为了正常的体验网站,请在浏览器设置里面开启Javascript功能!

医院感染诊断标准

2017-09-17 13页 doc 43KB 28阅读

用户头像

is_279425

暂无简介

举报
医院感染诊断标准医院感染诊断标准 医院感染诊断标准 【感染性与传染性疾病讨论版】 (1997年9月中华医院感染管理学会审定) 医院感染定义: 医院感染是指患者在入院时既不存在,也不处于潜伏期,而在医院内发生的感染,包括在医院获得而于出院后发病的感染。 一、下列情况属于医院感染 1、对于无明显潜伏期的感染,规定在48小时后发生的感染为医院感染;有明确潜伏期者则以自入院时起超过该平均(或常见)潜伏期的感染。 2、本次感染直接与上次住院有关。 3、在原有感染基础上出现其他部位新的感染(除外脓毒血症迁徒灶),或在原感染已知病原体基础上又分...
医院感染诊断标准
医院感染诊断 医院感染诊断标准 【感染性与传染性疾病讨论版】 (1997年9月中华医院感染管理学会审定) 医院感染定义: 医院感染是指患者在入院时既不存在,也不处于潜伏期,而在医院内发生的感染,包括在医院获得而于出院后发病的感染。 一、下列情况属于医院感染 1、对于无明显潜伏期的感染,规定在48小时后发生的感染为医院感染;有明确潜伏期者则以自入院时起超过该平均(或常见)潜伏期的感染。 2、本次感染直接与上次住院有关。 3、在原有感染基础上出现其他部位新的感染(除外脓毒血症迁徒灶),或在原感染已知病原体基础上又分离出新的病原体(排除污染和原来的混合感染)的感染 医学 教育网搜集整理 。 4、新生儿经产道时获得的感染。 医学 教育网搜集整理 5、由于诊疗措施激活的潜在性感染,如疱疹病毒、结核杆菌等的感染。 二、下列情况不属于医院感染 1、皮肤粘膜开放性伤口只要细菌定植而无症状和体征。 2、由于创伤或非生物性因子刺激而产生的炎症反应。 connection, tightening torque value by the corresponding value using smaller diameter rebar. 3, reinforced joints tested process: before the official construction, according to the same bar, same mechanical joint joint joint specimens in the form of not less than 3, and interception of joint specimen material, tensile strength tests are carried out. Site inspection: inspection lots under the same conditions using the same materials, forms, with the specifications of the connectors for every 500 for acceptance of a batch, by acceptance of a batch of less than 500 connectors, electric arc welding of steel bars after sampling. Each acceptance of a connector must be in engineering structure of random interception of 3 specimen tensile strength tests, when 3 joint tensile strength of specimens in accordance with the relevant provisions of strength, this test may be found qualified. (E) reinforcement of the engineering steel bars transverse reinforcement and ? 12 colligation, longitudinal reinforcement, design type, size, spacing and quantity according to the drawing for construction. Positioning the ladder bars with a diameter larger than the Stud. Painted steel position, note the start bar 50mm. Binding thread is eight-shaped, screwed. (1) the floor reinforcement slab reinforcement order: elastic steel line pad ? ? ? lay the bottom layer of the reinforcing steel tie beam reinforcement laying professional utility ? ? ? horse placed reinforcement bench marking top mat laying spacing ? ? secondary upper reinforcement wire locate 3、新生儿经胎盘获得(出生后48小时内发病)的感染,如单纯疱疹、弓形体病、水痘等。监测报按临床诊断统计,力求做出病原学诊断。 呼吸系统医院感染诊断标准 一、上呼吸道感染 临床诊断:鼻咽、鼻旁窦和扁桃腺等上呼吸道急性炎症表现,发热 38.5oC超过2天,并排除普通感冒和非感染性病因如过敏等。 病原学诊断: 分泌物涂片或培养可发现有意义的病原微生物。 二、下呼吸道感染 临床诊断: 1、 患者出现咳嗽、痰粘稠,并有下列情况之一者: (1)发热。 (2)出现肺部罗音。 (3)白细胞总数及嗜中性粒细胞比例增高。 (4)X线显示肺部有炎性浸润性病变,并排除非感染性原因如肺栓塞、心力衰竭、肺水肿、肺癌等。 2、 患者处于稳定期的慢性气道疾患(慢性支气管炎伴或不伴阻塞性肺气肿、哮喘、支气管扩张症)出现急性恶化,咳嗽及痰量明显增加或/和痰液性状变脓性,或者X线胸片与入院时比较有明显改变或新病变,并排除非感染原因(同上述第4)。 connection, tightening torque value by the corresponding value using smaller diameter rebar. 3, reinforced joints tested process: before the official construction, according to the same bar, same mechanical joint joint joint specimens in the form of not less than 3, and interception of joint specimen material, tensile strength tests are carried out. Site inspection: inspection lots under the same conditions using the same materials, forms, with the specifications of the connectors for every 500 for acceptance of a batch, by acceptance of a batch of less than 500 connectors, electric arc welding of steel bars after sampling. Each acceptance of a connector must be in engineering structure of random interception of 3 specimen tensile strength tests, when 3 joint tensile strength of specimens in accordance with the relevant provisions of strength, this test may be found qualified. (E) reinforcement of the engineering steel bars transverse reinforcement and ? 12 colligation, longitudinal reinforcement, design type, size, spacing and quantity according to the drawing for construction. Positioning the ladder bars with a diameter larger than the Stud. Painted steel position, note the start bar 50mm. Binding thread is eight-shaped, screwed. (1) the floor reinforcement slab reinforcement order: elastic steel line pad ? ? ? lay the bottom layer of the reinforcing steel tie beam reinforcement laying professional utility ? ? ? horse placed reinforcement bench marking top mat laying spacing ? ? secondary upper reinforcement wire locate 病原学诊断:临床诊断基础上,符合下列情况之一者 1、 经筛选的痰液(涂片镜检鳞状上皮细胞<10个/低倍镜视野和白细胞>25个/低倍镜视野;免疫抑制和粒细胞缺乏患者见到柱壮上皮细胞或锥状上皮细胞与白细胞同时存在,白细胞数量可以不严格限定)连续两次分离相同病原体。 2、 痰定量培养分类到病原菌计数 106 cfu/ml。 3、 血培养或并发胸腔积液者的胸液分离到病原体。 4、 经纤维支气管镜或人工气道吸引采集的下呼吸道分泌物分离到菌浓度 105cfu/ml的病原菌,经支气管肺泡灌洗(BAL)分离到菌浓度 104的病原菌,或经防污染标本刷(PSB)、防污染支气管肺泡灌洗(PBAL)采集的下呼吸道分泌物分离到病原菌(对于原有慢性阻塞性肺病包括支气管扩张者细菌浓度必须 103cfu/ml) 5、 痰或下呼吸道采样标本中分离到通常非呼吸道定植的细菌或其他特殊病原体。 6、 免疫血清学、组织病理学的病原学诊断依据。 [说明] 病变局限于气道者为医院内气管—支气管炎;出现肺实质炎症(X线显示)者为医院内肺炎(包括肺脓肿),报告时分别标明。 三、胸膜腔感染 临床诊断:发热,胸痛,胸水外观呈脓性,或带臭味,常规检查白细胞计数 >1011/L 病原学诊断: 临床诊断基础上,符合下列情况之一者 connection, tightening torque value by the corresponding value using smaller diameter rebar. 3, reinforced joints tested process: before the official construction, according to the same bar, same mechanical joint joint joint specimens in the form of not less than 3, and interception of joint specimen material, tensile strength tests are carried out. Site inspection: inspection lots under the same conditions using the same materials, forms, with the specifications of the connectors for every 500 for acceptance of a batch, by acceptance of a batch of less than 500 connectors, electric arc welding of steel bars after sampling. Each acceptance of a connector must be in engineering structure of random interception of 3 specimen tensile strength tests, when 3 joint tensile strength of specimens in accordance with the relevant provisions of strength, this test may be found qualified. (E) reinforcement of the engineering steel bars transverse reinforcement and ? 12 colligation, longitudinal reinforcement, design type, size, spacing and quantity according to the drawing for construction. Positioning the ladder bars with a diameter larger than the Stud. Painted steel position, note the start bar 50mm. Binding thread is eight-shaped, screwed. (1) the floor reinforcement slab reinforcement order: elastic steel line pad ? ? ? lay the bottom layer of the reinforcing steel tie beam reinforcement laying professional utility ? ? ? horse placed reinforcement bench marking top mat laying spacing ? ? secondary upper reinforcement wire locate 1、 胸水培养分离到病原菌(强调厌氧菌培养) 2、胸水普通培养无菌生长,但涂片见到细菌 [说明] 1、胸水发现病原菌,则不论胸水性状和常规检查结果如何,均可作出病原学诊断 2、 邻近部位感染自然扩散而来的胸膜腔感染,如并发于肺炎、支气管胸膜瘘、肝脓肿者,不列为医院胸膜腔感染;诊断操作促使扩散者则属医院感染。若肺炎系医院感染,如其并发脓胸按医院肺炎报告,另加注括号标明脓胸。 3、 结核性胸膜炎自然演变成结核性脓胸不属于医院感染。 泌尿系统医院感染诊断标准 临床诊断: 患者出现尿频、尿急、尿痛等尿路刺激症状,或有下腹触痛、肾区叩痛,伴或不伴发热 ,并具有下列情况之一者 1、 尿检白细胞男性 5个/高倍视野,女性 10个/高倍视野,插导尿管患者应结合尿培养。 2、 临床医师诊断为泌尿道感染,或抗菌治疗有效而认定的泌尿道感染。 病原学诊断: 临床诊断基础上,并符合下列情况之一者 1、 清洁中段尿或导尿留取尿液(非留置导尿)培养革兰氏阳性球菌浓度 104cfu/ml,革兰氏阴性杆菌浓度 105cfu/ml。 2、 耻骨联合上膀胱穿刺留取尿液培养细菌浓度 103cfu/ml 。 connection, tightening torque value by the corresponding value using smaller diameter rebar. 3, reinforced joints tested process: before the official construction, according to the same bar, same mechanical joint joint joint specimens in the form of not less than 3, and interception of joint specimen material, tensile strength tests are carried out. Site inspection: inspection lots under the same conditions using the same materials, forms, with the specifications of the connectors for every 500 for acceptance of a batch, by acceptance of a batch of less than 500 connectors, electric arc welding of steel bars after sampling. Each acceptance of a connector must be in engineering structure of random interception of 3 specimen tensile strength tests, when 3 joint tensile strength of specimens in accordance with the relevant provisions of strength, this test may be found qualified. (E) reinforcement of the engineering steel bars transverse reinforcement and ? 12 colligation, longitudinal reinforcement, design type, size, spacing and quantity according to the drawing for construction. Positioning the ladder bars with a diameter larger than the Stud. Painted steel position, note the start bar 50mm. Binding thread is eight-shaped, screwed. (1) the floor reinforcement slab reinforcement order: elastic steel line pad ? ? ? lay the bottom layer of the reinforcing steel tie beam reinforcement laying professional utility ? ? ? horse placed reinforcement bench marking top mat laying spacing ? ? secondary upper reinforcement wire locate 3、 新鲜尿液标本经离心,用相差显微镜检查(1:400),在30个视野中有半数视野见到细菌。 4、 无症状性菌尿症:患者虽然无症状,但在近期(1周)有内镜检查或留置导尿史,尿液培养革兰氏阳性球菌浓度 104cfu/ml,革兰氏阴性杆菌浓度 105cfu/ml,应视为泌尿系统感染。 [ 说明 ] 1、 非导尿或穿刺尿液标本细菌培养为2或2种以上细菌,需考虑污染可能,建议重送。 2、 尿液标本应及时接种。若尿液标本在室温下放置超过2小时,即使其接种培养结果细菌浓度 104或105cfu/ml,亦不应作为诊断依据,应予重送。 3、 影象学、手术、组织病理或其他方法证实的、可定位的泌尿系统(如肾、输尿管、膀胱、尿道、 肾周围组织)感染,报告时应分别标明。 消化系统和腹部医院感诊断标准 一、感染性腹泻 临床诊断:急性腹泻 3次/24小时或粪便常规镜检白细胞 10个/高倍视野,或伴发热、恶心、呕吐、腹痛,排除非感染性因素(如诊断治疗原因、基础疾病、心理紧张)所致和慢性胃肠炎急性发作。 connection, tightening torque value by the corresponding value using smaller diameter rebar. 3, reinforced joints tested process: before the official construction, according to the same bar, same mechanical joint joint joint specimens in the form of not less than 3, and interception of joint specimen material, tensile strength tests are carried out. Site inspection: inspection lots under the same conditions using the same materials, forms, with the specifications of the connectors for every 500 for acceptance of a batch, by acceptance of a batch of less than 500 connectors, electric arc welding of steel bars after sampling. Each acceptance of a connector must be in engineering structure of random interception of 3 specimen tensile strength tests, when 3 joint tensile strength of specimens in accordance with the relevant provisions of strength, this test may be found qualified. (E) reinforcement of the engineering steel bars transverse reinforcement and ? 12 colligation, longitudinal reinforcement, design type, size, spacing and quantity according to the drawing for construction. Positioning the ladder bars with a diameter larger than the Stud. Painted steel position, note the start bar 50mm. Binding thread is eight-shaped, screwed. (1) the floor reinforcement slab reinforcement order: elastic steel line pad ? ? ? lay the bottom layer of the reinforcing steel tie beam reinforcement laying professional utility ? ? ? horse placed reinforcement bench marking top mat laying spacing ? ? secondary upper reinforcement wire locate 病原学诊断: 临床诊断基础上,符合下列情况之一者 1、 粪便或肛拭子标本培养出肠道病原体。 2、常规镜检或电镜直接检出肠道病原体。 3、 从血液或粪中检出病原体的抗原或抗体,达到诊断标准。 4、 从组织培养的细胞病理变化(如毒素测定)判定系肠道病原体所致。 二、胃肠道(食道、胃、大小肠、直肠)感染 临床诊断:患者出现发热( 38.0oC)、恶心、呕吐(或)腹痛、腹泻,而无其它原因可解释。 病原学诊断: 临床诊断基础上,符合下列情况之一者 1、 从外科手术或内镜取得组织标本或外科引流液培养出病原体。 2、 上述标本革兰氏染色或氢氧化钾浮载片可见病原体、多核巨细胞。 3、 手术或内镜标本显示急性感染的组织病理学证据。 三、抗生素相关性腹泻 临床诊断:近期曾应用或正在应用抗菌药物,而出现腹泻( 3次/24小时)可伴大便形状改变(水样便、血便、粘液脓血便或见斑块条索状伪膜)、排除慢性肠炎急性发作或急性胃肠道感染及非感染性原因所致,可具有下列情况之一者 1、 发热 38.5oC。 2、腹痛或腹部压痛、反跳痛。 3、周围血白connection, tightening torque value by the corresponding value using smaller diameter rebar. 3, reinforced joints tested process: before the official construction, according to the same bar, same mechanical joint joint joint specimens in the form of not less than 3, and interception of joint specimen material, tensile strength tests are carried out. Site inspection: inspection lots under the same conditions using the same materials, forms, with the specifications of the connectors for every 500 for acceptance of a batch, by acceptance of a batch of less than 500 connectors, electric arc welding of steel bars after sampling. Each acceptance of a connector must be in engineering structure of random interception of 3 specimen tensile strength tests, when 3 joint tensile strength of specimens in accordance with the relevant provisions of strength, this test may be found qualified. (E) reinforcement of the engineering steel bars transverse reinforcement and ? 12 colligation, longitudinal reinforcement, design type, size, spacing and quantity according to the drawing for construction. Positioning the ladder bars with a diameter larger than the Stud. Painted steel position, note the start bar 50mm. Binding thread is eight-shaped, screwed. (1) the floor reinforcement slab reinforcement order: elastic steel line pad ? ? ? lay the bottom layer of the reinforcing steel tie beam reinforcement laying professional utility ? ? ? horse placed reinforcement bench marking top mat laying spacing ? ? secondary upper reinforcement wire locate 细胞升高。 病原学诊断: 临床诊断基础上,符合下列情况之一者 1、 大便涂片有菌群失调或培养发现有意义的优势菌群。 2、 如作纤维结肠镜检查见肠壁充血、水肿、出血,或见到2mm-20mm灰黄(白)色斑块伪膜。 四、病毒性肝炎 临床诊断:有输血或血制品史、不洁食物史、肝炎接触史,出现下列症状或体征中的任何两项并有肝功能异常,而无其它原因可解释者 1、 发热。 2、厌食、乏力。 3、恶心、呕吐。 4、肝区疼痛。 5、黄疸。 病原学诊断:在临床诊断基础上,血清甲、乙、丙、丁、戊、庚任何一种病毒肝炎活动性标志阳性。 [说明]非感染性病因(如α1-抗胰蛋白酶缺乏、酒精、药物等)和胆道疾病引起的肝炎或肝损害应注意排除。 五、腹(盆)腔内组织感染 包括胆囊、胆道、肝、脾、胰、腹膜、膈下、盆腔、其他组织或腔隙的急性感染,含持续腹膜透析继发性腹膜炎。不包括原发性脏器穿孔所致感染和慢性感染的急性发作。 临床诊断:具有下列症状体症中任何两项,而无其他原因可以解释,同时有影象学检查的相应异常发现。? connection, tightening torque value by the corresponding value using smaller diameter rebar. 3, reinforced joints tested process: before the official construction, according to the same bar, same mechanical joint joint joint specimens in the form of not less than 3, and interception of joint specimen material, tensile strength tests are carried out. Site inspection: inspection lots under the same conditions using the same materials, forms, with the specifications of the connectors for every 500 for acceptance of a batch, by acceptance of a batch of less than 500 connectors, electric arc welding of steel bars after sampling. Each acceptance of a connector must be in engineering structure of random interception of 3 specimen tensile strength tests, when 3 joint tensile strength of specimens in accordance with the relevant provisions of strength, this test may be found qualified. (E) reinforcement of the engineering steel bars transverse reinforcement and ? 12 colligation, longitudinal reinforcement, design type, size, spacing and quantity according to the drawing for construction. Positioning the ladder bars with a diameter larger than the Stud. Painted steel position, note the start bar 50mm. Binding thread is eight-shaped, screwed. (1) the floor reinforcement slab reinforcement order: elastic steel line pad ? ? ? lay the bottom layer of the reinforcing steel tie beam reinforcement laying professional utility ? ? ? horse placed reinforcement bench marking top mat laying spacing ? ? secondary upper reinforcement wire locate 1、 发热>38o C。 2、恶心、呕吐。 3、黄疸。 4、 腹痛、腹部压痛或反跳痛或触及包块状物伴触痛。? 病原学诊断:在临床诊断基础上,符合下列情形之一者 1 、 经手术切除、引流管、穿刺吸引或内镜获取的标本检出病原体。 2 、 血培养阳性,且与局部感染菌相同或与临床相符。 六、腹水感染 临床诊断:腹水原为漏出液,出现下列一项情况者? 1、 腹水性质为渗出液。 2、腹水不易消除,出现腹痛、腹部压痛或反跳痛。 3、 腹水常规检查白细胞>200*106/L,中性粒细胞>25%。 病原学诊断: 临床诊断基础上,腹水细菌培养阳性。 connection, tightening torque value by the corresponding value using smaller diameter rebar. 3, reinforced joints tested process: before the official construction, according to the same bar, same mechanical joint joint joint specimens in the form of not less than 3, and interception of joint specimen material, tensile strength tests are carried out. Site inspection: inspection lots under the same conditions using the same materials, forms, with the specifications of the connectors for every 500 for acceptance of a batch, by acceptance of a batch of less than 500 connectors, electric arc welding of steel bars after sampling. Each acceptance of a connector must be in engineering structure of random interception of 3 specimen tensile strength tests, when 3 joint tensile strength of specimens in accordance with the relevant provisions of strength, this test may be found qualified. (E) reinforcement of the engineering steel bars transverse reinforcement and ? 12 colligation, longitudinal reinforcement, design type, size, spacing and quantity according to the drawing for construction. Positioning the ladder bars with a diameter larger than the Stud. Painted steel position, note the start bar 50mm. Binding thread is eight-shaped, screwed. (1) the floor reinforcement slab reinforcement order: elastic steel line pad ? ? ? lay the bottom layer of the reinforcing steel tie beam reinforcement laying professional utility ? ? ? horse placed reinforcement bench marking top mat laying spacing ? ? secondary upper reinforcement wire locate
/
本文档为【医院感染诊断标准】,请使用软件OFFICE或WPS软件打开。作品中的文字与图均可以修改和编辑, 图片更改请在作品中右键图片并更换,文字修改请直接点击文字进行修改,也可以新增和删除文档中的内容。
[版权声明] 本站所有资料为用户分享产生,若发现您的权利被侵害,请联系客服邮件isharekefu@iask.cn,我们尽快处理。 本作品所展示的图片、画像、字体、音乐的版权可能需版权方额外授权,请谨慎使用。 网站提供的党政主题相关内容(国旗、国徽、党徽..)目的在于配合国家政策宣传,仅限个人学习分享使用,禁止用于任何广告和商用目的。

历史搜索

    清空历史搜索