Abstract:Preventing transmission of seasonal respiratory viral infections in the healthcare setting is critical for the safety of healthcare workers and patients. Seasonal respiratory viral infections are caused by viruses that belong to different viral families but share similar characteristics in the transmission mode and clinical presentations. Proper use of infection control strategies for patients, healthcare workers, and visitors with a respiratory viral infection can effectively prevent its transmission in healthcare settings. Besides the COVID -19 vaccine, vaccines against influenza and respiratory syncytial virus also achieved rapid development.

Abstract:Objective To evaluate the incidence and risk factors for organ/space surgical site infection (SSI) after gastric and colorectal cancer surgery, and construct simple and effective risk prediction models for patients. Methods Clinical data were retrospectively collected from 356 patients with gastric cancer and 305 patients with colorectal cancer who underwent radical surgery in a hospital from January 2018 to October 2022. Independent risk factors for organ/space SSI were identified by univariate and multivariate logistic regression analysis, and nomogram models were constructed. The concordance index (C-index) and calibration curve were used to evaluate the predictive performance of the gastric and colorectal cancer models. Results The incidences of postoperative organ/space SSI in gastric and colorectal cancer patients were 8.4% (30/356) and 9.5% (29/305), respectively. Patients with organ/space SSI had a longer hospital stay than those without SSI (P < 0.001). Multivariate analysis showed that male (OR=5.203, 95%CI: 1.167-23.193), pre-operative ASA grade Ⅲ(OR=5.078, 95%CI: 2.047-12.598), combined organ resection (OR=3.479, 95%CI: 1.261-9.546) and intraoperative blood loss (OR=3.629, 95%CI: 1.577-8.350) were independent risk factors for organ/space SSI after gastric cancer surgery (all P < 0.05). ASA grade (OR=3.128, 95%CI: 1.334-7.337), combined organ resection (OR=3.442, 95%CI: 1.292-9.168) and duration of operation (OR=3.091, 95%CI: 1.367-6.991) were independent risk factors for organ/space SSI after colorectal cancer surgery (all P < 0.05). Based on these risk factors, nomogram models for predicting organ/space SSI after gastric and colorectal cancer surgery were developed, with C-indexes of 0.808 (95%CI: 0.722-0.894) and 0.763 (95%CI: 0.674-0.852), respectively. The calibration curves indicated good consistency between the predicted curves and the ideal reference lines. Conclusion The nomogram models have an excellent prediction performance for organ/space SSI in gastric and colorectal cancer patients underwent radical resection, and provide a simple and effective tool for clinicians to identify high-risk individuals with SSI.

Abstract:Objective To investigate the risk factors for postoperative infection after D2 radical resection for gastric cancer, and construct a nomogram model that can accurately predict the risk of postoperative infection.Methods Clinical data of patients underwent D2 radical resection for gastric cancer in the gastrointestinal surgery department of the hospital affiliated to a Medical University in Anhui from January 2019 to December 2021 were retrospectively analyzed. Patients were randomly divided into the training set and the validation set in a ratio of 3 ∶1. Patients in the training set were divided into the infected group and the non-infected group. Univariate and multivariate logistic regression were used to analyze the independent risk factors for postoperative infection after D2 radical resection for gastric cancer. A nomogram model of risk prediction was constructed based on the independent risk factors after D2 radical resection for gastric cancer, validated and assessed in the training set and validation set data, respectively. Receiver operating characteristic (ROC) curve, Hosmer-Lemeshow goodness-of-fit test and calibration curve were used to assess the efficiency of the model. Clinical decision curve analysis (DCA) was used to evaluate clinical validity of the model.Results A total of 477 patients were included in analysis, with 358 in the training set and 119 in the validation set. Among them, 185 patients underwent D2 radical resection for gastric cancer developed postoperative infection, with lower respiratory tract infection being the main infection (n=98, 53.0%), followed by organ or cavity infection (n=48, 25.9%) and bloodstream infection (n=17, 9.2%). Multivariate logistic regression analysis showed the history of abdominal surgery (OR=1.922, 95%CI: 1.048-3.523), NRS 2002≥3 points (OR=3.525, 95%CI: 2.178-5.707), PNI < 49.6(OR=1.662, 95%CI: 1.061-2.602), high ASA classification (Grade 2 vs Grade 1: OR=3.513, 95%CI: 1.883-6.557; Grade 3 vs Grade 1: OR=10.219, 95%CI: 1.097-95.216), combined with organ resection (OR=2.115, 95%CI: 1.105-4.049), and admission to the intensive care unit (OR=15.927, 95%CI: 1.847-137.330) were independent risk factors for postoperative infection after D2 radical resection for gastric cancer (all P < 0.05). A nomogram model of risk prediction was constructed based on the above independent risk factors. The area under the curve (AUC) in the training set and validation set were 0.768 (95%CI: 0.718-0.818) and 0.750 (95%CI: 0.664-0.837), respectively, indicating good discrimination ability of the model. Hosmer-Lemeshow goodness-of-fit test suggested a good fit for the model (P>0.05), and the calibration curve showed good consistency in predicting infection after D2 radical resection for gastric cancer. DCA curve demonstrated the high clinical value of the model.Conclusion The nomogram prediction model based on independent risk factors for postoperative infection after D2 radical resection for gastric cancer can provide a quantitative and intuitive reference tool for early clinical evaluation of the probability of infection after D2 radical resection for gastric cancer.

Abstract:Objective To explore the risk factors for the infection within one week after totally implantable venous access port(TIVAP)surgery, and establish a prediction model. Methods 650 patients undergoing TIVAP surgery were included in the analysis. 480 cases from January 2017 to January 2022 were as the modeling set, and 170 cases from February 2022 to March 2023 were as the validation set. The modeling set was further divided into the infection group (n=17) and the non-infection group (n=463) according to the occurrence of postoperative infection. General condition and clinical characteristics of patients in two groups were compared using t-test and χ² test, and risk factors for postoperative infection were analyzed with binary logistic regression. Visualization was realized through nomogram. Results Among the 17 patients in the infection group of the modeling set, 6 had incisional infection, 10 had pocket infection, and only 1 had blood stream infection. Logistic regression analysis showed that age ≥65 years old (OR=3.093, 95%CI: 1.048-9.128, P=0.041), duration of surgery ≥2 hours (OR=3.286, 95%CI: 1.008-10.716, P=0.049), and pocket hematoma (OR=20.200, 95%CI: 6.750-60.455, P < 0.001) were independent risk factors for TIVAP postoperative infection. The receiver operating characteristic (ROC) curve showed an area under the curve of 0.833, sensitivity of 70.6%, and specificity of 88.1%, respectively. Calibration curve analysis showed a good consistency of the predictive model with the actual risk occurrence. Decision curve analysis (DCA) showed that the model had clinical benefits with risk threshold probability between 1% and 60%. Conclusion Age ≥65 years old, duration of surgery ≥2 hours, and pocket hematoma are independent risk factors for the infection within one week after TIVAP surgery. Prediction model constructed based on these factors has a good accuracy and calibration. Healthcare workers should keep in mind the high risk factors of infection and postope- rative infection care procedures, and strengthen postoperative observation on high risk patients.

Abstract:Objective To retrospectively study the distribution of bacterial species, clinical characteristics, as well as diagnosis and treatment information of non-tuberculous Mycobacterium (NTM) infections in bone and joints in a tertiary orthopedic hospital over the past five years, providing reference for clinical diagnosis, treatment, and rela-ted research of NTM infections in bone and joints. Methods Clinical data of patients diagnosed with NTM infections in bone and joint systems from January 2016 to December 2020 were collected. Cases that met the criteria were selected. Distribution of bacterial species, basic characteristics, clinical manifestations, treatment and prognosis information of patients with different types of infections were summarized and analyzed. Results From 2016 to 2020, a total of 24 cases of NTM infections in bone and joints were diagnosed. Among them, Mycobacterium fortuitum was found in 10 cases, Mycobacterium abscessus in 6 cases, Mycobacterium chelonae-Mycobacterium abscessus group in 3 cases, Mycobacterium houstonense in 3 cases, Mycobacterium smegmatis in 1 case, and Mycobacterium avium in 1 case. 13 patients had underlying diseases of varying degrees, and the infected sites involved various joints in the limbs, with the knee joint (n=9) and ankle joint (n=7) being the most common. All 24 patients presented abscesses and tenderness at the infected site, with a few cases showing local skin temperature elevation or systemic fever. 50.0% (12/24) of patients had sinus formation, and 20.8% (5/24) had granulomas. Among the 24 patients, 2 did not undergo surgery, while the other 22 underwent surgical treatment. All patients received both internal and external adjuvant treatment with antimicrobial agents combined with traditional Chinese medicine, with a median cure duration of 129 days and a cure rate of 83.3% (n=20). One patient was transferred to other hospital after pathogen detection, one died due to multiple organ failure, and two had poor treatment outcomes. Conclusion Timely and accurate early pathogenic diagnosis can shorten the diagnostic period of NTM infections in bone and joints, enabling timely, targeted and precise treatment to effectively reduce infection-related damage, and alleviate patient pain. Traditional Chinese medicine-assisted treatment can promote wound healing, shorten treatment course, and reduce adverse reactions.

Abstract:Objective To construct and validate a risk scoring tool for urinary tract infection (UTI) after ureteroscopic holmium laser lithotripsy(UHLL). Methods A total of 414 post-UHLL patients in the department of urology in a tertiary first-class hospital in Yichang City from January 2018 to December 2021 were selected as study objects through convenient sampling. According to a random number table, 288 patients were randomly assigned to the modeling group, and 126 patients to the validation group, in a 7 ∶3 ratio. Risk factors for UTI in patients after UHLL were identified via univariate and multivariate logistic regression analysis. Based on the data from the mode-ling group, a risk prediction model for post-UHLL UTI was constructed and a nomogram was depicted accordingly, the model was validated through data in validation group. The goodness of fit and predictive performance of the model were assesed using receiver operating characteristic (ROC) curve and Hosmer-Lemeshow test. A risk scoring tool based on the risk prediction model was constructed and applied in clinical practice. Results Among the 414 patients, 68 (16.43%) experienced postoperative UTI. Univariate analysis showed that age, history of smoking, diabetes, chronic diseases, hydronephrosis, and preoperative UTI, as well as preoperative serum protein level, history of azotemia, abnormal liver function, abnormal renal function, intraoperative perfusion time, stone size, urinary catheter retention days, duration of antimicrobial use, and combined use of antimicrobial were influencing factors for the occurrence of UTI in patients after UHLL. Multivariate logistic regression analysis revealed that age, history of diabetes, abnormal renal function, intraoperative perfusion time and combined use of antimicrobial agents were independent influencing factors for post-UHLL UTI. The area under ROC curve of the prediction model was 0.735, the maximum Yoden index was 0.448, the corresponding sensitivity and specificity were 73.3% and 71.5%, respectively and the critical value was determined as 5.5 points. With a cut-off value of 6 points, patients were divided into a low-risk group (0-5 points) and a high-risk group (6-13 points). Applying the post-UHLL UTI risk scoring tool in clinical practice yielded an accuracy of 86.8%, demonstrating favorable clinical utility. Conclusion The risk scoring tool provides guidance for nursing staff by predicting personalized risk of post-UHLL UTI and assisting them in implementing early interventions.

Abstract:Objective To explore the risk of post-periprosthetic infection and construct a nomogram model for predicting the risk of peri-prosthetic infection after mammoplasty through studying serum interleukin-6 (IL-6) and toll-like receptor 2 (TLR-2) levels as well as clinical data of patients who underwent mammoplasty. Methods Patients who underwent mammoplasty in a hospital from February 2019 to February 2022 were selected as research subjects and divided into the infected and non-infected groups. Univariate analysis was performed to analyze patients' general condition, clinical parameters, as well as serum IL-6 and TLR-2 levels, Risk factors affecting the occurrence of peri-prosthetic infection after mammoplasty were preliminarily screened. Independent risk factors were further screened with multivariate logistic regression analysis. A nomogram model for predicting the risk of peri-prosthetic infection after mammoplasty was constructed and validated. Results A total of 446 patients who underwent mammoplasty were included in the analysis, with an average age of (28.50±3.39) years old. Forty-two cases (9.42%) were devided into the infected group and 404 cases (90.58%) in the non-infected group. The levels of IL-6 and TLR-2 in the infected group were significantly higher than those in the non-infected group, with statistically significant difference (P < 0.05). Independent risk factors, including the history of diabetes and mastitis, C-reactive protein (CRP), white blood cell (WBC), as well as IL-6 and TLR-2 levels, were independent risk factors for post-periprosthetic infection after mammoplasty. Based on the screened risk factors, a nomogram model was constructed. The area under the curve (AUC) of receiver operating characteristic (ROC) curve before and after internal validation were 0.858 (95%CI: 0.804-0.911) and 0.842 (95%CI: 0.799-0.890), respectively. The cut-off value was 0.56. The sensitivity before and after internal validation were 88.1% and 88.2%, respectively, and the specificity were 92.3% and 91.7%, respectively, indicating good accuracy. Conclusion The history of diabetes and mastitis, CRP, WBC, IL-6 and TLR-2 levels have a good predictive ability for peri-prosthetic infection after mammoplasty. The nomogram model constructed based on these risk factors can predict the risk of peri-prosthetic infection after mammoplasty, which can assist clinicians to develop individualized treatment plans for patients and reduce the risk of post-operative infection.

Abstract:Objective To analyze the current status and existing problems of microbiological monitoring on duodenoscopes and linear array ultrasound endoscopes in China. Methods A convenience sampling method was used to conduct a questionnaire survey, titled "Questionnaire on the Current Status of Microbiological Monitoring of Duodenoscopes and Linear Array Ultrasound Endoscopes", among digestive endoscopy centers in 313 medical institutions (MIs) nationwide. The survey covered the implementation of microbiological monitoring, monitoring frequency, sampling methods, and result determination. Results The 313 tertiary MIs cover 27 provincial-level administrative regions. 97.76% of MIs performed microbiological monitoring on duodenoscopes and linear array ultrasound endoscopes, with monitoring frequency mainly being once a month (49.32%, 44.10%, respectively) and once a quarter (44.22%, 46.58%, respectively). Either full inspections (52.72%, 45.34%) or proportionately sampled inspections on a rotational basis (34.69%, 43.48%) were performed. Most MIs conducted biopsy channel sampling for duodenoscopes and linear array ultrasound endoscopes (91.50%, 93.79%, respectively), with common flushing method (83.22%, 78.48%, respectively) being the most common. Pump-assisted sampling (8.39%, 11.39%, respectively) and brush-assisted sampling (5.59%, 5.70%, respectively) were less used. Most MIs performed sampling of forceps with special structure for duodenoscopes and linear array ultrasound endoscopes (82.99%, 85.71%, respectively), primarily using the flushing method (56.15%, 52.17%, respectively). 65.99% of the MIs sampled the distal caps of duodenoscopes, with swab sampling (54.12%) being the primary method. For the determination of microbiological monitoring results of duodenoscopes and linear array ultrasound endoscopes, 60.20% and 58.39% of MIs used the quantity of microorganisms in the biopsy channel as the judgement criteria, while other MIs used the highest microbial number among multiple channels (sites) (26.87% and 29.19%, respectively) or the sum of microbial number in multiple channels (sites) (12.93% and 12.42%, respectively). Conclusion The standardization and implementation of microbiological monitoring on duodenoscopes and linear array ultrasound endoscopes in Chinese MIs need to be improved. In clinical practice, it is necessary to establish monitoring standards and detection criteria for duodenoscopes and linear array ultrasound endoscopes, so as to promote the effective implementation of endoscopy quality monitoring.

Abstract:Objective To summarize the clinical symptoms, imaging findings, and laboratory examination characteristics of patients with brucellosis sternoclavicular arthritis, and provide references for diagnosis and treatment. Methods Patients admitted to the brucellosis department of a hospital from August 2013 to February 2023 were analyzed retrospectively. The epidemiological characteristics, initial diagnosis, clinical manifestations, clinical signs, laboratory examinations, imaging examinations, as well as treatment and prognosis were analyzed. Results Among the 14 patients with brucellosis sternoclavicular arthritis, 11 were males and 3 were females, all of whom had a clear epidemiological history. Clinical manifestations included joint pain (n=14), fever (n=10), fatigue (n=10), hyperhidrosis (n=6), and chills (n=5). The main clinical signs were redness, swelling and pain of joints (n=14), splenomegaly (n=4), and lymphadenopathy (n=3). Abnormal laboratory examination results were mainly characterized by elevated inflammatory markers, with 14 cases showing elevated C-reactive protein (CRP) and 10 cases showing elevated erythrocyte sedimentation rate (ESR), accompanied by hematological and liver damage. All 14 patients received at least 12 weeks full course of anti-infection therapy, out of which 13 were cured and 1 underwent surgical treatment, with a 100% effective rate. Conclusion The incidence of brucellosis sternoclavicular arthritis is low, which is prone to misdiagnosis and missed diagnosis. Clinical attention should be paid to differential diagnosis. Early detection, diagnosis, and treatment lead to better clinical prognosis.

Abstract:Rhodococcus erythropolis is an opportunistic pathogen with low virulence, human infection of which is rare, with few reports in China. This article reports a case with fever and pulmonary nodules as the main clinical manifestations on the basis of diabetes, which was confirmed as Rhodococcus erythropolis infection by lung biopsy and metagenomic next-generation sequencing. Relevant literatures from China and abroad were systematically reviewed, clinical manifestations as well as diagnosis and treatment experience of the infection caused by this bacteria were summarized, providing reference for domestic and foreign peers, in order to enable timely and accurate diagnosis and treatment of Rhodococcus erythropolis infection in the future.

Abstract:Objective To systematically evaluate the relationship between gestational diabetes mellitus (GDM) and reproductive tract infection in China. Methods Literatures related to GDM and reproductive tract infection published from database establishment to May 23, 2023 were retrieved from the China National Knowledge Infrastructure (CNKI), Wanfang database, VIP database, China Biology Medicine disc, PubMed, Embase, Web of Science, and The Cochrane Library. After independent screening, data extraction and quality assessment of the included lite-ratures by 2 researchers, a Meta-analysis was conducted using Stata 14.0 software. Results A total of 23 studies were included, involving 4 575 GDM women and 18 540 non-GDM women. Meta-analysis showed that the risk of reproductive tract infection in pregnant women with GDM was 3.28 times higher than that in non-GDM pregnant women (95% CI: 2.29-4.69, P < 0.001). Subgroup analysis revealed that GDM was a risk factor for reproductive tract infection regardless of different study types, publication years, and adjustment for confounding factors (all P < 0.05). For different economic regions, the combined effects in the eastern and central regions showed that GDM was a risk factor for reproductive tract infection (P < 0.05), while in the western and northeast regions, it could not be identified whether GDM was a risk factor for reproductive tract infection (P > 0.05). Conclusion GDM increases the risk of reproductive tract infection, making it an important risk factor for reproductive tract infection.

Abstract:Objective To understand the detection and antimicrobial resistance of bacteria in the pharynx and umbilicus of neonates during admission to hospital, and provide basis for the prevention and control of neonatal infection. Methods Active screening results of 3 639 neonates admitted to the neonatal ward of a hospital from 2017 to 2022 were retrospectively investigated. Changes in bacterial detection in the three years (2017-2019) before COVID -19 pandemic and the three years (2020-2022) during COVID -19 pandemic were compared and analyzed. Results From 2017 to 2022, a total of 3 639 neonates were investigated, and 1 152 strains were detected from 914 neonates. The top 5 detected bacteria were Escherichia coli, Staphylococcus aureus, coagulase negative Staphylococcus, Enterococcus faecalis, and Klebsiella pneumoniae. The top 3 bacteria detected in the three years before the pandemic were different from that during the pandemic, and the positive rate of bacteria detected in umbilicus was higher than that in pharynx, with statistically significant differances (P < 0.001). The major multidrug-resistant organism was methicillin-resistant Staphylococcus aureus (MRSA) (n=71). The positive detection rates of Staphylococcus aureus and MRSA in the three years during COVID -19 epidemic were both significantly lower than that before the pandemic (2.79% vs 4.76%; 0.63% vs 1.31%, respectively, both P < 0.05). The positive rate of MRSA in umbilicus was higher than that in pharynx (2.25% vs 0.38%) in the three years before pandemic. The positive detection rate of MRSA in umbilicus in the three years during the epidemic decreased compared to before the pandemic (0.61% vs 2.25%)(P < 0.001). Antimicrobial usage rate of hospitalized patients from the neonatal ward in the three years during the epidemic was lower than that before the pandemic (60.89% vs 67.42%, P < 0.001). Conclusion The positive rates of Staphylococcus aureus and MRSA detected in umbilical via neonatal screening were lower during the COVID -19 epidemic than that before the pandemic, which may be related to the increased awareness of public health behaviors in and outside hospitals during the epidemic.

Abstract:Objective To explore the effect of quality control circle (QCC) on improving the removal rate of contaminants on object surface in the operating room and reducing the incidence of surgical site infection (SSI). Methods The QCC management mode was applied to supervise and manage the cleaning and disinfection quality of object surface in the operating room. The period of pre-improvement was from October to November 2020, and that of post-improvement was from December 2020 to March 2021, and monitoring continued until September 2021. Fluorescence labeling and microbiological culture were adopted to identify the causes for low removal rate of contaminants on object surface in the operating room. Through 3 strategies including improving equipments, refining procedural protocols, and enhancing training methods, differences in the removal rate of contaminants on object surface in the operating room as well as the incidence of SSI before and after the improvement were compared. Results The removal rate of contaminants on object surface in the operating room increased from 52.26% before improvement to 88.02% after improvement. The passing rate of staff's knowledge assessment increased from 46.82% to 90.29%. Incidence of SSI decreased from 0.18% to 0.07%. Differences were all statistically significant (all P < 0.05). From April to September 2021, incidence of SSI was 0.06%, removal rates of contaminants on object surface in the ope-rating room were 89.24%, 90.80%, 91.67%, 92.53%, 93.40%, and 94.10%, respectively, maintaining a good improvement trend. Conclusion The application of QCC for continuous quality improvement can effectively improve the removal rate of contaminants on object surface in the operating room and the passing rate of environmental clea-ning and disinfection knowledge among staff with different occupations. Ensuring the cleaning quality of the operating room can help reducing the incidence of SSI, meanwhile, the abilities of QCC members are improved, making it a valuable approach for widespread application.

Abstract:Objective To explore the application of hand hygiene (HH) smart cloud system based on Internet of things (IoT) technology in the monitoring of HH in neonatal department. Methods Staff in the neonatal department of a hospital were selected as the research objects. Data about HH compliance rate from May 2021 to June 2022 were collected using the HH smart cloud system and compared with data recorded using the "direct observation method" during the same period. The impact of the application of HH smart cloud system on staff's HH compliance and data authenticity were analyzed. Results After using the HH smart cloud system, HH compliance rate of medical staff was 89.76%, which was lower than 92.73% recorded using the direct observation method during the same period, with statistically significant difference (P < 0.001). When comparing the HH compliance rates obtained by the two monitoring methods for staff at different job positions, nurse's HH compliance rate monitored by the smart cloud system was lower than that observed directly, with statistically significant difference (P < 0.001). HH compliance rates monitored by the smart cloud system were lower than those observed directly before and after contact with patients, before clean aseptic procedures, differences were statistically significant (all P < 0.05). HH compliance rates monitored by HH smart cloud system during different working hours showed statistically significant differences (P < 0.01). Daily consumption of hand disinfectants monitored by HH smart cloud system was 39.16 mL per bed. Conclusion Using the HH smart cloud system to monitor the HH of medical staff can obtain real and effective data.

Abstract:Objective To investigate the distribution and antimicrobial resistance characteristics of fastidious bacteria in a children's hospital, and provide reference for pediatricians to use antimicrobial agents rationally. Methods Main species and antimicrobial resistance of fastidious bacteria from respiratory specimens in a hospital from 2018 to 2022 were analyzed through continuous monitoring. Results The top three isolated fastidious bacteria were Streptococcus pneumoniae (Spn), Haemophilus influenzae (Hi), and Moraxella catarrhalis (Mc). The average resis-tance rate of Spn to erythromycin, clindamycin, tetracycline and cefuroxime was high (>75%), while to penicillin, ceftriaxone, and amoxicillin/clavulanic acid was low (< 15%). The average resistance rate of Hi to ampicillin was high (close to 75%), to cefotaxime, cefuroxime, cefaclor and amoxicillin/clavulanic acid was low (< 45%). The average resistance rate of Mc to ampicillin was high (>90%), to the remaining frequently used antimicrobial agents was low (< 30%). The resistance rates of the three types of bacteria to the above mentioned antimicrobial agents over the past 5 years showed statistically significant differences (all P < 0.05). Conclusion Considering the particularity of antimicrobial use in children, and combined with the results of this study, for Spn infections, empirical treatment may be initiated with penicillin, third-generation cephalosporins, or beta-lactamase inhibitors; for Hi infections, empirical treatment may involve second- and third-generation cephalosporins or beta-lactam antibiotics; for Mc infections, empirical treatment can use antimicrobial agents other than ampicillin. Subsequently, the treatment regimen should be adjusted based on the pathogen and drug sensitivity results.

Abstract:Severe fever with thrombocytopenia syndrome Bunyavirus can invade the nervous system and cause severe fever with thrombocytopenia syndrome encephalitis. Its clinical manifestations are non-specific, and pathogen detection is difficult. Clinicians have insufficient awareness, leading to potential misdiagnosis and underdiagnosis. This article reports a 59-year-old male patient with clinical major manifestations including fever, thrombocytopenia, consciousness disorders, and multiple organ failure. Viral encephalitis was considered clinically, but there was no pathogenic evidence. Metagenomic next-generation sequencing (mNGS) of cerebrospinal fluid detected a novel Bunyavirus. After treatment with ribavirin, the patient's condition improved.

Abstract:Q fever is a highly pathogenic zoonotic disease caused by Coxiella burneti worldwide. Clinical manifestations of Q fever are atypical, and routine laboratory and imaging examinations lack specificity. Most patients have mild symptoms that can self-resolve. Q fever is not a notifiable infectious disease in China. There is a lack of relevant diagnosis and treatment guidelines, making it a long-neglected and underdiagnosed disease. This article reports a case of acute Q fever diagnosed by metagenomic next-generation sequencing (mNGS) of blood specimen, who did not respond to 14 days treatment with doxycycline, condition improved after being treated with minocycline for 3 days. The article aims to improve the awareness of acute Q fever among clinicians and shorten the time of diagnosis and treatment.

Abstract:Post-COVID -19 syndrome, also known as long COVID and post-COVID -19 condition, is a series of symptoms occurring after the acute phase of COVID -19 infection. The main symptoms are fatigue, headache, cognitive impairment, musculoskeletal pain, dyspnea, depression, and insomnia. Patients' quality of life and work ability can be seriously affected. Post-COVID -19 syndrome has gained the attention in the international medical community, leading to a series of studies on its pathogenesis, diagnosis and treatment options. Due to the effective epidemic prevention and control measures taken in China in the first three years of the global epidemic, the number of COVID -19 cases in China has been relatively low. With the adjustment of national epidemic prevention and control policies in early 2023, China has experienced large-scale infections nationwide in a short period. Currently, the treatment of acute COVID -19 in China has mostly concluded, and the diagnosis and treatment of post-COVID -19 syndrome will be the focus of hospitals at all levels in the future. This article summarizes the international research progress in post-COVID -19 syndrome, aiming to provide reference for the diagnosis and treatment of post-COVID -19 syndrome in China.

Abstract:Oxacillinase (OXA) belongs to class D β-lactamase, named for its high hydrolytic activity on oxacillin. OXA-type β-lactamases locate on chromosomes or plasmids, and their horizontal transfer among strains is mediated by mobile elements such as plasmids and transposons. Over a thousand variants have been derived to date. In recent years, carbapenem-hydrolyzing OXA have emerged and spread among strains, posing a huge challenge to clinical anti-infection treatment. In 2001, OXA-48 was found in a strain of Klebsiella pneumoniae in Turkey, which was the firstly reported carbapenem-hydrolyzing OXA in Enterobacterales. Subsequently, various variants of OXA-48 enzyme were identified and nominated as OXA-48-like enzymes. These enzymes not only have strong hydrolytic activity against penicillin, but also hydrolyze carbapenems such as ertapenem and meropenem, mediating resistance to various β-lactam antimicrobial agents, including carbapenems. Shewanella spp. is considered to be the origin of the bla_OXA-48-like gene, and 12 OXA-48-like genes derived from Shewanella spp. have been reported. In order to comprehensively understand the characteristics and distribution of carbapenem-hydrolyzing OXA enzymes, this article reviews the origin, distribution status, epidemiological characteristics, and development trends of carbapenem-hydrolyzing OXA.

Abstract: