Clinical characteristics and risk factors of infections caused by Stenotrophomonas maltophilia in a hospital in northwest China.

INTRODUCTION: Stenotrophomonas maltophilia infections have recently increased in importance in China, particularly in intensive care units (ICUs). The aim of this study was to investigate the clinical characteristics and risk factors of S. maltophilia infection in ICU of a hospital in northwest China. METHODOLOGY: The characteristics and outcomes of patients with any type of S. maltophilia infection at Shaanxi Provincial People's Hospital, Shaanxi, China, over a two-year period (from July 2011 to June 2013) were studied. S. maltophilia antimicrobial susceptibility was tested with the agar dilution method. The risk factors for all-cause in-hospital mortality were assessed with multivariate logistic regression. RESULTS: Forty patients (median age, 72 years; 77.5% males) with S. maltophilia infection were identified. The main type of infection was lower respiratory tract infection (97.5%); one patient had a bloodstream infection. A total of 97.5% patients were infected with two or more organisms at the same time. The main characteristics of the patients were prolonged use of mechanical ventilation, urethral catheter, and central venous catheter before the infections occurred. The case number of infection was not different in the four seasons. High in vitro sensitivity was observed to minocycline (91.2%), levofloxacin (85.3%), and trimethoprim-sulfamethoxazole (79.4%). Most patients received therapy with a combination of agents. The crude mortality was 50%. By multivariate analysis, low albumin content and hypotension were the independent prognostic factors for mortality. CONCLUSIONS: Appropriate antimicrobial treatment had no positive impact on mortality. The impacts of albumin supplements and increasing blood pressure on mortality require further clinical studies.

[Soil heavy metal cadmium standard limit and range of background value research].

With the rapid development of industrial and agricultural production in China, problems such as excessive soil pollutants worsen year by year, and soil cadmium pollution resulting from the emergence of "cadmium rice" and other food security incidents occur frequently. It causes the extensive concern of society on soil cadmium environmental standards. A soil environmental standard is the foundation for the evaluation of soil environmental quality. The maximum allowable value of cadmium that affects plant and animal and human health is regarded as the basis value all over the world; however, the certification methods and the goals of standard application are different, thus the standard limit has a great difference. Through the research on domestic and foreign soil cadmium standard limits and the soil cadmium background values in China, the soil cadmium background content range values of the provinces and of some types of soil are given. We report the outstanding problems existing in China's current environmental quality standard of soil cadmium. It is proposed that the soil environmental quality standard should allow the coexistence of gradient of soil cadmium standard limit, effective state and total standard limit, and anthropogenic pollution and background values exceeding the standard should be strictly distinguished.

[Risk factors of nurses' occupational adaptability].

OBJECTIVE: To explore factors affecting occupational adaptability in nurses for offering basis to increase their occupational adaptability. METHODS: Five hundred and forty-five nurses were investigated with work ability index questionnaire and occupational stress instruments. RESULTS: There were many risk factors affecting occupational adaptability in nurses. The main variables that influenced occupational adaptability included work-overtime, mental load, social support, physical environment, and job hazards. The social support was the factor increasing the occupational adaptability of the nurses (P < 0.01, OR = 0.912). Five factors including work overtime, mental load, social support, physical environment and job hazards were introduced in the Logistic equation. The established functions were: Logit (P) = -11.357 + 1.011x(1) + 0.335x(2) - 0.076x(3) + 0.260x(4) + 0.129x(5). CONCLUSION: There are many risk factors affecting occupational adaptability in nurses. Relevant measures should be taken to promote the occupational adaptability in nurses to reduce the risk factors.