Abstract:Mosquito-borne viruses, a class of pathogens primarily transmitted by mosquitoes, present severe glo-bal epidemics and pose serious threats to human health. These viruses rely on specific mosquito species for transmi-ssion, and their clinical manifestations vary from mild symptoms to severe complications. Most viruses lack effective treatment agents and vaccines. This review systematically describes the mechanisms of the mosquito-borne virus infection transmission, encompassing two key stages: host infection and mosquito infection. During the host infection stage, saliva components of mosquito promote viral invasion and systemic spread within the host by disrupting host hemostasis process, directly interacting with the virus, altering host cell function, and regulating local immune response, ultimately targeting specific organs and causing disease. During the mosquito infection stage, the targeting of mosquito is regulated by metabolites from host’s skin microbiome. Host blood components and mosquito’s gut microbiome exert bidirectional regulation in the infection in mosquito’s midgut. The viruses break through the midgut barrier to enter the hemolymph and further infect the salivary glands. These mechanisms reveal the viruses’ adaptive strategies within the host-mosquito ecosystem and emphasize the importance of multifactorial regulation. Future research should focus on molecular interventions, microbial applications, and integrated prevention and control strategies to reduce the risk of mosquito-borne viral transmission.

Abstract:Objective To analyze the global literatures related to Chikungunya fever (CHIKF), explore the research status, hotspots, and frontiers of CHIKF, and provide reference for researchers and clinical workers. Methods CHIKF-related literatures were retrieved from PubMed from 2010 to 2025. Bibliometrix and VOSviewer software were used for visualization analysis. Results From 2010 to 2025, a total of 834 CHIKF-related literatures were retrieved. The annual publication volume presented a fluctuating upward trend. The journal with the highest publication volume was PLoS Neglected Tropical Diseases (n=25, 3.00%). The institution with the highest publication volume was The University of Texas Medical Branch (n=36). The countries with the highest publication volume were Brazil (31.59%), India (15.52%), and the United States (10.43%). The countries with the top three citation rates were the United States (n=836), Brazil (n=671), and India (n=568). 20.86% of the literatures had international cooperation, with the United States being the country with the most international cooperation. The keywords have shifted from "Chikungunya virus" "infection" "vector aedes" and "molecular biology mechanism" during the period of 2010-2020 to "Chikungunya virus" "vector mosq uito (Aedes aegypti)" "immunity and vector control" "related diseases (dengue fever)" "vaccines", etc. during the period of 2021-2025. Conclusion The attention to CHIKF-related research continues to increase, and research direction is shifting from basic research to clinical applications. The development of antiviral drugs and vaccines may become a future focus. Strengthening international cooperation and optimizing resource allocation will be the key points to promoting the prevention and control of CHIKF.

Abstract:Objective To analyze the clinical characteristics of children with Chikungunya fever (CHIKF), and provide basis for the treatment and prevention of CHIKF in children. Methods Medical records of children under 14 years old with CHIKF admitted to Foshan Shunde District Le Cong Hospital from July 12 to August 17, 2025 were analyzed retrospectively.Epidemiological data, clinical characteristics, laboratory testing results, treatment methods of children were obtained through reviewing electronic health records. Results A total of 343 children confirmed with CHIKF were included in the analysis, all of whom resided in Foshan City, Guangdong Province. 198 were males (57.73%) and 145 were females (42.27%). The average age of children was (8.6±3.3) years old. The main initial symptoms were fever (n=302, 88.05%), rash (n=306, 89.21%), and joint pain (n=246, 71.72%). The initial laboratory testing results after admission showed that 95 cases (27.70%) had abnormal white blood cell count in blood routine, 3 cases (0.87%) had decreased platelets, 52 cases (15.16%) had increased C-reactive protein, and 87 cases (25.36%) reported Chikungunya virus nucleic acid CT values. All children were discharged after completing a 7-day quarantine or Chikungunya virus nucleic acid testing result turned negative, with no severe illness or death. Conclusion All cases from this epidemic experienced mild CHIKF. Early detection, early diagnosis, and early treatment are beneficial for reducing the occurrence of complications, and all children have good prognoses.

Abstract:Objective To explore the magnetic resonance (MR) imaging characteristics of joint damage caused by Chikungunya virus (CHIKV) and its correlation with pain severity, and analyze the value of T2-Mapping in asse-ssing the severity and prognosis of such damage. Methods A multicenter retrospective study design was adopted, and patients with CHIKV infection accompanied by joint pain were included in analysis. Multi-joint MR scans were performed to assess joint effusion, synovial thickening, bone marrow edema, and cartilage damage. T2-Mapping values were measured. Pain severity was assessed using the Visual Analog Scale (VAS), and imaging findings were independently assessed by two radiologists. Results A total of 131 patients were included in the study. The incidence of joint cavity and/or synovial sac effusion was the highest (77.1%, n=101), with knee and ankle joint effusion accounting for 81.2% (severe, mild-moderate were 17 and 65 cases, respectively), other joint effusion were mild. 78 cases had synovial thickening (14 and 64 were severe and mild-moderate cases, respectively), 27 cases had tenosynovitis, 21 cases had bone marrow edema (primarily in the knee and ankle joints). 19 cases had cartilage damage, 114 cases presented muscle soft tissue edema (17 and 97 were severe and mild-moderate cases, respectively), 28 cases had Kager’s fat pad edema. Patients with elevated T2-Mapping values exhibited more pronounced chronic joint pain, with T2-Mapping values in the cartilage damage site increasing by 40%-60% compared with normal cartilage site (19 cases in total). The T2-Mapping value for severely damaged soft tissue was (52.3±6.7) ms, while for mildly to moderately damaged soft tissue was (42.3±5.2) ms, both significantly higher than normal refe-rence values (<35 ms, both P<0.05). Among 17 patients with severe soft tissue damage, 12 experienced persistent pain for over one month, with statistically significant differences in T2 values compared with those with mild-mode-rate damage (P<0.05). This further suggested that the degree of elevation in T2-Mapping values was closely related to the duration of pain and the severity of damage. After one-month follow-up, 103 patients had pain relief. Among the 28 patients with ongoing pain, 17 developed into subacute bone joint pain. Bone marrow edema (81.0%), elevation of T2-Mapping value of cartilage (89.5%), and severe synovial thickening (71.4%) were high-risk MR manifestations of subacute bone joint pain. The incidences of subacute joint cavity/sac effusion and subacute tenosynovitis were 3.0% and 7.4%, respectively. Conclusion MR can clearly display the inflammatory and structural changes in CHIKV joint damage, and T2-Mapping values may serve as a potential imaging measurement parameter for assessing severity and prognosis of damage.

Abstract:Objective To understand the current situation of healthcare-associated infection (HAI) in China, provide data support and decision-making basis for formulating scientific and effective strategies for HAI prevention and control. Methods A nationwide cross-sectional survey on HAI was conducted among various types and levels of medical institutions in China according to a unified protocol of bedside surveys and case investigations. Results In 2024, a total of 5 736 medical institutions and 2 751 765 patients were surveyed. Among them, 34 889 HAI cases were identified, with a prevalence rate of 1.27%. The number of HAI episodes was 38 032, and case prevalence rate was 1.38%. The prevalence rate of HAI in medical institutions in different regions of China ranged from 0.66% to 2.35%. Among medical institutions of different scales, those with a bed capacity of ≥900 had the highest incidence of HAI, reaching 1.65%. The most common infection site was the lower respiratory tract (44.66%), followed by the urinary tract (12.94%), surgical site (9.32%), upper respiratory tract (7.02%), and bloodstream infection (5.78%). The top 3 departments with the highest HAI rates were the general intensive care unit (10.02%), department of neurosurgery (5.51%), and department (group) of hematology (5.34%). A total of 23 238 strains of HAI pathogens were detected, with 10 714 strains (46.10%) from lower respiratory tract specimens. The top 5 detected strains were Klebsiella pneumoniae (14.76%), Pseudomonas aeruginosa (13.33%), Escherichia coli (12.79%), Acinetobacter baumannii (9.23%), and Staphylococcus aureus (7.88%). 231 944 patients underwent class I incision surgery were monitored, with 1 647 cases experienced surgical site infection, and the prevalence rate of surgical site infection was 0.71%. The number of patients who should undergo pathogen detection (patients receiving therapeutic and therapeutic combined prophylactic antimicrobial agents) was 715 179, while the actual number was 480 492, with a pathogen detection rate of 67.18%. 425 225 patients received pathogenic detection before treatment, with a detection rate of 59.46%. Conclusion The overall HAI prevalence in China is lower, showing disparities among medical institutions of different regions and scales. Therefore, precise implementation of measures is necessary for HAI prevention and control, with a focus on high-risk institutions and high-risk departments, key areas, and critical procedures. All levels of medical institutions should continuously reduce the incidence of HAI by strengthening monitoring, standardizing the use of antimicrobial agents, and reinforcing basic HAI prevention and control measures.

Abstract:Objective To systematically evaluate the risk prediction models for neonatal early-onset sepsis (EOS), aiming to provide reference for the construction and optimization of models, as well as for clinical selection of appropriate prediction models. Methods PubMed, Web of Science, Embase, Cochrane Library, China National Know-ledge Infrastructure (CNKI), Wanfang Data, China Biology Medicine disc (CBM), and VIP databases were retrieved, and studies relevant to neonatal EOS risk prediction models were collected. The retrieval period was from the inception of the database to January 18, 2025. Two researchers independently screened literatures, extracted data, and evaluated the quality of the included literatures using PROBAST tool. Any disagreements were resolved through consultation with a third reviewer. Results A total of 14 literatures were included in analysis, containing 19 risk prediction models. The area under receiver operating characteristic (ROC) curve (AUC) of the included model ranged 0.71-0.999. The number of prediction factors ranged 3-21. Common prediction factors included young gestational age, low birth weight, 1-minute Apgar score, abnormal neonatal temperature, prolonged premature rupture of membranes, amniotic fluid turbidity, maternal Group B streptococcal infection, maternal chorioamnionitis, as well as elevated levels of procalcitonin and C-reactive protein in neonates. The risk of model overall bias was high, mainly due to insufficient number of outcome variable events in the analysis field, improper processing of missing data, screening of prediction factors based on univariate analysis, lacking model performance evaluation, and overfitting of model. Conclusion The neonatal EOS risk prediction model is still at the development stage. Although the current prediction models have better overall predictive performance, the overall quality needs to be improved. Future modeling can follow the PROBAST and TRIPOD specifications to reduce bias risk, explore the combination of multiple modeling methods, and focus on strengthening external validation and localized application to enhance the clinical applicability and promotion value of the model.

Abstract:Objective To understand the epidemiological characteristics and trends of postoperative pneumonia (POP) in tertiary general hospitals in Jiangsu Province, and provide theoretical basis for carrying out targeted prevention and control measures. Methods Surgery patients from 22 tertiary general hospitals in 12 cities in north, central, and south of Jiangsu Province from January 1, 2022 to December 31, 2023 were chosen as studied subjects, occurrence of POP was analyzed and compared. Results A total of 848 274 surgical procedures were performed in 22 hospitals, and 3 606 cases of POP occurred, with an incidence of 0.43%. The incidence in 2023 was 0.37%, which was lower than that in 2022 (0.49%), with statistically significant difference (P<0.001). The top three departments with high incidence of POP were neurosurgery (6.71%), cardiothoracic surgery (2.91%), and general surgery (0.77%). Among hospitals of different grades, the incidence of POP in tertiary first-class hospitals was 0.44%, which was higher than that in other tertiary hospitals (0.37%). There was no statistically significant difference in the incidence of POP between municipal and district/county hospitals (P>0.05). The incidence of POP in hospitals with a bed: infection control full-time staff ratio<200∶1 was lower than that in hospitals with the ratio ≥200∶1 (0.39% vs 0.47%, P<0.001), while the incidence of POP in hospitals with a proportion ≥30% of full-time staff being doctors was higher than that in hospitals with a proportion ＜30% (0.45% vs 0.36%, P<0.001). The incidence of POP in male patients was higher than that in female patients (0.62% vs 0.26%, P<0.001). The incidence of POP in elderly patients aged ≥65 was higher than that in patients aged <65 (0.73% vs 0.26%, P<0.001). A total of 2 667 strains of infectious pathogens were detected, with the top three being Acinetobacter baumannii,Klebsiella pneumoniae, and Pseudomonas aeruginosa, accounting for 28.95%, 22.72%, and 15.45%, respectively. The detection rates of carbapenem-resistant Acinetobacter baumannii (CRAB), carba-penem-resistant Klebsiella pneumoniae (CRKP), and carbapenem-resistant Pseudomonas aeruginosa (CRPA) were 60.75%, 21.45%, and 32.28%, respectively. The detection rate of CRKP decreased in 2023 compared with 2022, with statistically significant difference (P<0.05). Conclusion The overall incidence of POP in tertiary general hospitals in Jiangsu Province is relatively low, but there are significant differences among different hospitals. Therefore, perioperative prevention and control measures should be carried out based on the epidemiological characteristics of patients.

Abstract:Objective To understand the current situation as well as the implementation of infection prevention and control measures against bacterial contamination of external and vaginal ultrasound probes in medical institutions (MIs), and explore the risk of ultrasound probe-related infection under current prevention and control measures. Methods Through on-site sampling, external ultrasound probes from 179 MIs and vaginal ultrasound probes from 83 MIs in 15 prefecture-level cities in Henan Province underwent quantitative bacterial detection, and the implementation of relevant infection prevention and control measures was assessed using questionnaire survey. Results A total of 513 ultrasound probe specimens were detected. Bacterial detection rate and exceedance rate of the disinfected vaginal ultrasound probes were 18.02% (20/111) and 2.70% (3/111), respectively, which were both lower than external ultrasound probes (40.05%[161/402] and 5.22%[21/402], respectively). Bacterial detection rate of disinfected specimens was lower than that of the towel-wiping group ([33.86%, 149/440] vs[50.00%, 27/54], χ²=5.46, P=0.019). Bacterial detection rate of the quaternary ammonium salt disinfectant group was lower than that of the alcohol disinfectant group ([17.31%, 18/104] vs[40.63%, 128/315], χ²=18.74, P<0.001). The qualified rates of specimens using different disinfection methods and with different probe types showed no statistically significant differences (all P>0.05). The implementation rates of "single disinfection for every use" for external ultrasound probes and vaginal ultrasound probes were 60.34% (108/179) and 70.54% (79/112), respectively. The disinfectants used were mainly quaternary ammonium salts (57.27%) and alcohols (36.36%). The coupling agents used for external and vaginal ultrasound examinations were mainly large packaged products for multiple time use, accounting for 93.85% and 57.89%, respectively. 33.33% (56/168) of external ultrasound coupling agents and 20.00% (11/55) of vaginal ultrasound coupling agents were used for more than 7 days. In vaginal ultrasound exa-minations, the usage rates of disinfectant coupling agents and sterile coupling agents were 28.42% (27/95) and 14.74% (14/95), respectively. In vaginal ultrasound examinations, 50.00% (56/112) of MIs used condoms as probe co-vers, and 45.54% (51/112) used sound-transmission ultrasound isolation membranes. 60.55% (66/109) of MIs didn’t change gloves after cleaning and disinfecting the vaginal ultrasound probe and before examination. Conclusion Ultrasound probes have cross infection risks in key processes such as reprocessing (disinfection/sterilization), phy-sical barrier use, coupling agent selection, and glove replacement. It is urgent to develop and implement standar-dized ultrasound probe infection prevention and control technical specifications based on evidence-based research.

Abstract:Objective To comprehensively describe the epidemiology, clinical outcomes, and treatment modes of post-transplant cytomegalovirus (CMV) infection in solid organ transplant (SOT) recipients in China. Methods Relevant studies were retrieved from domestic and foreign databases from 2013 to 2023. Indicators such as CMV infection incidence were included. Random-effects model analysis was conducted using R software. Results A total of 29 studies were included in the analysis, with an overall CMV infection incidence of 22.51%. CMV infection incidence after liver and kidney transplant were 23.62% and 13.01%, respectively. CMV infection rates after thoracic organ transplant were 52.27% and 61.24%. When serological status of donors and recipients was D+/R-, the incidence of CMV infection in transplant recipients was higher (83.89%). The incidence of CMV disease in CMV infected patients was 46.22%. Ganciclovir and valganciclovir were commonly used agents, but both had high risks of bone marrow suppression. Conclusion In China, CMV infection is a common viral infection after SOT surgery. Agents with better treatment efficacy and tolerance is necessary in clinics.

Abstract:Objective To analyze the temporal changing trend of postoperative pneumonia (POP) monitoring data in a tertiary first-class cancer hospital in Fujian Province from 2018 to 2023, and provide reference for the effectiveness of implementation of healthcare-associated infection (HAI) prevention and control measures. Methods The temporal changing trend of POP monitoring data of cancer patients in this hospital from 2018 to 2023 was analyzed by Joinpoint regression model, and the average annual percentage change (AAPC) was calculated. Results From 2018 to 2023, the POP incidences of all cancer patients and patients with different tumors in this hospital were as follows: 3.46% in all cancer patients, 4.77%, 18.16%, 11.50%, 4.66%, 0.85%, 3.74%, and 0.46% in patients with lung cancer, esophageal cancer, gastric cancer, intestinal cancer, gynecological tumors, hepatobiliary-pancreatic tumor, as well as head and neck tumors, respectively. From 2018 to 2023, the POP incidence of all can-cer patients in the hospital decreased from 5.47% to 1.73%, and POP incidences of patients with lung cancer, gastric cancer, and intestinal cancer decreased from 12.23%, 14.93%, and 4.40% to 2.60%, 3.73%, and 2.09%, respectively. Joinpoint regression model analysis showed that from 2018 to 2023, the AAPC of POP incidence of all cancer patients in the hospital was -19.78%, and the AAPCs of patients with lung cancer, gastric cancer, and intestinal cancer were -23.69%, -27.30%, and -19.40%, respectively. The incidences of POP in all cancer patients, as well as patients with lung cancer, gastric cancer, and intestinal cancer all showed downward trends, and the differences were all statistically significant (all P<0.05). According to age, the AAPCs of the ≤60 and >60 year old groups were -22.02% and -20.48%, respectively, both groups showed statistically significant difference in trends (both P<0.05). In terms of gender, the AAPCs of the male and female groups were -16.56% and -28.35%, respectively, both groups showed statistically significant difference in trends (both P<0.05). From 2018 to 2023, Klebsiella pneumoniae showed a significant upward trend in the constituent of POP pathogens in cancer patients, with an AAPC of 6.92%, and the difference was statistically significant (P<0.05). Conclusion The incidences of POP in some cancer patients in the hospital present significant downward trends, indicating that HAI infection prevention and control measures are effective, but it is still necessary to strengthen the meticulous management of the whole perioperative process.

Abstract:Objective To understand the current situation and dynamic changing trends of healthcare-associated infection (HAI) in a tertiary first-class hospital in the northwest of Hunan Province from 2015 to 2024, and provide scientific basis for optimizing infection control strategies. Methods A single-day cross-sectional survey method was employed to investigate the HAI prevalence rates of hospitalized patients on the given survey day each year from 2015 to 2024. The standardized survey protocol on prevalence rate issued by the National Medical Institution Infection Surveillance Network was strictly adhered, lanqingting real-time HAI monitoring management platform was adopted to retrieve cases from the hospital information system, and R4.2.2 was applied for statistical analysis. Results From 2015 to 2024, the prevalence rate of HAI decreased from 3.03% in 2015 to 1.76% in 2024 (Z=-3.37, P<0.001), and the HAI case prevalence rate decreased from 3.55% in 2015 to 2.20% in 2024 (Z=-2.81, P=0.005). Department of critical care medicine continuously had the highest HAI case prevalence rate, which presented a downward trend over time (Z=-2.84, P=0.004). The main site of HAI was lower respiratory tract, accounting for 39.36% to 48.15%, bloodstream infection increased from 3.57% in 2015-2016 to 10.60% in 2023-2024 (Z=2.41, P=0.016). A total of 302 strains of HAI pathogens were detected, including 212 strains (70.20%) of Gram-negative bacteria, mainly Pseudomonas aeruginosa (n=55, 18.21%), Escherichia coli (n=45, 14.90%), Acinetobacter baumannii (n=33, 10.93%), and Klebsiella pneumoniae (n=31, 10.26%). 65 strains (21.52%) of Gram-positive bacteria were identified, with Enterococcus faecium (n=19, 6.29%) and Staphylococcus aureus (n=18, 5.96%) accounting for the highest proportions. 25 fungal strains (8.28%) were detected, mainly Candida albicans (n=11, 3.64%). The use rate of antimicrobial agents showed a downward trend over the past decade (Z=-4.01, P<0.001). Therapeutic antimicrobial use accounting for 82.42%, and its proportion increased over time (Z=6.02, P<0.001). Prophylacticantimicrobial use accounted for 16.42%, showing a decreasing trend (Z=-2.75, P<0.001). The pathogen detection rate presented an upward trend over the past decade (Z=13.01, P<0.001). Conclusion The prevalence rate and case prevalence rate of HAI present a downward trend in this hospital. In the future, it is necessary to establish a monitoring data-based dynamic analysis mechanism, achieve timely feedback and intervention in data monitoring, pay attention to high-risk links in department of critical care medicine, implement precise prevention and control mearsures, perform targeted prevention and control for lower respiratory tract, urinary tract, and bloodstream infection, optimize diagnosis and treatment processes, use antimicrobial agents rationally, and pay attention to the prevalence trend of Gram-negative bacteria.

Abstract:Objective To explore the application efficacy of refined management on antimicrobial agents in a chest specialty hospital. Methods Multiple measures were implemented through perfecting management systems and processes, as well as conducting knowledge training, such as multi-dimensional specialized prescription reviewing, optimizing information systems, and implementing grid-based management of clinical pharmacist. A refined management mode for antimicrobial agents in a chest specialty hospital has been established. Antimicrobial management indicators for the whole hospital and each clinical specialty in 2023 (before management) and 2024 (after management) were analyzed. Results Compared with 2023, antimicrobial use rate among hospitalized patients in 2024 decreased from 47.48% to 45.92%, and antimicrobial use density (AUD) decreased from 46.28 defined daily doses (DDDs)/(100 person · day) to 39.73 DDDs/(100 person · day). The ratio of antimicrobial cost to total drug cost decreased from 12.71% to 9.51%, and the per capita cost of antimicrobial use decreased from 1 344.18 Yuan to 975.52 Yuan. The use rate of prophylactic antimicrobial agents for class Ⅰ incision surgery increased from 84.48% to 89.52%, and the rationality rate increased from 69.25% to 94.53%. The management indicators of each clinical specialty improved significantly. Conclusion Through adopting a series of refined management measures, antimicrobial management modes that are suitable for the actual situation of the hospital has been constructed, and obvious efficacy was achieved. Clinical application of antimicrobial agents is more standardized and rational.

Abstract:Objective To explore the application effect of constructing a data sharing-based multidrug-resistant organism (MDRO) information reminder system combined with multidisciplinary standardized measures on the whole-process closed-loop management of MDRO. Methods Hospitalized patients from whom MDRO were detected from January 1 to July 31, 2024 were taken as the control group, those from August 1, 2024, to May 31, 2025 were as the intervention group. The control group adopted the traditional manual reporting mode for MDRO, while the intervention group adopted the combination of MDRO reminder system and multidisciplinary management mode. Differences in isolation order issuing rate for MDRO and process- and outcome-indicators for multidisciplinary specialty before and after system implementation were compared. Results After implementing information reminder system combined with multidisciplinary measures, issuing rates of ≤24 hour and ＜4 hour MDRO isolation orders in the intervention group were both higher than in the control group ([90.20% vs 65.23%, P<0.05],[80.64% vs 55.08%, P<0.001], respectively). Antimicrobial use rate in the intervention group was lower than in the control group (36.27% vs 43.41%), with a statistically significant difference (P<0.05). The implementation rates of MDRO prevention and control measures, pathogen detection rates, and fluorescence labeling clearance rates in the intervention group were all higher than those in the control group, all with statistically significant differences (all P<0.05). The detection rate of MDRO decreased compared with the control group (10.83% vs 16.49%), and the incidence of MDRO healthcare-associated infection in the intervention group was lower than that in the control group (0.09% vs 0.19%), both with statistically significant differences (both P<0.001). The treatment expense in the intervention group reduced by 27 422 Yuan compared with the control group. Conclusion This study constructed an MDRO reminder system, realized full-chain monitoring system for the multidisciplinary MDRO information interaction platform, strengthened multidisciplinary in-depth integration, and improved the prevention and control effect for MDRO.

Abstract:Objective To retrospectively analyze pathogen distribution, antimicrobial resistance, and their changing trends in patients with infectious endophthalmitis admitted to a hospital in Xingtai area during the past 10 years. Methods Patients with infectious endophthalmitis and were detected pathogens admitted to Hebei Eye Hospital from January 2014 to December 2023 were selected for a retrospective study. Culture results and antimicrobial resistance of pathogens from patients with endophthalmitis were summarized and analyzed. The mutation characteristics of resistance genes and cassette chromosome recombinase genes in methicillin-resistant Staphylococcus epidermidis (MRSE) strains were explored. In vitro virulence between MRSE strains carrying mutant and non-mutant genes was compared using serum killing test. Results A total of 671 patients (671 eyes) with infectious endophthalmitis were included in the study, with 484 pathogenic strains (from 484 eyes) isolated. The average age of patients was (65.66±25.14) years old. There were no statistically significant differences in the constituent rates of pathogens among infectious endophthalmitis patients of different genders and ages (both P>0.05). Incidence of infectious endophthalmitis was higher in summer and lower in winter. Except 2018, there were statistically significant differences in the constituent rate of infectious endophthalmitis among different seasons from 2016 to 2023 (all P<0.05). A total of 176 strains of Staphylococcus epidermidis, 81 strains of Streptococcus, and 48 strains of Pseudomonas aeruginosa were isolated. The resistance rates of Staphylococcus epidermidis to penicillin, erythromycin, and oxacillin were all over 40%, with a resistance rate of 64.20% to penicillin. From 2019 to 2023, the resistance rates of Staphylococcus epidermidis to penicillin, erythromycin, oxacillin, compound sulfamethoxazole, and ciprofloxacin were all higher than those from 2014 to 2018, and the differences were all statistically significant (all P<0.05). The resistance rates of Streptococcus to azithromycin, erythromycin, and clindamycin were all over 80%. The resistance rate of Pseudomonas aeruginosa to both ciprofloxacin and piperacillin exceeded 70%. Among the 113 MRSE strains, the resistance genes ermA, ermB, and ermC accounted for 12.39% (n=14), 13.27% (n=15), and 74.34% (n=84), respectively. The cassette chromosome recombinase genes mainly included ccrA1-ccrB1, ccrA2-ccrB2, and ccrA3-ccrB3 types. Gene mutations were detected from all three types of resistance genes, with a mutation rate of 81.42% (92/113). The colony count of antimicrobial-resistant gene-mutated Staphylococcus epidermidis was higher than that of non-mutated strains in serum killing test at 2 and 3 hours (both P<0.05). Conclusion The constituent rates of pathogens in infectious endophthalmitis remained stable over the 10 years, with the highest proportion in summer and the lowest in winter. The detection rate of antimicrobial-resistant pathogens presented rising tendency, and the resistance gene of MRSE was mainly ermC. Testing and monitoring of MRSE strains should be strengthened in clinic to prevent the cloning and spread of resistance genes.

Abstract:This paper reports a case of disseminated infection caused by Fusarium solani in a patient with acute myeloid leukemia after transplantation. Fusarium solani was cultured from the patient’s blood as well as foot and ocular secretion. Anti-infection treatment was not effective. Combined with literature review, characteristics, clinical diagnosis, and treatment strategies of Fusarium disseminated infection were analyzed, aiming to assist the early detection, early diagnosis, and early treatment in clinical practice.

Abstract:This paper reports a death due to septic shock caused by Shewanella algae bloodstream infection and Epstein-Barr virus (EBV) co-infection in an elderly male patient who had no history of seawater exposure. Shewanella algae was identified in blood culture. Antimicrobial susceptibility testing showed that the strain was susceptible to meropenem while resistance to ceftriaxone. EBV sequence was detected by metagenomic next-generation sequencing (mNGS) of blood specimen. Despite meropenem combined with antiviral and anti-shock treatment, the patient still rapidly progressed to multiple organ failure and died. This case suggests that Shewanella algae infection relevant to freshwater environment exposure should be alerted, co-infection with EBV can exacerbate the severity of sepsis, and potential risk of treatment failure should be paid attention in clinical practice despite carbapenems susceptibility confirmed by testing.

Abstract:Clostridioides difficile infection (CDI) is the leading cause of hospital-acquired diarrhea and has become a major challenge in the global public health field. In recent years, it has been found that nutrients and gut microbes play key roles in regulating growth, metabolic activity, and virulence expression of Clostridioides difficile. However, current research focuses on the independent effects of a single nutrient or gut microbe, systematic understanding on the interactions between them is still lacking. This paper reviews the specific effect of different nutrients on Clostridioides difficile, explores how other gut microbes inhibit the growth of Clostridioides difficile by competing or metabolizing nutrients. In addition, this paper also discusses the application of emerging technologies in CDI research and their potentiality in clinical intervention strategies. Future research needs to integrate multi-omics data and artificial intelligence analysis, deeply analyze the complex interactive network of nutrient-microbe-host, and provide new ideas for precise prevention and treatment of CDI.

Abstract:In recent years, the escalating risks of healthcare-associated infection (HAI) and the transmission of multidrug-resistant organisms have emerged as significant global public health challenges, posing a grave threat to medical care quality and safety. HAI prevention and control are confronted with issues such as pathogen transmission complex routes, dynamic changes in infection risks of specific populations, and the lag in traditional monitoring methods. Traditional HAI management model relies on manual monitoring and information systems, presenting predicaments such as low efficiency, fragmented data, and delayed warnings. Artificial intelligence (AI) technology integrates electronic health records (EHRs), vital signs, and other clinical data to develop predictive models based on machine learning (ML) and deep learning (DL), and has enhanced multimodal data fusion and real-time dynamic analysis capabilities, demonstrating significant advantages in risk prediction, early diagnosis, and precision intervention of HAI. This paper systematically reviews the developmental trajectory, scientific achievements, and innovative practices of AI technology in HAI management, delves into existing bottlenecks such as data quality, algorithm relia-bility, and ethical norms, aiming to provide theoretical and practical references for establishing intelligent and precise HAI prevention and control system.

Abstract:Polymyxin serves as the "last line of defense" for treating infection with multidrug-resistant Gram-ne-gative bacteria. However, the emergence and spread of polymyxin-resistant genes such as mcr-1 severely weakens its clinical efficacy. This paper systematically summarizes the antimicrobial and resistance mechanisms of polymy-xin, comprehensively summarizes the current research progresses in polymyxin sensitizers particular focusing on three aspects: natural compounds, synthetic small molecules, and drug repurposing. Furthermore, this paper explores the innovative strategies of gene intervention, new targets, and nanotechnology-based formulations in the development of sensitizer, aiming to provide systematic theoretical support and research ideas against polymyxin resistance.