铜绿假单胞菌生物膜的抵抗性研究

目的了解铜绿假单胞菌生物膜对常规消毒方法和抗生素的抵抗性. 方法采用碘伏、5%"84"消毒液、75%乙醇、"健之素"泡腾片液(1片/L)、2%戊二醛消毒液等浸泡,甲醛(福尔马林)熏蒸和紫外灯照射等常规消毒方法处理铜绿假单胞菌形成的生物膜,观察生物膜细菌被杀灭情况;同时将生物膜分别放入含不同种类和不同浓度的抗生素的M-H肉汤中,观察其生长,并与裸菌的MIC作比较. 结果 2%戊二醛消毒液对铜绿假单胞菌形成的生物膜杀灭作用最强,碘伏和75%乙醇次之,5%"84"消毒液和"健之素"泡腾片液作用较弱,甲醛熏蒸和紫外灯照射的作用最差;生物膜细菌能生长的抗生素最高浓度:亚胺培南400 μg/ml,头孢他啶800 μg/ml,左氧氟沙星32 μg/ml,哌拉西林1 024 μg/ml. 结论铜绿假单胞菌形成的生物膜对外界不利因素有很强的抵抗力.     

肺炎克雷伯菌生物膜对消毒剂抵抗性研究

目的：研究肺炎克雷伯菌生物膜对常用消毒剂的抵抗性。方法：用高分子滤膜制备生物膜，观察不同时间条件下75％乙醇、安尔碘、1％“84”消毒液、6．7％新沽尔灭和2％戊二醛对生物膜中细菌杀灭作用。结果：2％戊二醛和安尔碘灭菌效果最好，75％乙醇次之，1％“84”消毒液和6．7％新清尔灭效果较差。结论：肺炎克雷伯菌生物膜对常用消毒剂抵抗性较强。     

一元过氧乙酸清除消化内镜生物膜的效果

目的调查临床重复使用内镜的生物膜污染情况,检测一元过氧乙酸对内镜污染生物膜的清除效果。方法按照《医院消毒卫生标准》GB15982-2012中方法检测2019年8-10月临床200例次重复使用的内镜消毒后的消毒效果,采用活菌计数法检测内镜生物膜污染情况。分别采用一元过氧乙酸、戊二醛清除生物膜,监测生物膜的去除效果。结果高水平消毒前提下,经检测30%的内镜出现生物膜;一元过氧乙酸对生物膜的清除率均>99%,戊二醛对生物膜的清除效率仅为62%,差异有统计学意义(P<0.05)。一元过氧乙酸连续使用14天后,所有内镜均未形成生物膜,与戊二醛组对比菌落计数,差异有统计学意义(P<0.05)。结论一元过氧乙酸可有效清除内镜生物膜,并可预防控制生物膜的生成。     

爱尔碘皮肤消毒剂对生物膜阳性致病菌的体外杀菌试验

目的 了解爱尔碘皮肤消毒剂对生物膜阳性致病菌的最小杀菌浓度.方法 将所有受试菌进行生物膜形成检测,再用对倍稀释法,以爱尔碘皮肤消毒剂不同浓度对生物膜阳性致病菌作用不同时间,观察杀菌效果.结果 金黄色葡萄球菌、大肠埃希菌和铜绿假单胞菌生物膜形成阳性率分别为54.3％、47.3％和57.0％;爱尔碘皮肤消毒剂在有效碘含量为9.203×10-4 mg/L时,作用1 min后,可将所有受试菌株全部杀灭.结论 爱尔碘皮肤消毒剂对生物膜阳性致病菌具有高效的杀菌性.     

铜绿假单胞菌消毒剂-磺胺耐药基因检测及对消毒剂的抗性研究

目的了解铜绿假单胞菌Ⅰ类整合子消毒剂-磺胺耐药基因(qacE△1-sull)的携带情况以及阳性菌株对碘伏、戊二醛、氯己定、"84"消毒液的抗性。方法对某院2007年12月-2008年1月连续分离的20株铜绿假单胞菌以聚合酶链反应(PCR)法检测qacE△l-sull基因,测定其阳性菌株对上述4种消毒剂的最低抑菌浓度(MIC)。结果 20株铜绿假单胞菌中检出qacE△1-sull阳性株10株(50.00%)。碘伏、戊二醛、氯己定、"84"消毒液对qacE△1-sull阳性菌株的MIC范围分别为:8.0～128.0μg/mL、16.0～256.0μg/mL、1.0～16.0μg/mL、4.0～64.0μg/mL。结论 qacE△1-sul1基因普遍存在于临床分离的铜绿假单胞菌中,阳性菌株对碘伏、戊二醛、氯己定、"84"消毒液存在抗性差异,应合理使用消毒剂并增加作用时间,以有效控制铜绿假单胞菌的播散。     

老年男性尿路感染病原菌生物膜检测及耐药性分析

目的探讨老年男性尿路感染的病原菌分布以及产生物膜阴性及阳性病原菌在耐药性上的差异,为临床使用抗菌药物提供依据。方法对358例老年男性尿路感染患者中段尿进行培养,对培养出的致病菌进行鉴定、药敏试验以及生物膜检测,并对产生物膜阴性及阳性病原菌的药敏结果进行对比统计。结果共分离出362株病原菌,以革兰阴性杆菌为主,占69.89%,革兰阳性球菌次之,占20.44%,真菌和其他病原菌占9.67%,革兰阳性球菌生物膜的检出率为40.54%,革兰阴性杆菌生物膜的检出率为41.11%,分离的主要病原菌为大肠埃希菌、凝固酶阴性葡萄球和变形菌属,分别占53.87%、15.75%、7.74%,其生物膜检出率分别为41.03%、45.61%、39.29%;生物膜检出阳性病原菌的耐药率高于生物膜检出阴性的病原菌,两者差异有统计学意义(P<0.01)。结论引起老年男性尿路感染的本研究以大肠埃希菌、凝固酶阴性葡萄球和变形菌属为主;耐药率较高的抗菌药物为氨苄西林、磺胺甲噁唑/甲氧苄啶、头孢呋辛以及青霉素;生物膜检出阳性病原菌的耐药率高于生物膜检出阴性的病原菌。     

医院多重耐药菌对常用消毒剂抗性的研究

目的观察医院环境分离致多重耐药菌对常用消毒剂抗性。方法选取于2018年1月2日—2018年1月30日于本医院住院患者所用被褥、物品表面和医务人员手部研究对象,检验细菌状况,并进行培养,记录结果。结果铜绿假单胞菌以患者被褥检出率最高(66.67%);肺炎克雷伯杆菌检出以被褥检出率最高(46.67%);鲍曼不动杆菌检出以被褥检出率最高为(60.00%)。铜绿假单胞菌对84消毒液有抗性;肺炎克雷伯杆菌对苯扎溴铵有抗性;鲍曼不动杆菌对84消毒液和苯扎溴铵有抗性。三种致病菌差异有统计学意义(P<0.05)。结论医院环境有多重耐药菌,建议临床依据平时对耐药菌的监测情况,适时调整消毒方案,做好医院环境清洁。     

新型复方戊二醛杀菌效果观察

目的了解一种新型复方戊二醛消毒液实际应用的杀菌效果及其他相关性能。方法采用问卷方法调查山东利尔康消毒科技有限公司研发的新型低味低泡复方戊二醛的气味和泡沫;用胃镜、医疗器械的现场消毒试验及连续使用稳定性杀菌试验检测该消毒液杀灭微生物的效果。结果与普通戊二醛消毒液相比,该新型复方戊二醛低味、低泡;使用中戊二醛消毒浸泡器械3、7、14 d后,其戊二醛含量平均下降率分别为1.06%、2.28%、5.58%;胃镜在该戊二醛消毒液中浸泡1 h,经检测,细菌总数平均为9个,无致病菌;浸泡10 h后,细菌总数为0,无致病菌;医疗器械在该戊二醛消毒液中浸泡10 h,可达到灭菌效果;连续使用14 d后的该戊二醛消毒液浸泡医疗器械10 h,仍可达到灭菌效果。结论该新型复方戊二醛消毒液低味、低泡、性能稳定,对胃镜、医疗器械的消毒、灭菌效果良好,连续性使用灭菌效果亦好。     

麻醉器械细菌污染状况与消毒方法探讨

（目的）探讨医院麻醉器械的细菌污染状况以寻找有效的消毒方法。（方法）对我院3种全麻用麻醉器械消毒前后进行细菌监测,消毒方法采用1∶200的84消毒液进行浸泡消毒10次,并以清水冲洗作对照。（结果）只用清水冲洗挂晾的麻醉器械平均含菌数：面罩：83．4cfu/cm^2,螺纹管61.3cfu/cm^2,气管导管29．6cfu/cm^2。采用1∶200的84消毒液浸泡30min后,平均含菌数：面罩1．0cfu/cm^2,螺纹管1．7cfu/cm^2,气管导管0．6cfu/cm^2。（结论）1∶200的84消毒液降菌效果明显,已被医院采用。     

2%碱性戊二醛使用中的浓度变化和灭菌效果

2%碱性戊二醛属高效消毒剂,具有广谱、高效、低毒对金属腐蚀性小,受有机物影响小等特点,适用于医疗器械和耐湿忌热的精密仪器等的消毒与灭菌。为做好医院感染的预防和监测工作,对2%碱性戊二醛消毒液连续使用7 d的浓度变化和灭菌效果进行了监测。1材料与方法分别对各科使用中的2%碱性戊二醛消毒液进行取样测试,对各科使用至第7天的消毒液用无菌吸管吸取1.0 ml,加入到含有1.0%甘氨酸9.0 ml无菌试管中混匀,用无菌吸管吸取上述溶液0.2 ml,滴于干燥普通琼脂平板,每份样品同时做2个平行样,一平板置20℃暖箱中培养7 d,观察真菌生长情况;另一平板置3…     

The human drama of genetics: 'hard' and 'soft' media representations of inherited breast cancer

This paper examines media coverage of 'breast cancer genetics', and explores its implications for public understanding. We present a content analysis of coverage in British newspapers and look at a variety of popular forms, including women's magazines, television soap opera and radio drama. Genetic/inherited risk receives a great deal of coverage across a wide range of media formats and outlets. Much of this attention has focused on individuals from 'high risk families' and dilemmas around prophylactic mastectomies. Through examining media coverage, combined with interviews with media personnel and their sources, we show why this story proved so attractive to the media and highlight the different production values which influence coverage. Finally, we introduce preliminary findings from focus group discussions to demonstrate how such 'human interest' framing has engaged audience attention and influenced public understandings. The paper concludes by highlighting the implications for analysing, predicting, and engaging with, media representations of science.     

The occurrence of antimicrobial substances in toilet,sink and shower drainpipes of clinical units: A neglected source of antibiotic residues

Antibiotics represent one of the most important drug groups used in the management of bacterial infections in humans and animals. Due to the increasing problem of antibiotic resistance, assurance of the antibacterial effectiveness of these substances has moved into the focus of public health. The reduction in antibiotic residues in wastewater and the environment may play a decisive role in the development of increasing rates of antibiotic resistance. The present study examines the wastewater of 31 patient rooms of various German clinics for possible residues of antibiotics, as well as the wastewater of five private households as a reference.To the best of our knowledge, this study shows for the first time that in hospitals with high antibiotic consumption rates, residues of these drugs can be regularly detected in toilets, sink siphons and shower drains at concentrations ranging from 0.02?μg·L^?1 to a maximum of 79?mg·L^?1. After complete flushing of the wastewater siphons, antibiotics are no longer detectable, but after temporal stagnation, the concentration of the active substances in the water phases of respective siphons increases again, suggesting that antibiotics persist through the washing process in biofilms. This study demonstrates that clinical wastewater systems offer further possibilities for the optimization of antibiotic resistance surveillance.     

Worker education in the primary prevention of occupational dermatoses

This paper reports the evaluation of a skin care education programmeconducted on a fine chemicals manufacturing site where over1,000 employees are located. Approximately 60% are involvedin chemical manufacture. Over a 12 month period production staffreceived training in prevention of occupational dermatoses linkedto a site-wide poster initiative. The incidence of new casesof occupational dermatoses fell from 0.055 (70 cases in 1,277employees) to 0.021 (27 cases in 1,277 employees) before andafter the intervention respectively (p<0.0001). After otherfactors such as chemicals handled, observer bias and changesin reporting related to socioeconomic climate were taken intoaccount it is concluded that this study demonstrates the importanceof worker education as a tool for primary prevention of disease.Training materials such as video and poster presentations maybe effectively used in the chemical manufacturing industry asan adjunct to prevention and control of exposure to substanceshazardous to the skin. Such methods may also be used in otherindustries where there are significant risks of dermatoses.     

Regional Variation in Travel-related Illness acquired in Africa,March 1997–May 2011

To understand geographic variation in travel-related illness acquired in distinct African regions, we used the GeoSentinel Surveillance Network database to analyze records for 16,893 ill travelers returning from Africa over a 14-year period. Travelers to northern Africa most commonly reported gastrointestinal illnesses and dog bites. Febrile illnesses were more common in travelers returning from sub-Saharan countries. Eleven travelers died, 9 of malaria; these deaths occurred mainly among male business travelers to sub-Saharan Africa. The profile of illness varied substantially by region: malaria predominated in travelers returning from Central and Western Africa; schistosomiasis, strongyloidiasis, and dengue from Eastern and Western Africa; and loaisis from Central Africa. There were few reports of vaccine-preventable infections, HIV infection, and tuberculosis. Geographic profiling of illness acquired during travel to Africa guides targeted pretravel advice, expedites diagnosis in ill returning travelers, and may influence destination choices in tourism.     

Self-reported health problems among Swedish miners one year after unemployment

Unemployment is considered to be a public health concern sincedeterioration in the health of the unemployed is often anticipated.However, for some groups, such as miners, unemployment mightimprove health due to a cessation of potentially harmful occupationalexposures. This study evaluates the health of 79 miners in oneSwedish iron-ore mine, and 226 age-matched controls from thegeneral population, during one year after the closure of themine. The participants received a questionnaire regarding medicalhistory and subjective symptoms at the beginning of the studyperiod, and after one year. Statistically significant negativeeffects on self-reported health attributable to unemploymentwere not found, although neuropsychiatric symptoms were morecommon among the unemployed miners. The miners reported a statisticallysignificant improvement in grip force (p=0.031). They had asignificantly higher prevalence of symptoms associated withmining related exposures when compared with the population controls;pain in the upper extremities [relative risk (RR)=2.27, 95%confidence interval (Cl)=1.44–3.59), back pain (RR=1.84;Cl=1.237–2.75), vasospastic disease of the fingers (RR=2.05;Cl=1.18–3.57) and obstructive respiratory symptoms (attacksof dyspnea and wheezing: RR=3.67; Cl=1.167–11.6).     

Excès de cas humains et animaux de tularémie en France au cours de l’hiver 2007–2008 : émergence ou phénomène isolé ?

Context

Tularemia is a zoonosis affecting humans and hares in France. We describe the results of surveillance in both species, in 2007 and 2008.

Methods

Human tularemia cases are mandatorily notifiable in France since 2003. In hares, surveillance relies on volunteer hunter associations in all districts of the country. Data from mandatory reports and volunteer surveillance in 2007/2008 were analyzed and compared with previous results.

Results

In 2007/2008, 144 cases were reported in humans and 117 cases in hares. This was a 100% increase compared to previous years. Human cases differed from those of previous years only by the frequency of contact with breeding animals. Human cases without any documented risk exposure were also more frequent.

Conclusion

An increase of tularemia cases occurred in 2007/2008 in both species. Complementary studies are needed to identify the species reservoir in France to understand the causes of this peak of cases.     

Fatigue and health in a seafaring population

Background Occupational fatigue is relatively common withinthe general population and has been linked to reduced performance,injury and longer term ill-health. Despite growing acknowledgementof this problem in the maritime sector, little research hasbeen conducted into the risk factors, prevalence and consequencesof seafarers' fatigue. Aims To examine the prevalence of fatigue among seafarers, identifypotential risk factors and assess possible links with poor performanceand ill-health. Methods Cross-sectional questionnaire survey of seafarers workingin the offshore oil support, short-sea and deep-sea shippingindustries. A number of tools were used including the fatiguesubscale of the profile of fatigue-related symptoms, the CognitiveFailures Questionnaire, the General Health Questionnaire andthe SF36 General Health scale. Results In all, 1855 questionnaires were completed giving anoverall response rate of 20%. Fatigue symptoms were associatedwith a range of occupational and environmental factors, manyunique to seafaring. Reporting a greater number of risk factorswas associated with greater fatigue [e.g. OR = 2.53 (1.90–3.35)for those with three or four risk factors and OR = 9.54 (6.95–13.09)for those with five or more risk factors]. There was also astrong link between fatigue and poorer cognitive and healthoutcomes, with fatigue the most important of a number of riskfactors, accounting for 10–14% of the variance. Conclusions Seafarers' fatigue could impact on safety withinthe industry and may be linked to longer term individual ill-health.It can only be addressed by considering how multiple factorscombine to contribute to fatigue.     

The design of hazard risk assessment matrices for ranking occupational health risks and their application in mining and minerals processing

Two hazard risk assessment matrices for the ranking of occupational health risks are described. The qualitative matrix uses qualitative measures of probability and consequence to determine risk assessment codes for hazard-disease combinations. A walk-through survey of an underground metalliferous mine and concentrator is used to demonstrate how the qualitative matrix can be applied to determine priorities for the control of occupational health hazards. The semi-quantitative matrix uses attributable risk as a quantitative measure of probability and uses qualitative measures of consequence. A practical application of this matrix is the determination of occupational health priorities using existing epidemiological studies. Calculated attributable risks from epidemiological studies of hazard-disease combinations in mining and minerals processing are used as examples. These historic response data do not reflect the risks associated with current exposures. A method using current exposure data, known exposure-response relationships and the semi-quantitative matrix is proposed for more accurate and current risk rankings.     

Occupational health hazards in mining: an overview

This review article outlines the physical, chemical, biological, ergonomic and psychosocial occupational health hazards of mining and associated metallurgical processes. Mining remains an important industrial sector in many parts of the world and although substantial progress has been made in the control of occupational health hazards, there remains room for further risk reduction. This applies particularly to traumatic injury hazards, ergonomic hazards and noise. Vigilance is also required to ensure exposures to coal dust and crystalline silica remain effectively controlled.