Lin Gao Qiming

Chapter 2234 Drug Resistance

"Furthermore, don't talk about traffic problems that can't be solved in a while, just say that I can eliminate this mess. Guess what is the most common cause of death in frontline health centers?"

"What is it?"

"Bacillary dysentery accounts for almost one-fifth of the cases." Fu Liangqi's expression was a little grim.Since he became the person in charge of Guangdong's health and epidemic prevention department, he has been in charge of the whole province's health and epidemic prevention plus eradication—theoretically, it is much larger than his superior in Lingao, Rennes, but he can obtain It is really pitiful to face such a arduous and huge task.

Dysentery is very common in this time and space, but prevention is not difficult.This kind of disease, which is obviously caused by unclean diet, can cause such a high fatality rate, which shows that the work is not done properly, which will make his debriefing report ugly-of course, it is not a big problem, after all, the Senate stands The starting point is too low, and any progress is seen from the outside as a remarkable result.

"It shouldn't be." Song Junxing was a little surprised: "Is there not enough disinfectant?"

"Disinfectants have never been used enough. It is mainly an old problem: the implementation is not in place, and our logistics personnel are actually in short supply, and the situation may be even more serious because of insufficient attention." Fu Liangqi explained. , "It is impossible for me to follow each company to supervise them one by one to carry out the killing work. I can only convey the spirit and requirements, but it is meaningless to raise the requirements too high, because there is no company that can meet them."

"Don't talk about the company, do you know how bad the hospital infection control in the clinic is?" Song Junxing snorted, "Borrowing beds is everywhere, borrowing and borrowing make the isolation work messy, patients with pneumonia, patients with dysentery You and burn patients are all crowded in a tent, and the beds are next to the beds! Let me tell you, this is the shortage of talents caused by the boss’s request to work hard and quickly, and there is chaotic management everywhere. It has nothing to do with you, you Even if you turn all the water into distilled water, it won’t stop you.”

Song Junxing's so-called "nosocomial infection" is the full name of "nosocomial infection". Including infections that have been acquired before admission or have been in the incubation period at the time of admission.Nosocomial sense management is a very important work content in modern hospitals, covering all aspects of content, ranging from the "hand hygiene" of medical staff washing hands and hand disinfection, to the systematic occupational protection regulations for medical staff and professional isolation wards , all belong to the category of hospital sense management.

The hospitals of the Senate naturally also have hospital sense management work, and the frontline health centers naturally also have them-although they are placed in the "medical administration management" section of the hodgepodge, the medical administration administrators are the same as the front-line medical staff. A considerable part of it is the result of surprise training. No matter how Chief Deng claims that the Provincial and Hong Kong General Hospital is a "world-class hospital", it cannot conceal the low level of 99% of the employees.

And even if these management personnel can meet the requirements of the old plane, it can't solve all the problems.Fu Liangqi felt that the overall sanitation awareness of the army could not be established by a few hygienists for a year or two.

Fu Liangqi is not here as a front-line clinician, but to guide the sanitation and epidemic prevention work in the camp and the resident, which is basically what he claims to be "killing and killing".

Before Fu Liangqi came to Guangdong and Guangxi, he was "fully prepared" for the health and epidemic prevention situation, but after reading the reports of the previous elders, he discovered that the implementation of epidemic prevention work in Guangdong and Guangxi, which has not yet been peaceful throughout the territory, will face many difficulties: The scope of this kind of work is limited to the army.

Guangdong and Guangxi are located in the subtropical zone, with hot and humid climate, dense forests, and relatively complex terrain, which is very suitable for the reproduction of harmful medical insects, animals and microorganisms. Mosquitoes, flies, gnats, and snakes and leeches are everywhere.The Little Ice Age doesn't make summers here comfortable and hygienic.

Fu Liangqi concluded from the report of the frontline that the disease spectrum in quasi-security areas is mainly malaria, bacillary dysentery, leptospirosis, typhus, scrub typhus, arbovirus diseases, and parasitic diseases. Diseases, and the epidemic is very serious.From the perspective of the natural environment, Guangxi at the end of the Ming Dynasty was simply a reservoir of "damp-heat pests and diseases" with five poisons. Under the background of the troubled times at the end of the Ming Dynasty, these problems could only become more serious.During the public security war, the frontline troops often had to chase down the remnants for a long time. Although the fighting intensity was not high, the physical exertion was not small. In addition, food and clothing were not as expensive as those in the rear, and the resistance of personnel was significantly reduced.Although the martial law system has been fully enforced, after all, the Senate’s control in the quasi-security area is not strong, the turnover of personnel is high, and combat troops have to often enter natural epidemic foci to fight against epidemic areas. It is very difficult to control the source of infection.

Before formally intervening in Guangdong and Guangxi, before Lin Motian applied for the first batch of support, he conducted a little sanitation investigation work with several veterans of the public health office, and roughly figured out the sanitation situation, spectrum of infectious diseases, endemic diseases and Water quality conditions.In fact, the results are not unexpected, the most important ones are intestinal infectious diseases and malaria.Due to the ubiquitous capacity problem, killing and killing medicines and equipment are not available at will, and there is not enough vaccine, Lin Motian can only use some methods of rights and interests, such as drawing on the experience of the old plane of the People's Liberation Army to create a Set up a system of "three strikes, two cents and one storage", that is, "cooks are specially assigned to cook rice, vegetables, and soup, divide water to wash hands, wash dishes, and keep the dishes and chopsticks by themselves"; Re-screen the relevant medical history; or use more intensive publicity and education campaigns to emphasize routine drinking water disinfection and prohibit drinking raw water, etc., in order to prevent the outbreak of intestinal epidemics.

But when the battle is fought, it is often too much to take care of.Tens of thousands of small troops were scattered throughout the province, and even in the county towns the conditions of the garrisons were not much better.When carrying out clean-up and patrol missions, the food and accommodation conditions are even more difficult, and the health and disease prevention measures formulated and issued are mostly dead letters.Even after the rectification of the frontline health system, the situation facing Fu Liangqi is still the same.

Take bacillary dysentery, which is the least optimistic of the epidemic situation, as an example. Due to insufficient medicines, it is difficult to complete the treatment of patients in time.Not to mention the conditions on the way back to the camp, contact with each other and transmission is unavoidable. After returning to the camp, only a small number of patients can be isolated, and a large number of patients cannot be isolated, which is prone to reinfection and the spread of the epidemic.

"And Brother Song, there are new tricks in the epidemic recently... You should read this first." Fu Qiliang took out a page of documents from his arms.

Song Junxing took it and saw that it was a telegram from the Health Commission of Guangdong Region:
1 Luwei: Wu Jiangdian learned.Bacillary dysentery can also be seen sporadically in the ear. The front line should follow the new regulations of the central government to keep bacteria samples for drug sensitivity check and report back in time.Liu, Lin.

"According to the new regulations of the central government, it is necessary to retain bacterial samples to check for drug sensitivity... Is it necessary? There are not many antibacterial drugs that can be used now. Even if it is done, is there still a choice for drug sensitivity? Isn't it the same as sulfonamide..." Song Junxing It's a little surprising that the full name of the so-called "drug sensitivity" should be "in vitro antibacterial drug susceptibility test", which is a typical test method in the era of antibiotics.To put it simply, when there are many antibiotics to choose from, the bacterial samples obtained from the patient's infection focus are cultured in vitro, and different antibiotics are added to observe whether the bacteria are sensitive or resistant to these antibiotics.Obviously, this is not a useful check for the Senate where almost only sulfa is available.

"I sent a telegram to Guangdong earlier, reporting the situation of the bacillary dysentery epidemic here." Fu Qiliang took the telegram and said, "It seems that bacillary dysentery also appeared in Guangzhou, but it was only distributed. This is the first time we have done drug sensitivity...Anyway, it is to carry out the order, so I did a drug sensitivity, and this really discovered new problems..."

"What new question?"

"You also said that drug sensitivity is useless, right? Anyway, the only thing that can be used now is sulfonamide. It is for this reason that we have basically not done drug sensitivity testing for any kind of bacteria so far." Fu Qiliang's expression became more and more dignified, "The dysentery strains I received include Sonnei's and Flexneri's. The ones used for drug susceptibility are all of them. Guess what the drug-resistant rate is? An average of 20%! The highest can to 74%!"

"It's so high!" Hearing this number, Song Junxing, who didn't take it seriously at first, was shocked.

The only antibiotics widely used in the Senate are sulfonamide and oxytetracycline.Mainly sulfonamides—this kind of antibacterial drug, which pioneered the war between humans and bacteria for tens of millions of years, has passed the test of time, but has been gradually marginalized in the old plane. This situation is not unreasonable of.Sulfonamides are generally considered to have only antibacterial effects but no bactericidal effects, and a very serious problem of drug resistance has formed in the old plane.The sulfonamides produced by the Senate have limited purity, and there is no trimethoprim as a synergist, so the problem of drug resistance is something that everyone knows will come sooner or later, and bacillary dysentery is originally one of the first-choice indications for sulfonamides. It is very large, and it is not unexpected that drug-resistant bacteria were found in Shigella.

It's just that no one expected that this day would come so early.

Although the current proportion of drug-resistant strains is not high, it is a very bad sign. In the case of insufficient drugs, the emergence of drug-resistant strains will undoubtedly make the dysentery epidemic even worse.
-
Next update: Volume 438 - Guangzhou Governance Chapter [-]

(End of this chapter)