鱼骨图分析模式改进措施对消毒供应中心院感预防的价值

目的探讨在消毒供应中心院感预防的过程中实施鱼骨图分析模式的效果。方法选择2022年1月—2023年1月在合肥市第二人民医院消毒供应中心工作人员40名为研究对象,按照随机数表法将工作人员分为对照组(n=20)与观察组(n=20)。对照组实施常规管理措施,观察组实施基于鱼骨图分析模式的改进措施。对2组医院感染发生率、医疗器械消毒合格率、工作人员专业能力进行统计比较。结果观察组医院感染发生率为0,对照组医院感染发生率为30.00%,观察组明显低于对照组(P<0.05)。观察组在实施鱼骨图分析模式的改进措施后,其医疗器械消毒合格率为99.33%(298/300),高于对照组的96.67%(290/300),差异有统计学意义(P<0.05)。观察组工作人员实施鱼骨图分析模式的改进措施后其各项指标得分均较对照组显著要高(P<0.05)。结论消毒供应中心质量控制及院感预防中实施基于鱼骨图分析模式的改进措施,价值较高,同时有助于提高工作人员专业能力。

某部聚集性诺如病毒感染的预防及治疗措施

诺如病毒是非细菌性急性肠胃炎的主要病原之一,具有高度感染性,潜伏期短,排毒时间长,传播迅速,疫情暴发频率高。诺如病毒的高异质性,使得目前尚无有效的抗病毒药物及疫苗。文章就2017年2月医院针对某部聚集性诺如病毒感染,依据中国疾病预防控制中心发布的《诺如病毒感染暴发调查和预防控制技术指南》,结合疫情实际情况,制定相关预防及治疗措施,主要从临床诊断、疫情报告、治疗措施、预防感控4个方面阐述,着重强调切断传播途径、防控交叉感染和病例排查监控等预防控制措施的重要性。

应用品管圈提高境外旅客医学观察隔离区工作人员感控预防措施达标率

目的加强境外旅客医学观察隔离区感控管理,不断提高感控预防措施达标率,以保障医患双方的安全。方法2020年3月国内新型冠状病毒肺炎疫情得到控制,境外疫情开始暴发蔓延,作为境外旅客定点筛查医院,为防止境外输入病例造成医院感染,科室开展“提高境外旅客医学观察隔离区工作人员感控预防措施达标率”为主题的品管圈活动,结合现况把握、目标设定、要因分析、对策拟定等确定4项对策实施方案。结果比较品管圈实施前后境外旅客医学观察隔离区工作人员感控预防措施达标率,实施后工作人员感控预防措施达标率由原来的45.08%提升至91.54%,实施前后差异有统计学意义(P<0.001)。目标达标率为84.43%,进步率为108.85%。结论品管圈活动可以提高境外旅客医学观察隔离区工作人员感控预防措施达标率,从而保障患者及工作人员的安全。

消毒供应中心采取全程质控管理对预防院感的作用

目的探讨全程质控管理在消毒供应中心(CSSD)预防院感的作用。方法 2015年全年我院采取常规消毒质控管理,将其设为对照组,2016年全年采取全程质控管理,将其设为全程组。在2015和2016年全年均对CSSD工作环节质量合格率进行900次检测,并每年选取1 200例入院诊治的患者进行院感发生率统计。结果全程组院感总发生率明显低于对照组,且清洗、消毒、灭菌、包装、存放、发放工作合格率均明显高于对照组(P<0.05)。结论全程质控管理能有效切断消毒供应中心细菌传播途径,有利于降低院感发生率,提高器械消毒合格率,有临床应用价值。

探讨血站实施感控标准预防措施的效果

目的:探讨在血站采供血过程中实施感控标准预防措施管理的效果。方法:本血站从2018年9月应用医院消毒和感控管理方法实施血站感控标准预防措施管理后,对监测效果进行比较分析,将2017年9月到2018年8月完善感控标准预防措施前的工作情况作为对照组,将2018年9月到2019年8月完善感控标准预防措施管理后的工作情况作为观察组进行本次研究。观察实施血站感控标准预防措施后的效果。结果:两组使用中消毒液染菌监测、无菌间尘埃计数监测、献血者肘部消毒效果监测、高压灭菌效果监测、紫外线灯强度监测合格率组间比较差异不明显,P>0.05。观察组工作间空气消毒效果、工作人员手指细菌监测、运血箱消毒效果监测合格率高于对照组,组间比较具有明显差异,P<0.05。结论:在血站采供血的过程中实施完善的消毒感控管理措施具有良好的效果,可有效改善采供血工作人员消毒感控工作质量,提高消毒和感控监测的合格率,从而降低感染事件发生的几率。

山区医院新生儿应用恒温箱预防院感的措施

目的：通过分析总结我院新生儿使用恒温箱后医院感染的调查报告，不断完善医院内感染的监控措施，提高医院内感染的防治水平。方法：采取回顾性调查方法分析2007年8月-2008年8月本院新生儿应用恒温箱的医院内感染监控情况。结果：应用恒温箱的新生儿医院感染发生率为o。结论：有效的管理措施在预防控制医院感染中起到了举足轻重的作用，全员的充分认识和认真落实各项消毒隔离制度是根本保证。

Eradication of H pylori for the prevention of gastric cancer

Infection with H pylori is the most important known etiological factor associated with gastric cancer. While colonization of the gastric mucosa with H pylori results in active and chronic gastritis in virtually all individuals infected, the likelihood of developing gastric cancer depends on environmental, bacterial virulence and host specific factors. The majority of all gastric cancer cases are attributable to H pylori infection and therefore theoretically preventable. There is evidence from animal models that eradication of H pylori at an early time point can prevent gastric cancer development. However, randomized clinical trials exploring the prophylactic effect of Hpylori eradication on the incidence of gastric cancer in humans remain sparse and have yielded conflicting results. Better markers for the identification of patients at risk for H pylori induced gastric malignancy are needed to allow the development of a more efficient public eradication strategy. Meanwhile, screening and treatment of H pylori in first-degree relatives of gastric cancer patients as well as certain high-risk populations might be beneficial.

Cycling of antibiotics for the prophylaxis of recurrent spontaneous bacterial peritonitis in a cirrhotic patient

More than 80% of cirrhotic patients who have been treated successfully for spontaneous bacterial peritonitis （SBP） experience a recurrence. Long-term prophylaxis with single daily oral antibiotic has been shown to be cost effective in delaying a recurrence but only for a short time. What has never been tested in this population is the cycling of antibiotics. We report the beneficial use of antibiotic cycling for 36 weeks in a 74-year-old woman with cryptogenic cirrhosis and recurrent SBE

siRNA, miRNA and HIV: promises and challenges

Small interfering RNA (siRNA) and microRNA (miRNA) are small RNAs of 18-25 nucleotides (nt) in length that play important roles in regulating gene expression. They are incorporated into an RNA-induced silencing complex (RISC) and serve as guides for silencing their corresponding target mRNAs based on complementary base-pairing. The promise of gene silencing has led many researchers to consider siRNA as an anti-viral tool. However, in long-term settings, many viruses appear to escape from this therapeutical strategy. An example of this may be seen in the case of human immunodeficiency virus type-1 (HIV-1) which is able to evade RNA silencing by either mutating the siRNA- targeted sequence or by encoding for a partial suppressor of RNAi (RNA interference). On the other hand, because miRNA targeting does not require absolute complementarity of base-pairing, mutational escape by viruses from miRNA- specified silencing may be more difficult to achieve. In this review, we discuss stratagems used by various viruses to avoid the cells’ antiviral si/mi-RNA defenses and notions of how viruses might control and regulate host cell genes by encoding viral miRNAs (vmiRNAs).

Prophylactic antibiotics for variceal hemorrhage: Clostridium difficile infection still can be a risk

Bron et al presented a retrospective study regarding the prophylactic use of antibiotics for variceal hemorrhage. Antibiotics appeared to improve the survival rate of patients without increasing clostridium difficile infection (CDI). We argue against the conclusion of the authors and consider that this result may be simply due to concurrent use of metronidazole, a therapeutic agent against CDI.

Selection Pressure on Haemagglutinin Genes of H9N2 Influenza Viruses from Different Hosts

Positive selection and differential selective pressure analyses were carried out to study Haemagglutinin (HA) genes of H9N2 influenza viruses from different hosts in this paper. Results showed that, although most positions in HAs were under neutral or purifying evolution, a few positions located in the antigenic regions and receptor binding sites were subject to positive selection and some of them were even positively selected at the population level. In addition, there were always some positions differentially selected for viruses from different hosts. Both selection pressure working on HA codons and positions differentially selected might account for the extension of the host range and adaptations to different hosts of H9N2 influenza viruses.

Universal precaution practice and barriers to compliance among nurses in Aseer public Hospitals, Saudi Arabia

Background:Studies have shown that for every 100 hospitalized patients at any given time,10 in developing,and 7 in the developed countries would eventually develop at least one episode of healthcare associated infections.This highlights the imperativeness of adherence to Universal Precautions(Ups)for prevention of infections.Proper compliance with standard would lead to a decrease in rate of HAI.Aim:The aim of the study is to determine the perception of nurses toward compliance with universal precautions in Aseer region hospitals,Saudi Arabia and factors that may hinder the nurses from complying with those standards.Methods:A cross sectional study was performed.Data collected using validated questionnaire of universal precautions from convenience sample of 302 respondents’nurses across four public hospitals in Aseer region.Analysis was performed through descriptive statistics and chi square tests of association.Results:The overall compliance toward universal precautions among nurses was high at 88%.The results reveal that all constructs that define the actions of the nurses to have a statistically significant association at 99%with the extent to which nurses utilized the universal precautions.Discussion:The results indicate that nursing staff adhere to the universal precautions for prevention of infection.However,the hospitals should solve the main barriers including lack of personal protective clothing,challenges during emergencies,and lack of training on how to use.

Detection of Antibody to Hepatitis Delta Virus in Human Serum by Double Antigen Sandwich ELISA

A simple rapid detection of antibody to hepatitis delta virus (anti-HDV) in human serum was developed by using double antigen sandwich ELISA. HDV gene fragment encoding HDAg was isolated from a Chinese patient infected with HDV by RT-PCR, and a high-efficient expression HD-PQE31 strain was constructed with the fragment. We obtained high titer and good quality hepatitis delta virus protein purified by Ni-NTA metal-affinity chromatography, which was identified by Western blot and ELISA, then we set up the double antigen sandwich ELISA for detection of anti-HDV in human serum, and the performance of the sandwich ELISA was evaluated in terms of specificity and sensitivity. Results were: 1) The purified HDAg protein’s purity was 90%, and its ELISA titer was 1/100 000. 2) 42 anti-HDV positive sera were detected and showed that the sensitivity of sandwich ELISA was higher than that of competitive ELISA (t=2.44, p<0.01). 3) The inhibitory rates for 2 anti-HDV positive sera by the specific HDAg were 74% and 93% respectively. 4) For the assay of specificity, all 60 samples infected by other hepatitis viruses and 30 normal samples were negative for anti-HDV. These results suggested that the double antigen sandwich ELISA with purified recombinant HDAg showed higher specificity and sensitivity, It can be used in routine laboratories to diagnose the HDV infection.

International non-governmental actors in HIV/AIDS prevention in China

International non-governmental organizations were among the first international actors that responded to the emer- gence of AIDS crisis in China. Since 1994, the number of international non-governmental organizations and charitable foundations working in AIDS related issue areas in China has grown steadily and substantially. Despite their organiza- tional differences, most of these non-governmental actors present the characteristics of independent mission, localized practice and diverse working focus. Even though they are constrained by financial and other factors compared with multilateral and bilateral official assistance agencies, they have still played a unique role in fighting against AIDS in China as technical experts, public educators, and civil society supporters.

Present and future of prophylactic antibiotics for severe acute pancreatitis

AIM: To investigate the role of prophylactic antibiotics in the reduction of mortality of severe acute pancreatitis (SAP) patients, which is highly questioned by more and more randomized controlled trials (RCTs) and metaanalyses. METHODS: An updated meta-analysis was performed. RCTs comparing prophylactic antibiotics for SAP with control or placebo were included for meta-analysis. The mortality outcomes were pooled for estimation, and re-pooled estimation was performed by the sensitivity analysis of an ideal large-scale RCT. RESULTS: Currently available 11 RCTs were included. Subgroup analysis showed that there was significant reduction of mortality rate in the period before 2000, while no significant reduction in the period from 2000 [Risk Ratio, (RR ) = 1.01, P = 0.98]. Funnel plot indi-cated that there might be apparent publication bias in the period before 2000. Sensitivity analysis showed that the RR of mortality rate ranged from 0.77 to 1.00 with a relatively narrow confidence interval (P < 0.05). However, the number needed to treat having a minor lower limit of the range (7-5096 patients) implied that certain SAP patients could still potentially prevent death by antibiotic prophylaxis. CONCLUSION: Current evidences do not support prophylactic antibiotics as a routine treatment for SAP, but the potentially benefited sub-population requires further investigations.

加强中医康复科管理对预防院感的实践效果

目的:探讨和研究加强中医康复科管理方法对预防院感的实践效果,为降低院感形成率提供一定的理论参考。方法:将2021年9月—2022年6月的136例中医康复科患者作为研究的调查对象,根据康复科患者的入院治疗时间分为对照组和观察组,每组68例。对照组接受常规的康复管理方法进行干预。观察组在对照组常规管理方法上添加中医康复加强管理措施进行干预。使用中医临床康复效果评估量表对患者的康复效果进行评价,康复效果根据从好到差分为显效、有效、未愈3个等级,计算康复整体有效率值。统计干预后患者的医院感染形成率值、满意度评分值值、并发症形成率值。使用简易生活状况及身体健康程度评价量表(SF-36)对患者的生活质量进行评价,评价的维度包括生理质量评分值、心理质量评分值、沟通质量评分值。结果:观察组康复科患者的康复整体有效率明显高于对照组(P<0.05)。观察组接受干预后医院感染形成率及并发症形成率明显低于对照组(P<0.05);观察组康复科患者的满意度评分明显高于对照组(P<0.05)。管理后,观察组患者生理质量评分、心理质量评分、沟通质量评分明显高于对照组(P<0.05)。结论:加强中医康复科管理能够对预防院感起到较好的作用,其中加强管理后康复科患者的康复效果及生活质量提高较为明显,患者的医院感染形成率和并发症形成率有所降低,满意度有所提高,效果显著。

Surgical Site Infection Prevention Practices and Associated Factors among Nurses Working in Government Hospitals of Harari Regional State and Dire Dawa City Administration, Eastern Ethiopia

Background:Surgical site infections are the most frequent type of preventable hospital acquired infections with a serious and undesirable outcome of surgery associated with increase morbidity,mortality rate,hospital stay,readmission and excess cost.Surgical site infection prevention is one of the most important challenge in delivering optimal nursing care.Studies suggest that the nurses’practices of surgical site infection prevention is not well addressed.Moreover,there is clearly paucity of information,in Africa including the study area.Objective:The aim of this study was to assess surgical site infection prevention practices and associated factors among nurses working in government hospitals of Harari Regional State and Dire Dawa City Administration,Eastern Ethiopia from March 01 to 28,2019.Method and Materials:An institutional based cross-sectional study design was employed for a total of 515 nurses.Simple random sampling method was used to select study participants.Data were collected using pretested structured self-administered questionnaire supplemented by observation.Data were checked,coded,entered and cleaned using Epi-data version 3.1 and exported to SPSS version 20 for analysis.Bivariate and multivariate analysis were undertaken and P values less than 0.05 at 95%confidence interval were considered as statistically significant.Result:The overall self-reported level of SSI prevention practice was found to be 40.8%(95%CI:36.9%,45.4%).Nurses with BSc and above[Adjusted odds ratio(AOR)=2.52,95%CI(1.14,5.54)],trained on infection prevention[AOR=2.22,95%CI(1.29,3.82)],good knowledge[AOR=2.21,95%CI(1.32,3.71)],good attitude[AOR=5.11,95%CI(3.05,8.57)],got supply of personal protective equipment[AOR=2.57,95%CI(1.46,4.49)],had management support[AOR=3.41,95%CI(1.90,6.12)],experience of 5 to 10 years[AOR=5.38,95%CI(2.82,10.27)]and≥11 years[AOR=3.48,95%CI(1.47,8.25)],were found to be statistically and positively associated with nurses SSI prevention practice.Conclusion:In this study,the level of surgical site infection prevention practice was poor.Being BSc and above,being knowledgeable and good attitude,got personal protective equipment,had management support,serving for≥5 years and trained on infection prevention were found to be significantly associated with surgical site infection prevention practice.Updating knowledge and practice of nurses through in-service education and training on latest evidence-based practice,regularly supplying of personal protective equipment,developing hospital policy and procedures for surgical site infection prevention practice is recommended.

如何做好儿科轮状病毒肠炎的消毒隔离

目的:消毒预防院内感染。方法:对我科2011年1月-2012年7月收治的轮状病毒性肠炎患儿75例进行消毒管理。结果:无1例发生院内感染。讨论:规范轮状病毒肠炎患儿的病房消毒,做好周围环境及物品消毒可降低此类疾病的传染性。

The Influences of CPTED on Fear of Crime and Sense of Community

Fear of crime varies considerably depending on its attitude towards environmental conditions. Sense of community and CPTED （crime prevention through environmental design） are believed to have an influence on fear of crime. This paper investigates the hypotheses of influences of CPTED on FOC （fear of crime） and SOC （sense of community）. A total of 171 respondents from the designated residential areas were involved in this study. The structural equation modeling technique was employed and the results indicate that CPTED has a direct influence on fear of crime and sense of community. However, no significant relationship was found between SOC and FOC.

The best method of detecting prior Helicobacter pylorimfection

AIM： Prior Helicobacterpylori （Hpylori infection has often been underestimated. These underestimations have misled physicians attempting to determine the significance between Hpyloriand certain gastrointestinal lesions such as intestinal metaplasia, atrophic gastritis, and gastric cancer. Our study endeavored to debit past Hppylorinfections accurately, easily, and rapidly with the newly developed irnmunoblot kit, Helico Blot 2.1. METHODS： Thirty-three patients, including 25 H pylori infected and 8 uninfected cases, were enrolled in our study. All patients received consecutive gastroendoscopic examinations and ^3C-urea breath test （UBT） tests at 6- or 12-mo intervals for up to 4 years. Serum samples were obtained from each patient at the same time. Intragastric H pylori infection was confirmed in accordance with the gold standard. Twenty-five H pylori-infected patients received triple therapies after initial bacterial confirmation, and were successful in eradicating their infections. Serially obtained sera were tested by means of Helico Blot 2.1. RESULTS： Current infection marker detected by Helico Blot 2.1 was unreliable for representing ongoing Hpylori infection. Only 35 and 37 ku antibodies of H pylorihad significant seroconversion rates 1 year after having been cured. The seroposiUve rates of 116 ku （cytotoxin-associated antigen [CagA]） and Helico Blot 2.1 were nearly 100% during 4-year follow-up period. Both CagA antigen and Helico blot 2.1 could serve as indicators of long-term H pylori infection. CONCLUSION： Helico Blot 2.1 can detect past H pylori infections for up to 4 years, and is the best method to date for detecting previous long-term H pylori infection. 2005 The WJG Press and Elsevier Inc. All rights reserved.