

目的　探讨肾移植术后肺部真菌感染的诊断与治疗。　方法　回顾性分析 4 3例肾移植术后肺部真菌感染患者的临床资料。男 35例 ,女 8例 ,平均年龄 32岁。发病时间平均为术后 5 9d。　结果　 4 3例患者中 ,白色念珠菌 16例 ,克柔念珠菌 4例 ,近平滑念珠菌 2例 ,曲霉菌 4例 ,毛霉菌 3例 ,新型隐球菌 1例 ,奴卡菌 2例 ,其中 14例有细菌、巨细胞病毒混合感染。 11例培养阴性。氟康唑10 0mg/次 ,3次 /d ,连续 10d ,治愈 2 3例 ;两性霉素B脂质体 5 0mg/d ,连续 10d ,治愈 17例 ;死亡 3例。　结论　肺部真菌感染是肾移植术后的严重并发症 ,死亡率高。早期诊断与治疗效果良好。     

Alveolar hydatid disease of the liver: Brief review and spectrum of adjacent organ invasion

The purpose of this study is to show the spectrum of adjacent organ invasion and to make a brief review of hepatic alveolar hydatid disease (AHD), using CT and MR imaging. We retrospectively reviewed CT and MR images of three patients with various adjacent organ invasions surgically and histologically proven to be AHD. Local invasion to right kidney and adrenal, right hemidiaphragm and lung were detected in one patient, right adrenal in another patient and gall bladder, duodenum, gastric wall and pancreas invasion in the other. AHD may rarely extend to the gall bladder, stomach, duodenum, pancreas, right adrenal and kidney, diaphragm, pleura and lung. The extension of the disease outside the liver is usually encountered in patients with large, peripherally located masses in the advanced stage of the disease.     

小儿腮腺炎并发中枢神经系统感染52例临床分析

目的:探讨小儿腮腺炎并发中枢神经系统感染的临床特点.方法:对52例小儿腮腺炎并发中枢神经系统感染的临床资料进行回顾性总结分析.结果:3～7月份为小儿腮腺炎并发中枢神经系统感染的发病高峰季节(92.31%).发病年龄以6～12岁为主(82.69%),多发生于腮腺肿痛3天以上伴有持续发热者(78.85%),少数患者同时有其它脏器的损害,一般治疗疗效较好.结论:腮腺炎极易并发中枢神经系统感染,年长儿发生率高,应推广接种流腮活疫苗降低发病率.     

不同器官细胞因子在多细菌感染性炎症时的基因表达和临床意义

目的探讨肝、肺细胞因子基因表达与腹腔吞噬细胞上清液、循环血中细胞因子含量的关系,为临床诊治多细菌感染引发的炎症提供实验依据.方法将30只小鼠分为假手术对照组(sham组)和盲肠结扎组(CLP组).采用RT-PCR法检测肝脏和肺脏肿瘤坏死因子α(TNF-α)和白细胞介素10(IL-10)的基因表达情况,采用ELISA法检测腹腔巨噬细胞上清液和循环血液中相应细胞因子含量.结果CLP组的TNF-α、IL-10基因表达和腹腔巨噬细胞上清液、循环血液中的相应细胞因子含量均高于sham组.CLP后18h组与4h组比较,TNF-α在腹腔巨噬细胞上清液、循环血液中的活性均有显著性差异(P＜0.05),在肝、肺中基因表达有非常显著性差异(P＜0.01);IL-10在腹腔巨噬细胞上清液和循环血液中的含量无显著性差异,而在肝、肺中基因表达有显著性差异.结论发生多细菌感染性炎症时,肝、肺参与细胞因子的表达;血液中细胞因子含量不能完全代表组织器官内的基因表达情况;多细菌感染性炎症治疗应考虑靶器官细胞因子的表达状态.     

Intracranial actinomycosis in juvenile patients Case report and review of the literature

A case of actinomycotic brain infection in a juvenile patient is described. Cases of actinomycosis affecting the head and neck are rare, particularly in juvenile patients. In this case complete resolution of the infection was achieved by means of surgical treatment and prolonged antibiotic therapy. The authors emphasize the importance of a combined approach for treatment of this unusual brain infection and stress the difficulties involved in the diagnosis of this pathology. Received: 3 November 1997     

Congenital endophthalmitis following maternal shellfish ingestion

Purpose: To highlight an unusual organism causing a unilateral endophthalmitis by transplacental spread.
Method: We report a case of Plesiomonas shigelloides endophthalmitis, presenting in a newborn, with co-existing septicaemia and meningitis. There was a significant maternal history of diarrhoea associated with the ingestion of oysters 2 weeks prior to delivery.
Result: The endophthalmitis was treated with parenteral antibiotics and topical mydriatics with complete resolution, although subsequent assessment of the affected eye suggests a poor visual outcome.
Conclusion: Endophthalmitis in the newborn is an unusual clinical finding and usually presents with other manifestations of bacteraemia. Plesiomonas shigelloides is fortunately an infrequent cause of neonatal infection, but is associated with a high degree of morbidity and mortality. We postulate that this neonate acquired P. shigelloides via the transplacental route, and suggest that this organism be included in the list of 'other' causes of transplacental infection that has been abbreviated to 'O' in the acronym TORCH.     

呼吸道感染与气象因素的关系

呼吸道感染是呼吸系统常见病、多发病。利用杭州地区1990年1月～1992年12月气象资料作了统计分析，并对同期来海军杭州疗养院门诊就诊的呼吸道感染病人进行了调查。结果为1～3、11、12月发病率高，与5～9月相比有非常显著差异（P＜0．001），呼吸道感染与气温低，湿度高，温差大，天气骤变等气象因素密切相关。潮冷天气（气温在10℃以下），频繁降温（每月3次以上），大幅度降温（4℃以上）三种气象因素共同存在情况下可导致呼吸道感染性疾病的高发。同时从气象学角度提出了预防该病的一些措施。     

Nephrotic syndrome in a mother and her infant: relationship with cytomegalovirus infection

This case report describes infantile nephrotic syndrome (NS) in a baby girl with a clinically severe cytomegalovirus (CMV) infection. Culture of the baby's urine was positive for CMV and IgM anti-CMV antibodies were detected. After an unsuccessful course of corticosteroids, gancyclovir treatment was started and a remission of cutaneous, pulmonary, and renal symptoms was achieved. As the mother also developed NS at the end of pregnancy, a common etiology could be postulated, although there were no signs of recent CMV infection in the mother, only anti-CMV IgG. The relationship between CMV infection and glomerular disease is still unclear: NS may represent another manifestation of CMV disease.