Isolation rate of gram negative microflora and its sensitivity to antibiotics in hemoblastosis patients

A total of 67 patients with blood system diseases and infectious complications were examined. During the period of the examination 139 microorganisms were isolated. Of these gram negative microorganisms constituted 51%, gram positive microorganisms--34.8% and fungal flora--14.2%. Most frequently the following gram negative microorganisms were isolated from the patients: Pseudomonas sp. (including P. aeruginosa), Klebsiella pneumoniae, Escherichia coli, Haemophilus influenzae. All isolated microorganisms retained sensitivity to imipenem, with the exception of individual strains of Pseudomonas sp.; the latter exhibited sensitivity to amicacin and ceftazidim. Cefotaxime was active with respect to 75% of K. pneumoniae strains and all E. coli strains, ciprofloxacin was active with respect to 43% of E. coli strains, 80% of K. pneumoniae strains and 83.4% of Pseudomonas sp. strains, cefepim was active with respect to 85.7% of Pseudomonas sp. strains and all E. coli strains, ceftazidim was active with respect to all Pseudomonas sp. and E. coli strains. 75% of K. pneumoniae strains, 77.8% of Pseudomonas sp. strains and 86% of E. coli strains retained sensitivity to amicacin. 25% of K. pneumoniae strains required testing for ESBL production.     

2012—2019年上海市某三甲医院境外输入性传染病病例特征分析

本研究分析近年来上海市境外输入性传染病的病例特点,为上海市输入性传染病的防控提供依据。对上海市某三甲医院2012—2019年报告的所有法定及重点监测传染病中确定为境外感染的305例传染病病例进行回顾性分析。采用WPS Office 2019和 SPSS17.0软件对所收集病例的病种、数量、输入时间、病例人口学特征以及输入地区等进行整理分析。结果显示,2012—2019年该院报告境外输入性传染病11种,分别为疟疾、登革热、肺结核、麻疹、甲型肝炎、戊型肝炎、伤寒、人类免疫缺陷病毒(human immunodeficiency virus,HIV)感染、黄热病、白喉、隐性梅毒。确诊的305例病例中,疟疾226例,占74.10%;登革热68例,占22.30%;其他9种疾病共11例,占3.6%。疟疾、登革热全年均有输入,其中6月、9月和11月为疟疾输入高峰,6～8月为登革热输入高峰,肺结核、麻疹、甲型肝炎、戊型肝炎、伤寒、HIV感染、黄热病、白喉、隐性梅毒无明显季节性分布特征。输入性病例中,中国籍多于外籍,男性多于女性,以青壮年为主;主要职业为商业服务和工人;主要输入地为非洲。本研究结果提示境外输入性传染病以疟疾、登革热等虫媒传染病为主,病种呈现多样化的变化趋势,输入高峰主要在夏秋季。应加强非洲、东南亚劳务和旅游人群的健康教育,做好病例监管和防蚊、灭蚊,减少二代病例。     

急性传染病休克的临床诊治与转归分析

目的:探讨急性传染病休克患者的诊治策略,提高救治成功率.方法:回顾分析急性传染病休克患者的人口学、流行病学、病因分类、传染病发生至休克出现时间、早期临床诊治与转归等情况,总结诊治经验.结果:本组68例急性传染病休克主要来自呼吸道、消化道传染病,细菌和病毒是休克发生的主要病原,分别占54.4％和30.9％,仅25％的病例病前有明确的传染病接触史.51.9％的患者存在误诊误治现象.在明确休克发生病理机制的前提下,早期快速有效的抗休克、抗感染治疗,短期使用糖皮质激素,积极纠正酸碱、电解质紊乱,并给予必要的对症支持治疗,治愈出院率92.6％,平均康复住院时间3～11天,平均(5.8±2.4)天.结论:急性传染病休克早期误诊现象突出;给予积极抗体克、抗感染、激素治疗,纠正酸碱和电解质紊乱,结合对症支持治疗,可在短期内治愈患者.     

Uveitis- a rare disease often associated with systemic diseases and infections- a systematic review of 2619 patients

ABSTRACT: BACKGROUND: Uveitis is an autoimmune disease of the eye that refers to any of a number of intraocular inflammatory conditions. Because it is a rare disease, uveitis is often overlooked, and the possible associations between uveitis and extra-ocular disease manifestations are not well known. The aim of this study was to characterise uveitis in a large sample of patients and to evaluate the relationship between uveitis and systemic diseases. METHODS: The present study is a cross-sectional study of a cohort of patients with uveitis. Records from consecutive uveitis patients who were seen by the Uveitis Service in the Department of Ophthalmology at the Medical University of Vienna between 1995 and 2009 were selected from the clinical databases. The cases were classified according to the Standardization of Uveitis Nomenclature Study Group criteria for uveitis. RESULTS: Data were available for 2619 patients, of whom 59.9% suffered from anterior, 14.8% from intermediate, 18.3% from posterior and 7.0% from panuveitis. 37.2% of all cases showed an association between uveitis and extra-organ diseases; diseases with primarily arthritic manifestations were seen in 10.1% of all cases, non-infectious systemic diseases (i.e., Behcet's disease, sarcoidosis or multiple sclerosis) in 8.4% and infectious uveitis in 18.7%. 49.4% of subjects suffering from anterior uveitis tested positively for the HLA-B27 antigen. In posterior uveitis cases 29% were caused by ocular toxoplasmosis and 17.7% by multifocal choroiditis. CONCLUSION: Ophthalmologists, rheumatologists, infectiologists, neurologists and general practitioners should be familiar with the differential diagnosis of uveitis. A better interdisciplinary approach could help in tailoring of the work-up, earlier diagnosis of co-existing diseases and management of uveitis patients.     

感染性和非感染性发热的临床特征与鉴别

目的分析感染性和非感染性发热的鉴别诊断。方法收集1997年1月。2003年3月收住的以发热为主要临床表现的患者706例,进行回顾性分析。结果感染性疾病550例（81．12％）,其中局灶感染203例（29．94％）,多系统性感染347（51．18％）。非感染性疾病107例（15．78％）。结论感染性和非感染性发热的鉴别诊断在于鉴别诊断思路的完整性,综合衡量是诊断的方法。     

What are the complications of influenza and can they be prevented? Experience from the 1989 epidemic of H3N2 influenza A in general practice.

OBJECTIVES--In an epidemic: to measure the incidence and risk of complications of influenza; to determine the effect of pre-existing disease on complications; to estimate vaccine uptake and efficacy. DESIGN--Case-control study. SETTING--Primary care: two group practices. SUBJECTS--342 of the 395 cases of clinically diagnosed influenza reported to the general practice surveillance of infectious diseases scheme of the Public Health Laboratory Service during the 1989 epidemic, and 342 age and sex matched controls. INTERVENTIONS--Examination of records. MAIN OUTCOME MEASURES--Documented recognised complications; hospital admission; previous vaccination. RESULTS--Of 15 recognised complications, bronchitis was the commonest (rate 190.1/1000 cases) and significantly commoner in cases (summary odds ratio 9.7) after adjusting for higher consultation rates (mean 6.1 per annum v 4.2 among controls; p < 0.0001). No deaths were recorded. The risk of bronchitis complicating influenza was higher in patients with pre-existing illnesses regarded as an indication for vaccination (odds ratio 3.3; p < 0.0001). Observed vaccination efficacy in those with pre-existing illnesses and in elderly subjects was high (63% and 77% respectively) but uptake was low (4.5% and 6.1% respectively). CONCLUSIONS--Bronchitis complicates about one fifth of all cases of influenza presenting to general practitioners. Patients with pre-existing illnesses regarded as an indication for vaccination are particularly at risk. Vaccine uptake is extremely low, precluding an unequivocal demonstration of a protective effect.     

剑阁县2001-2010年法定传染病流行特征及防治对策分析

目的：通过分析10年法定传染病疫情的流行趋势和三间分布特征,为制定传染病预防控制策略和措施提供依据。方法：采用描述性流行病学方法分析疫情趋势和三间分布情况,数据资料用SPSS10．0和Excel2003进行统计分析。结果：2001～2010年共报告乙、丙类传染病25种26129例,年均发病率386．89／10万,年均死亡率0．15／10万,10年间报告法定传染病以血源及性传播传染病和呼吸道传染病为主,居第1位的是血源及性传播传染病,共报告5种12453例,占53．03％;其次是呼吸道传染病,共报告5种9828例,占41．85％,近3年发病居于各类传染病首位;第三位的是肠道传染病,共报5种1149例,占4．89％。发病居前5位的传染为乙肝、肺结核、流行性腮腺炎、痢疾、麻疹,主要传染病以乙肝、肺结核为主,近年性传播疾病呈快速增长趋势。结论：血源及性传播传染病和呼吸道传染病是今后重点防控传染病。     

剑阁县2001～2010 年法定传染病流行特征及防治对策分析

目的:通过分析10年法定传染病疲情的流行趋势和三间分布特征,为制定传染病预防控制策略和措施提供依据.方法:采用描述性流行病学方法分析疫情趋势和三间分布情况,数据资料用SPSS10.0和Excel 2003进行统计分析.结果:2001～2010年共报告乙、丙类传染病25种26 129例,年均发病率386.89/10万,年均死亡率0.15/10万,10年间报告法定传染病以血源及性传播传染病和呼吸道传染病为主,居第1位的是血源及性传播传染病,共报告5种12 453例,占53.03％;其次是呼吸道传染病,共报告5种9828例,占41.85％,近3年发病居于各类传染病首位;第三位的是肠道传染病,共报5种1149例,占4.89％.发病居前5位的传染为乙肝、肺结核、流行性腮腺炎、痢疾、麻疹,主要传染病以乙肝、肺结核为主,近年性传播疾病呈快速增长趋势.结论:血源及性传播传染病和呼吸道传染病是今后重点防控传染病.     

Use of the indirect hemagglutination reaction for detecting antibodies to Pseudomonas pyocyanea in acute suppurative destructive pneumonia]

No less than 4-fold increase in the antibody titres to Pseudomonas aeruginosa during the infectious process served as laboratory confirmation of its participation in the infectious process. In 49 of 91 patients hemagglutining titre exceeded the diagnostic one (1:640). In 9 patients (chiefly in infants) hemagglutinin titre remained low, but there was a rise of antibody level to Pseudomonas aeruginosa during the disease. High hemagglutinin titres were noted in 12 patients on admission to the clinic, with reduction of the antibody titres at the late periods of the disease. Antibody titres remained unchanged during the disease in 15 patients. In 3 cases the indirect hemagglutination test was assesed as negative. In the rest of the patients hemagglutinin titres varied within the range of the diagnostic titre. Thus, the indirect hemagglutination test with erythrocytic diagnostic agent permitting to determine antibodies to Pseudomonas aeruginosa could be used at the clinic in combination with bacteriological and other investigations for establishing etiology of the destructive process.     

改良Masquelet技术治疗胫骨感染性缺损的临床疗效分析

摘要 目的：探讨和分析使用改良Masquelet技术在胫骨感染性缺损中的临床疗效。方法：回顾性分析2018.01-2022.01范围内,使用改良Masquelet治疗胫骨感染性缺损的共计21患者。通过骨愈合(Samantha X 线评分),软组织愈合,感染控制,下肢功能,并发症等方面对临床疗效进行评价。结果：21例患者均获得完整随访,随访时间为12-36个月,平均为18.6个月。所有患者均达到骨愈合标准（3.2±8.3个月）。Samantha X 线评分：1例为4分,8例为5分,12例6分。PALEY功能评分为：优9人,良11人,可1人,差0人,优良率为95.2%。患者中均未出现严重并发症(P>0.05)。结论：在胫骨感染性缺损的治疗中,改良Masquelet技术是一种简单,安全,有效的治疗方法,在临床中可以进一步推广。     

Sensitivity of nosocomial microflora circulating in a transplantation clinic to medicinal bacteriophages

The sensitivity of 239 isolates obtained from patients with postoperative infectious complications to phagolysis was determined. Staphylococcus aureus, Pseudomonas aeruginosa and Escherichia coli were found to have the highest sensitivity to phages. Variations in the sensitivity of the same cultures to phages from different producers and even from the same producer were established. The sensitivity of cultures to phages may serve as an additional criterion of the biological properties of strains and their marker.     

Clinical experience with the treatment of severe nosocomial infections by inhibitor-protected 3rd generation cephalosporin cefoperazone/sulbactam]

A retrospective analysis of the clinical and microbiological efficacy and safety of cefoperazone/sulbactam in the treatment of 39 cardiosurgical patients operated under the conditions of artificial circulation is presented. The age of the adult patients (n = 28) varied from 44 to 58 years and that of the pediatric patients varied from 4 months to 6 years. Antibacterial therapy of 26 patients was needed because of postoperative infectious complications, such as nosocomial pneumonia in 22 patients and sepsis in 4 patients. The antibacterial therapy with cefoperazone/sulbactam in 9 patients was performed during the operation because of active infectious endocarditis. In 4 patients there were observed clinical and laboratory signs of infection without the infection foci. The initial empirical therapy with cefoperazone/sulbactam was applied to 14 patients (group 1) and the target-aimed therapy based on the data of the pathogen susceptibility to cefoperazone/sulbactam was used in 6 patients (group 2). 19 patients (group 3) were treated with cefoperazone/sulbactam because of the fail of the previous antibacterial therapy, including the 4th generation cephalosporins and carbapenems as well. Cefoperazone/sulbactam was used in the monotherapy of 15 cases (38%). Cefoperazone/sulbactam showed high efficacy in the treatment of severe nosocomial infections and infectious endocarditis (in combination with vancomycin or linezolid). It amounted to 93, 100 and 79% in groups 1, 2 and 3 respectively, the total of 94%. The results of the microbiological assay were evident of the cefoperazone/sulbactam high activity against the problem gram nagative isolates of Klebsiella pneumoniae (n = 12), Acinetobacter baumanii (n = 4), Pseudomonas aeruginosa (n = 4) and Stenotrophomonas maltophilia (n = 5). Adverse reactions were stated in 2 patients (5%), 1 case of urticaria requiring discontinuation of the drug use. Many of the patients proved to be colonized by MRS before the therapy with cefoperazone/sulbactam. The high probability of staphylococcal superinfection required combination of cefoperazone/sulbactam with antistaphylococcal agents, such as rifampicin, fusidin, vancomycin, linezolid. The best results were provided by the target-aimed therapy based on the microbiological monitoring.     

头孢哌酮联合夫西地酸 对细菌性皮肤病患者皮肤菌群的影响及疗效

摘要：目的 探讨头孢哌酮联合夫西地酸软膏对细菌感染性皮肤病患者皮肤菌群种类的影响及疗效,为细菌感染性皮肤病的治疗提供参考。方法 选择2015年11月至2019年6月在我院诊治的100例细菌感染性皮肤病患者作为研究对象,入选患者随机分为对照组（n=50）与观察组（n=50）。对照组患者采取头孢哌酮/舒巴坦静脉注射治疗,观察组患者采用头孢哌酮/舒巴坦联合夫西地酸软膏治疗。对各组患者治疗第3天和第7天时皮损处菌群进行检测,同时观察两组患者的疗效。结果 与对照组相比,观察组患者治疗第3天和第7天时皮损处的菌群数量及种类数量呈现明显的下降趋势,差异有统计学意义（P＜0.05）。观察组中疗效极好病例的占比为78.0%,治疗的总有效率为100.0%。结论 头孢哌酮联合夫西地酸软膏对细菌感染性皮肤病患者疗效确切,对患者皮损处的细菌具有较强的抑制作用,值得推广使用。     

腹腔镜和开腹手术治疗结石性胆囊炎疗效探讨

目的：观察腹腔镜和开腹手术治疗结石性胆囊炎的临床疗效,探讨术后并发症的发生率、患者的康复情况并评价手术的安全性。方法：选取2012年2月．2013年4月我院肝胆外科住院治疗的急性结石性胆囊炎患者100倒,随机分为观察组和对照组,每组50例。观察组采用腹腔镜手术治疗;对照组采用传统开腹手术治疗。观察并比较两组的手术时间、术中出血量、愈合时间、术后并发症及患者恢复情况等。结果：观察组手术治疗的有效率为96％,对照组为80％,差异具有统计学意义（P〈0．05）;观察组术后出现胆心反射3例,腹腔出血l例,感染2例;对照组术后出现胆心反射3例,腹腔出血4例,感染5例,差异有统计学意义（P〈0．05）。结论：腹腔镜治疗结石性胆囊炎较传统开腹手术治疗术式疗效显著,术中出血较少,并发症少,术后恢复快,患者术后痛苦少,值得临床推广。     

Ciprofloxacin in the treatment of infections in oncology patients

Treatment of infectious complications with ciprofloxacin in 65 patients provided good and satisfactory results in 67.7 and 20.0 per cent of the cases, respectively. The drug was efficient in sepsis, urogenital infections, respiratory infections and postoperative purulent complications. Ciprofloxacin showed a broad antibacterial spectrum. 96.3 per cent of the isolates belonging to aerobic organisms causing purulent inflammatory processes, including those with high antibiotic resistance levels, such as Pseudomonas spp., Proteus spp., Klebsiella tribe and Staphylococcus aureus were sensitive to the drug. In its antibacterial spectrum ciprofloxacin was similar to ofloxacin. The advantage of ciprofloxacin is its possible use not only orally but also intravenously. Adverse reactions to ciprofloxacin were observed in 5 (7.7 per cent) out of the 65 patients. In two cases discontinuation of the drug use was required. The use of ciprofloxacin in treatment of infectious complications in oncological patients is promising.     

Viral infection of infants and children with benign transient hyperphosphatasemia

In this study, we screened serum samples for transient hyperphosphatasemia (TH) using cellulose acetate membrane electrophoresis over a period of 3 years. In the patients found to suffer from TH, we examined the relationship between the clinical condition and viral infection. The frequency of TH was 0.26%, and all of the cases detected were in infants or young children. The female to male ratio of TH was 1.29/1. While there was no clear seasonal fluctuation or periodicity in the appearance of TH, two peaks were recognized in spring and autumn. Research on the clinical manifestations clarified that most of the TH cases had infectious diseases of the upper airways accompanied by symptoms of fever and diarrhea. We examined antibody titers for viruses causing upper airway infectious diseases and identified antibodies for enteroviruses such as Echo 22, Entero 71, and Coxsackie B4. Our results suggested that TH might be caused by an infection of the enterovirus group.     

2006～2008年我院法定报告传染病疫情分析

目的了解鹰潭市人民医院法定传染病报告情况,分析其流行病学特点,为制定传染病防治对策及降低传染病的发生提供科学依据。方法对鹰潭市人民医院2006～2008年法定传染病疫情资料进行分析．结果共报告法定传染病19种,累计报告发病4170例,其中无甲类传染病报告。主要病种为感染性腹泻、肺结核、病毒性肝炎、流行性腮腺炎、菌痢,占报告总数的93．62％;死亡13例（5个病种）．结论肺结核、乙型肝炎、肠道传染病是今后传染病防治工作的重点和难点,应加大管理力度．做好传染病的预防和控制工作．     

血清PCT、CRP以及T淋巴细胞亚群的动态变化及与胃癌患者术后感染性并发症的关系

目的:探讨血清降钙素原(PCT)和C反应蛋白(CRP)以及T淋巴细胞亚群的动态变化及与胃癌患者术后感染性并发症的关系。方法:选取2014年1月到2017年10月期间在中国人民解放军联勤保障部队第967医院接受治疗的胃癌患者163例,根据患者术后是否出现感染性并发症将其分为感染组和未感染组,其中感染组83例,未感染组80例,计算感染组患者各种术后感染性并发症的构成比例,检测术前、术后1d、术后3d血清PCT、CRP以及T淋巴细胞亚群的动态变化。采用ROC曲线分析PCT、CRP对感染性并发症的预测价值。结果:胃癌患者术后感染性并发症种类主要为肺部感染和手术部位感染,其次为腹腔感染和十二指肠残端瘘。术后1d、术后3d两组患者血清中PCT、CRP的水平明显高于术前(P0.05),术后1d、术后3d感染组患者血清中PCT的水平高于未感染组(P0.05),术后3d感染组血清中CRP的水平较未感染组升高(P0.05);经ROC曲线分析显示,术后3d血清PCT对胃癌患者术后感染性并发症的曲线下面积(AUC)为0.90,高于CRP的0.81;术后1d、术后3d两组患者的CD3~+、CD4~+、CD4~+/CD8~+均明显低于术前,术后1d、术后3d感染组患者的CD8~+明显高于术前(P0.05);术后3d感染组患者的CD3~+、CD4~+、CD4~+/CD8~+均明显低于未感染组(P0.05)。结论:血清PCT、CRP以及T淋巴细胞亚群的动态变化与胃癌患者术后感染性并发症密切相关,且PCT对胃癌患者术后感染性并发症的预测价值高于CRP。     

C反应蛋白、白细胞计数和T淋巴亚群与胃癌患者术后感染性并发症的关系及其诊断价值分析

摘要 目的：研究C反应蛋白（CRP）、白细胞计数（WBC）和T淋巴亚群与胃癌患者术后感染性并发症的关系,并分析其诊断价值。方法：以2016年3月～2018年6月于本院行根治术治疗的胃癌患者120例为研究对象,将其按照术后是否发生感染性并发症分为并发症组56例与无并发症组64例。分别比较两组患者术前、术后24 h以及术后48 h的血清CRP、WBC和T淋巴亚群相关指标水平变化情况。采用多因素Logistic回归分析胃癌感染性并发症的影响因素,采用受试者工作特征（ROC）曲线分析各项指标诊断胃癌根治术后感染性并发症的效能。结果：术后24 h、术后48 h两组患者血清CRP、WBC水平高于术前（P<0.05）,且并发症组高于无并发症组（P<0.05）。术后48 h,并发症组CD3⁺、CD4⁺、CD4⁺/CD8⁺低于无并发症组（P<0.05）,而手术前后CD8⁺无明显变化。多因素Logistic回归分析显示,年龄≥55岁、CRP≥10 mg/L、WBC≥10×10⁹/L和CD4⁺/CD8⁺＜1是患者术后发生胃癌感染性并发症的危险因素（P＜0.05）。ROC曲线分析发现：CRP、WBC、CD3⁺、CD4⁺联合检测诊断胃癌根治术后感染性并发症的敏感度、特异度均高于单独检测。结论：CRP、WBC和T淋巴亚群与胃癌患者术后感染性并发症的发生密切相关,临床工作中对CRP、WBC、CD3⁺、CD4⁺进行联合检测有助于胃癌术后感染性并发症的早期诊断。     

腹腔镜和开腹手术治疗结石性胆囊炎疗效探讨

目的:观察腹腔镜和开腹手术治疗结石性胆囊炎的临床疗效,探讨术后并发症的发生率、患者的康复情况并评价手术的安全性。方法:选取2012年2月-2013年4月我院肝胆外科住院治疗的急性结石性胆囊炎患者100例,随机分为观察组和对照组,每组50例。观察组采用腹腔镜手术治疗;对照组采用传统开腹手术治疗。观察并比较两组的手术时间、术中出血量、愈合时间、术后并发症及患者恢复情况等。结果:观察组手术治疗的有效率为96%,对照组为80%,差异具有统计学意义(P0.05);观察组术后出现胆心反射3例,腹腔出血1例,感染2例;对照组术后出现胆心反射3例,腹腔出血4例,感染5例,差异有统计学意义(P0.05)。结论:腹腔镜治疗结石性胆囊炎较传统开腹手术治疗术式疗效显著,术中出血较少,并发症少,术后恢复快,患者术后痛苦少,值得临床推广。