Management of Gas Gangrene in Wenchuan Earthquake Victims

Gas gangrene is an emergency condition,which usually develops after injuries or surgery.This study was designed to investigate clinical characteristics,appropriate therapy,and effective control of nosocomial cross-infection of gas gangrene in Wenchuan earthquake victims.Data on diagnosis,treatment,and prevention of confirmed,suspected,or highly suspected gas gangrene were collected.Sixty-seven（2.41%） cases of suspected gas gangrene were found,in which 32 cases were highly suspected of gas gangrene and 5 cases were confirmed by culture of Clostridium perfringens.Thereof,injury sites were mainly located on the limbs,and typical indications,including crepitation,severe localized pain,swelling,wound discoloration,dark red or black necrotic muscle,foul smell as well as different degrees of systemic toxic performance were common among them.After hospitalization,all patients were isolated and had surgery quickly to remove dead,damaged or infected tissue.The wounds were also exposed for drainage and washed or padded with 3% liquid hydrogen peroxide for disinfection before all diagnostic test results were available.Additionally,high doses of antibiotics（mainly penicillin） were given for the prevention of infection,and supportive therapy was applied for corresponding symptoms control.Among those cases,no fatality was reported.In summary,in post-disaster emergency relief,the diagnosis of gas gangrene should be primarily based on clinical manifestationswhile patient isolation,wound debridement and disinfection,as well as antibiotics treatment,is the main measures for proper treatment and control of nosocomial infection for gas gangrene.

The molecular epidemiological study of colistin-only-sensitive strains in multi-drug resistant Acinetobacter baumannii

This paper reported the epidemiology of the colistin-only-sensitive Acinetobacter baumannii(COS-AB)in a tertiary teaching hospital in China.We analyzed the clinical data of 136 COS-AB isolates from June 2004 to May 2005 and collected 66 A.baumannii isolates in which 33 strains were COS-AB,and the rest were non-COS-AB.Random amplified polymorphic DNA(RAPD)analysis(primer ERIC2 and 272)showed that all COS-AB were identical,while pulsed-field gel electrophotesis(PFGE)analysis showed two separate genotypes of these COS-AB which were distinctly different from that of non-COS-AB.The COS-AB from burn wards showed the identical PFGE pattern which was distinguished from the genotype of COS-AB in other departments,mainly surgical systems.The cross-infection was severe and strict methods of disinfection and sterilization should be implemented.Meanwhile,the epidemiology of COS-AB in environment and patients should be closely monitored.The PFGE analysis is a reliable method of A.baumannii typing.