Enterococcal bacteremia in a medical center

BACKGROUND: The enterococci have become important nosocomial pathogens. They can cause multiple site infections and enterococcal bacteremia becomes more frequently associated with a high mortality rate. Previous studies of enterococcal bacteremia showed a variety of results. To establish the significance and importance of enterococci as nosocomial pathogens in this hospital, to characterize their clinical pictures and to search for the risk factors for mortality, this retrospective study was performed. METHODS: There were 208 cases of enterococcal bacteremia which occurred from 1988 to 1992. Twenty-seven cases had no medical charts, dismissing possibility of evaluation. Finally, 181 cases of enterococcal bacteremia were analysed. RESULTS: One hundred and eighteen episodes were nosocomial infections. Polymicrobial bacteremia occurred in 68.5% of the patients and the most common co-isolate was Pseudomonas aeruginosa. Those patients (78.5%) with underlying diseases and malignancies were the most common underlying problems. The portal of entry could be found in 69.6 percent of patients, with the gastrointestinal tract the most common sources. Antimicrobial susceptibility testing showed high gentamicin resistance rate (89.5%), and ampicillin still had about 80 percent sensitivity rate. The group who received specific antibiotic therapy for enterococcus showed lower mortality (36.4% versus 47.6%). Only one case had infective endocarditis. Forty-nine patients suffered from septic shock, the cause of 30 deaths. Totally 75 patients died during hospitalization. Besides sepsis, another major cause of death was their underlying diseases itself. CONCLUSIONS: Enterococci have no doubt become important nosocomial pathogens and enterococcal bacteremia were associated with high mortality, especially in elderly patients with underlying diseases such as malignancy or diabetes. When clinically dealing with sepsis from the gastrointestinal or biliary tract, especially when previous cephalosporins therapy showed no response, the possibility of enterococcal bacteremia should always be considered.     

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以程序升温脱附(TPD)为主要试验手段,对乙二胺在5种不同沸石分子筛上的吸附、脱附行为进行了研究。结果表明,沸石分子筛对乙二胺有着较强的吸附作用,但不同的沸石分子筛对乙二胺的吸附能力受其结构和表面酸性特征的影响而有所不同;适用于交联条件的有效吸附部位为一与沸石分子筛表面酸性有关的弱化学吸附位;乙二胺从不同沸石分子筛表面脱附的动力学与晶内扩散有关,其表观脱附活化能分别为:69.9kJ/mol(5A)、78.3kJ/mol(13X)、22.4kJ/mol(菱沸石)、37.5kJ/m0l(NaY)、44.7kJ/mol(ZSM-5)。     

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本文通过分析现有工程图纸扫描图象的识别与理解系统，提出了表面粗造度的自动识别算法，从而弥补了以往系统的不足，基于图形约束的表面粗造度整体识别算法符合技术人员的读图规律，处理速度快，可靠性高，该算法已在微机上调试成功。     

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