Abstract:Objective To explore the structure and functions of Rv0037c protein, a member of major facilitator superfamily (MFS) proteins of Mycobacterium tuberculosis. Methods Bioinformatics analysis on Rv0037c protein was performed with TMHMM Server v.2.0, Swiss-model and DNAMAN software. The PMV261-Rv0037c overexpressed strain was constructed in Mycobacterium smegmatis, pMV261/Msm control strain was obtained, its biolo-gical function was analyzed. Results Rv0037c protein contained 11 transmembrance domains, the C/N domain consisted of "3+2" helical bundles, which was highly conservative in genus Mycobacterium. The growth kinetics curves of the overexpressed strain and the control strain almost completely overlapped, and there was no statistical difference in growth between the overexpressed strain and the control strain (P>0.05). The OD₆₀₀ of the control strain was 2.567±0.162, while that of the overexpressed strain was 2.419±0.456, there was no statistical diffe-rence in biofilm growth between the two strains (P>0.05). The accumulation of ethidium bromide (EB) in overexpressed strain was lower than that in control strain, difference was statistically significant (P<0.001). There was no statistically significant difference in the minimum inhibitory concentration (MIC) of two bacterial strains against various drugs (both P>0.05). Conclusion The Rv0037c protein is a special member of the Mycobacterium MFS family proteins and has a very conserved structure. Overexpression of Rv0037c has no effect on the growth, colony morphology, sliding ability, biofilm formation, and MIC of Mycobacterium smegmatis, but can significantly reduce the accumulation of EB.

Abstract:Objective To observe the expression of pro-inflammatory factors including interleukin (IL)-1α, IL-1β, IL-6 and IL-8 after silencing and over-expressing of tumor necrosis factor receptor-associated factor 6 (TRAF6) in vitro, explore the effect of TRAF6 on pro-inflammatory factors after Kaposi’s sarcoma-associated herpesvirus (KSHV) infection, and provide new ideas for the study of the pathogenesis of KSHV. Methods The silence and over-expression TRAF6 models were established using KSHV(+)iSLK cell line, and the transfection level was detected by real-time fluorescence quantitative polymerase chain reaction (RT-PCR). After 48 and 72 hours of cultivation of cells, the expression levels of pro-inflammatory factors after silencing and over-expressing TRAF6 were detected by enzyme-linked immunosorbent assay (ELISA) and compared. Results TRAF6-silence (siTRAF6) and TRAF6-over-expression (TRAF6-OE) cell models were established successfully. ELISA results showed that pro-inflammatory factors IL-1α, IL-1β, IL-6, and IL-8 increased in varying degrees after silencing TRAF6, while these pro-inflammatory factors decreased in varying degrees after TRAF6 over-expression, IL-6 and IL-8 levels changed remarkablely, suggesting that TRAF6 had a certain inhibitory effect on pro-inflammatory factors and played an important role in the signaling pathway of pro-inflammatory effects after KSHV infection. Conclusion TRAF6 has a certain inhibitory effect on pro-inflammatory factors and is expected to serve as a potential target to inhibit the progression of Kaposi’s sarcoma.

Abstract:Objective To explore the antimicrobial activity of antiparasitic drug dichlorophenol (DIC)against Staphylococcus aureus (S. aureus). Methods Antimicrobial susceptibility and resistance inducing ability of S. aureus against DIC was detected by micro-broth dilution assay and disc diffusion test; bactericidal efficacy of DIC was assessed by time-killing curve; inhibitory effect of DIC on the formation of biofilm and eradicating of formed biofilm of S. aureus was detected by crystal violet and XTT staining; cytotoxicity of DIC was detected by cell counting kit-8 (CCK-8), and a mouse model of skin abscess infection was constructed to detect the in vivo antimicrobial activity and toxicity of DIC. Results The minimal inhibitory (MIC) and minimal bactericidal concentration (MBC) of DIC against S. aureus standard strains were 2-4 μg/mL and 2-8 μg/mL, respectively. The MIC and MBC of DIC against S. aureus clinical strains were 2-8 μg/mL and 8-32 μg/mL, respectively. Disc diffusion test indicated the obvious concentration-dependent bacterial growth inhibitory effects of DIC on S. aureus standard strains. Time-killing assay revealed that DIC concentration of 4×MIC was found to reduce the viable bacterial cells of S. aureus standard strains ATCC 29213 and ATCC 43300 from (5.51±0.27) Log₁₀ CFU/mL and (5.44±0.08) Log₁₀ CFU/mL to the limit of detection after 2 hours and 4 hours treatment, respectively. No drug-resistant mutant strains of S. aureus were found after 15 consecutive passage of DIC with subinhibitory concentration on bacteria. 2 μg/mL DIC could significantly inhibit the formation of S. aureus biofilm and reduce the total amount of biofilm from (100±7.49)% to (11.12±2.86)% (P<0.001). 2 μg/mL DIC significantly eradicated the formed S. aureus biofilm and reduced the total biofilm from (100±10.34)% to (42.53±16.87)% (P<0.001). DIC could significantly reduce the viable bacterial load of S. aureus in abscess in mice, and reduce the number of viable bacteria from (9.54±0.46) Log₁₀ CFU/abscess to (7.78±0.62) Log₁₀ CFU/abscess (P<0.05). Hematoxylin-eosin staining result showed that DIC could significantly reduce the abscess area and inflammatory cell infiltration in mice tissue, and was well tolerated in vivo. Conclusion DIC has low cytotoxicity and obvious in vitro and in vivo antimicrobial activity, which is expected to be an alternative treatment for drug-resistant S. aureus infection.

Abstract:Objective To analyze the detection rate, distribution characteristics, resistance mechanism, and molecular typing of carbapenem-resistant Citrobacter freundii (CRCF), providing theoretical basis for clinical treatment and prevention. Methods Antimicrobial susceptibility testing results of CRCF isolated from Quanzhou First Hospital Affiliated to Fujian Medical University from 2020 to 2023 were analyzed. Resistance phenotypes of the strains were verified; resistance genes were amplified; strain homology was analyzed by multi-locus sequencing ty-ping (MLST). Whole genome sequencing analysis was performed on CF17 strains carrying both bla_VIM-1 and bla_NDM-1. Results A total of 119 strains of non-repetitive Citrobacter freundii were detected, 27 strains were CRCF, accounting for 22.7%. CRCF was mainly isolated from departments of neurosurgery and urology, and the specimen type was mainly midstream urine. Strains were resistant to both carbapenems and cephalosporins, less resistant to amikacin, susceptible to both tigecycline and polymyxin, and with a resistance rate of >50% to other antimicrobial agents. 22 CRCF strains were successfully recovered and all were positive for antimicrobial resistance phenotype and genes. 17 strains (77.3%) carried single resistance genes, including 14 strains carrying bla_NDM-1, 2 strains carrying bla_KPC-2, and 1 strain carrying bla_NDM-5. 5 strains (22.7%) carried dual antimicrobial resistance genes, including strains carrying both bla_KPC-2 and bla_NDM-1 (n=3), strain carrying both bla_NDM-1 and bla_IMP (n=1), and strain carrying both bla_VIM-1 and bla_NDM-1 (n=1). A total of 8 ST types were detected, with 8 and 6 strains being ST116 and ST532, respectively. CF17 was ST116, carrying bla_VIM-1 and bla_NDM-1 on different plasmids, namely IncA and IncX3, respectively. Conclusion CRCF strains are mostly multidrug-resistant, with the presence of bla_NDM-1 being the major resistance mechanism. Some strains also carry dual resistance genes, mainly ST116 and ST532. CF17 is currently the first isolated and reported Citrobacter freundii that carries both bla_VIM-1 and bla_NDM-1 resistance genes in China.

Abstract:Objective To explore the spatial cluster of incidence and changing trend of clustering area over time of hepatitis C in China from 2004 to 2020, so as to provide reference for identifying the key areas for scientific prevention and control of hepatitis C. Methods Data from the China Public Health Science Data Center Network Direct Reporting System were used for analysis. Software GeoDa was adopted to conduct the global and local spatial clustering analysis on various provinces in mainland China. Results The global spatial autocorrelation coefficients Moran’s I were all positive (all P<0.05), indicating that there was spatial cluster of hepatitis C incidence areas in various provinces across the country during this period. Local spatial autocorrelation analysis detected a total of 46 hot spots (areas with high incidence of hepatitis C) and 46 cold spots (areas with low incidence of hepatitis C). The hot spots concentrated mainly in Gansu, Tibet, Heilongjiang, Inner Mongolia, Jilin, Ningxia and Guangxi; while the cold spots were mainly in Jiangsu, Zhejiang, Shanghai, Anhui and Jiangxi. Conclusion Firstly, great attention should be paid to the hot spot areas of hepatitis C incidence, and less economically developed provinces as Gansu and Ningxia should have health resources priority. At the same time, surveillance on infectious disease of inbound personnel should be strengthened to stop cross-border transmission of infectious diseases timely, and prevent these area from becoming new high incidence areas of hepatitis C. Secondly, Public health education should be strengthened, awareness of active screening as well as increase of detection and cure rates of hepatitis C should be enhanced. Specific indicators for the prevalence, mortality, treatment and cure rates of hepatitis C should be refined. Based on the actual national conditions, the relevant successful international experiences can be drawn to help achieve the World Health Organization’s 2030 goal of eliminating the public health hazards of viral hepatitis.

Abstract:Objective To evaluate the management and indicators of pathogen detection before antimicrobial treatment for inpatients in second level and above medical institutions (MIs) in Guangdong Province, and provide direction and decision-making basis for the improvement of pathogen detection quality in the region. Methods The ma-nagement status, information system functions, and pathogen detection rate indicators of secondary and above MIs in 21 cities in Guangdong Province was surveyed through online questionnaire surveys and system submission. A baseline survey on sentinel monitoring MIs was conducted from July 15th to August 8th, 2023. From November 7th to 30th, a baseline survey on non-sentinel monitoring MIs was launched. Surveys on indicator information of all MIs were completed from January 15th to 30th, 2024. Results A total of 265 MIs were surveyed, and the proportions of establishing special working groups (83.98%), developing special action improvement plans (79.01%), establishing pathogen detection rate management systems (91.71%), and developing management assessment plans (76.80%) of tertiary MIs were all higher than that of secondary MIs, differences were all statistically significant (all P<0.05). The proportion of tertiary MIs with various information system functions was higher than that of secondary MIs (all P<0.05). The pathogen detection rate (61.07%) before antimicrobial treatment and healthcare-associated infection (HAI) diagnosis-related pathogen detection rate (88.00%) of inpatients in tertiary MIs were both higher than those in secondary MIs (both P<0.05). Among different types of MIs, pathogen detection rate before antimicrobial treatment of inpatients in maternal and child health MIs was higher than that in other types of MIs. HAI diagnosis-related pathogen detection rate in other specialized hospitals was the highest, and pathogen detection rate before combined use of key antimicrobial treatment in traditional Chinese medicine hospitals was the lowest, differences were all statistically significant (all P<0.05). Conclusion Tertiary MIs have more advantages in management strategies and information technology construction than secondary MIs, secondary MIs need more guidance and support. Monitoring and analysis of pathogen detection rate indicators in MIs of different levels and types should be strengthened through special actions.

Abstract:Objective To understand the epidemic characteristics of Norovirus infection in schools in Hefei City, and provide scientific basis for the prevention and control of Norovirus infection in schools. Methods The investigation reports of Norovirus infection reported by the centers for disease control and prevention (CDC) of all counties (cities and districts) in Hefei City and the laboratory test results of Hefei CDC from 2018 to 2022 were analyzed by descriptive epidemiological methods. The related indicators of Norovirus infection, including the attack rate, timeliness of reporting, duration of epidemic, clinical symptoms, as well as GⅠand GⅡ classification of Norovirus were compared. Results From 2018 to 2022, there were 217 school Norovirus infections outbreaks in Hefei City, with 3 002 cases and 314 006 affected people. The average annual attack rate ranged from 0.82% to 1.32%. Most cases were from kindergartens, there were 116 cases, accounting for 53.46%, with an average attack rate of 2.87%. The time distribution was bimodal, concentrated in March-June and September-December each year. The attack rate and duration of outbreaks were both significantly higher than those of clustering epidemics (both P<0.001). Positive correlation existed between the timeliness of reporting and the number of outbreaks at the time of receiving the report as well as the duration of the epidemic (r=0.182, 0.783, respectively, both P<0.001). With the advancement of the academic stage, the symptom with diarrhea showed an increasing trend (χ²_trend=743.236, P<0.001), the symptom with vomiting presented a decreasing trend (χ²_trend=386.888, P<0.001), and the symptoms with both diarrhea and vomiting presented an increasing trend (χ²_trend=327.264, P<0.001), while the symptom with fever presented a decreasing trend (χ²_trend=15.717, P<0.001). The positive detection rate of anal swab specimens (60.10%) was higher than that of vomit and environmental specimens (38.71%, 14.29%, respectively, χ²=135.685, P＜0.001). The laboratory identified 181 cases with Norovirus GⅠ and GⅡ subtypes, including 28 cases of GⅠsubtype, accounting for 15.47%, and 149 cases of GⅡsubtype, accounting for 82.32%. Conclusion Schools are locations with high incidence of Norovirus infection. At the beginning of the school season, various prevention and control measures should be strictly implemented to improve the monitoring sensitivity of symptoms like vomiting, diarrhea, and so on, so as to achieve early detection, early report and early treatment.

Abstract:Objective To analyze the characteristics of healthcare-associated infection (HAI) in patients in liver transplantation intensive care unit (ICU), and provide basis for the effective prevention and control of liver post-transplantation infection. Methods Targeted surveillance data of HAI in liver transplantation ICU from 2018 to 2022 were analyzed retrospectively. Incidence, incidence trend, infection site, pathogens and drug resistance were analyzed. Results A total of 3 762 liver transplantation patients were surveilled, 106 patients developed 133 cases of HAI, with an incidence of 2.82% and a case incidence of 3.54%. There was no significant difference among the years (P=0.473). Infection mainly occurred within 2 weeks after admission to ICU, accounting for 85.85%. The main infection sites included blood system (26.32%), respiratory system (22.56%), and surgical site (19.55%). The average utilization rates of central veinous catheterization, urethral catheterization, and ventilator were 85.77%, 70.58%, and 40.83%, respectively. The incidences of central line-associated bloodstream infection (CLABSI), catheter-associated urinary tract infection (CAUTI), and ventilator-associated pneumonia (VAP) were 0.54‰, 0.33‰, and 1.84‰, respectively. A total of 131 strains of pathogens were detected, of which Gram-negative bacteria accounted for 38.17% and Gram-positive bacteria accounted for 29.77%. The top three pathogens were Klebsiella pneumoniae (15.27%), Enterococcus faecium (11.45%), and Acinetobacter baumannii (9.16%). Conclusion Effective prevention and control measures should be taken based on the characteristics of HAI in the liver transplantation ICU, so as to curb bacterial resistance and reduce liver post-transplantation HAI.

Abstract:Objective To evaluate the disinfection quality of gastroscopes and enteroscopes in medical institutions across China, and provide scientific guidance for the disinfection of digestive endoscopes. Methods From 2010 to 2022, relying on the "National Hospital Disinfection and Infection Control Surveillance" project, the disinfection status of gastroscopes and enteroscopes in 184 medical institutions in 30 provinces in China was investigated, clea-ning and disinfection quality of gastroscopes and enteroscopes was analyzed. Results From 2010 to 2022, a total of 6 421 post-disinfection endoscope specimens were collected from 184 medical institutions, including 4 011 gastroscope specimens and 2 410 enteroscope specimens. From 2010 to 2022, the qualified rate of disinfection of gastroscopes and enteroscopes in China increased from 87.6% to 97.9% and 75.9% to 95.4%, respectively. The average qualified rate of disinfection of endoscopes in secondary medical institutions was lower than that in tertiary medical institutions (87.5% vs 92.1%). The disinfection efficacy of different kinds of endoscopic disinfectants was also different, among which the qualified rate of peracetic acid was the highest (95.6%-95.7%), followed by o-phthalaldehyde (93.6%-95.0%). The qualified rate of acidic electrolyzed-oxidizing water was low, only 55.0%-85.0%. Conclusion The disinfection quality of gastroscopes and enteroscopes in China has been continuously improved, and it is still necessary to strengthen the surveillance on daily disinfection quality.

Abstract:Objective To analyze the type of onychomycosis pathogens in China, and systematically study their spatial distribution characteristics. Methods Relevant literatures in China National Knowledge Infrastructure (CNKI) and PubMed from 2010 to 2022 were systematically reviewed. Results A total of 57 literatures were included in the analysis, covering 23 provinces, municipalities and autonomous regions in China. A total of 17 292 strains of pathogens were included in the study, with at least 28 genus and 60 species. Dermatophytes (DMPs), yeast, and on-dermatophyte molds (NDMs) accounted for 59.1% (n=10 223), 35.1% (n=6 063), and 5.8% (n=1 006), respectively. The most common pathogen was Trichoton rubrum (44.9%, n=7 765), followed by Candida albicans (13.7%, n=2 371). The regional distribution of DMPs in the North was generally higher than that in the South, and the constituent ratio of DMPs gradually decreased with the geographical migration to the South. The distribution of yeast was opposite to that of DMPs, distribution of NDMs was scattered. In addition, DMPs was dominant in the climate regions with low accumulated temperature and less rainfall, yeast was more distributed in the climate regions with high accumulated temperature and more rainfall, distribution of NDMs was scattered. Conclusion The main pathogen causing onychomycosis in China is DMPs, among which Trichoton rubrum is the most important pathogen of onychomycosis in China. The spatial distribution of pathogens varies with geographical location and climate.

Abstract:Objective To systematically evaluate the effectiveness of active screening in the prevention and control of healthcare-associated infection (HAI) with carbapenem-resistant Enterobacterales (CRE) in Chinese medical institutions through Meta-analysis. Methods Studies on active screening combined with intervention for CRE in Chinese medical institutions published from the establishment of databases to April 2024 were retrieved from Wanfang Database, VIP database, China National Knowledge Infrastructure, China Biomedical Literature Database, Embase, PubMed, Cochrane Library, and Web of Science. Meta-analysis was performed to study the effectiveness of active screening combined with intervention in CRE prevention and control. Results A total of 14 literatures were included in the analysis, including 12 non-randomized controlled studies and 2 randomized controlled studies. Meta-analysis results showed that active screening and timely intervention measures against CRE in hospitalized patients could effectively reduce the incidence of HAI with CRE (relative risk ［RR］=0.51, 95%CI ［0.43, 0.61］, P<0.05). Conclusion Active screening combined with intervention for CRE among hospitalized patients can effectively reduce the risk of CRE cross infection in hospitals.

Abstract:Objective To analyze the epidemiological characteristics, causes and disposal of blood-borne occupational exposure of health care workers (HCWs) in a tertiary traditional Chinese medicine hospital, and provide reference for reducing exposure risks. Methods Data on blood-borne occupational exposure reported by a traditional Chinese medicine hospital from January 2014 to December 2023 were collected retrospectively, and analyzed descriptively. Results The reported incidence of blood-borne occupational exposure among HCWs from 2014 to 2023 was 3.08% (527/17 098). Among them, 55 cases had damaged skin or mucous membrane exposure, with an incidence of 0.32%; 472 cases had sharp device injuries, with an incidence of 2.76%. Difference between the two was statistically significant (χ²=335.125, P＜0.001). The main characteristcs of blood-borne occupational exposures were sharp device injuries (89.56%), female (83.49%) , HCWs with less than 5 years of service (42.69%) and intermediate professional titles (67.93%). Damaged skin or mucous membrane exposure mainly occurred in doctors (58.18%), while sharp device injury occurred mainly in nurses (73.73%). Department of internal medicine had the highest exposure to sharp device injuries (42.80%), and operating room had the highest damaged skin or mucous membranes exposure (47.27%). The main occurrence timing of sharp device injuries were needle pulling (21.82%), disposal of used sharp devices and randomly placed sharp devices (20.34%), as well as injection, puncture, acupuncture, tube sealing or blood collection (19.49%). 71.73% exposure sources were clear, and the top three detected blood-borne pathogens were hepatitis B virus (70.86%), hepatitis C virus (11.92%), and Treponema pallidum (9.27%). The correct disposal rate after exposure was 88.05%. Conclusion From 2014 to 2023, blood-borne occupational exposure in this traditional Chinese medicine hospital was mainly caused by sharp device injuries. Nurses experienced more incidents during needle pulling and sharp device handling. Damaged skin or mucous membrane exposure was mainly due to splashing patient’s blood into the eyes of doctors during surgery.

Abstract:Objective To investigate the current status and influencing factors of nurses’ missed nursing care in infection prevention and control, and provide reference for establishing targeted programs to improve nursing care situation in clinical infection prevention and control. Methods From October to November 2023, 369 nurses from two tertiary first-class hospitals in Zhejiang Province were selected as surveyed subjects by convenience sampling methods. General information questionnaire, missed nursing care in infection prevention and control survey, hospital ethical climate survey, and safety attitudes questionnaire were used for questionnaire survey. Univariate analysis, Pearson correlation analysis, and multiple linear regression analysis were adopted to analyze the influencing factors. Results A total of 364 valid questionnaires were collected, with a respond rate of 98.64%. The scores of 364 nurses’ missed nursing care in infection prevention and control survey B and C were (48.94±15.06) and (47.88±14.54) points, respectively. The score of hospital ethical climate was (103.00±16.01) points, and the score of safety attitude was (128.50±17.00) points. Multiple linear regression analysis showed that the influencing factors for missed nursing care in infection control and prevention were temporary employment modes, work at pre-hospital emergency departments, and low scores in hospital ethical climate (all P<0.05). Conclusion Nurses’ missed nursing care in infection prevention and control is at a lower-middle level, there is still room for improvement. Nur-sing managers should reduce missed nursing care in infection prevention and control by improving the hospital ethical climate and taking appropriate intervention measures for nurses in different departments and employment styles.

Abstract:Objective To analyze the characteristics and risk factors of healthcare-associated infection (HAI) in patients receiving veno-venous extracorporeal membrane oxygenation (V-V ECMO) treatment. Methods Clinical data of 141 patients who received V-V ECMO treatment in the intensive care unit (ICU) of a tertiary first-class hospital in Qingdao from January 2019 to November 2023 were collected. Patients were divided into the infection group and non-infection group based on whether HAI occurred. Characteristics of HAI were analyzed, risk factors were analyzed by univariate and multivariate logistic regression analyses. Results Among 141 V-V ECMO patients, incidence of HAI was 37.59% (n=53). A total of 81 strains of pathogens were isolated from patients in the infection group, Gram-negative bacteria accounted for 56.79% (n=46), mainly Acinetobacter baumannii, which was up to 28.39% (carbapenem-resistant Acinetobacter baumannii ［CRAB］ accounted for 16.05%). The main type of HAI in V-V ECMO patients was pulmonary infection alone (54.72%), followed by bloodstream infection alone (20.75%), multi-site infection accounted for 22.64%. Univariate analysis result showed that compared with the non-infection group, there were statistically significant differences in the history of immunosuppressive agents use, ICU transfer history, surgical history, fiberbronchoscopy, renal replacement therapy, duration of ICU stay, duration of tracheal intubation and/or tracheotomy, duration of urinary catheterization, duration of gastric tube placement, duration of central venous catheterization, duration of antimicrobial use, and duration of V-V ECMO support (all P<0.05). Multivariate logistic regression analysis result showed that ICU transfer history and fiberbronchoscopy were independent risk factors for HAI in V-V ECMO patients (OR=6.850, 4.643, respectively, both P<0.05). Conclusion Hospitals should take effective prevention and control measures based on the characteristics and related risk factors of HAI in patients receiving V-V ECMO treatment to reduce the occurrence of HAI.

Abstract:Objective To monitor healthcare-associated infection (HAI) through a systematic intelligent information-based surveillance system, and gradually reduce the underreporting rate of HAI in the newly built tertiary hospital through continuous improvement measures. Methods Underreporting rate of HAI in a tertiary hospital at the baseline period of the initial establishment stage (from March to December 2021) was analyzed. Under the monitor of a systematic intelligent information system, intervention measures in the first period (from January to October 2022) focusing on informing the usage path of the system and urging timely reporting; in the second period (from November 2022 to June 2023), intervention measures focusing on improving warning strategies and increasing on-site monitoring frequency were implemented. Differences in HAI underreporting rate before and after taking intervention measures were compared. Results The underreporting rate of HAI during the baseline period was as high as 29.14%, which decreased to 5.48% at the first intervention period, and 1.84% at the second intervention period. The diffe-rence in underreporting rates of HAI among three periods was statistically significant (χ²=125.659, P＜0.001). The achievement rate and progress rate of continuous improvement at the first, second period were 123.62% and 81.19%, 142.63% and 93.69%, respectively. Conclusion Based on a systematic intelligent information system, HAI underreporting rate at the early stage of the construction of a newly built tertiary hospital can be effectively reduced by adopting a series of continuous improvement measures.

Abstract:Objective To investigate the causes and intervention measures of healthcare-associated infection (HAI) cluster events after cataract phacoemulsification combined intraocular lens(Phaco+Iol) implantation in an eye hospital, and provide reference for the prevention and control of HAI. Methods Epidemiological investigation was carried out on 4 cases of endophthalmitis after Phaco+Iol implantation within 34 days from July 25 to August 27, 2020. Environmental hygiene monitoring on surgical environment was carried out, and comprehensive intervention measures were taken ( from October to November) to avoid the spread of HAI. Results Within 34 days, a total of 1 219 patients underwent Phaco+Iol implantation, and 4 patients developed endophthalmitis, with an infection rate of 0.32%. The 4 infected patients, with an average age of 74 years, were implanted with three different brands and models of intraocular lenses respectively. They were diagnosed with endophthalmitis at different periods from the 2nd to the 9th day after surgery, which was initially suspected to be a cluster event of HAI. A total of 13 environmental hygiene monitoring specimens from operating room were unqualified. After taking infection prevention and control measures, the qualified rate of environmental hygiene monitoring before and after intervention was compared, difference was statistically significant (P=0.006). Three different bacterial species (Staphylococcus chromogenes, Staphylococcus epidermidis, and Enterococcus faecalis) were identified from vitreous and aqueous humor specimens of 4 patients. Bacteria culture results of vitreous specimens from 1 patient was negative. After the implementation of the infection prevention and control strategy, no similar infection occurred. Conclusion Improving the awareness on HAI prevention and control, strengthening the comprehensive monitoring and management of the operating room and related departments in the hospital, as well as taking timely and targeted preventive and control measures can effectively control the occurrence of HAI cluster events.

Abstract:Objective To provide theoretical basis for determining whether disinfection is necessary before reco-nnecting the infusion device after intermittent administration of medicine via needleless connectors (NC) during intravenous infusion. Methods The actual situation of clinical intravenous infusion was simulated in a laboratory environment. Taking intravenous injection as an example, microorganisms on the surface of NC and in the remaining liquid after infusion at different intermittent administration times (1-9 times) were detected by adenosine triphosphate (ATP) bioluminescence detection technique. The experiment was repeated in 15 groups for each administration frequency, and a total of 270 specimens were detected and statistically analyzed. ATP detection value ≤25 relative light unit (RLU) was considered to be qualified. Results With the increase of intermittent administration frequency, the overall microorganisms on NC surface gradually increased, but all were ≤25 RLU. Microorganisms on the surface of NC among different disconnection times were statistically different (P<0.001). Compared with the microorganisms when disconnecting 9 times, numbers of microorganisms on the surface of NC with disconnection of 1, 2, 3, and 4 times were all statistically different, respectively (all P<0.05), while those with other disconnection frequencies did not show statistical differences among each other (all P>0.05). Microorganisms in liquid after infusion among different intermittent administration frequencies were not statistically different (P=0.946). Conclusion In laboratory environment, with the increase of intermittent administration frequency, microorganisms on the surface of NC increase, but the safety of the infusion process is not compromised.

Abstract:Pasteurella multocida infection in humans is rare, and people with low immunity are susceptible to infection. This paper reports a case of an elderly woman bitten by a dog on her left calf. After routine emergency treatment, patient developed skin and soft tissue infection, presenting clinical manifestations of redness, swelling, heat, and pain around the wound, exudation of secretions, as well as blackness and necrosis of the surrounding tissues, etc, Pasteurella multocida infection was diagnosed according to secrection culture result and clinical manifestations. After amoxicillin/clavulanate potassium and surgical treatments, the patient recovered and was discharged. Based on literature review, this study discusses the clinical characteristics, laboratory examinations, and treatment of Pasteurella multocida infection, aiming to improve clinicians’ understanding on Pasteurella multocida, achieve early detection, diagnosis and treatment.

Abstract:A patient was admitted to hospital due to umbilical pain. Gram-staining presented short, positive coccobacillus in the purulent secretions from the umbilical cord of the patient. Meanwhile, matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS), 16S rRNA detection, and in vitro antimicrobial susceptibility testing were performed on the isolated strains. Corynebacterium tuberculostearicum was identified by Gram-staining, MALDI-TOF MS and 16S rRNA. Antimicrobial susceptibility testing results showed that the strain was sensitive to penicillin, ceftriaxone, cefepime, meropenem, vancomycin, daptomycin, linezolid, compound sulfamethoxazole, ampicillin, gentamicin and tetracycline. Smear of microorganisms is helpful for the identification of Corynebacterium tuberculostearicum morphology, and MALDI-TOF MS is necessary for rapid identification of strains. Antimicrobial susceptibility testing can also assist the empirical treatment for infection due to this strain.

Abstract:Tuberculosis (TB)is still a serious threat to global public health, causing millions of people infected every year. Mycobacterium tuberculosis (MTB) is the main pathogen causing TB. In recent years, MTB extracellular vesicles (MEVs) as important carriers for MTB-secreted Mycobacterium antigens have attracted the attention of researchers. MEVs enable MTB to secrete phospholipid, nucleic acid, lipopolysaccharide, and periplasmic component in a centralized protective mode, and interact with the host. Some progress has been made on the study of partial contents of MEVs, but the understanding of their biological mechanisms, functions, and roles in the immune responses during MTB infection is still at its early stages. This article reviews the current progress in the biogenesis of MEVs, their roles in MTB infection and immune responses regulation, and discusses their applications in vaccine development and diagnostic techniques.