Semmelweis’ present day follow-up: Updating bacterial sampling and enrichment in clinical hygiene

Potentially dangerous antibiotic resistant contaminants have permanently penetrated at least well-off western populations. The danger is so evident that some hospitals have started to refuse accepting patients who carry such bacteria. Sampling and enrichment measures in hygiene monitoring must be updated as they are corner stones in handling the problems and safeguarding the health care units. Their patients, when exposed to microorganisms are strenuous to treat. Sometimes even this fails, if the infections are spreading in weakened patients. The present review summarizes currently used technologies and the abilities of bacteria to avoid detection. Improved protocols on environmental monitoring in healthcare units are required. They should be comparable with contamination control in industries. Actually these measures in health care should be even stricter because human lives are directly endangered as the resistance of especially elderly patients is low.     

Different opinions of physicians on the importance of measures to prevent acquisition of Pseudomonas aeruginosa from the environment

BACKGROUND: Since chronic infection with mucoid Pseudomonas aeruginosa (PA) is associated with deteriorating lung function, many parents of young children with cystic fibrosis (CF) fear the first PA positive throat swab as a milestone in the progression of the disease. To reduce the risk of PA acquisition from the environment, they perform preventive measures at home or outdoors. METHODS: In an attempt to evaluate the attitude of CF physicians towards these measures and the respective consulting practice, we mailed a questionnaire to all 65 certified paediatric CF centres in Germany. RESULTS: Physicians from 54 (83%) CF clinics replied. They expressed widely different ideas about the impact of the environment for the acquisition of P. aeruginosa, and recommended a large spectrum of preventive measures. Some physicians proposed only few precautions, which focussed on the prevention of cross-infection between patients, whereas others suggested prevention of any contact with moist or wet places, e.g. use different toothbrushes for mornings and evenings, or do without air-conditioning in the car. CONCLUSIONS: CF physicians have different opinions on the risk of PA acquisition from the environment. Doctors who recommend strict precautions could engender a parental fear of a ubiquous threat from invisible bacteria. The resulting extended safety measures might impair the family's quality of life.     

医学微生物学"项目-导师制"实验教学改革初探

目的:探讨"项目-导师制"实验教学改革效果及其在医学微生物学实验教学中应用价值.方法:采用"项目-导师制"法对2001级学生进行医学微生物学实验教学,以无记名问卷调查和专家评议方式了解实验教学效果,以现场操作了解学生实验技能,以相对标准化试卷综合测试学生成绩,并与2000级学生医学微生物学实验教学效果、实验技能、考试成绩进行回顾性和对比分析.结果:2001级和2000级学生实验教学效果不满意、满意、很满意率分别为0%(0/180)、25.00%(45/180)、75.00%(135/180)和55.38%(72/130)、34.62%(45/130)、10.00%(13/130),差异有显著性(P＜0.01).实验技能考核及格、良好、优秀率分别为0%(0/180)、22.22%(40/180)、77.78%(140/180)和56.92%(74/130)、35.38%(46/130)、7.69%(10/130),差异有显著性(P＜0.01).综合考试成绩不及格、及格、良好、优秀率分别为0%(0/180)、17.78%(32/180)、47.22%(85/180)、35.00%(63/180)和154%(2/130)、38.46%(50/130)、52.31%(68/130)、7.69%(10/130),差异有显著性(P＜0.01).结论:"项目-导师制"实验教学是一种新型实验教学模式,可显著增强实验教学效果,帮助学生快速掌握实验技能,提高学生综合考试成绩,克服传统实验教学存在的一些弊端,具有应用推广价值.     

医学微生物学实验线上教学的实践与思考

针对医学微生物学实验线上教学面临的诸多难题,本研究采取线上直播+操作视频+虚拟实验的授课模式,通过操作视频和虚拟实验弥补了操作上的缺口;考核模式采用紧扣操作流程的主观型思考题+实验设计+文献综述（围绕传统实验由于条件所限无法开展的临床检验重头技术或新技术,如质谱分析、荧光定量PCR、G实验等展开）的模式,从而可以较大限度了解学生对教学目标的掌握程度和综合应用、创新性思维等能力。学生调查问卷显示,大部分学生对线上实验教学模式持肯定态度,学生作业的完成质量表明大部分学生学习效果良好。     

A European perspective on intravascular catheter-related infections: report on the microbiology workload, aetiology and antimicrobial susceptibility (ESGNI-005 Study)

The laboratory workload, microbiological techniques and aetiology of catheter-related infections in European hospitals are mostly unknown. The present study (ESGNI-005) comprised a 1-day (22 October 2001), laboratory-based, point-prevalence survey based on a questionnaire completed by microbiology laboratories in European (European Union (EU) and non-EU) hospitals. Also included were questions requesting retrospective information for the year 2000. In total, 151 hospitals from 26 European countries participated, of which 78.1% were teaching institutions. Overall, the estimated population served by these institutions was 121,363,800, and the estimated number of admissions during 2000 was 6,712,050. The total number of catheter tips processed during 2000 was 142,727, or 21/1,000 admissions, of which 23.7% were considered to be positive in the institutions using semiquantitative or quantitative techniques. Overall, EU centres received significantly more catheter tip samples/1,000 admissions and had a significantly higher rate of 'positivity' (p < 0.0001) than non-EU centres. Of the institutions surveyed, 11.4% (7.2% in EU countries and 23.7% in non-EU countries; p 0.04) used only qualitative techniques for catheter tip sample processing. On the day of the study, 167 microorganisms were recovered from significant catheter tip cultures (122 patients), of which Gram-positive bacteria represented 70.7%, Gram-negative bacteria 22.2%, and yeasts 7.2%. The five most common microorganisms were coagulase-negative staphylococci, Staphylococcus aureus, Candida spp., Enterococcus spp. and Pseudomonas spp. Overall, 19% of catheter tip cultures were polymicrobial. In the case of S. aureus, 40% of isolates were resistant to oxacillin, as were 63.4% of coagulase-negative staphylococcus isolates. Of 37 Gram-negative isolates, 35% were resistant to cefotaxime, 31% to ceftazidime, and 27% to ciprofloxacin. Imipenem and cefepime had the lowest reported rates of resistance (11%).     

萎缩性阴道炎阴道菌群的研究

目的：研究萎缩性阴道炎患者的阴道菌群分布情况。方法：收集萎缩性阴道炎病人５０ 例、绝经前健康妇女３０ 例和绝经后阴道萎缩妇女２０ 例,进行阴道需氧菌和厌氧菌培养。结果：５０ 例萎缩性阴道炎组共分离出需氧菌６５ 株,分离率由高到低前４ 位依次是大肠埃希氏菌（１３／５０ ,２６ ％ ） 、表皮葡萄球菌（９／５０ ,１８ ％ ） 、粪链球菌（７／５０ ,１４ ％ ） 和绿色链球菌（６／５０ ,１２ ％ ） ,分离出厌氧菌５６ 株,分离率由高到低前４ 位依次是拟杆菌（２１／５０ ,４２ ％ ） 、消化链球菌（１９／５０ ,３８ ％ ） 和真杆菌（６／５０ ,１２ ％ ） 。除大肠埃希氏菌的分离率明显高于绝经前对照组外,其余各菌群与另外两组比较无明显差异, Ｐ ≤００５ 。结论：萎缩性阴道炎的菌群分布除大肠埃希氏菌外,其它菌群与绝经前妇女基本相似。     

广州地区女性生殖道支原体感染及其药敏状况

目的： 了解广州地区女性生殖道支原体感染及药敏状况及其临床意义。方法：收集我院妇科门诊５４３ 例宫颈分泌物标本进行支原体培养及药敏分析。结果：本院妇科门诊生殖道支原体感染率６０．８％ ;其中,解脲脲原体感染占６８．９％ ;新一代大环内酯类药及喹诺酮类药对解脲脲原体的敏感性较高;支原体混合感染可使其耐药性提高６～１２ 倍。结论：宫颈分泌物支原体阳性标本的药敏试验有助于本地区妇科门诊合理用药,减少盲目性。