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A组乙型溶血性链球菌感染90例临床分析 预览
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作者 陈阳 朱紫瑶 +1 位作者 章婉 徐志伟 《中国抗生素杂志》 CAS CSCD 2019年第5期591-594,共4页
目的分析总结A组乙型溶血性链球菌(group A Streptococcus pyogens,GAS)感染患者的临床特点以提高诊疗水平。方法收集温州医科大学附属第二医院自2005-2016年收住的90例证实为GAS感染患者的临床资料并进行统计分析。结果GAS感染在儿童... 目的分析总结A组乙型溶血性链球菌(group A Streptococcus pyogens,GAS)感染患者的临床特点以提高诊疗水平。方法收集温州医科大学附属第二医院自2005-2016年收住的90例证实为GAS感染患者的临床资料并进行统计分析。结果GAS感染在儿童中最常见的疾病表现为扁桃体炎(38.0%),成人中则为局部皮肤软组织感染(72.7%)。实验室指标,C反应蛋白(CRP)、白细胞(WBC)、降钙素原(PCT)、抗链球菌溶血素O(ASO)可有所升高。目前GAS对常用抗菌药物仍较敏感。预后89例治愈后出院,1例死亡病例。结论GAS感染在儿童中以学龄期常见,在成人中以中年期常见。GAS感染患者在合理使用抗菌药物后,预后良好,少有危重症感染发生。 展开更多
关键词 A组乙型溶血性链球菌:感染 临床特点
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糖尿病足复发感染90例临床特点及危险因素分析
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作者 吴旭红 廖立新 +1 位作者 潘实 康春福 《中国基层医药》 CAS 2019年第10期1217-1220,共4页
目的通过分析糖尿病足感染患者的临床资料,探讨糖尿病足复发感染的临床特征及相关危险因素。方法选择2014年1月至2017年12月厦门大学附属第一医院整形美容烧伤科收治的糖尿病足感染患者158例为研究对象,其中90例糖尿病足复发感染者,行... 目的通过分析糖尿病足感染患者的临床资料,探讨糖尿病足复发感染的临床特征及相关危险因素。方法选择2014年1月至2017年12月厦门大学附属第一医院整形美容烧伤科收治的糖尿病足感染患者158例为研究对象,其中90例糖尿病足复发感染者,行常规细菌培养,对比分析复发感染与非复发感染患者临床资料,多因素logistic回归分析糖尿病足复发感染相关危险因素。结果90例糖尿病足复发感染者培养108株病原菌,其中革兰阳性菌(G+)、革兰阴性菌(G-)、其他病原菌分别占54.63%(59株)、39.81%(43株)、5.56%(6株),糖尿病足复发感染与非复发感染患者在病程、年龄、白细胞计数、血红蛋白、纤维蛋白原、白蛋白水平及Wanger分级4~5级比例、双下肢周围血管病变、近期使用抗菌药物、溃疡愈合时间比较,差异均有统计学意义(t=6.003、6.132、3.144、4.322、4.513、11.179、7.164,χ^2=4.269、8.613、25.083、23.298,均P<0.05),多因素分析显示糖尿病足复发感染独立危险因素为双下肢周围血管病变、近期使用抗菌药物、溃疡愈合时间≥65 d(χ^2=5.134,4.807,10.512,均P<0.05)。结论溃疡愈合时间≥65 d、双下肢周围血管病变、近期使用抗菌药物的糖尿病足患者复发感染的风险较高,应密切观察,依据患者自身情况早期采取预防措施。 展开更多
关键词 糖尿病足 复发 危险因素 外周血管疾病 抗感染药 伤口愈合
Preface
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作者 Zhi-Ming Zheng Ke Lan +1 位作者 Eric O. Freed Zheng-Li Shi 《中国病毒学:英文版》 CAS CSCD 2019年第2期117-118,共2页
Viral infections remain a global threat to world health in the twenty-first century. They are caused by both DNA and RNA viruses and can manifest as acute or chronic infections, in some cases causing epidemics or even... Viral infections remain a global threat to world health in the twenty-first century. They are caused by both DNA and RNA viruses and can manifest as acute or chronic infections, in some cases causing epidemics or even global pandemics.Persistent viral infections lead to host immunodeficiency and the development of ~12% of human cancers worldwide. 展开更多
关键词 VIRAL INFECTIONS twenty-first CENTURY CANCERS WORLDWIDE
Status of intestinal parasitic infections among rural and urban populations, southwestern Iran
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作者 Molouk Beiromv Esmat Panabad Abdollah Rafiei 《亚太热带医药杂志:英文版》 SCIE CAS 2019年第3期130-136,共7页
Objective: To evaluate the prevalence and risk factors of intestinal parasitic infections in the urban and rural areas of Shushtar County,southwest Iran.Methods: A total of 1 008 fecal samples were analyzed by direct ... Objective: To evaluate the prevalence and risk factors of intestinal parasitic infections in the urban and rural areas of Shushtar County,southwest Iran.Methods: A total of 1 008 fecal samples were analyzed by direct smear examination,formalinether concentration,and Ziehl-Neelsen and trichrome staining;furthermore,PCR was used to distinguish Trichostrongylus and hookworm species based on 28 S rRNA gene.Results: Totally,16.0% cases tested positive,either with a pathogenic or a non-pathogenic parasite. Protozoa were detected in 14.0%,helminths in 1.0%,protozoa and helminth coinfections were detected in 0.3%,and co-infections of two protozoa were detected in 0.7% of cases. The most common protozoa and helminths were Giardia duodenalis(7.7%) and Trichostrongylus spp.(0.5%),respectively. Among five microscopy Trichostrongylus positive cases,Trichostrongylus culbriformis was successfully identified in three isolates by sequencing. In the rural areas,the prevalence of parasitic infection was higher(9.8%) than that in the urban areas(6.2%). A significant association was found between educational level,type of drinking water,animals contact,hand-washing,and clinical symptoms. Conclusions: This study indicates that intestinal parasitic infections remain as a public health priority in Shushtar County. It seems that drinking water and environmental sanitation are the main risk factors of parasitic infections in rural areas. 展开更多
关键词 INTESTINAL PARASITIC INFECTIONS Risk factors Iran
Prevalence of respiratory syncytial virus infection among children hospitalized with acute lower respiratory tract infections in Southern India 预览
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作者 Sandesh Kini Bhuvanesh Sukhlal Kalal +2 位作者 Sara Chandy Ranjani Shamsundar Anita Shet 《世界临床儿科杂志》 2019年第2期33-42,共10页
BACKGROUND Respiratory syncytial virus (RSV) is a leading cause of lower respiratory infections among children. AIM To investigate the proportion of RSV and non-RSV respiratory viral infections among hospitalized chil... BACKGROUND Respiratory syncytial virus (RSV) is a leading cause of lower respiratory infections among children. AIM To investigate the proportion of RSV and non-RSV respiratory viral infections among hospitalized children ≤ 5 years. METHODS Hospitalized children aged < 5 years, with a diagnosis of acute lower respiratory infections (ALRI), admitted between August 2011-August 2013, were included. Cases were defined as laboratory-confirmed RSV and non-RSV respiratory viruses by direct fluorescence assay from the nasopharyngeal wash. RESULTS Of 383 1-59 mo old children hospitalized with an acute lower respiratory infection, 33.9%(130/383) had evidence of viral infection, and RSV was detected in 24.5%(94/383). Co-infections with RSV and other respiratory viruses (influenza A or B, adenovirus, para influenza 1, 2 or 3) were seen in children 5.5%(21/383). Over 90% of the RSV-positive children were under 2 years of age. RSV was detected throughout the year with peaks seen after the monsoon season. Children hospitalized with RSV infection were more likely to have been exposed to a shorter duration of breastfeeding of less than 3 mo. RSV positive children had a shorter hospital stay, although there were significant complications requiring intensive care. Use of antibiotics was high among those with RSV and non-RSV viral infections. CONCLUSION Our study provides evidence of a high proportion of RSV and other virusassociated ALRI among hospitalized children in India. RSV infection was associated with fewer days of hospital stay compared to other causes of lower respiratory infections. A high level of antibiotic use was seen among all respiratory virus-associated hospitalizations. These results suggest the need for implementing routine diagnostics for respiratory pathogens in order to minimize the use of unnecessary antibiotics and plan prevention strategies among pediatric populations. 展开更多
关键词 RESPIRATORY syncytial virus Acute lower RESPIRATORY INFECTIONS CHILDREN Epidemiology India RESPIRATORY VIRAL INFECTION
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Hepatitis in slaughterhouse workers 预览
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作者 Hassan Tariq Muhammad Umar Kamal +5 位作者 Jasbir Makker Sara Azam Usman Ali Pirzada Vaniza Mehak Kishore Kumar Harish Patel 《世界肝病学杂志:英文版(电子版)》 2019年第1期37-49,共13页
Slaughterhouse workers (SHW) are at increased risk of hepatitis which can occur due to different organisms and should be investigated for viral, bacterial, and parasitic organisms. Slaughter house personnel including ... Slaughterhouse workers (SHW) are at increased risk of hepatitis which can occur due to different organisms and should be investigated for viral, bacterial, and parasitic organisms. Slaughter house personnel including butchers are at a higher risk of infections from cuts and blood-letting, with the possible risk of the transmission of blood-borne pathogens to their colleagues. The objective of this review is to evaluate the common etiologies of hepatitis in SHW which will assist in the assessment of these patients presenting with transaminitis. Types of Microorganisms causing hepatitis with their reservoirs, routes of transmission, laboratory diagnosis, clinical features, treatment options and preventive strategies are included in this review. Proper investigation and awareness is of utmost importance as it causes significant financial constraints derived from workers health cost and from livestock production losses when the disease is confirmed. The work up is essential because infected workers might be a source of infections to other colleagues, family and the consumers. 展开更多
关键词 HEPATITIS SLAUGHTERHOUSE workers LIVER INFECTIONS Transaminitis OCCUPATIONAL safety ABATTOIR
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经静脉途径拔除植入心律起搏装置导线25例临床体会
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作者 杨杰 程自平 +6 位作者 陈刚 赵韧 杜丽 冯俊 李超 史学功 林敏 《临床心血管病杂志》 CAS 北大核心 2019年第3期221-224,共4页
目的:回顾性分析和总结经静脉途径拔除植入心律起搏装置(CIED)导线的方法和体会。方法:25例CIED患者(导线断裂3例、感染22例)的47根导线经静脉途径成功拔除,其中6例导线徒手拔除,15例应用锁定钢丝和扩张鞘拔除,1例运用Evolution机械鞘拔... 目的:回顾性分析和总结经静脉途径拔除植入心律起搏装置(CIED)导线的方法和体会。方法:25例CIED患者(导线断裂3例、感染22例)的47根导线经静脉途径成功拔除,其中6例导线徒手拔除,15例应用锁定钢丝和扩张鞘拔除,1例运用Evolution机械鞘拔除,3例经下腔静脉途径拔除;22例患者于对侧植入新的心律起博装置,2例患者无植入新的起搏装置指证,1例患者因感染性心内膜炎积极治疗无效死亡。结果:所有导线均完全拔除,术中术后均未发生严重并发症。结论:经静脉途径拔除CIED导线是根治心律起博装置导线相关问题的重要措施,科学、有效的运用多种器械和技术在复杂病例的应用中十分重要。 展开更多
关键词 植入心律起博装置 导线拔除 感染
血清可溶性髓系细胞触发受体-1在骨折术后感染中的诊断价值 预览
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作者 宋倩 《临床输血与检验》 CAS 2019年第1期77-81,共5页
目的探讨血清可溶性髓系细胞触发受体-1(sTREM-1)在骨折术后感染中的诊断价值。方法将本院骨科收治的187例骨折患者按照术后感染情况分为感染组34例和非感染组153例,分别于术前1d、术后即刻和术后24h采集患者肘静脉血5mL,采用魏氏法测... 目的探讨血清可溶性髓系细胞触发受体-1(sTREM-1)在骨折术后感染中的诊断价值。方法将本院骨科收治的187例骨折患者按照术后感染情况分为感染组34例和非感染组153例,分别于术前1d、术后即刻和术后24h采集患者肘静脉血5mL,采用魏氏法测定红细胞沉降率(ESR),免疫透射比浊法测定血清C-反应蛋白(CRP)值,免疫化学发光法检测血清降钙素原(PCT)值,酶联免疫吸附试验检测血清sTREM-1值,利用受试者工作曲线(ROC)比较ESR、CRP、PCT、sTREM-1对骨折术后感染的诊断效能。结果与术前1d比较,感染组和非感染组术后ESR、CRP、PCT、sTREM-1持续升高,不同时间点比较差异具有统计学意义(P<0.05);感染组术后即刻、术后24hESR、CRP、PCT、sTREM-1明显高于同时段非感染组,组间差异亦有统计学意义(P<0.05)。术前1d,ESR、CRP、PCT、sTREM-1诊断术后感染的AUC均低于0.7,准确性较低;术后即刻,PCT诊断术后感染的AUC(0.951)高于ESR(0.830)、CRP(0.738)和sTREM-1(0.840);术后24h,sTREM-1诊断术后感染的AUC(0.920)高于ESR(0.731)、CRP(0.822)和PCT(0.780)。结论血清PCT可以作为骨折术后感染早期诊断的指标,sTREM-1可以作为判断术后感染病情和病程的重要指标。 展开更多
关键词 感染 红细胞沉降率 C-反应蛋白 降钙素原 可溶性髓系细胞触发受体-1
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Proton pump inhibitors and dysbiosis: Current knowledge and aspects to be clarified 预览
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作者 Giovanni Bruno Piera Zaccari +5 位作者 Giulia Rocco Giulia Scalese Cristina Panetta Barbara Porowska Stefano Pontone Carola Severi 《世界胃肠病学杂志:英文版》 SCIE CAS 2019年第22期2706-2719,共14页
Proton pump inhibitors (PPIs) are common medications within the practice of gastroenterology. These drugs, which act through the irreversible inhibition of the hydrogen/potassium pump (H+/K+-ATPase pump) in the gastri... Proton pump inhibitors (PPIs) are common medications within the practice of gastroenterology. These drugs, which act through the irreversible inhibition of the hydrogen/potassium pump (H+/K+-ATPase pump) in the gastric parietal cells, are used in the treatment of several acid-related disorders. PPIs are generally well tolerated but, through the long-term reduction of gastric acid secretion, can increase the risk of an imbalance in gut microbiota composition (i.e., dysbiosis). The gut microbiota is a complex ecosystem in which microbes coexist and interact with the human host. Indeed, the resident gut bacteria are needed for multiple vital functions, such as nutrient and drug metabolism, the production of energy, defense against pathogens, the modulation of the immune system and support of the integrity of the gut mucosal barrier. The bacteria are collected in communities that vary in density and composition within each segment of the gastrointestinal (GI) tract. Therefore, every change in the gut ecosystem has been connected to an increased susceptibility or exacerbation of various GI disorders. The aim of this review is to summarize the recently available data on PPI-related microbiota alterations in each segment of the GI tract and to analyze the possible involvement of PPIs in the pathogenesis of several specific GI diseases. 展开更多
关键词 Proton pump inhibitors Hypochloridria GUT MICROBIOTA DYSBIOSIS GASTROINTESTINAL TRACT Cancer Helicobacter pylori GASTROINTESTINAL INFECTIONS
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Infection management strategy based on prevention and control of nosocomial infections in intensive care units
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作者 Long-Xiang Su Xiao-Ting Wang +2 位作者 Pan Pan Wen-Zhao Chai Da-Wei Liu 《中华医学杂志:英文版》 SCIE CAS CSCD 2019年第1期115-119,共5页
Sepsis is defined as life-threatening organ dysfunction caused by a dysregulated host response to infection,which is clinical problem often faced by intensive care units (ICU) doctors.Without positive treatment,the in... Sepsis is defined as life-threatening organ dysfunction caused by a dysregulated host response to infection,which is clinical problem often faced by intensive care units (ICU) doctors.Without positive treatment,the incidence and mortality of sepsis are high.^[1]As hospital infection control plays an essential role in treating the nosocomial infections in the ICU,and according to the clinical presentation of critically ill patients,the biological characteristics of pathogenic microorganisms and the ICU environment,this article put forward a strategy for the nosocomial infections in the ICU. 展开更多
关键词 NOSOCOMIAL INFECTIONS INTENSIVE CARE units PREVENTION control
比阿培南延时输注治疗复杂性腹腔内感染的疗效评价 预览
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作者 成云兰 钱春艳 +4 位作者 杨玲 陈学敏 徐茵 张妍 薛晓燕 《医药导报》 CAS 北大核心 2019年第1期100-102,共3页
目的观察比阿培南延时输注治疗复杂性腹腔感染患者的临床疗效,促进临床合理用药。方法2011-2015年常州市第一人民医院使用比阿培南治疗严重腹腔感染的患者52例,根据比阿培南输注方式将患者分为治疗组(延时输注组)24例,比阿培南持续泵入0... 目的观察比阿培南延时输注治疗复杂性腹腔感染患者的临床疗效,促进临床合理用药。方法2011-2015年常州市第一人民医院使用比阿培南治疗严重腹腔感染的患者52例,根据比阿培南输注方式将患者分为治疗组(延时输注组)24例,比阿培南持续泵入0.3g,q6h/q8h,滴注3h;对照组(正常输注组)28例,比阿培南常规静脉输注0.3g,q6h/q8h,滴注0.5h。比较两组临床疗效。结果治疗组和对照组退热时间分别为(13.5±8.3),(16.7±14.9)d;住院时间分别为(38.9±16.9),(45.8±13.6)d;治疗3d后降钙素原分别下降(7.284±10.126),(5.234±8.004)μg·L^-1,治疗组疗效优于对照组。结论对于复杂性腹腔感染患者,比阿培南延时输注优于正常输注。 展开更多
关键词 比阿培南 延时输注 感染 腹腔内 复杂性 降钙素原
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丽水地区中老年宫颈癌患者人乳头瘤病毒感染现状及危险因素
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作者 赵晓 冯骏 张伟珍 《国际流行病学传染病学杂志》 CAS 2019年第2期135-138,共4页
目的调查分析丽水地区中老年宫颈癌患者HPV的感染率及危险因素.方法选取丽水市3家二甲以上医院2016年10月至2018年9月确诊的≥35岁宫颈癌患者200例,检测患者宫颈脱落细胞HPV感染情况及其基因型别,对患者的年龄、婚育史和家族史进行调查... 目的调查分析丽水地区中老年宫颈癌患者HPV的感染率及危险因素.方法选取丽水市3家二甲以上医院2016年10月至2018年9月确诊的≥35岁宫颈癌患者200例,检测患者宫颈脱落细胞HPV感染情况及其基因型别,对患者的年龄、婚育史和家族史进行调查.采用多因素Logistic回归分析法探讨丽水地区宫颈癌患者HPV感染的危险因素.结果 35~49岁年龄段宫颈癌患者HPV感染率为78.99%,高危型HPV感染率为61.34%,HPV混合感染率为51.26%,均显著高于50~65岁年龄段患者(x2=12.488、7.268和25.634,P均<0.05).HPV感染组患者<50岁、孕次≥2次、分娩次数≥2次、性伴侣数目≥2个、未绝经、伴有宫颈炎病史、伴有尿路感染病史的患者占比均显著高于非HPV感染组(x2=10.374、4.908、6.208、4.169、5.603、10.960和7.460,P均<0.05).Logistic回归分析可知,分娩次数≥2次、性伴侣数目≥2个、宫颈炎病史是患者发生HPV感染的独立危险因素[OR(95%CI)=1.464(1.043~2.055)、1.682(1.097~2.579)和1.554(1.056~2.287)].结论丽水地区中老年宫颈癌患者HPV感染率较高,分娩次数增加、性伴侣数目增加、宫颈炎病史会提高患者发生HPV感染的风险. 展开更多
关键词 宫颈肿瘤 人乳头瘤病毒 感染 危险因素
Rhombencephalitis caused by Listeria monocytogenes with hydrocephalus and intracranial hemorrhage: A case report and review of the literature 预览
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作者 Jing-Jing Liang Xiao-Yan He Hong Ye 《世界临床病例杂志》 2019年第4期538-547,共10页
BACKGROUND Listeria monocytogenes (L. monocytogenes), a Gram-positive facultatively intracellular bacterium, is the causative agent of human listeriosis. Listeria infection is usually found in immunocompromised patien... BACKGROUND Listeria monocytogenes (L. monocytogenes), a Gram-positive facultatively intracellular bacterium, is the causative agent of human listeriosis. Listeria infection is usually found in immunocompromised patients, including elderly people, pregnant women, and newborns, whereas it is rare in healthy people. L. monocytogenes may cause meningitis, meningoencephalitis, and some very rare and severe complications, such as hydrocephalus and intracranial hemorrhage, which cause high mortality and morbidity worldwide. Up to now, reports on hydrocephalus and intracranial hemorrhage due to L. monocytogenes are few. CASE SUMMARY We herein report a case of rhombencephalitis caused by L. monocytogenes in a 29- year-old man. He was admitted to the hospital with a 2-d history of headache and fever. He consumed unpasteurized cooked beef two days before appearance. His medical history included type 2 diabetes mellitus, and contaminated beef intake 2 d before onset. Cerebrospinal fluid analysis revealed Gram-positive rod infection, and blood culture was positive for L. monocytogenes. Magnetic resonance imaging findings suggested rhombencephalitis and hydrocephalus. Treatment was started empirically and then modified according to the blood culture results. Repeated CT images were suggestive of intracranial hemorrhage. Although the patient underwent aggressive external ventricular drainage, he died of a continuing deterioration of intracranial conditions.CONCLUSION Hydrocephalus, intracranial hemorrhage, and inappropriate antimicrobial treatment are the determinations of unfavorable outcomes. 展开更多
关键词 Rhombencephalitis LISTERIA MONOCYTOGENES Central nervous system INFECTIONS HYDROCEPHALUS INTRACRANIAL HEMORRHAGE Case report
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Infectious diseases during the European Union training mission Mali(EUTM MLI)–a four-year experience
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作者 Hagen Frickmann Ralf Matthias Hagen +1 位作者 Florian Geiselbrechtinger Nagpal Hoysal 《军事医学研究:英文版》 CAS 2018年第4期293-303,共11页
Background: The European Union Training Mission Mali(EUTM MLI) is a multinational military training deployment to the Western African tropical nation of Mali. Based on routinely collected disease and non-battle injury... Background: The European Union Training Mission Mali(EUTM MLI) is a multinational military training deployment to the Western African tropical nation of Mali. Based on routinely collected disease and non-battle injury surveillance data, this study quantifies the true impact of infectious diseases for this tropical mission and potential seasonal variations in infectious disease threats.Methods: Categorized health events during the EUTM MLI mission and associated lost working days were reported using the EpiNATO-2 report. Infection-related health events were descriptively analyzed for a 4-year period from the 12 th week in 2013 to the 13 th week in 2017. Aggregated EpiNATO-2 data collected from all missions other than EUTM MLI were used as a comparator.Results: Among the infectious diseases reported by EUTM MLI, non-severe upper respiratory infections and gastrointestinal diseases dominated quantitatively, accounting for 1.65 and 1.42 consultations per 100 person-weeks, respectively. The number of recorded infectious disease-associated lost working days during the whole study interval was 723. Seasonal changes in disease frequency were detectable. More gastrointestinal infections were seen in the rainy season, and more respiratory infections occurred in the dry season;these were associated with peaks of more than 2.5 consultations per 100 person-weeks for both categories.Conclusion: Despite initial concerns focused on tropical infectious diseases during this mission in tropical Mali, upper respiratory tract and gastrointestinal infections predominate. The relatively low number of reported lost working days may indicate that these infections are at the milder end of the spectrum of infectious diseases despite a likely reporting bias. 展开更多
关键词 TROPICAL DEPLOYMENT INFECTIOUS diseases TROPICAL medicine Gastrointestinal INFECTIONS Upper respiratory tract INFECTIONS MALI
Analysis of a ten step protocol to decrease postoperative spinal wound infections 预览
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作者 Hossein Elgafy Craig J Raberding +2 位作者 Megan L Mooney Kyle A Andrews Joan M Duggan 《世界骨科杂志》 2018年第11期271-284,共14页
AIM To define a ten-step protocol that reduced the incidence of surgical site infection in the spine surgery practice of the senior author and evaluate the support for each step based on current literature.METHODS In ... AIM To define a ten-step protocol that reduced the incidence of surgical site infection in the spine surgery practice of the senior author and evaluate the support for each step based on current literature.METHODS In response to unexplained increased infection rates at our institution following spine surgery,a ten-step protocol was implemented:(1)preoperative glycemic management based on hemoglobin A1c(HbA1c);(2)skin site preoperative preparation with 2%chlorhexidine gluconate disposable cloths;(3)limit operating room traffic;(4)cut the number of personnel in the room to the minimum required;(5)absolutely no flash sterilization of equipment;(6)double-gloving with frequent changing of outer gloves;(7)local application of vancomycin powder;(8)re-dosing antibiotic every 4 h for prolonged procedures and extending postoperative coverage to 72 h for high-risk patients;(9)irrigation of subcutaneous tissue with diluted povidone-iodine solution after deep fascial closure;and(10)use of DuraPrep skin preparation at the end of a case before skin closure.Through an extensive literature review,the current data available for each of the ten steps was evaluated.RESULTS Use of vancomycin powder in surgical wounds,routine irrigation of surgical site,and frequent changing of surgical gloves are strongly supported by the literature.Preoperative skin preparation with chlorhexidine wipes is similarly supported.The majority of current literature supports control of HbA1c preoperatively to reduce risk of infection.Limiting the use of flash sterilization is supported,but has not been evaluated in spine-specific surgery.Limiting OR traffic and number of personnel in the OR are supported although without level 1 evidence.Prolonged use of antibiotics postoperatively is not supported by the literature.Intraoperative use of DuraPrep prior to skin closure is not yet explored.CONCLUSION The ten-step protocol defined herein has significantly helped in decreasing surgical site infection rate.Several of the steps have already been shown in the lit 展开更多
关键词 Wound INFECTIONS SPINE TEN STEP PROTOCOL Surgical site INFECTIONS
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Management of bacterial and fungal infections in end stage liver disease and liver transplantation:Current options and future directions 预览
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作者 Elda Righi 《世界胃肠病学杂志:英文版》 SCIE CAS 2018年第38期4311-4329,共19页
Patients with liver cirrhosis are susceptible to infections due to various mechanisms,including abnormalities of humoral and cell-mediated immunity and occurrence of bacterial translocation from the intestine.Bacteria... Patients with liver cirrhosis are susceptible to infections due to various mechanisms,including abnormalities of humoral and cell-mediated immunity and occurrence of bacterial translocation from the intestine.Bacterial infections are common and represent a reason for progression to liver failure and increased mortality.Fungal infections,mainly caused by Candida spp.,are often associated to delayed diagnosis and high mortality rates.High level of suspicion along with prompt diagnosis and treatment of infections are warranted.Bacterial and fungal infections negatively affect the outcomes of liver transplant candidates and recipients,causing disease progression among patients on the waiting list and increasing mortality,especially in the early posttransplant period.Abdominal,biliary tract,and bloodstream infections caused by Gram-negative bacteria[e.g.,Enterobacteriaceae and Pseudomonas aeruginosa(P.aeruginosa)]and Staphylococcus spp.are commonly encountered in liver transplant recipients.Due to frequent exposure to broad-spectrum antibiotics,invasive procedures,and prolonged hospitalizations,these patients are especially at risk of developing infections caused by multidrug resistant bacteria.The increase in antimicrobial resistance hampers the choice of an adequate empiric therapy and warrants the knowledge of the local microbial epidemiology and the implementation of infection control measures.The main characteristics and the management of bacterial and fungal infections in patients with liver cirrhosis and liver transplant recipients are presented. 展开更多
关键词 LIVER cirrhosis LIVER transplant RECIPIENTS BACTERIAL INFECTIONS Fungal INFECTIONS MULTIDRUG resistant organisms MANAGEMENT
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脊柱术后手术部位感染的危险因素分析
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作者 戴利明 刘师良 +2 位作者 陈其荣 吴可沁 杨东方 《国际流行病学传染病学杂志》 CAS 2018年第1期22-25,共4页
目的 探讨脊柱手术后手术部位感染(SSI)的危险因素.方法 收集浙江省嘉兴市第一医院2010-2016年行脊柱手术患者的病历资料.采用病例对照研究方法,以患者术后发生SSI的49例患者为病例组,按1∶3配比原则,从经历脊柱手术的患者数据库中随机... 目的 探讨脊柱手术后手术部位感染(SSI)的危险因素.方法 收集浙江省嘉兴市第一医院2010-2016年行脊柱手术患者的病历资料.采用病例对照研究方法,以患者术后发生SSI的49例患者为病例组,按1∶3配比原则,从经历脊柱手术的患者数据库中随机选择147例非感染患者作为对照.分析患者脊柱术后SSI的可能危险因素.结果 糖尿病(OR=4.114,95%CI:1.582~10.683)、术前吸烟史(OR=4.302,95%CI:1.324~13.992)、美国麻醉医生协会评分≥3分(OR=2.962,95%CI:1.062~8.271)、手术时间>135 min(OR=6.132,95%CI:2.421~15.522)、术后闭合引流时间>5 d(OR=3.182,95%CI:1.342~7.608)以及术前住院时间>13d(OR=4.231,95%CI:1.237~14.432)均与SSI发生的风险有关.结论 控制患者的血糖、尽早戒烟、缩短手术时间、尽早拔除引流管以及减少术前住院时间可降低患者脊柱术后SSI的风险. 展开更多
关键词 感染 脊柱外科 危险因素
艾滋病抗病毒治疗对HIV阳性男男性行为者肛门HPV感染的影响 被引量:1
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作者 范俊丽 赵敏 +3 位作者 桂希恩 邱红艳 王琍 张永喜 《中国艾滋病性病》 CSCD 北大核心 2018年第4期330-333,共4页
目的探讨艾滋病联合抗病毒治疗(cART)对艾滋病病毒(HIV)阳性男男性行为者(MSM)感染人乳头瘤病毒(HPV)的影响。方法前瞻性研究,以HIV阳性MSM为研究对象,cART前后接受问卷调查、完成CD4+T淋巴细胞(简称CD4细胞)计数、梅毒快速... 目的探讨艾滋病联合抗病毒治疗(cART)对艾滋病病毒(HIV)阳性男男性行为者(MSM)感染人乳头瘤病毒(HPV)的影响。方法前瞻性研究,以HIV阳性MSM为研究对象,cART前后接受问卷调查、完成CD4+T淋巴细胞(简称CD4细胞)计数、梅毒快速血浆反应素实验、HIV载量及肛门脱落细胞HPV基因检测。对比分析开展cART前后HPV感染率的变化。结果该地区HIV阳性MSM常见的HPV基因型分别是16型、18型、52型、11型和6型。cART前和开展cART后30个月,77例HIV阳性MSM的CD4细胞显著升高(291±177个/μL vs 421±159个/μL,P〈0.05),肛门HPV高危型(76.6%vs 42.9%)和多重高危型(40.3%vs 9.1%)感染率显著降低,单纯低危型感染率(14.3%vs 37.7%)显著升高(P〈0.05)。cART期间,机会感染和肛门尖锐湿疣的患病率较cART前明显减少(P〈0.05),但梅毒和生殖器疱疹的患病率无明显变化(P〉0.05)。结论长期有效的cART可有效降低HIV阳性MSM肛门高危型HPV感染率,降低尖锐湿疣的患病率;对梅毒和生殖器疱疹的患病率无明显影响。 展开更多
关键词 联合抗病毒治疗 人乳头瘤病毒 艾滋病病毒 感染
Spontaneous bacterial and fungal peritonitis in patients with liver cirrhosis:A literature review 预览
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作者 Toru Shizuma 《世界肝病学杂志:英文版(电子版)》 2018年第2期254-266,共13页
Spontaneous bacterial(SBP)and spontaneous fungal peritonitis(SFP)can be a life-threatening infection in patients with liver cirrhosis(LC)and ascites.One of the possible mechanisms of developing SBP is bacterial transl... Spontaneous bacterial(SBP)and spontaneous fungal peritonitis(SFP)can be a life-threatening infection in patients with liver cirrhosis(LC)and ascites.One of the possible mechanisms of developing SBP is bacterial translocation.Although the number of polymorphonuclear cells in the culture of ascitic fluid is diagnostic for SBP,secondary bacterial peritonitis is necessary to exclude.The severity of underlying liver dysfunction is predictive of developing SBP;moreover,renal impairment and infections caused by multidrug-resistant(MDR)organism are associated with a fatal prognosis of SBP.SBP is treated by antimicrobials,but initial empirical treatment may not succeed because of the presence of MDR organisms,particularly in nosocomial infections.Antibiotic prophylaxis is recommended for patients with LC at a high risk of developing SBP,gastrointestinal bleeding,or a previous episode of SBP,but the increase in the risk of developing an infection caused by MDR organisms is a serious concern globally.Less is known about SFP in patients with LC,but the severity of underlying liver dysfunction may increase the hospital mortality.SFP mortality has been reported to be higher than that of SBP partially because the difficulty of early differentiation between SFP and SBP induces delayed antifungal therapy for SFP. 展开更多
关键词 Liver cirrhosis SPONTANEOUS BACTERIAL PERITONITIS SPONTANEOUS FUNGAL PERITONITIS BACTERIAL INFECTIONS
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头颈部恶性肿瘤患者医院感染回顾性分析 预览
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作者 万璐颖 谢贤和 《中国现代医生》 2018年第31期25-28,32共5页
目的 分析头颈部恶性肿瘤患者医院感染情况、常见致病菌和药敏结果,为临床防治提供依据。方法 收集2016年1月1日~2017年12月31日期间我院头颈部恶性肿瘤合并医院感染患者220例,分析患者临床资料、感染部位、病原菌种类及抗菌药物耐药... 目的 分析头颈部恶性肿瘤患者医院感染情况、常见致病菌和药敏结果,为临床防治提供依据。方法 收集2016年1月1日~2017年12月31日期间我院头颈部恶性肿瘤合并医院感染患者220例,分析患者临床资料、感染部位、病原菌种类及抗菌药物耐药情况。结果 220例头颈部恶性肿瘤患者中培养阳性者113例,共培养出病原菌158株,其中革兰阴性菌124株占78.5%,革兰阳性菌25株占15.8%,真菌9株占5.7%。G-菌中铜绿假单胞菌占比最高(24.7%),对亚胺培南耐药率最高,为17.9%。G+菌以金葡菌为主(8.9%),对青霉素G耐药率最高,为85.7%。医院感染部位以下呼吸道感染为主(61.8%),其次为手术切口感染(33.2%)。结论 头颈部恶性肿瘤患者医院感染时以G-菌为主,临床应根据药敏结果合理规范使用抗生素以提高疗效。 展开更多
关键词 头颈部恶性肿瘤 感染 抗菌药物 耐药
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