文摘翻译有奖（2010年国外医院感染相关杂志）

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美国感染控制杂志“American journal of infection control”和英国医院感染杂志“The Journal of hospital infection”等国外杂志是影响力较大的医院感染控制相关杂志，为及时跟踪医院感染研究动态和最新理念，特推出这国外医院感染相关杂志摘要翻译有奖活动，欢迎大家踊跃参加。
翻译有奖活动规则
1、 发布：版主在本贴发布上述杂志最新论文目录（中文）及论文摘要。
2、认领：各位会员跟帖认领，认领后需在72小时内完成翻译，一次只能认领1篇摘要，完成翻译后跟帖发布中英文论文摘要。
3、加分：跟帖认领加2金钱鼓励，完成翻译视翻译质量加1-10分经验鼓励,谢绝纯粹的翻译软件译文。
4、鼓励大家对翻译进行修正和点评，言之有物者酌情加分。
其他未竟事宜由版主讨论决定。

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1。Wristwatch use and hospital-acquired infection手表使用与医院感染（已翻译）
Journal of Hospital Infection
Volume 74, Issue 1, January 2010, Pages 16-21
Summary
The wrists and hands of hospital-based healthcare workers (HCWs) were sampled for bacterial contamination in two consecutive cross-sectional cohort studies of wristwatch wearers and non-wristwatch wearers. In the first study (N = 100), wrists were sampled by skin swabs and hands by direct plate inoculation. In the second study (N = 155) wrists were sampled after each HCW removed the watch immediately prior to sampling. Staphylococcus aureus was found on the hands of 25% of wristwatch wearers and 22.9% of non-wristwatch wearers in the first study. Watch wearers had higher counts of bacteria on their wrist (P < 0.001) but not on their hands. In the second study, removal of the watch prior to sampling resulted in increased counts of bacteria on both hands as well as on the watch wrist compared with non-watch wearers (P < 0.001). In conclusion, wearing a wristwatch results in an increase in bacterial contamination of the wrist but excess hand contamination does not occur unless the watch is manipulated.
Keywords: Hand hygiene; Infection control; Wristwatch

2。Can changes in clinical attire reduce likelihood of cross-infection without jeopardising the doctor–patient relationship?
在不影响医患关系的情况下医院改变白大衣能减少交叉感染率吗？(已翻译）
Journal of Hospital Infection
Volume 74, Issue 1, January 2010, Pages 22-29Summary
Research has shown that healthcare workers' clothes can become contaminated with pathogens. This study aimed to determine whether hospital doctors can change their attire to reduce the possibility of cross-infection without jeopardising the doctor–patient relationship. In this experimental repeated-measures study, 55 male and 45 female inpatients (mean age: 52.89 years) were randomly selected. Participants were shown photographs of medical dresscodes and asked to rate their appropriateness on a 5-point Likert scale. They were then read a standardised statement regarding the significance of attire to cross-infection and the exercise was repeated. Pre statement, there was no significant difference between the majority of dress options, though casual dress (male and female) and short-sleeved top (female) were considered significantly less appropriate. Post statement, surgical ‘scrubs’ and short-sleeved top/shirt were deemed most appropriate (P < 0.0001). There was no significant difference between short-sleeved shirt and scrubs for males. For females, scrubs were preferred (P = 0.0005). Participants expressed no significant preference for medical attire, with the exception of a dislike of casual dress. However, once informed of the significance of attire to cross-infection, preference changes to favour dresscodes which may minimise infection risk.
Keywords: Attire; Clothing; Cross-infection; Doctor–patient relationship

3。Patients' perspectives on how doctors dress病人对医生穿着的评价（已翻译）
Journal of Hospital Infection
Volume 74, Issue 1, January 2010, Pages 30-34
Summary
Infection in hospitals is a serious problem. Attempting to address the spread of infection, many UK National Health Service trusts have adopted a ‘bare-below-the-elbows’ and tie-less dress-code policy. This followed publication of Department of Health guidelines on staff uniforms in September 2007. Although the potential for colonisation of clothing with pathogens has been investigated, patients' opinions on dress-code and policy change have not. This survey of 75 patients in Great Western Hospital, Swindon, UK, used questionnaires to address this. The survey showed that, although patients did feel that doctors' dress was important, neckties and white coats were not expected. Moreover, surgical scrubs were considered acceptable forms of attire. Problems of identifying doctors and determining their grade were repeatedly raised. Patients were generally unaware of the new dress-code, and few knew anything of its relationship to infection control. This work demonstrates that more ‘traditional’ dress is not expected. Given the problems of identification and perception of surgical scrubs as suitable, their introduction as a ‘uniform for doctors’ should be considered. Furthermore, work needs to be done to advertise policy change and increase patient awareness of infection control.
Keywords: Bare-below-the-elbows; Dress-code; Infection control


4 Universal screening for meticillin-resistant Staphylococcus aureus: interim results from the NHS Scotland pathfinder projectMRSA普查-苏格兰NHS项目初步结果
Journal of Hospital Infection
Volume 74, Issue 1, January 2010, Pages 35-41Summary
Following recommendations from a Health Technology Assessment (HTA), a prospective cohort study of meticillin-resistant Staphylococcus aureus (MRSA) screening of all admissions (N = 29 690) to six acute hospitals in three regions in Scotland indicated that 7.5% of patients were colonised on admission to hospital. Factors associated with colonisation included re-admission, specialty of admission (highest in nephrology, care of the elderly, dermatology and vascular surgery), increasing age, and the source of admission (care home or other hospital). Three percent of all those who were identified as colonised developed hospital-associated MRSA infection, compared with only 0.1% of those not colonised. Specialties with a high rate of colonisation on admission also had higher rates of MRSA infection. Very few patients refused screening (11 patients, 0.03%) or had treatment deferred (14 patients, 0.05%). Several organisational issues were identified, including difficulties in achieving complete uptake of screening (88%) or decolonisation (41%); the latter was largely due to short duration of stay and turnaround time for test results. Patient movement resulted in a decision to decolonise all positive patients rather than just those in high risk specialties as proposed by the HTA. Issues also included a lack of isolation facilities to manage patients with MRSA. The study raises significant concerns about the contribution of decolonisation to reducing risks in hospital due to short duration of stay, and reinforces the central role of infection control precautions. Further study is required before the HTA model can be re-run and conclusions redrawn on the cost and clinical effectiveness of universal MRSA screening.
Keywords: Hospital-acquired infection; Infection control; Meticillin-resistant Staphylococcus aureus; Universal screening


5Healthcare-associated infection and the patient experience: a qualitative study using patient interviews 医源性感染与病人经历：一项病人访谈定性研究（已翻译）

Journal of Hospital Infection
Volume 74, Issue 1, January 2010, Pages 42-47
Summary
There is an increasing emphasis on the need for further patient involvement within healthcare to ensure that the voice of the patient is heard. This exploratory study utilised in-depth face-to-face interviews with patients to explore narratives from their experiences around healthcare-associated infection (HCAI). Interviews were undertaken with patients who had been diagnosed with a Staphylococcus aureus bloodstream infection and patients who had been in the same hospital but had not been diagnosed with a bloodstream infection. The lack of both verbal and written communications was a major concern for most patients regardless of their infection status. Some patients also stated that they were not comfortable about asking questions, and only a small number of patients and relatives stated that they would challenge staff about their practice. Although some patients retained confidence in the National Health Service (NHS), the majority had very little or no confidence in the NHS in relation to HCAI and would have serious concerns about this if they were to return to hospital. The results suggest that there are a number of issues that must be addressed in order to enhance the quality of care, safety of patients and the patient experience in relation to infection prevention and control. In addition, policy-makers, managers and all healthcare workers must ensure that patients are involved in the design and evaluation of systems change and information.
Keywords: Communication; Healthcare-associated infection; Infection control; Interviews; Patient experience

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认领举例：
本人认领1号摘要（Wristwatch use and hospital-acquired infection手表使用与医院感染），72小时后若未提高译文，请其他会员自由认领。
翻译举例：
1 Wristwatch use and hospital-acquired infection手表使用与医院感染

The wrists and hands of hospital-based healthcare workers (HCWs) were sampled for bacterial contamination in two consecutive cross-sectional cohort studies of wristwatch wearers and non-wristwatch wearers. In the first study (N = 100), wrists were sampled by skin swabs and hands by direct plate inoculation. In the second study (N = 155) wrists were sampled after each HCW removed the watch immediately prior to sampling. Staphylococcus aureus was found on the hands of 25% of wristwatch wearers and 22.9% of non-wristwatch wearers in the first study. Watch wearers had higher counts of bacteria on their wrist (P < 0.001) but not on their hands. 在In the second study, removal of the watch prior to sampling resulted in increased counts of bacteria on both hands as well as on the watch wrist compared with non-watch wearers (P < 0.001). In conclusion, wearing a wristwatch results in an increase in bacterial contamination of the wrist but excess hand contamination does not occur unless the watch is manipulated. Keywords: Hand hygiene; Infection control; Wristwatch

在带手表和不带手表的两个连续横断面队列研究中对医院人员的手部和腕部进行微生物污染检测。在第一个研究中（100人）腕部用棉签拭子采样，手部直接接种到平皿中。在第二研究中（155人）医务人员摘除手表后腕部被立即采样。第一个研究中金葡菌在25%的带手表的人手上培养出来，而检出金葡菌的不带手表的人占22.9%。但是带手表的金葡菌菌落数明显高于不带手表的人（P < 0.001)。在第二个研究中摘除手表立即检测手部和腕部的菌落数明显高于不带手表者(P < 0.001)。结论，带手表能导致增加腕部细菌但不会造成严重污染除非摆弄手表。

关键词：手卫生；感染控制；手表

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6 Two-step glutamate dehydrogenase antigen real-time polymerase chain reaction assay for detection of toxigenic Clostridium difficile 两步法谷氨酸脱氢酶抗原PCR检测产毒艰难梭菌
Journal of Hospital Infection
Volume 74, Issue 1, January 2010, Pages 48-54
Summary
Current diagnosis of Clostridium difficile infection (CDI) relies upon detection of toxins A/B in stool by enzyme immunoassay [EIA(A/B)]. This strategy is unsatisfactory because it has a low sensitivity resulting in significant false negatives. We investigated the performance of a two-step algorithm for diagnosis of CDI using detection of glutamate dehydrogenase (GDH). GDH-positive samples were tested for C. difficile toxin B gene (tcdB) by polymerase chain reaction (PCR). The performance of the two-step protocol was compared with toxin detection by the Meridian Premier EIA kit in 500 consecutive stool samples from patients with suspected CDI. The reference standard among samples that were positive by either EIA(A/B) or GDH testing was culture cytotoxin neutralisation (culture/CTN). Thirty-six (7%) of 500 samples were identified as true positives by culture/CTN. EIA(A/B) identified 14 of the positive specimens with 22 false negatives and two false positives. The two-step protocol identified 34 of the positive samples with two false positives and two false negatives. EIA(A/B) had a sensitivity of 39%, specificity of 99%, positive predictive value of 88% and negative predictive value of 95%. The two-step algorithm performed better, with corresponding values of 94%, 99%, 94% and 99% respectively. Screening for GDH before confirmation of positives by PCR is cheaper than screening all specimens by PCR and is an effective method for routine use. Current EIA(A/B) tests for CDI are of inadequate sensitivity and should be replaced; however, this may result in apparent changes in CDI rates that would need to be explained in national surveillance statistics.
Keywords: Algorithm; Clostridium difficile toxin; Diagnosis; Enzyme immunoassay; Glutamate dehydrogenase

7 Evaluation of hydrogen peroxide gaseous disinfection systems to decontaminate viruses
过氧化氢气体消毒系统杀灭病毒评价
Journal of Hospital Infection
Volume 74, Issue 1, January 2010, Pages 55-61
Summary
This study assessed the efficacy of two commonly used gaseous disinfection systems against high concentrations of a resistant viral surrogate in the presence and absence of soiling. MS2 bacteriophage suspensions were dried on to stainless steel carriers and exposed to hydrogen peroxide vapour (HPV) and vapour hydrogen peroxide (VHP) gaseous disinfection systems. The bacteriophages were also suspended and dried in 10% and 50% of horse blood to simulate the virus being present in a spill of blood/bodily fluids in a hospital ward environment. Carriers were removed from the gaseous disinfectant at regular intervals into phosphate-buffered saline, vortexed and assayed using a standard plaque assay. The effectiveness of both the HPV and VHP systems varied with the concentration of the bacteriophage with HPV resulting in a 6 log10 reduction in 10 min at the lowest viral concentration [107 plaque-forming units (pfu)/carrier] and requiring 45 min at the highest concentration (109 pfu/carrier). For the VHP system a 30 min exposure period was required to achieve a 6 log10 reduction at the lowest concentration and 60–90 min for the highest concentration. The addition of blood to the suspension greatly reduced the effectiveness of both disinfectants. This study demonstrates that the effectiveness of gaseous disinfectants against bacteriophage is a function of the viral concentration as well as the degree of soiling. It highlights the importance of effective cleaning prior to gaseous disinfection especially where high concentration agents are suspended in body fluids to ensure effective decontamination in hospitals.
keywords: Gaseous disinfection; Hydrogen peroxide vapour; MS2 Bacteriophage; Stainless steel; Vaporised hydrogen peroxide

8 Performance of ultramicrofibre cleaning technology with or without addition of a novel copper-based biocide使用新型铜基杀菌剂的超微纤维清洁技术性能？
Journal of Hospital Infection
Volume 74, Issue 1, January 2010, Pages 62-71
Summary
This study compared the bacterial removal performance of ultramicrofibre cloths and mops (UMF) moistened with water (UMF + water), with those moistened with a novel copper-based biocide (UMF + CuWB50, 300 ppm) in several working hospital environments, specifically accident and emergency (A&E) and three other wards. A total of 13 defined sampling sites (10 sites per ward) were sampled in order to retrieve, culture, and enumerate total viable (bacterial) counts (TVC) for each site. We sampled 1 h before, and 1 and 4 h after, cleaning three times per week. The trial ran for 7 weeks. Two wards were cleaned with UMF + water for 3 weeks, and UMF + CuWB50 for 4 weeks. The reverse applied to the other two wards in a cross-over design fashion, to eliminate ward- and time-specific bias. Multivariate statistical analyses were used to establish extent and significance of any perceived differences, and to eliminate the effects of potential confounders. Cleaning with UMF + water reduced TVC on the test surfaces by 30%, whereas cleaning with TVC + CuWB50 reduced TVC by 56%. CuWB50 had two separate effects; a direct antibacterial effect (evident shortly after cleaning), and a residual antibacterial effect that lasted approximately 2 weeks. The residual effect requires regular application of CuWB50 if it is to persist. This ‘real life’ hospital implementation study demonstrates encouraging microbiological cleaning performance for UMF, which is further enhanced with CuWB50.
Keywords: Bacterial levels; Copper-based biocide; Hospital cleaning; Ultramicrofibre

9 Role of copper in reducing hospital environment contamination铜在降低医院环境污染中的角色
Journal of Hospital Infection
Volume 74, Issue 1, January 2010, Pages 72-77
Summary
The environment may act as a reservoir for pathogens that cause healthcare-associated infections (HCAIs). Approaches to reducing environmental microbial contamination in addition to cleaning are thus worthy of consideration. Copper is well recognised as having antimicrobial activity but this property has not been applied to the clinical setting. We explored its use in a novel cross-over study on an acute medical ward. A toilet seat, set of tap handles and a ward entrance door push plate each containing copper were sampled for the presence of micro-organisms and compared to equivalent standard, non-copper-containing items on the same ward. Items were sampled once weekly for 10 weeks at 07:00 and 17:00. After five weeks, the copper-containing and non-copper-containing items were interchanged. The total aerobic microbial counts per cm2 including the presence of ‘indicator micro-organisms’ were determined. Median numbers of microorganisms harboured by the copper-containing items were between 90% and 100% lower than their control equivalents at both 07:00 and 17:00. This reached statistical significance for each item with one exception. Based on the median total aerobic cfu counts from the study period, five out of ten control sample points and zero out of ten copper points failed proposed benchmark values of a total aerobic count of <5 cfu/cm2. All indicator micro-organisms were only isolated from control items with the exception of one item during one week. The use of copper-containing materials for surfaces in the hospital environment may therefore be a valuable adjunct for the prevention of HCAIs and requires further evaluation.
keywords: Antimicrobial activity; Copper; Environmental contamination; Healthcare-associated infection

harmoni

我来认领第2号：
2。Can changes in clinical attire reduce likelihood of cross-infection without jeopardising the doctor–patient relationship?
在不影响医患关系的情况下医院改变白大衣能减少交叉感染率吗？
Journal of Hospital Infection
Volume 74, Issue 1, January 2010, Pages 22-29Summary
Research has shown that healthcare workers' clothes can become contaminated with pathogens. This study aimed to determine whether hospital doctors can change their attire to reduce the possibility of cross-infection without jeopardising the doctor–patient relationship. In this experimental repeated-measures study, 55 male and 45 female inpatients (mean age: 52.89 years) were randomly selected. Participants were shown photographs of medical dresscodes and asked to rate their appropriateness on a 5-point Likert scale. They were then read a standardised statement regarding the significance of attire to cross-infection and the exercise was repeated. Pre statement, there was no significant difference between the majority of dress options, though casual dress (male and female) and short-sleeved top (female) were considered significantly less appropriate. Post statement, surgical ‘scrubs’ and short-sleeved top/shirt were deemed most appropriate (P < 0.0001). There was no significant difference between short-sleeved shirt and scrubs for males. For females, scrubs were preferred (P = 0.0005). Participants expressed no significant preference for medical attire, with the exception of a dislike of casual dress. However, once informed of the significance of attire to cross-infection, preference changes to favour dresscodes which may minimise infection risk.
Keywords: Attire; Clothing; Cross-infection; Doctor–patient relationship

有研究发现医疗卫生工作者的衣服可能会受病原体的污染。本研究目的在于通过改变白大衣是否能减少交叉感染的可能性，同时又不会影响医患关系。本研究中，随机选择55名男性和45名女性住院患者（平均年龄为52.89岁）并进行复测研究。开始，向参与者展示医疗行业规范着装的照片并被要求通过莱克特5级量表来评价这些着装的适当性。随后让他们阅读一份关于白大褂对交叉感染有关的报告，再次重复以上评价过程。
前者，对于多数着装的评价无显著性差异，尽管随意性着装（男性和女性）和短袖上衣被认为缺乏适当性。后者，外科洗手衣和短袖上衣被认为更具适当性（P< 0.0001）。对于男性着装，短袖上衣和洗手衣没有显著差异。而对于女性着装，洗手衣更可取（P< 0.0005）。对于白大衣，参与实验的人都没有显著的偏好，但对随意性着装存在有反感。但是，一旦了解到白大衣于交叉感染的的密切联系后，，考虑到正式着装可能减少感染风险，会被更多选择。

关键词：白大衣；衣服；交叉感染；医患关系
（水平有限，请多指教）

harmoni

认领第3号：

3、Patients' perspectives on how doctors dress病人对医生穿着的评价
Journal of Hospital Infection
Volume 74, Issue 1, January 2010, Pages 30-34
Summary
Infection in hospitals is a serious problem. Attempting to address the spread of infection, many UK National Health Service trusts have adopted a ‘bare-below-the-elbows’ and tie-less dress-code policy. This followed publication of Department of Health guidelines on staff uniforms in September 2007. Although the potential for colonisation of clothing with pathogens has been investigated, patients' opinions on dress-code and policy change have not. This survey of 75 patients in Great Western Hospital, Swindon, UK, used questionnaires to address this. The survey showed that, although patients did feel that doctors' dress was important, neckties and white coats were not expected. Moreover, surgical scrubs were considered acceptable forms of attire. Problems of identifying doctors and determining their grade were repeatedly raised. Patients were generally unaware of the new dress-code, and few knew anything of its relationship to infection control. This work demonstrates that more ‘traditional’ dress is not expected. Given the problems of identification and perception of surgical scrubs as suitable, their introduction as a ‘uniform for doctors’ should be considered. Furthermore, work needs to be done to advertise policy change and increase patient awareness of infection control.
Keywords: Bare-below-the-elbows; Dress-code; Infection control
医院感染问题是目前受关注的问题。为解决工作服传播感染的问题，已经有部分的英国健康单位正在采取
一种“无袖”和“贴身”的衣着规范。这些规范是由英国卫生部2007年十一月颁布的医疗卫生人员制服指
引所规定。尽管有研究发现衣物会成为病原菌的定植场所，但是患者对衣着规范和政策的认识还未发生改
变。此项调查涉及75名斯文顿市西部医院住院患者，采用问卷方式收集相关数据。调查发现，尽管患者认
为医生正规着装很重要，但是他们并不希望医生看病时戴领结和穿白大衣。甚至，他们认为外科医生洗手
衣是可接受的医务人员着装。 同样，能区分医生级别的着装也被病人所关注。病人对医疗机构着装新规
范知之甚少。同样，他们对医生着装与医院感染控制的关系也缺乏了解。本调查发现，医生传统着装更少
被患者接受。鉴于患者认为外科洗手衣是医生的合适穿着，因此他们对“医生制服”的观念应该引起重视
。再者，还需向公众宣传医生着装规范来改变和提升患者对感控的了解。
关键词：无袖；着装规范；感染控制

nancywhite

我来认领第5个Healthcare-associated infection and the patient experience: a qualitative study using patient interviews 医源性感染与病人经历：一项病人访谈定性研究

Summary
There is an increasing emphasis on the need for further patient involvement within healthcare to ensure that the voice of the patient is heard. This exploratory study utilised in-depth face-to-face interviews with patients to explore narratives from their experiences around healthcare-associated infection (HCAI). Interviews were undertaken with patients who had been diagnosed with a Staphylococcus aureus bloodstream infection and patients who had been in the same hospital but had not been diagnosed with a bloodstream infection. The lack of both verbal and written communications was a major concern for most patients regardless of their infection status. Some patients also stated that they were not comfortable about asking questions, and only a small number of patients and relatives stated that they would challenge staff about their practice. Although some patients retained confidence in the National Health Service (NHS), the majority had very little or no confidence in the NHS in relation to HCAI and would have serious concerns about this if they were to return to hospital. The results suggest that there are a number of issues that must be addressed in order to enhance the quality of care, safety of patients and the patient experience in relation to infection prevention and control. In addition, policy-makers, managers and all healthcare workers must ensure that patients are involved in the design and evaluation of systems change and information.
Keywords: Communication; Healthcare-associated infection; Infection control; Interviews; Patient experience
摘要 需要确保更多参与医疗活动的病人愈来愈多的受到重视，这个实验性是研究利用和病人面对面的深度访谈，从他们医源性感染经历的叙述中来探讨。访谈来自同一医院被诊断为金黄色葡萄球菌血流感染的病人和未被诊断为金黄色葡萄球菌血流感染的病人。对多数病人来说不考虑他们的感染状况，口头和书面交流的缺乏是主要的担忧。有些病人在询问时感到不舒服，只有小数量的病人和家属将质疑工作人员的操作。尽管一些病人仍旧相信国家医疗机构（NHS），对于医源性感染（HCAI）大多数病人几乎或根本不相信NHS，如果他们返回医院，他们对此将有严重的担忧。结果显示，为了增强护理的质量、病人的安全和关于感染预防与控制的病人的经历，很多有争论的问题必须被设法解决。另外，政策的制定者，管理者和所有医疗工作人员必须确保在设计、系统变更评估和信息中涉及的病人。
关键词：交流；医源性感染；感染控制；访谈；病人经历

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英国医院感染杂志2010年2月份论文：
（已翻译）10、Dental unit waterlines: source of contamination and cross-infection口腔科水路系统：交叉感染和污染的源头
Journal of Hospital Infection
Volume 74, Issue 2, February 2010, Pages 99-111
Summary
Dental chair units (DCUs) are used in the treatment of many patients throughout each day and microbial contamination of specific component parts is an important potential source of cross-infection. The quality of dental unit water is of considerable importance since patients and dental staff are regularly exposed to water and aerosols generated from the dental unit. This water hosts a diverse microflora of bacteria, yeasts, fungi, viruses, protozoa, unicellular algae and nematodes which may be contaminated with micro-organisms found in the biofilm formed due to water stagnation in the narrow-bore dental unit waterline (DUWL) tubings. The water thus contaminated, when used for various treatment procedures through dental handpieces, air/water/three-in-one syringe, etc., produces aerosols that can cause infection. The present review emphasises the risks of infection from DUWL and various water treatment procedures available to disinfect the DUWLs.

Keywords: Dental unit waterlines; Dentist; Disinfection; Infection; Microbial contamination; Patient

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英国医院感染杂志2010年2月份论文：
（已翻译）11、Surgical hand preparation: state-of-the-art 最适当的外科洗手准备
Journal of Hospital Infection
Volume 74, Issue 2, February 2010, Pages 112-122
Summary
Surgical hand preparation has been recommended since the nineteenth century as a measure to reduce infection resulting from surgery. We review the evidence and major objectives of surgical hand preparation, as well as the criteria for the choice of products currently in use. Test and validation procedures for selecting products for surgical hand preparation in North America and Europe are compared. Surgical hand antisepsis using medicated soap and alcohol-based hand-rub formulations is discussed, including the technical aspects, time required for the procedure, drying time, potential for side-effects, and the parameters for the selection of the most appropriate formulations. Brushes are not recommended for surgical hand preparation. Rapid antimicrobial action, wider spectrum of activity, lower side-effects, and the absence of the risk of hand contamination by the rinsing water, clearly favour the use of alcohol-based hand rubs for surgical hand preparation, even in countries with limited resources where the provision of water is scarce or of doubtful quality.
Keywords: Alcohol-based hand rub; Hand hygiene; Surgical hand preparation

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英国医院感染杂志2010年2月份论文：
（已翻译）12、Contamination of laryngoscope handles喉镜的消毒处理
Journal of Hospital Infection
Volume 74, Issue 2, February 2010, Pages 123-128
Summary
Despite use of sterile or disposable laryngoscope blades for each patient, disinfection of laryngoscope handles does not routinely occur, and these devices present a potential route of transmission of pathogens between patients and staff. A total of 192 specimens from 64 laryngoscope handles deemed ‘ready for patient use’ in the anaesthetic rooms of 32 operating theatres were semiquantitatively assessed for bacterial contamination. A further 116 specimens from 58 of the handles were tested for occult blood contamination. One or more species of bacteria were isolated from 55 (86%) of the handles, and included organisms such as enterococci, meticillin-susceptible Staphylococcus aureus, Klebsiella and acinetobacter. Cultures did not yield any anaerobes, fungi, meticillin-resistant Staphylococcus aureus, vancomycin-resistant enterococci or multiply-resistant Gram-negative bacilli. No occult blood contamination was demonstrated. Although the majority of organisms isolated were not pathogenic, their presence indicates the potential for transmission of pathogens from laryngoscope handles. Strategies to address contamination of handles include revision of procedures for disinfection and storage prior to use, introduction of disposable handles or sheaths, and re-design of handles to eliminate knurled surfaces and contact points.

Keywords: Anaesthesia; Decontamination; Equipment; Infection; Laryngoscope

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英国医院感染杂志2010年2月份论文：
13、Effect of anaesthesia maintained with sevoflurane and propofol on surgical site infection after elective open gastrointestinal surgery 七氟醚和异丙酚麻醉剂在预防择期胃肠手术后手术部位感染的效果
Journal of Hospital Infection
Volume 74, Issue 2, February 2010, Pages 129-136
Summary
Perioperative increase in oxidative activity in surgical patients reportedly prevents postoperative surgical site infection (SSI). Several clinical studies have shown that oxidative activity under sevoflurane anaesthesia was higher than that under propofol anaesthesia. Therefore, we hypothesised that sevoflurane anaesthesia would discourage SSI compared with propofol anaesthesia. To examine the effect of anaesthesia maintained with sevoflurane and propofol on SSI, a total of 265 consecutive adult patients, with American Society of Anesthesiologists physical status 1–3, who underwent elective open gastrointestinal surgery under general anaesthesia, were surveyed for SSI between January 2007 and December 2008. Sevoflurane or propofol was selected to maintain anaesthesia in 95 and 170 patients, respectively. A propensity score was used for pairwise matching of these patients to avoid selection biases between the two methods of anaesthesia. Propensity matching yielded 84 pairs of patients. We compared standardised infection ratios (SIRs), i.e. the quotient of the number of SSI cases observed and the number of SSI cases expected, calculated using data from the National Nosocomial Infection Surveillance, between sevoflurane and propofol anaesthesia. After propensity matching, SIR after sevoflurane anaesthesia was 1.89 [95% confidence interval (CI): 1.46–2.32], which was significantly lower than after propofol anaesthesia (4.78; 95% CI: 4.30–5.27) (P = 0.02). This study suggests that sevoflurane tends to suppress SSI after elective open gastrointestinal surgery compared with propofol.

Keywords: Gastrointestinal surgery; Sevoflurane; Surgical site infection

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英国医院感染杂志2010年2月份论文：
14、Thermostable adenylate kinase technology: a new process indicator and its use as a validation tool for the reprocessing of surgical instruments 耐高温腺苷酸激酶技术：一个新的手术器械消毒指示器和验证工具
Journal of Hospital Infection
Volume 74, Issue 2, February 2010, Pages 137-143
Summary
Adenylate kinase (tAK), a thermostable enzyme, was assessed as a possible means of providing a quantitative measure of cleaning efficacy suitable for validating the performance of an automated washer disinfector (AWD) during routine use. Two indicator formulations were developed using either a commercially available washer disinfector soil or a protein-based soil. Each indicator consisted of 100 μg (in test soil) of tAK dried on to a steel or plastic surface. These indicators were placed in each basket of a washer disinfector and processed alongside soiled surgical instruments during a standard day's operation. After processing, remaining tAK activity was detected using a rapid enzyme assay (2 min detection time) in a handheld hygiene monitor. The amount of tAK remaining on each indictor after a full AWD cycle was found to range from 0.1 to 0.4 ng, which represented a mean log10 removal of 5.8 ± 0.3. There was no statistical difference in the residual tAK activity between individual runs or the position of the indicator in the machine. The tAK indicator was also used to analyse the protein removal within each component of the wash cycle. These results demonstrated that all phases of the wash process contributed to the removal of the protein load, with the main wash alone being responsible for 3.6–4.0 log10 reductions in protein activity. We propose that a quantitative cleaning index using such rapid readout indicator devices would provide a valuable addition to the methodologies for validating cleaning processes.

Keywords: Adenylate kinase; Cleaning process validation; Decontamination

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英国医院感染杂志2010年2月份论文：
15、Quantitative measurement of the efficacy of protein removal by cleaning formulations; comparative evaluation of prion-directed cleaning chemistries 定量测定清洁配方的去除蛋白质功效，化学处理朊毒体的比较评估。
Journal of Hospital Infection
Volume 74, Issue 2, February 2010, Pages 144-151
Summary
The stability of the infectious agent causing variant Creutzfeldt–Jakob disease (vCJD) has highlighted the importance of cleaning surgical instruments for controlling potential spread of iatrogenic CJD. In this study, thermostable adenylate kinases (tAKs) in test soil were coated on to stainless steel and these surrogate agents used to evaluate the efficacy of a range of cleaning chemistries in a bench-top washer disinfector (btWD), or as a pre-soak either with or without subsequent treatment by btWD. Two tAKs were tested initially for ease of removal, the most persistent being Sulfolobus acidocaldarius-derived tAK which was used for evaluating the cleaning chemistries. Conventional chemistries were generally more effective when used in a btWD than as pre-soaks. Cleaning efficacy improved when pre-soaks were followed by treatment with intermediate performing enzymes, demonstrating greater than additive effect on residual tAK activity. Three of the four prion-directed chemistries reduced residual tAK activity to below the limit of quantification (LoQ) by more than 4.8 log10; <175 pg tAK remaining as a pre-soak alone. A conventional alkaline cleaning product also reduced residual tAK activity to below the LoQ but only when used in a btWD. tAK soil dried on to the device was removed less efficiently than tAK soil still moist on the device, with a 320-fold and 28-fold increase in residual tAK activity for pre-soak and btWD, respectively. The study demonstrated the potential for a tAK indicator to describe the effectiveness of protein removal using different chemistries or treatment processes.

Keywords: Creutzfeldt–Jakob disease; Decontamination; Detergent; Prion; Transmissible spongiform encephalopathy

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英国医院感染杂志2010年2月份论文：
15、Quantitative measurement of the efficacy of protein removal by cleaning formulations; comparative evaluation of prion-directed cleaning chemistries 定量测定清洁配方的去除蛋白质功效，化学处理朊毒体的比较评估。
Journal of Hospital Infection
Volume 74, Issue 2, February 2010, Pages 144-151
Summary
The stability of the infectious agent causing variant Creutzfeldt–Jakob disease (vCJD) has highlighted the importance of cleaning surgical instruments for controlling potential spread of iatrogenic CJD. In this study, thermostable adenylate kinases (tAKs) in test soil were coated on to stainless steel and these surrogate agents used to evaluate the efficacy of a range of cleaning chemistries in a bench-top washer disinfector (btWD), or as a pre-soak either with or without subsequent treatment by btWD. Two tAKs were tested initially for ease of removal, the most persistent being Sulfolobus acidocaldarius-derived tAK which was used for evaluating the cleaning chemistries. Conventional chemistries were generally more effective when used in a btWD than as pre-soaks. Cleaning efficacy improved when pre-soaks were followed by treatment with intermediate performing enzymes, demonstrating greater than additive effect on residual tAK activity. Three of the four prion-directed chemistries reduced residual tAK activity to below the limit of quantification (LoQ) by more than 4.8 log10; <175 pg tAK remaining as a pre-soak alone. A conventional alkaline cleaning product also reduced residual tAK activity to below the LoQ but only when used in a btWD. tAK soil dried on to the device was removed less efficiently than tAK soil still moist on the device, with a 320-fold and 28-fold increase in residual tAK activity for pre-soak and btWD, respectively. The study demonstrated the potential for a tAK indicator to describe the effectiveness of protein removal using different chemistries or treatment processes.

Keywords: Creutzfeldt–Jakob disease; Decontamination; Detergent; Prion; Transmissible spongiform encephalopathy

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英国医院感染杂志2010年2月份论文：
（已翻译）16、Resistance of Legionella pneumophila serotype 1 biofilms to chlorine-based disinfection 嗜肺军团菌生物膜对含氯消毒剂的抵抗力
Journal of Hospital Infection
Volume 74, Issue 2, February 2010, Pages 152-159
Summary
The presence of Legionella spp. in potable water systems is a major concern to municipal water providers and consumers alike. Despite the inclusion of chlorine in potable supplies and frequent chlorination cycles, the bacterium is a recalcitrant human pathogen capable of causing incidents of Legionnaires' disease, Pontiac fever and community-acquired pneumonia in humans. Using two materials routinely employed for the delivery of potable water as a substratum, copper and stainless steel, the development of Legionella pneumophila biofilms and their response to chlorination was monitored over a three-day and a three-month period, respectively. Preliminary in vitro studies using broth and sterile tap water as culture media indicated that the bacterium was capable of surviving in low numbers for 28 days in the presence of chlorine. Subsequently, biofilms were grown for three days, one month and two months, respectively, on stainless steel and copper sections, which are widely used for the conveyance of potable water. Immediately after exposure to 50 mg/L chlorine for 1 h, the biofilms yielded no recoverable colonies, but colonies did reappear in low numbers over the following days. Despite chlorination at 50 mg/L for 1 h, both one- and two-month-old L. pneumophila biofilms were able to survive this treatment and to continue to grow, ultimately exceeding 1 × 106 cfu per disc. This research provides an insight into the resistance afforded to L. pneumophila against high levels of chlorine by the formation of biofilms and has implications for the delivery of potable water.

Keywords: Biofilm; Chlorine; Disinfection; Legionella pneumophila; Water

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英国医院感染杂志2010年2月份论文：
17、Biofilm removal by medical device cleaners: comparison of two bioreactor detection assays 两种生化方法检测医疗器械清洗去除生物膜效果比较
Journal of Hospital Infection
Volume 74, Issue 2, February 2010, Pages 160-167
Summary
Currently there are no standards for testing efficacy of medical device cleaners. With fears of prion transmission, residual protein on medical devices needs to be minimised. A bioreactor model was used to grow Pseudomonas aeruginosa biofilm on polytetrafluoroethylene coupons. The biofilm was subjected to various cleaners and residual biofilm was detected either by Crystal Violet assay (CrV) or a commercially available protein assay (PA) following hydrolysis of the biofilm. Percentage reduction of biofilm was compared with untreated controls in three independent tests. There was no significant difference in percentage biofilm reduction irrespective of whether the CrV or PA was used to detect residual biofilm. Processing of coupons attached to the bioreactor rod and position of coupon within the rod had no significant effect on cleaning efficiency or detection of residual biofilm. Both within-run and between-run variation was very low for good cleaners such as 10 g/L NaOH, Zen, and 3 M Rapid Multi-Enzyme Cleaner (RMEC) 70500 but was higher for poor cleaners such as Tween 20 which removed less than 20% of the biofilm. Confocal microscopy and electron microscopy provided visual confirmation of the assay results. We propose that this method is suitable as a test method for evaluating the efficacy of surgical instrument cleaners in removing biofilm, as both within-run and between-run variation was low, detection of residual biofilm can be done using either CrV or PA, and the apparatus is easy to use, cheap and readily available.

Keywords: Biofilms; Crystal Violet; Medical device cleaning; Protein assay

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英国医院感染杂志2010年2月份论文：
18、Analysis of the sporicidal activity of chlorine dioxide disinfectant against Bacillus anthracis (Sterne strain) 二氧化氯消毒剂杀灭炭疽杆菌芽胞效果分析
Journal of Hospital Infection
Volume 74, Issue 2, February 2010, Pages 178-183
Summary
Routine surface decontamination is an essential hospital and laboratory procedure, but the list of effective, noncorrosive disinfectants that kill spores is limited. We investigated the sporicidal potential of an aqueous chlorine dioxide solution and encountered some unanticipated problems. Quantitative bacteriological culture methods were used to determine the log10 reduction of Bacillus anthracis (Sterne strain) spores following 3 min exposure to various concentrations of aqueous chlorine dioxide solutions at room temperature in sealed tubes, as well as spraying onto plastic and stainless steel surfaces in a biological safety cabinet. Serial 10-fold dilutions of the treated spores were then plated on 5% sheep blood agar plates, and the survivor colonies were enumerated. Disinfection of spore suspensions with aqueous chlorine dioxide solution in sealed microfuge tubes was highly effective, reducing the viable spore counts by 8 log10 in only 3 min. By contrast, the process of spraying or spreading the disinfectant onto surfaces resulted in only a 1 log10 kill because the chlorine dioxide gas was rapidly vaporised from the solutions. Full potency of the sprayed aqueous chlorine dioxide solution was restored by preparing the chlorine dioxide solution in 5% bleach (0.3% sodium hypochlorite). The volatility of chlorine dioxide can cause treatment failures that constitute a serious hazard for unsuspecting users. Supplementation of the chlorine dioxide solution with 5% bleach (0.3% sodium hypochlorite) restored full potency and increased stability for one week.

Keywords: Bacillus anthracis; Chlorine dioxide; Disinfectant; Sodium hypochlorite; Spores

harmoni

认领第10号：
10、Dental unit waterlines: source of contamination and cross-infection口腔科水路系统：交叉感染和污染的源头
Journal of Hospital Infection
Volume 74, Issue 2, February 2010, Pages 99-111
Summary
Dental chair units (DCUs) are used in the treatment of many patients throughout each day and microbial contamination of specific component parts is an important potential source of cross-infection. The quality of dental unit water is of considerable importance since patients and dental staff are regularly exposed to water and aerosols generated from the dental unit. This water hosts a diverse microflora of bacteria, yeasts, fungi, viruses, protozoa, unicellular algae and nematodes which may be contaminated with micro-organisms found in the biofilm formed due to water stagnation in the narrow-bore dental
unit waterline (DUWL) tubings. The water thus contaminated, when used for various treatment procedures through dental handpieces, air/water/three-in-one syringe, etc., produces aerosols that can cause infection. The present review emphasises the risks of infection from DUWL and various water treatment procedures available to disinfect the DUWLs.

Keywords: Dental unit waterlines; Dentist; Disinfection; Infection; Microbial contamination; Patient


牙科综合治疗台广泛应用于口腔患者的治疗，但被微生物污染的牙科综合治疗台特殊部件正在成为交叉感染的源头。鉴于牙病患者和牙科医生暴露于牙科治疗台产生的水和气溶胶之下，因此治疗用水质量则非常关键。而治疗用水中可以分离到细菌、酵母菌、霉菌、病毒、原生动物、非细胞型浮游生物和线虫，这些微生物都会携带在生物膜上，并淤滞在狭小的牙科治疗台水路管道内。一旦水质被污染，在各种治疗过程中，通过手机头、气/水枪等产生的气溶胶导致感染。应对牙科综合治疗台水路系统导致的感染风险加以重视，同时，应采用各种水处理系统对口腔科水路系统进行消毒。

关键词：口腔科水路系统；口腔医生；消毒；感染；微生物污染；患者

nancywhite

认领11号
摘要
自19世纪外科洗手准备作为一种降低外科感染的方法被推荐。我们来回顾外科洗手准备的证据和主要的目的，同时目前使用中产品选择的标准。北美和欧洲外科洗手准备产品选择的试验和批准过程进行比较。外科手消毒使用医用肥皂和含酒精搓揉双手的配方被讨论，包括技术方面，洗手过程需要的时间，待干时间，副作用的可能性，和最适合配方选择的决定因素。外科洗手准备手刷不推荐。快速抗菌作用，更大消毒范围，更低的副作用，和被洗涤水手污染风险的缺失，确实有利于外科洗手准备含酒精手搓揉的使用，甚至在一些限制水源地国家水的供给是缺乏的或质量是不确定的。
关键词：含酒精手搓揉；手卫生；外科洗手准备

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美国感染控制杂志2010年第2期
19、Body art practices among inmates: Implications for transmission of bloodborne infections罪犯的人体艺术（纹身）：对血源性传染病传播的影响
Background
Unsterile body art practices among inmates in prison have been implicated in the transmission of bloodborne viruses. The objectives of this study were to determine the prevalence of tattooing and body piercing among inmates, identify factors associated with receiving a tattoo in prison, and explore the contexts of tattooing and body piercing in prison.

Methods
A cross-sectional survey was conducted among randomly selected inmates in 17 state prisons in Illinois; a convenient sample of recently released exprisoners in Chicago, IL, participated in focus group discussions (FGDs).

Results
A total of 1819 (1293 men and 526 women) inmates participated in the survey, and 47 exprisoners participated in the FGDs. Sixty-seven percent of the survey sample had tattoos, and 60% had body piercings. More men (19.3%) than women (8.7%) had received tattoos in prison (odds ratio, 0.40; 95% confidence interval: 0.29-0.56); prevalence of body piercing in prison was low (1.3%) and similar for men and women. Factors associated with tattooing in prison include incarceration for 1 year or longer and having had sex in prison among both men and women; nonheterosexual identity for women only; and for men, being 30-39 years old; incarcerated 4 or more times; having a history of sharing needles, multiple vaginal sex partners, and inconsistent condom use in the 6 months before arrest. Focus groups provided information on body art practices in prison. Inmates had a variety of reasons for getting body art, equipment was often shared, and cleansing agents were not readily available.

Conclusion
Tattooing and body piercing practices exist in prison and could constitute risks for transmission of bloodborne viral infections. Interventions to reduce these risks are discussed.

Key Words: Body art, risk, infections, inmates