Abstract:Objective To explore the efficacy and influencing factors of polyethylene glycol interferon α-2b (Peg-IFNα-2b) combined nucleoside analogues (NAs) in the treatment of hepatitis B virus e-antigen (HBeAg)-negative chronic hepatitis B (CHB) patients who had received NAs treatment, and evaluate the correlation of mononucleotide polymorphisms of interleukin-28B and programmed death receptor-1 (PD-1) with interferon treatment response. Methods HBeAg-negative CHB patients who visited Xiangya Hospital of Central South University from January 2020 to December 2022 were analyzed retrospectively. Patients with Peg-IFNα-2b and NAs treatment were as the study group, while those with NAs therapy alone as the control group. Clinical efficacy of two groups of patients at the 12nd, 24th, and 48th weeks of treatment, as well as the persistent response and recurrence at the 72nd week were analyzed. PD-1 and IL-28B single nucleotide polymorphisms were adopted to evaluate the value of HBeAg- negative CHB patients in response to interferon treatment. Results At the 48th week of treatment, the response rate of HBeAg-negative CHB patients in the study group was higher than that in the control group (52.05% [38/73] vs 1.64% [1/61], P < 0.05). Among HBeAg-negative CHB patients in the study group, response rates at 48th week of treatment in patients with baseline HBsAg < 100 IU/mL and HBsAg < 1 000 IU/mL were higher than those with HBsAg≥1 000 IU/mL, respectively (both P < 0.05). Univariate and multivariate analyses showed that in HBeAg-negative CHB patients in the study group, the baseline HBsAg levels (OR=1.004, 95%CI: 1.001-1.006) and HBsAg decline magnitude at the 24th week of treatment (OR=0.111, 95%CI: 0.034-0.362) were influencing factors for the response of interferon treatment combined with NAs (both P < 0.05). The results of single nucleotide polymorphism analysis showed that in HBeAg-negative CHB patients in the study group, the proportion of PD-1 rs10204525 C/T heterozygous mutation in the response population was higher (66.67% vs 16.67%, P < 0.05), while that of IL-28B mutation was not significantly different (P>0.05). Conclusion Combined treatment with Peg-IFNa-2b can achieve higher HBsAg clearance rate and serological conversion rate in HBeAg-negative CHB patients who had received NAs treatment. HBsAg decline magnitude at the 24th week of treatment can better predict the response at the 48th week of treatment. Patients with low baseline HBsAg level and those carrying PD-1 rs10204525C/T heterozygous mutation gene present better therapeutic effect after receiving Peg-IFNa-2b.

Abstract:Objective To compare the clinical characteristics of diabetes mellitus (DM) patients complicated with pyogenic liver abscess (PLA) and non-DM (NDM) patients complicated with PLA, and provide evidence for clinical diagnosis and treatment. Methods PLA patients who admitted to an affiliated hospital of Anhui Medical University from July 2002 to February 2022 were selected and divided into DM+PLA group and NDM+PLA group according to whether they had DM. General condition, clinical manifestations and signs, complications, biochemical and patho- genic examination results, imaging findings, as well as clinical efficacy and influencing factors of the two groups of patients were analyzed retrospectively. Results 695 PLA patients were included in the analysis, 191 (27.5%) in the DM+PLA group and 504 (72.5%) in the NDM+PLA group. The proportions of males and complication of hypertension in the DM+PLA group were higher than those in the NDM+PLA group, while the proportion of bi-liary diseases and malignant tumors was lower (all P < 0.05). The proportions of patients developing fever, fatigue, as well as concurrent anemia and hypoalbuminemia in the DM+PLA group were higher than those in the NDM+PLA group (all P < 0.05). Compared with the NDM+PLA group, the neutrophil count and percentage in the DM+PLA group increased, while total protein, albumin content, and albumin/globulin ratio all decreased (all P < 0.05). The proportions of the detection of Klebsiella pneumoniae and the occurrence of liver right lobe abscess in DM+PLA patients were higher than those of the NDM+PLA group (both P < 0.05). Multivariate logistic regression analysis revealed that malignant tumor was a risk factor for affecting the clinical efficacy of PLA patients, invasive treatment was a protect factor for affecting the clinical efficacy of PLA patients, while blood sugar was a risk factor for affecting the clinical efficacy of NDM+PLA patients. Conclusion DM+PLA patients have more severe infection symptoms than NDM+PLA patients, and are accompanied by higher proportions of Klebsiella pneumoniae infection and liver right lobe abscess. It is necessary to strengthen attention to patients with malignant tumor and control blood sugar level, and timely supplement with invasive treatment if necessary.

Abstract:Objective To explore the efficacy of low-dose and short-course glucocorticoid treatment on moderate coronavirus disease 2019 (COVID-19) in elderly patients. Methods Clinical data of patients aged ≥80 years, diagnosed with COVID-19, and admitted to a hospital from December 9, 2022, to February 9, 2023 were investigated retrospectively. According to whether low-dose glucocorticoids was administered intravenously after admission, patients were divided into non-hormone usage group and hormone usage group. General information and laboratory test results of two groups of patients were described, changes of patients' conditions within 30 days were observed, and difference in efficacy between the two groups was compared. Results A total of 62 patients were recruited, including 21 in the non-hormone usage group and 41 in the hormone usage group. The general information and laboratory test indicators before treatment between two groups of patients showed no statistically significant differences (both P>0.05). Except hormone usage, there was no statistically significant difference in other treatment methods (all P>0.05). After treatment with glucocorticoids for 10 days, the clinical manifestations of cough (34.1% vs 66.7%), expectoration (19.5% vs 61.9%), palpitation (4.9% vs 23.8%) and shortness of breath (7.3% vs 28.6%) in the hormone usage group decreased compared with those in the non-hormone usage group, differences were statistically significant (all P < 0.05). After 10 days of treatment, compared with patients in the non-hormone usage group, the oxygenation indicator and lymphocyte count of patients in the hormone usage group increased, while the values of C-reactive protein and D-dimer decreased, with statistically significant differences (all P < 0.05). The incidence of disease exacerbation in the hormone usage group was lower than that in the non-hormone usage group (14.6% vs 47.6%), difference was statistically significant(χ² =7.895, P=0.005). Conclusion Low-dose and short-course systemic glucocorticoid usage in elderly patients with moderate COVID-19 can effectively control the progress of the disease and improve prognosis.

Abstract:Objective To identify and conduct antimicrobial susceptibility testing on Vibrio species isolated from blood culture specimens of two patients with bloodstream infection (BSI), analyze the microbiological characteristics of non-O1/non-O139 Vibrio cholerae (NOVC), and provide evidence for the diagnosis, prevention and control of Vibrio cholerae infection. Methods Two Vibrio strains were identified by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS), API bacterial biochemical reaction identification test strip, VITEK 2 Compact identification instrument and 16S rRNA gene sequencing. Serological typing, virulence gene molecular detection, and drug resistance phenotype detection were performed to the Vibrio strains. Results Two strains were identified as Vibrio cholerae, classified as NOVC by serological typing, and were negative for ctxAB virulence gene detection. Antimicrobial susceptibility testing showed that one strain was sensitive to ampici-llin, azi-thromycin, doxycycline and chloramphenicol, while resistant to tetracycline and trimethoprim-sulfametho-xazole. The other strain was sensitive to all tested antimicrobial agents. Conclusion BSI caused by NOVC is rarely reported in China. Accurate identification, typing and drug-resistant phenotype detection of Vibrio cholerae isolated from blood culture specimens are valuable for the diagnosis, treatment, prevention and control of Vibrio cholerae-associated infection.

Abstract:Objective To develop a prediction tool for post-endoscopic retrograde cholangiopancreatography (ERCP) early biliary tract infection (PEEBI) in patients with choledocholithiasis, and assist clinical decision-making before ERCP and early personalized intervention after ERCP. Methods An observational bidirectional cohort study was adopted to select inpatients with choledocholithiasis who underwent ERCP in a hospital. Directed acyclic graph (DAGs) and the least absolute shrinkage and selection operator (LASSO) were used to predict PEEBI based on logistic regression, and the models were compared and validated internally and externally. Results From January 1, 2020 to September 30, 2023, a total of 2 121 patients with choledocholithiasis underwent ERCP were enrolled, of whom 77 (3.6%) developed PEEBI, mostly in the first 2 days after surgery (66.2%). The major influencing factors for PEEBI were non-iatrogenic patient-related factors, namely diabetes mellitus(OR=2.43, 95%CI: 1.14-4.85), bile duct malignancy (OR=3.95, 95%CI: 1.74-8.31) and duodenal papillary diverticulum (OR=4.39, 95%CI: 1.86-9.52). Compared with the LASSO model, the DAGs model showed higher ability (3.0%) in comprehensive discrimination (P=0.007), as well as good differentiation performance (D=0.133, P=0.894) and calibration performance (χ²=5.499, P=0.703) in external validation. Conclusion The DAGs model constructed in this study has good predictive performance. With the help of this tool, targeted early preventive measures in clinical practice can be taken to reduce the occurrence of PEEBI.

Abstract:Objective To analyze the clinical and serological typing characteristics of invasive Haemophilus influenzae (Hin) infection in children. Methods Clinical data of 34 children with invasive Hin infection admitted to Children's Hospital of Shanxi from 2015 to 2021 were analyzed retrospectively. According to clinical diagnosis, they were divided into meningitis infection group and non-meningitis infection group. General data, symptoms, signs, laboratory serological indicators, and Hin serum typing characteristics of children, as well as differences in inflammatory factor level between the two groups were analyzed. Results Among the 34 patients, 22 were males and 12 were females, with a male to female ratio of 1.83 ∶1. Children aged ≤36 months accounted for 82.35%. The levels of procalcitonin (PCT) (23.71 [4.10, 77.80]) ng/mL and C-reactive protein (CRP) (200.00 [164.55, 200.00]) mg/L in children in the meningitis infection group were higher than those in the non-meningitis group (1.08 [0.49, 6.00] ng/mL, 69.46 [48.09, 125.63] mg/L, respectively), with statistically significant differences(both P < 0.05). The platelet (PLT) count in the non-meningitis group ([312.56±186.81]×10⁹/L) was higher than that in the meningitis group ([183.28±165.67]×10⁹/L), with statistically significant difference (P < 0.05). There was no statistically significant difference in white blood cell (WBC) count and neutrophil (NEUT) percentage between two groups (both P>0.05). Among the isolated Hin strains, 27, 2, and 2 strains were type b (Hib), e and f, respectively; 3 strains were not typed; serotype a, c and d strains were not found. There was no statistically significant difference in the distribution of typeable Hin strains between the two groups(χ² =0.25, P>0.05). There was no statistically significant difference in the constituent rate of typeable Hin strains between male and female children (67.74% vs 32.26%, χ² =1.42, P>0.05). Conclusion The majority of invasive Hin infection cases are children under 3 years old, and the predominant strain is type b. CRP and PCT levels of infected children increased significantly, while PLT is significantly lower than that of non-infected children, which has certain clinical diagnostic value and can provide effective support for early classified diagnosis and anti-infection treatment of invasive infectious diseases combined with other clinical testing items.

Abstract:Objective To evaluate the clinical and laboratory characteristics of listeriosis in patients during pregnancy, and improve the understanding on the disease. Methods Clinical characteristics and laboratory detection results of 18 pregnant women with gestational listeriosis admitted to two hospitals in Shanxi from 2012 to 2023 were analyzed retrospectively. Results Among the 18 pregnant women, 1, 3 and 14 cases developed listeriosis in the early, middle and late pregnancy, respectively (including 2 cases of dichorionic diamniotic twin pregnancy). The main clinical manifestations were fever (n=17, 94.44%), accompanied by vaginal bleeding (n=5, 27.78%), abdominal pain (n=4, 22.22%), and headache (n=2, 11.11%). White blood cell count, neutrophil percentage, and procalcitonin level in peripheral blood of pregnant women all increased. There were 1 spontaneous abortion during early pregnancy, 3 deaths during middle pregnancy, and 10 survival during late pregnancy. All pregnant women reco-vered and were discharged from hospital. Specimens with high isolation rate of Listeria monocytogenes (LM) were uterine secretion (n=11, 61.11%) and whole blood (n=10, 55.55%) of pregnancy women. Among the 17 newborns of 18 pregnant women, LM was isolated from 4 (23.53%) pharyngeal tracheal secretion specimens and 3 (17.65%) whole blood specimens. 10 cases out of 13 revealed chorioamnionitis via pathology examination of placenta. Antimicrobial susceptibility testing results of 15 LM strains showed that the susceptibility rates to ampicillin, compound sulfamethoxazole, and meropenem were all 100%, and the susceptibility rates to penicillin and erythromycin were both 93.33%. Conclusion Listeriosis during pregnancy lacks specific clinical characteristics and is prone to be misdiagnosed. The incidence of adverse pregnancy outcomes is high. The survival rate of fetus in late pregnancy is high. Empirical anti-infection treatment during early pregnancy should cover LM infection.

Abstract:Objective To establish an evaluation system of pathogen detection rate of hospitalized patients before antimicrobial treatment based on process and outcome indicators, and study its application effect. Methods Hospitalized patients with therapeutic antimicrobial treatment in a tertiary first-class hospital from July 2022 to June 2023 were selected as the study objects. Difference in process and outcome indicators were compared between before (July-December 2022, control group) and after (January-June 2023, intervention group) the implementation of intervention in the evaluation system for pathogen detection rate of hospitalized patients before antimicrobial treatment. Results 41 577 and 27 052 hospitalized patients received therapeutic antimicrobial agents were included in the intervention group and control group, respectively. Pathogen detection rate and the accurate pathogen detection rate in the intervention group were both higher than those in the control group (74.2% vs 62.8% and 90.3% vs 82.5%, respectively), both with statistically significant differences (both P < 0.001). The goal achievement rate and improvement rate for pathogen detection rate were 237.5% and 18.2% respectively, the goal achievement rate and improvement rate for accurate pathogen detection rate were 104.0% and 9.5% respectively. For the process indicators, the conformity rate of detection and diagnosis, accurate collection rate, timely transfer rate, acceptance rate of pathogen specimens in the intervention group were all higher than those in the control group, differences were all statistically significant (all P < 0.001). For the outcome indicators, detection rates of targeted indicators and blood culture specimens, pathogen detection rate before treatment of restricted and special grade antimicrobial agent, as well as detection rate of sterile body fluid specimens in the intervention group were all higher than those in the control group, with statistical significance (all P < 0.05). In addition, the positive rate of blood culture specimens increased from 18.5% before intervention to 21.7% after intervention, with statistically significant difference (P < 0.05). Conclusion The establishment of indicator evaluation system can improve the detection rate and accurate detection rate of pathogens before antimicrobial treatment, as well as the management quality and connotation of indicators.

Abstract:Objective To explore the application effect of multi-disciplinary team (MDT) model in hospital antimicrobial management. Methods Relevant data on antimicrobial use in hospitalized patients in a hospital from January 2021 to December 2022 were analyzed retrospectively, January-December 2021 adopted conventional management mode and was as the control group, January-December 2022 adopted MDT management model and was as the intervention group. Antimicrobial therapy relevant indicators between two groups of patients were compared. Results After adopting the MDT management model, pathogen detection rate before the therapeutic antimicrobial use in the intervention group (73.62%) was higher than that in the control group (70.56%), difference was statistically significant (P < 0.001). Pathogen detection rate related to healthcare-associated infection diagnosis was 87.98% in the control group and 88.89% in the intervention group, with no statistically significant difference between two groups (P>0.05). Pathogen detection rate before combined use of key antimicrobial agents in the intervention group (93.94%) was higher than that in the control group (92.00%), difference was statistically significant (P < 0.05). Antimicrobial use rate in hospitalized patients and use rate of prophylactic antimicrobial agents in class Ⅰ incision surgery decreased from 38.03% and 21.03% to 32.78% and 10.30%, respectively, with statistically significant differences (both P < 0.05). The amount and intensity of antimicrobial use in hospitalized patients in the intervention group decreased. The implementation rate of bundled prevention and control measures for multidrug-resistant organism (MDRO) after intervention was significantly higher than that of the control group, with statistically significant differences (all P < 0.05). MDRO detection rate decreased from 34.70% to 32.37%, difference was statistically significant (P=0.027). there was no significant change in the MDRO case infection rate. Conclusion The MDT model can effectively improve the standardized management of antimicrobial agents, promote the rational use of antimicrobial agents in clinical practice, and prevent bacterial resistance.

Abstract:Objective To evaluate the effect of delayed cleaning on the cleaning and disinfection quality of gastroscopes after pre-treatment with different solutions. Methods According to the factorial design table, combination of the pre-treatment cleaning solutions (factor A) (including multi-enzyme cleaning solution [A₁], clean water [A₂]) and delayed cleaning durations (factor B) (including 0 minutes after pre-treatment [B₁], 30 minutes after pre-treatment [B₂], 1 hour after pre-treatment [B₃], and 3 hours after pre-treatment [B₄])yielded eight groups (A₁B₁, A₁B₂, A₁B₃, A₁B₄, A₂B₁, A₂B₂, A₂B₃, A₂B₄). According to the usage order of gastroscopes, 96 gastroscopes used in the digestive endoscopy center of a tertiary first-class hospital from May to September, 2023 were randomly assigned to each group by random number table method, with 12 gastroscopes in each group. Specimens were taken at four time points: after pre-treatment, before cleaning, after cleaning, and after disinfection. Due to instant clea-ning, no specimen before cleaning were taken from A₁B₁ and A₂B₁ groups, thus only 3 specimens were taken from these two groups each. Four specimens were taken from gastroscopes in the rest groups, resulting in 360 specimens in total. The internal condition of the biopsy cavity was observed through a cavity detector during each delayed cleaning period after pre-treatment, and specimens were taken at the subsequent reprocessing processes of the gastroscopes. The microbial conditions of the gastroscopes after pre-treatment, before cleaning, after cleaning, and after disinfection were compared. Results After pre-treatment with multi-enzyme cleaning solution and clean water, there was no statistically significant difference in microbiological detection result (P>0.05). The biopsy cavity remained moist during the delayed cleaning period. There was no statistically significant difference in the microbial detection results of factors A and B before and after delayed cleaning as well as after disinfection (all P>0.05). There was no interaction effect between factor A and B. The distribution of bacterial colonies and disinfection qualified rate of gastroscopes after pre-treatment with two cleaning solutions were also not statistically different (both P>0.05). Conclusion Delayed cleaning for 30 minutes, 1 hour, and 3 hours after pre-treatment does not affect the cleaning and disinfection quality of gastroscopes. When clinical demand is urgent, immediate cleaning should be carried out. However, a certain buffering time (no longer than 3 hours) before cleaning is acceptable, when cleaning and disinfection workload is heavy and timely cleaning cannot be carried out.

Abstract:Aggregatibacter aphrophilus (A. aphrophilus) is a normal bacterial flora in the oropharynx, and rarely causes lumbar spine infection in clinical practice. As fastidious bacteria, A. aphrophilus has high nutritional requirements, thus is difficult to be cultured and identified, and prone to be missed in detection. A. aphrophilus was detected from the blood culture of a patient with lumbar spine infection in a hospital. The anti-infection treatment based on detection results for the patient was effective after adjusting antimicrobials. This paper reports a rare case of A. aphrophilus lumbar spine infection with literature reviews.

Abstract:Objective To understand the current situation of protective mask wearing behavior of health care workers (HCWs), analyze the influencing factors for the failure to wear medical protective masks in a standard manner, and provide basis for the improvement of mask-wearing related training. Methods From June 2022 to March 2023, staff in a tertiary first-class hospital were selected as the research object. Real-time quantitative fitness testing using aerosol condensation particle counting method was applied to test 5 commonly used medical protective masks available in the market. Fitness factor changes of the testing instrument and assistance from professional personnel were needed to comprehensively estimate the wearing condition of medical protective masks. Participants were surveyed through a self-made general information questionnaire. Heads and faces of participants were scanned by three-dimensional (3D) laser scanning technology, and scanned images were imported into Geomagic Studio 2013 software to measure head and face dimensions. Results A total of 222 HCWs were investigated, 991 real-time tests and 208 times of 3D scanning were conducted. 221 (22.30 %) tests showed failure of participants in wearing masks in a standard manner. The non-standard wearing rates of 5 types of medical protective masks were 30.56%, 25.62%, 25.87%, 23.15%, and 7.35%, respectively. The non-standard mask-wearing rates showed statistically significant difference between groups categorized in terms of medical protective masks with different shapes, participants' occupation, time of last training for wearing medical protective masks, and participants' experience in prevention and control of respiratory infectious disease (all P < 0.05). There were no statistically significant differences in non-standard mask-wearing rate between groups with different brands and sizes of medical protective masks, as well as gender and department of participants, etc. (all P>0.05). The body mass index (BMI) was significantly different among participants who wear foldable medical protective masks in the standard and non-standard manner (both P < 0.05). Conclusion Wearing medical protective masks by HCWs in a non-standard manner is influenced by multiple factors. It is recommended to conduct real-time testing before formal quantitative fitness testing, so as to save time and improve testing efficiency. When conducting training on wearing medical protective masks in the future, targeted training should be provided based on mask shape and focus on logistics personnel, interns, individuals with high BMI, those who have never received training on wearing medical protective masks, and those who have never participated in the prevention and treatment of respiratory infectious diseases.

Abstract:Objective To explore the application effect of disinfection-oriented bundle management mode of environmental cleaning and disinfection quality management of intensive care unit (ICU). Methods The bundle mana-gement mode was used to intervene the cleaning and disinfection of ICU environment. January-December 2022 and January-December 2023 were classified as pre- and post-intervention periods respectively. The awareness rate of disinfection knowledge, monitoring results of environmental hygiene, detection of MDRO and healthcare-associated infection (HAI) of patients before and after intervention were compared. Results The awareness rates of disinfection knowledge and the clearance rate of fluorescent labeling on frequently-touched environmental surface increased from 68.58% and 78.45% (pre-intervention) to 88.45% and 96.44% (post-intervention), respectively, both with statistical significance (both P < 0.05). The qualification rates of bacterial culture from frequently-touched environmental surface and hands of healthcare workers (HCWs) increased from 70.63% and 87.90% (pre-intervention) to 88.36% and 94.15% (post-intervention), respectively, both with statistical significance (both P < 0.05). The detection rates of methicillin-resistant Staphylococcus aureus (MRSA) and carbapenem-resistant Acinetobacter baumannii (CRAB) from frequently-touched environmental surface were 0.49% and 1.46% (pre-intervention), as well as 0 and 0.27% (post-intervention), respectively, both with statistical significance (both P < 0.05). The incidences of HAI (4.97%) and CRAB HAI (0.77%) post-intervention were lower than pre-intervention (7.46% and 1.62%, respectively), differences were both statistically significant (both P < 0.05). Conclusion Intervention in environmental cleaning and disinfection of ICU with bundle management mode can effectively improve the effect of cleaning and disinfection in ICU, enhance cleaners' awareness on disinfection prevention and control, decrease the detection rates of MRSA and CRAB, reduce the risk of HAI, and ensure medical safety.

Abstract:Objective To explore the optimal morning discharge time and pipeline disinfection frequency of the final rinse water from the endoscopy center according to the microbial culture results. Methods Different morning discharge timing and number of bacterial colonies in the pipeline for the final rinse water from the endoscopy center of a hospital in Jiangsu Province were monitored. Microbial detection was conducted on water samples collected from the two final rinse water sampling sites in the endoscopy room after 0, 1, 3, 5, and 7 minutes of discharge, respectively (100 mL each, continuously monitored for 35 days, with 70 samples at each time point) to explore the optimal discharge timing. The optimal disinfection frequency of pipelines for purified water was explored according to the determined optimal morning discharge timing. Two samples were taken daily from 2 sampling sites after pipeline disinfection and continued for 5 weeks, resulting in 70 samples in total. Results Sampling and monitoring of the final rinse water at different morning discharge time points showed that the median numbers of bacterial colonies at 0, 1, 3, 5, and 7 minutes were 745.00 (373.00, 1 452.50), 150.00 (96.75, 235.75), 44.00 (38.00, 48.00), 12.00 (5.00, 18.00), and 6.00 (4.00, 9.00) CFU/100 mL, respectively. Except the difference between the 5 minute group and the 7 minute group (P>0.05), differences among all the other groups were statistically significant (all P < 0.05). The median of the 0, 1, 3, and 5 minute groups was > 10 CFU/100 mL, while the median of the 7 minute group was < 10 CFU/100 mL, within the qualified range. The discharge time was therefore determined to be 7 minutes. The average numbers of bacterial colonies from the final rinse water samples taken at different time points after pipeline disinfection (1, 2, 3, 4, and 5 weeks after disinfection) were (4.21±0.86), (4.43±0.71), (6.00±0.56), (6.43±0.45), and (13.57±1.03) CFU/100 mL, respectively. The qualification rates of pipeline in terms of bacterial colony were 100%, 100%, 100%, 100%, and 28.57%, respectively. The differences of average numbers of bacterial colonies from the final rinse water samples taken at different time points after pipeline disinfection were statistically significant (P < 0.001). The average number of bacterial colonies 5 weeks after pipeline disinfection was different from those after 1, 2, 3, and 4 weeks, with statistically significant differences(all P < 0.05), while no statistically significant differences among the other groups were observed(all P>0.05). The optimal disinfection frequency for the purified water pipeline was once every 4 weeks. Conclusion The final rinse water remaining in the terminal of pipeline is contaminated to a certain degree. It is recommended to discharge water in the morning for 7 minutes before using it, and disinfect the purified water pipeline every 4 weeks.

Abstract:Pulmonary nocardiosis and pneumocystis pneumonia are rare opportunistic infections clinically, both tend to occur in immunocompromised patients. However, the co-infection of the two has been reported rarely. With complex clinical and imaging findings, the co-infection is difficult to diagnose and treat. This article reports the dia-gnosis and treatment process of a case of the co-infection with Nocardia asiatica and Pneumocystis, reviewed the relevant literatures, so as to improve the understanding of the disease.

Abstract:Streptococcus anginosus group (SAG) used to be considered as normal oral flora. With the advancement of diagnostic techniques, an increasing number of case reports confirm that SAG group can be an opportunistic pathogen causing a series of fatal infection. Therefore, this article reviews the diseases caused by SAG as opportu-nistic pathogens and its related pathogenic mechanisms.

Abstract:Non-tuberculous Mycobacteria exists widely in the environment. Due to medical water and equipment contamination, it can cause bloodstream, skin and soft tissue infection, even lead to infection outbreaks. In this paper, healthcare-associated infection (HAI) outbreaks of non-tuberculous Mycobacteria in foreign countries from 1985 to 2023 were summarized and analyzed by searching HAI outbreak-related literatures from PubMed, providing reference for the formulation and supervision of non-tuberculous Mycobacterium HAI prevention and control mea-sures in the future.

Abstract:With high morbidity and mortality, the treatment of sepsis still remains a worldwide problem. More and more studies believe that intestinal microbiota has an impact on the occurrence, development and evolution of sepsis. On one hand, sepsis leads to disorder of intestinal microbiota, inducing and aggravating terminal organ dysfunction; on the other hand, the activation of intestinal microbiota as well as the reduction of beneficial microorga-nisms and their products can increase the host's susceptibility to sepsis. Refering to the latest literatures and research progress, this article aims to explore the relationship between adult sepsis and intestinal microbiota, as well as intervention measures for the disorder of intestinal microbiota, so as to develop new ideas for the treatment of sepsis.

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