Abstract:Objective To explore the prediction of hospital indoor microbial concentration in air based on real-time indoor air environment monitoring data and machine learning algorithms. Methods Four locations in a hospital were selected as monitoring sampling points from May 23 to June 5, 2022. The "internet of things" sensor was used to monitor a variety of real-time air environment data. Air microbial concentration data collected at each point were matched, and the gradient boosting decision tree (GBDT) was used to predict real-time indoor microbial concentration in air. Five other common machine learning models were selected for comparison, including random forest (RF), decision tree (DT), k-nearest neighbor (KNN), linear regression (LR) and artificial neural network (ANN). The validity of the model was verified by the mean absolute error (MAE), root mean square error (RMSE) and mean absolute percentage error (MAPE). Results The MAPE value of GBDT model in the outpatient elevator room (point A), bronchoscopy room (point B), CT waiting area (point C), and nurses' station in the supply room (point D) were 22.49%, 36.28%, 29.34%, and 26.43%, respectively. The mean performance of the GBDT model was higher than that of other machine learning models at three sampling points and slightly lower than that of the ANN model at only one sampling point. The mean MAPE value of GBDT model at four sampling points was 28.64%, that is, the predicted value deviated from the actual value by 28.64%, indicating that GBDT model has good prediction results and the predicted value was within the available range. Conclusion The GBDT machine learning model based on real-time indoor air environment monitoring data can improve the prediction accuracy of indoor air microbial concentration in hospitals.

Abstract:Objective To quantitatively analyze the impact of environmental hygiene on the occurrence of healthcare-associated infections (HAI). Methods Monitoring data of HAI and environmental hygiene from a tertiary first-class hospital from January 2018 to December 2022 were collected, and the impact of environmental bacterial colony forming unit (CFU) on the occurrence of HAI was analyzed by a time-series generalized additive model. Results The single-contamination model showed a significant positive correlation between HAI and staff's hand bacterial CFU (β₁=0.009, P=0.012). For an increase of 1 interquartile range (IQR) in the monthly mean CFU per dish (MCFU/Dish) of staffs' hand, the incidence of HAI increased by 13.28% (95%CI: 2.82%-24.81%). Subgroup and lag effect analysis showed that when the monthly MCFU/Dish (after hand disinfection) of staffs' hand increased by one IQR, the excess risk (ER) of HAI for the month (lag0) was 16.26% (95%CI: 15.45%-17.09%). In the multi-contamination model, the correlation between surface contamination and HAI was also statistically significant. Conclusion There is a significant correlation between hospital environmental hygiene and the occurrence of HAI.

Abstract:Objective To study the application of the trinity model and trinity forecasting method in predicting the incidence trend of pulmonary tuberculosis (PTB). Methods By applying the monthly PTB incidence data in Zhejiang Province from 2011 to 2021, a prediction model was constructed based on the trinity model and trinity forecasting method. Predictive performance of the model was evaluated. Results The mean relative prediction errors of model 1 and model 2 based on trinity model and trinity forecasting method were 7.94% and 8.43%, respectively. The mean relative prediction error obtained by adopting autoregressive integrated moving average (ARIMA) model was 8.87%, and the above mean relative prediction error were all in the range of 7.9%-8.9%, which presented an excellent performance of the forecasting model. Conclusion The trinity model is an excellent time series forecasting model, and the trinity forecasting method is an excellent time series forecasting method, with high application value.

Abstract:Objective To analyze the spatial-temporal distribution characteristics and influencing factors of the incidence of tuberculosis (TB) in Chinese mainland, and provide scientific basis for relevant departments to formulate policies and guidelines. Methods TB incidence in Chinese mainland from 2017 to 2022 was as the research object, and data of relevant influencing factors were collected. The spatial autocorrelation analysis method was adopted to establish a spatial lag model to explore the spatial-temporal distribution characteristics of TB incidence, and the important influencing factors of TB incidence were screened. Results From 2017 to 2022, TB incidence reported in 31 provinces and cities in Chinese mainland were 60.53/100 000, 59.27/100 000, 55.55/100 000, 47.76/100 000, 45.37/100 000 and 39.76/100 000, respectively, showing a yearly downward trend. Global Moran's Ⅰ analysis showed that TB incidence presented spatial-temporal aggregation. The spatial distribution map and the local indicators of spatial association (LISA) aggregation diagram analysis results for the incidence of reported TB showed a decreasing trend from west to east in TB incidence. In the spatial lag model, the coefficients of 6 insignificant factors shrank to 0, and 6 important factors were screened out: gross domestic product (GDP) per capita (coefficient -0.259), urban unemployment rate (coefficient -0.198), annual sunshine duration (coefficient -0.332), annual mean relative humidity (coefficient -0.433), annual mean NO₂ concentration (coefficient -0.263), and annual mean PM₁₀ concentration (coefficient -0.336). Conclusion From 2017 to 2022, TB incidences in Chinese mainland declined year by year, and presented spatial difference and spatial aggregation: high in the east, low in the west, and stable in the middle area. Social economy, climate and air pollution have strong effects on the incidence of TB. Relevant departments should pay more attention to the prevention and treatment of TB in the western region and take targeted preventive measures.

Abstract:Objective To study the economic burden caused by healthcare-associated infection (HAI) in patients with hemorrhagic stroke. Methods Patients with hemorrhagic stroke in a tertiary first-class hospital from January 1, 2021 to December 31, 2022 were surveyed retrospectively. Data on demographic characteristics, clinical information, and hospitalization expenses were collected. According to the occurrence of HAI, patients were divided into the HAI group and control group. The length of hospital stay, increase in hospitalization expense, and hospital economic burden of the HAI group and control group were studied by propensity score matching (PSM) method and generalized linear model method. Results A total of 688 patients were included in the study, with 266 cases experiencing HAI and a HAI incidence of 38.66%. After propensity score matching, 199 patients in the HAI group were successfully matched. Compared with the control group, the median length of hospital stay in the HAI group doubled, increasing by 16 days (Z=11.779, P < 0.001); the median hospitalization expense increased by 34 597.42 Yuan, with an increase of 85% (Z=6.299, P < 0.001). Based on the generalized linear model method, length of hospital days attributed to HAI increased by 1.24 times, hospitalization expense increased by 76% (both P < 0.001). Except surgical expenses, the HAI group had higher single medical expenses than the control group (all P < 0.05). Economic burden to hospital caused by HAI was 541 900 Yuan. Conclusion HAI significantly increases the economic burden of hemorrhagic stroke patients and hospitals, and prolongs the length of hospital stay. Clinical staff should enhance the awareness on infection control, reduce the incidence of HAI, and save medical resources.

Abstract:Objective To analyze the influencing factors for surgical site infection (SSI) after gastrointestinal perforation repair surgery by decision tree and logistic regression model. Methods Patients who underwent gastrointestinal perforation repair surgery at a hospital of Mianyang City from January 2018 to January 2023 were selected as the research subjects. Clinical data of the patients were collected. Patients were divided into the SSI (+) group (n=41) and the SSI (-) group (n=322) based on whether SSI occurred after surgery. Influencing factors for SSI after gastrointestinal perforation repair surgery were analyzed by univariate and multivariate logistic regression. Re-levant decision tree prediction model was constructed. Results Among the 363 patients who underwent gastrointestinal perforation repair surgery, 41 developed postoperative SSI, with an incidence of 11.29%. Univariate analysis results showed that there were statistically significant differences between two groups of patients in body mass index (BMI), albumin level, preoperative antimicrobial use, duration of preoperative abdominal pain, and duration of surgery (all P < 0.05). Multivariate logistic regression analysis showed that higher BMI (OR=2.059, 95%CI: 1.103-3.842), albumin levels < 35 g/L (OR=2.761, 95%CI: 1.312-5.811), duration of preoperative abdominal pain ≥24 hours (OR=3.589, 95%CI: 1.659-7.763), and duration of surgery ≥2 hours (OR=3.314, 95%CI: 1.477-7.435) were independent risk factors for postoperative SSI in patients after gastrointestinal perforation repair surgery (P < 0.05), while preoperative antimicrobial use was a protective factor (OR=0.338, 95%CI: 0.166-0.690, P < 0.05). The decision tree model based on the above factors was constructed to predict the risk of SSI in patients after gastrointestinal perforation repair surgery. Validation of the model showed that the area under the receiver operating characteristic (ROC) curve (AUC) was 0.811 (95%CI: 0.794-0.825). Conclusion The risk factors for postoperative SSI in patients after gastrointestinal perforation repair surgery include high BMI, albumin level < 35 g/L, duration of preoperative abdominal pain ≥24 hours, and duration of surgery ≥2 hours. The protective factor is antimicrobial use before surgery. The decision tree model constructed based on the influencing factors has good predictive ability for the risk of postoperative SSI in patients after gastrointestinal perforation repair surgery.

Abstract:Objective To explore the potential mechanism of carvacrol on inhibiting the formation of biofilm of hypervirulent Klebsiella pneumoniae (hvKP). Methods The possible mechanisms of carvacrol were analyzed based on the detection of its effects on the formation and morphology of biofilms, changes in extracellular polysaccharide and capsule polysaccharide content, as well as changes in the expression levels of biofilm-related genes rmpA2, magA, mrkA, mrkB, and treC of hvKP. Results The minimum inhibitory concentration of carvacrol on hvKP was 512 μg/mL, with an obvious inhibitory effect on the biofilm formation of hvKP, presenting a concentration-depen-dent effect. Under the scanning electron microscope, it was observed that the biofilm structure was loose and the intercellular connections were not dense under the intervention of carvacrol. The Congo Red adsorption test and m-hydroxybiphenyl colorimetric method showed that carvacrol could reduce the content of capsule polysaccharides of hvKP, but didn't affect the total extracellular polysaccharide content. Fluorescence quantitative polymerase chain reaction (PCR) showed that under the effect of carvacrol at sub-inhibitory concentration, the synthesis of capsule polysaccharide, expression levels of sugar transport system and pili adhesion-related genes all decreased by more than 50%. Conclusion Carvacrol has a significant inhibitory effect on the formation of biofilm in hvKP, and its mechanism may be related to the decrease of synthesis of capsule polysaccharide as well as expression of biofilm-related genes, such as sugar transport system and pili adhesion.

Abstract:Objective To evaluate the application effect of broth microdilution (BMD) method in susceptibility testing of multidrug-resistant Mycobacterium tuberculosis (MDR-MTB). Methods The Roche's proportion method and BMD method were adopted in drug susceptibility testing on 108 MDR-MTB strains and 11 non-MDR-MTB strains in Hainan Province. Whole genome sequencing (WGS) was performed on strains with inconsistent results by the above two methods. Results The average time to acquire drug susceptibility testing results by Roche's proportional method and BMD method were 28.0 and 8.5 days, respectively. Roche's proportional method showed higher resistance rates to isoniazid (INH), rifampicin (RFP), ethambutol (EMB), kanamycin (KM), and capreomycin (CPM) than BMD method (all P < 0.001). BMD method showed higher resistance rates to protionamide (PTO) and para-aminosalicylic acid (PAS) than Roche's proportional method (both P < 0.001). Taking Roche's proportional method as the gold standard, the sensitivity and specificity of BMD method for testing drug resistance were 50.00%-100% and 95.69%-100%, respectively. Except EMB (87.39%) and INH (94.96%), the consistency rates of the BMD method in testing drug resistance of other drugs were all ≥95.00%. The overall consistency rate between Roche's proportional method and WGS was 76.19% (32/42), while the consistency rate between BMD method and WGS was 23.81% (10/42), difference was statistically significant (χ²=23.048, P < 0.001). 34 MTB strains showed inconsistent results by two drug susceptibility testing methods. Among the 26 MTB strains that were resis-tant in Roche's proportion method but sensitive in BMD method, 22 strains (84.62%) had mutations in relevant resistance genes. Among the 11 MTB strains that were sensitive in Roche's proportion method but resistant in BMD method, 5 strains (45.45%) had mutations in relevant resistance genes. Conclusion BMD method is an accurate and rapid MDR-MTB susceptibility testing method, but further improvement and optimization are still needed. Drug resistance is closely related to mutations in relevant resistance genes.

Abstract:Objective To analyze the status and influencing factors of rifampicin resistance in re-treated pulmonary tuberculosis (PTB) patients registered in Chongqing City, and provide basis for the prevention and control of drug-resistant tuberculosis in this city. Methods Descriptive epidemiological method was adopted to analyze the status of rifampicin resistance in re-treated PTB patients registered in districts and counties of Chongqing City from 2018 to 2022. Chi-square test and binary logistic regression were used to analyze the influencing factors for the status of ri-fampicin resistance in re-treated PTB patients. Results The detection rate of rifampicin resistance in re-treated PTB patients in districts and counties of Chongqing City from 2018 to 2022 was 14.45% (558/3 862), presenting an overall downward trend (χ²_trend=22.739, P < 0.001). Univariate analysis showed that among re-treated PTB patients, the detection rate of rifampicin resistance was the highest among migrant population, residents in urban areas, workers, and migrant workers (all P < 0.05); rifampicin resistance decreased with the increase of age (P _trend < 0.001). Multivariate logistic regression analysis showed that the risk of rifampicin resistance gradually decreased with the increase of age; OR value decreased from 2.778 in the < 25 year old group to 1.654 in the ≥45 year old group (all P < 0.001). The risk factors for rifampicin resistance in re-treated PTB patients were migrant population, residents in urban areas, workers, and migrant workers, with statistically significant differences (all P < 0.05). Conclusion Although the detection rate of rifampicin resistance in re-treated PTB patients in Chongqing has been decreasing year by year, the situation is still severe, and special attention should be paid to the migrant population, young population, population in the main urban areas, and migrant workers.

Abstract:Objective To analyze the influencing factors for the knowledge level, cognition willingness and attitude of health care workers (HCWs) towards monkeypox. Methods A cross-sectional survey was conducted, from January to April 2023, 700 HCWs were randomly selected from a tertiary hospital in Shanghai. Based on a self-designed questionnaire, the survey was conducted anonymously through the online platform "Wenjuanxing". Results A total of 612 questionnaires were collected, 581 were valid, with a response rate of 87.43% and an effective rate of 94.93%. The mean score of the questionnaire was (128.80±27.70) points, with a score rate of 58.54%. Multiple linear regression analysis showed that there were statistically significant differences in the knowledge level of monkeypox among HCWs of different ages, occupations, departments, educational levels, years of working experience, professional titles, initiative cognition on monkeypox, and participation in monkeypox-related lectures organized by the units (all P < 0.05). Conclusion HCWs' cognition on monkeypox is at a moderate level. The training of HCWs on monkeypox knowledge should be strengthened to improve the emergency response capabilities during monkeypox outbreaks.

Abstract:Objective To explore the effect of collaborative mode of adopting infection prevention and control (IPC) and antimicrobial stewardship (AMS) by medical institutions on reducing bacterial resistance. Methods Healthcare-associated infection (HAI) management and antimicrobial-related indicators, as well as multidrug-resis-tant organism (MDRO) detection rates of all hospitalized patients in a hospital from January 1, 2015 to December 31, 2022 were collected. The effectiveness of collaborative mode of IPC and AMS was evaluated. Results Compared with 2015-2016, the incidence of MDRO HAI in 2021-2022 decreased from 0.22% to 0.16% (P < 0.05), antimicrobial use density in hospitalized patients decreased from 48.48 to 42.17, antimicrobial use rate decreased from 49.45% to 45.21% (P < 0.05). The use rate of prophylactic antimicrobial agents in class Ⅰ incision surgery decreased from 48.62% to 33.13% (P < 0.05). Compared with 2017-2018, pathogen detection rate before antimicrobial therapy increased from 60.73% to 72.18% in 2021-2022 (P < 0.05). Compared with 2015-2016, except the detection rate of vancomycin-resistant Enterococcus faecalis slightly increased in 2021-2022, detection rates of other common MDRO decreased, especially methicillin-resistant Staphylococcus aureus, carbapenem-resistant Acinetobacter baumannii, carbapenem-resistant Pseudomonas aeruginosa, broad-spectrum β-lactamase-producing Klebsiella pneumoniae, broad-spectrum β-lactamase-producing Escherichia coli and fluoroquinolone-resistant Escherichia coli, differences were all statistically significant (all P < 0.05). Conclusion The collaborative mode of IPC and AMS can effectively promote the rational use of antimicrobial agents, decrease the occurrence and transmission of MDRO, and decrease bacterial resistance.

Abstract:Objective To evaluate the direct economic burden caused by surgical site infection(SSI)in patients with orthopaedic trauma under the payment management of disease diagnosis-related groups (DRG). Methods Clinical data of patients with orthopaedic trauma in a tertiary first-class hospital from May 1, 2022 to May 30, 2023 were surveyed retrospectively. Patients were grouped based on whether SSI occurred. Differences in average length of hospital stay, average hospitalization expense, and other indicators between SSI patients and non-SSI patients in the same DRG subgroup were compared, and the direct economic burden caused by SSI was analyzed. Results A total of 435 patients who paid according to the DRG payment management were included in the study. Twenty-two patients had SSI, with an SSI incidence of 5.06%. Both the average length of hospital stay and average hospitalization expense of patients in the SSI group were higher than those in the non-SSI group, with statistically significant differences (P < 0.05). The DRG subgroups of SSI patients were mainly four groups: IF45, IF15, IJ13, and ZC13. Among them, the average length of hospital stay of SSI patients in the IF45, IF15, and ZC13 groups increased significantly (P < 0.05), and the average hospitalization expense of SSI patients in the IJ13 group increased significantly (P < 0.05). Conclusion Under the DRG payment management, the direct economic burden of orthopaedic trauma patients with SSI increases significantly. It is necessary to periodically evaluate and identify high-risk DRG subgroup patients, so as to adopt precise infection control interventions and reduce SSI incidence.

Abstract:Objective To explore food intolerance (FI) characteristics and its relationship with Helicobacter pylori (Hp) infection in chronic gastritis (CG) patients of different age groups. Methods Patients admitted to a hospital from August 2021 to August 2022 were selected as the study subjects. According to age, patients were divided into the young-middle-aged group and the elderly group. According to whether Hp infection occurred, they were divided into the infection group and non-infection group. Clinical data and 14 food allergen specific immunoglobulin G (IgG) levels of patients were collected. Testing results were analyzed by statistical software, risk factors were analyzed by multivariate logistic regression, and predictive value of the model was evaluated. Results A total of 108 CG patients were admitted to the hospital, with 65 males and 43 females. There were 78 cases (18-64 years old) in the young-middle-aged group and 30 (≥ 65 years old) in the elderly group, 60 cases in the Hp infection group and 48 cases in the non-infection group. The total positive rate of FI tests of 14 kinds of food was 56.48% (61/108). Five food types with highest FI positive rates were shrimp (44.44%), egg (40.74%), crab (35.19%), soybean (31.48%), and cod (29.63%); five food types with highest FI positive rates in the young-middle-aged group were egg (46.15%), shrimp (38.46%), soybean (37.18%), cod (32.05%), and crab (29.49%); in elderly group, they were shrimp (60.00%), crab (50.00%), chicken (33.33%), rice (33.33%), and egg (26.67%). The FI positive rates for 6 food types (crab, egg, milk, shrimp, soybean, and wheat) in patients of different age groups were compared, and the differences were all statistically significant (all P < 0.05). Compared with Hp non-infection group, the infection group had higher proportions of patients under 65 years old, male, smoking, and higher IgG antibody levels, differences were all statistically significant (all P < 0.05). FI positive rates in the infection group and non-infection group were 65.00% and 45.83%, respectively. Difference between the two groups was statistically significant (χ²=3.985, P=0.046). FI positive rates for 6 food types (cod, crab, egg, mushroom, milk, and shrimp) in the two groups of patients were compared, and differences were all statistically significant (all P < 0.05). After adjusting patient factors as age, gender, and smoking, seafood and non-seafood FI were risk factors for Hp infection (all P < 0.05). The receiver operator characteristic (ROC) curve of the predictive model presented a high accuracy. Conclusion FI is generally present in CG patients, and FI is related to age. The FI test results can provide guidance for patient's diet and reduce the risk of food adverse reactions. Hp infection can easily induce FI, which can increase the risk of Hp infection.

Abstract:Objective To evaluate the process risk of the implementation of prevention and control measures for surgical site infection (SSI) after colorectal surgery, and explore the application effect of failure mode and effects analysis (FMEA) based on action priority. Methods FMEA based on action priority was adopted to evaluate the whole process of the implementation of prevention and control measures for SSI after colorectal surgery. Prioritization ranking was conducted according to whether optimized measures were taken. Standard-reaching rate of comp-liance to SSI prevention and control measures as well as SSI incidence before and after the implementation of FMEA were compared. Results After evaluation, there were 7 high-priority and 22 medium-priority prevention and control measures for SSI. The control of medium-priority measures was strengthened, with a focus on developing further preventive and detectable measures for high-priority measures. The re-evaluation results after improvement showed that 7 high-priority measures have been downgraded to medium priority, and 16 medium-priority measures have been downgraded to low priority. Standard-reaching rate of compliance to SSI prevention and control measures increased from 77.15% (2 566/3 326) to 92.47% (3 096/3 348), and SSI incidence decreased from 6.04% (58/960) to 2.54% (60/2 364). Conclusion Application of FMEA based on action priority can effectively evaluate the risk of prevention and control process of SSI after colorectal surgery, and adopting preventive risk control measures according to the current situation can reduce the incidence of SSI after colorectal surgery.

Abstract:Objective To develop a scheme for preventing catheter-associated urinary tract infection (CAUTI) based on project management method, and evaluate its application effect on the prevention and control of CAUTI in patients with indwelling urinary catheters in the medical intensive care unit (MICU). Methods A total of 153 patients with indwelling urinary catheters admitted to the MICU of a hospital were selected for analysis. Patients from July 2021 to March 2022 were set as the control group (n=78), adopting routine nursing methods. Patients from July to December 2022 were set as the intervention group (n=75), and intervened with nursing measures of project management. Catheterization days, length of hospital stay, and incidence of CAUTI between two groups of patients were compared. Difference in the main indicators of patients with brought catheters and those receiving catheters in this department in the intervention group during three quality cycles was compared. Results The duration of indwelling urinary catheters in the intervention group was shorter than that in the control group ([9.51±2.57] days vs [11.10±2.82] days), with a statistically significant difference (t=8.207, P=0.038). There was no statistically significant difference in the length of hospital stay between two groups of patients (P>0.365). In terms of catheterization days of patients, those in the second quality cycle was shorter than in the first quality cycle, and those in the third quality cycle was shorter than in the second quality cycle, both with statistically significant differences (both P < 0.05). The overall incidence of CAUTI in patients with indwelling catheters in the intervention group was shorter than that of the control group(20.00% vs 24.36%), with statistically significant differences (χ²=6.937, P=0.026). Catheterization days between patients with brought catheters and those receiving catheters in this department were statistically significantly different both in the first and second quality cycles (both P < 0.05). The incidences of CAUTI between patients with brought catheters and those receiving catheters in this department were significantly different in the intervention group, as well as in the first and second quality cycles, respectively (all P < 0.05). Conclusion The application of project management method can reduce the incidence of CAUTI and catheterization duration of patients with indwelling urinary catheters in MICU, and improve the nursing quality of the entire process of indwelling catheters.

Abstract:Clinical data of 3 patients with linezolid-induced lactic acidosis treated in 2 hospitals in Beijing and Shandong were retrospectively analyzed, and relevant literatures at home and abroad were retrieved. The pathogenesis, risk factors, clinical manifestations, and treatment scheme were valuated. Three patients received linezolid anti-infection treatment due to their disease condition. At different phases of treatment, they developed lactic acidosis that was difficult to be explained with septic shock. After discontinuing linezolid and receiving bedside continuous veno-venous hemofiltration (CVVH) treatment, patient's blood lactate levels decreased significantly. It is clinically diagnosed linezolid-induced lactic acidosis finally, but the initial diagnosis was septic shock by all doctors. After active treatment, 2 patients recovered and 1 patient died. Linezolid-induced lactic acidosis is easily to be misdiagnosed as septic shock. Clinicians should enhance their understanding and recognition of the early diagnosis of the adverse reactions, take effective measures, so as to improve patient prognosis.

Abstract:Quorum sensing (QS) is an important communication mechanism for bacterial intra- and inter-species information transmission, and is an important target for the prevention and control of bacterial infections. However, the QS network is complex and diverse, with a wide variety of low content signaling molecules. The detection of signaling molecules is hot and difficult in the research fields of QS system. In this paper, the structure of QS signaling molecules and corresponding detection methods are reviewed, and the future research direction and existing problems are prospected, so as to provide reference for the research fields in QS system pathway and mechanism, pharmacy, food, clinical practice, environment, et al.

Abstract:Clostridium perfringens is an important foodborne pathogen that causes intestinal infections and tissue necrosis in both human and animals. A variety of exotoxins it produces are lethal. The increasing demand for ratio-nal use of antimicrobial agents and healthy farming make the implementation of vaccination critically important. However, traditional Clostridium perfringens exotoxin vaccines may have problems such as inconsistent efficacy, residual toxins and formaldehyde, raising concerns about the safety of these vaccines. This article systematically introduces the latest research progress in traditional toxoid vaccine, genetically engineered recombinant vaccines, and epitope peptide vaccines designed based on reverse vaccinology and immunoinformatics for Clostridium perfringens, providing new ideas for the development and preparation of effective and safe novel Clostridium perfringens toxin vaccines.

Abstract: