Abstract:The aging trend is intensifying currently, but there is still a lack of standardized diagnosis and treatment schemes for severe infections in elderly people. This paper focuses on the recommendations for immune-related clinical diagnosis and treatment routes as well as the idea of risk stratified diagnosis and treatment for elderly people, aiming to effectively prevent infectious diseases in elderly people and perform stratified management through systematic and scientific means of immune function monitoring and regulation, so as to enhance the standardized level of diagnosis and treatment as well as clinical treatment effect of infection in elderly people.

Abstract:Objective To study the epidemiological characteristics of special pathogenic infection in Wenchang area following the super typhoon "Yagi" disaster, and provide basis for the diagnosis, treatment, prevention and control of infectious diseases in disaster-affected areas. Methods Clinical characteristics and pathogenic data of 7 groups of patients infected with 9 species of zoonotic pathogens and opportunistic pathogens were analyzed retrospectively. The 7 groups included: pre-typhoon landfall group (August 6 to September 5, 2024), post-typhoon landfall group (September 6 to October 5, 2024), and groups in the past years of the same period (A2023, B2022, C2021, D2020, E2019, September 6 to October 5 of each year in 2019-2023). Epidemiological characteristics of patients as well as distribution and resistance of pathogens were compared and analyzed. Results In post-typhoon landfall group, 26 patients were infected. The overall infection rate of the post-typhoon landfall group was higher than all groups except B2022 group (all P<0.05). The infected cases mainly distributed in coastal areas. The main route of infection was outside the hospital (88.5%). Male accounted for 80.8%, agricultural workers accounted for 53.9%, and 69.2% of the cases occurred within 10 days after the typhoon. The major infection sites were multiple site co-infection, bloodstream infection, and soft tissue infection. The main pathogens maintained high sensitivity to commonly used antimicrobial agents. The accuracy of clinical initial empirical antimicrobial use was relatively low (45.5% in post-typhoon landfall group vs 62.8% in the groups of the same period in the past). The clinical cure rate decreased to 76.9%, and mortality increased to 7.7%. The mortality of patients infected with Burkholderia pseudomallei and kidney infected with Leptospira were 25.0% and 50.0%, respectively. Conclusion After typhoon disaster, special pathogen infection significantly increases and the prognosis is poor. It is recommended to emphasize blood culture and molecular biology testing to facilitate early diagnosis and precise treatment, optimize prevention and control measures, and enhance the accuracy of clinical empirical medication.

Abstract:Objective To evaluate the clinical characteristics and risk factors of healthcare-associated urinary tract infection (HA-UTI) due to vancomycin-resistant Enterococcus (VRE), and provide basis for clinical prevention and control. Methods Patients with VRE HA-UTI in a tertiary first-class hospital in Guangdong Province from January 2021 to October 2023 were selected as the VRE group. A 1 ∶2 case-control study method was conducted to select patients with vancomycin-sensitive Enterococcus (VSE) UTI as the VSE group. Clinical characteristics of two groups of patients were compared and analyzed. Risk factors for VRE HA-UTI were analyzed using univariate regression and logistic multivariate regression. Results A total of 32 patients in the VRE group and 64 patients in the VSE group were included in the analysis. In VRE group, most patients were female (68.75%), aged ≥60 years (71.88%), and from intensive care unit (ICU, 56.25%). The main detected pathogen was vancomycin-resistant Enterococcus faecium (VREfm, 96.87%). The proportion of clinical symptoms such as fever and lumbago as well as the levels of procalcitonin (PCT) and C-reactive protein (CRP) in patients in the VRE group were all higher than those in the VSE group (all P<0.05). Logistic regression analysis results showed that concomitant pulmonary infection (OR=6.890, 95%CI: 1.098-43.218, P=0.039), history of hypertension (OR=4.240, 95%CI: 1.084-16.581, P=0.038), and cephalosporin antibiotic exposure before infection (OR=4.642, 95%CI: 1.270-16.967, P=0.020) were independent risk factors for VRE HA-UTI. There were 32 and 64 strains of Enterococcus detected from VRE group and VSE group, respectively. VRE had higher resistance rates to ciprofloxacin, amoxicillin, ampicillin, penicillin G, tetracycline, high concentration gentamicin, and levofloxacin than VSE (all P<0.05). Conclusion Patients with VRE HA-UTI often have multiple underlying diseases and poor nutritional status, and are highly resis-tant to multiple antimicrobial agents. Clinical attention should be focused on patients with concomitant pulmonary infection, history of hypertension, and exposure to cephalosporin antibiotics.

Abstract:Objective To investigate the current status of job competency of full-time personnel who engaged in gastrointestinal endoscope cleaning and disinfection in medical institutions in Hubei Province, analyze the influencing factors, and provide reference for conducting the training for full-time personnel in gastrointestinal endoscope clea-ning and disinfection. Methods Through expert consultation and revision, as well as forming of questionnaire, an online survey was conducted. The questionnaire was filled out by full-time personnel who engaged in endoscope cleaning and disinfection in the endoscopy centers/rooms in medical institutions. Results A total of 195 full-time personnel engaged in cleaning and disinfecting gastrointestinal endoscopes in 185 medical institutions participated in the survey, with a self-assessment score of (4.48±0.41) point for job competency. Univariate analysis showed that there were statistically significant differences in the self-assessment scores of job competency based on different le-vels of training, training frequency, income satisfaction, and daily diagnosis and treatment volume (all P<0.05). Multiple linear regression analysis indicated that full-time personnel with working years ＞10 years, satisfying with their income, participating in provincial/national level training, receiving training at least once per year, and having an average daily diagnosis and treatment volume >50 cases had higher self-assessment score of job competency (all P<0.05). Conclusion In order to enhance the job competency of personnel who engage in gastrointestinal endoscope cleaning and disinfection, it is recommended to encourage the participation in provincial/national training, and the hospital-wide training should emphasize the application and disposal of cleaning, disinfection, and storage devices of gastrointestinal endoscope, as well as disinfection knowledge, and encourage personnel to conduct relevant research.

Abstract:Objective To explore the epidemiological characteristics and differences in antimicrobial resistance between catheter-associated urinary tract infection (CAUTI) and non-CAUTI of healthcare-associated infection (HAI), and provide scientific basis for precise clinical prevention and control. Methods Based on the regional HAI surveillance platform in Suzhou City, urinary tract infection (UTI) surveillance data reported by 61 member units from January 2020 to December 2024 were analyzed retrospectively. Pathogen distribution, detection rate of multidrug-resistant organisms (MDROs), and antimicrobial resistance spectrum characteristics of patients in the CAUTI group and non-CAUTI group were compared. Results The incidence of CAUTI in patients in CAUTI group was 0.99‰, the incidence of healthcare-associated UTI in patients in non-CAUTI group was 0.14%. There was statistically significant difference in the distribution of UTI pathogens between the two groups (P<0.05). The pathogens of the CAUTI group were mainly Gram-negative bacteria (56.0%), with high proportions of Escherichia coli (19.6%) and Klebsiella pneumoniae (15.0%). In the non-CAUTI group, the proportion of Gram-negative bacteria was higher (64.7%). Antimicrobial susceptibility testing results showed that the resistance rates of Escherichia coli to tobramycin, cephalosporins, and carbapenems in the CAUTI group were all higher than those in the non-CAUTI group (all P<0.05). Except for tigecycline, the resistance rates of Klebsiella pneumoniae to other antimicrobial agents in the CAUTI group were all significantly different from the non-CAUTI group (all P<0.05). The resis-tance rates of Acinetobacter baumannii to ticarcillin/clavulanic acid, quinolones, most cephalosporins, carbapenems, and aminoglycosides in the CAUTI group were higher than those of the non-CAUTI group (all P<0.05). The detection rates of MDROs were higher in the CAUTI group, especially that of carbapenem-resistant Klebsiella pneumoniae, accounting for 57.8%. Conclusion There are significant differences in pathogen distribution and antimicrobial resistance of UTI between the CAUTI group and the non-CAUTI group. It is necessary to establish a regional antimicrobial resistance surveillance system for pathogens in UTI, and provide basis for the rational use of antimicrobial agents in clinical practice.

Abstract:Objective To systematically evaluate the research progress of risk prediction models for periprosthetic joint infection (PJI) after total joint arthroplasty (TJA), analyze the limitations of current researches, and propose optimized suggestions. Methods Chinese and English databases such as PubMed, Embase, Web of Science, Cochrane Library, SinoMed, Wanfang Database, VIP Database, and CNKI were retrieved systematically. The retrieved period was from the establishment of each database to August 31, 2024. Two researchers independently screened literatures and extracted data according to the CHARMS checklist, and the risk of bias in the included studies was evaluated by the PROBAST tool. Results A total of 14 studies were included in this study, involving 17 prediction models. The most common predictors included history of diabetes mellitus, obesity (body mass index ［BMI］ ≥30 kg/m²), advanced age (≥65 years old), history of traumatic fracture, and prolonged operation time (≥2 hours). All of the included studies had high risks of bias, mainly study subject selection bias (such as single-center sample) and statistical analysis bias (such as unadjusted confounding factors). Conclusion Most of the currently published risk prediction models for PJA after TJA have good predictive performance, however, there are significant limitations in the research design, especially in the insufficient control of bias risk. Future research needs to focus on improving methodological design, including adoption of prospective multi-center studies, definition of standardized predictive variables, and sufficient adjustment of confounding factors.

Abstract:Objective To understand the molecular epidemiological characteristics and hypervirulence evolution trend of ST11 carbapenem-resistant Klebsiella pneumoniae (CRKP) isolated from medical institutions in Shanghai, and provide scientific basis for formulating the prevention and control measures of drug-resistant organisms. Methods A total of 201 strains of CRKP isolated from 12 medical institutions in Shanghai from 2021 to 2022 were collected. Antimicrobial susceptibility testing and whole genome sequencing were performed. The concatenated data was used for multilocus sequencing typing (MLST), serum typing (wzi typing), as well as analysis of resistance and virulence genes. Results All 201 CRKP strains were multidrug-resistant organisms (MDROs). These strains were almost completely resistant to carbapenems, cephalosporins, and quinolones. Drug resistance gene analysis showed that 93.03% of CRKP strains carried KPC gene. 201 CRKP strains were divided into 6 ST types and 10 capsule wzi types, with ST11-KL64 (n=104) being the dominant type, followed by ST15-KL19 (n=54). 52.24% (n=105) of CRKP carried rpmA/rpmA2+iucA+iutA+iroN genes. Conclusion CRKP isolated from medical institutions in Shanghai is mainly ST11-KL64 type with severe multidrug resistance, and more than half of the strains are hypervirulent carbapenem-resistant Klebsiella pneumoniae (hv-CRKP). It is necessary to continuously strengthen the monitoring of the molecular characteristics of CRKP, so as to prevent outbreaks of healthcare-associated infection.

Abstract:Objective To evaluate the impact of intensified infection control measures on the incidence of healthcare-associated infection (HAI) under the background of the reform of diagnosis-intervention packet (DIP) payment, and provide decision-making basis for HAI management under the reform of medical insurance payment. Methods The interrupted time series research design was used to collect the monitoring data of HAI in a tertiary first-class hospital from October 2021 to September 2024. The changing trend of HAI incidence was analyzed by piecewise li-near regression, and the intervention effect was evaluated by standardized infection ratio (SIR). Results From October 2021 to September 2022, the incidence of HAI was 2.17% (95%CI: 2.08%-2.26%), which dropped to 1.87% (95%CI: 1.82%-1.92%) after the intervention. Piecewise linear regression analysis showed that the incidence of HAI decreased by 0.324% immediately after the intervention (95%CI: -0.481%- -0.167%, P<0.001), and the trend after the intervention changed significantly compared with that before the intervention (95%CI: -0.033%- -0.009%, P=0.001). SIR analysis showed that the actual incidence during the entire intervention period was equivalent to 74.56% of the incidence in intervention period, gradually stabilized from 88.39%-93.81% at the beginning of the intervention to 67.03%-71.22% at the end of the study, and the intervention effect was sustained. Conclusion Intensified infection control measures under the background of the reform of DIP significantly reduce the incidence of HAI and improve the stability of infection control management, which provide new insights into the synergistic improvement of medical insurance payment and HAI management quality.

Abstract:Objective To evaluate the effect of multi-disciplinary team (MDT) management mode on the prevention and control of carbapenem-resistant Enterobacterales (CRE) infection after lung transplant surgery, and explore the influencing factors for CRE infection after lung transplant. Methods A total of 654 lung transplant recipients from Lung Transplant Center of Wuxi People’s Hospital from January 2014 to July 2023 were selected as the research subjects. According to the time nodes of the implementation of MDT management mode, lung transplant recipients from January 2014 to December 2019 were assigned to the control group without implementation of MDT management mode. Lung transplant recipients from January 2020 to July 2023 were in the intervention group with MDT management mode implementation. Kaplan-Meier method was used to calculate the risk of CRE infection in lung transplant recipients 90 days after surgery. Cox regression model was used to adjust variables such as length of hospital stay, surgical duration, and catheterization days of three catheters, and the effect of implementing MDT management mode on the risk of CRE infection was analyzed. Results Among 654 lung transplant recipients, 215 had healthcare-associated infection(HAI), including 158 cases from the control group and 57 from the intervention group, with HAI rates of 38.54% and 23.36%, respectively. The incidence of HAI in lung transplant recipients in the intervention group was lower than that in the control group (χ²=15.965, P<0.001). A total of 74 cases of CRE infection were confirmed, and CRE infection rate in the intervention group was lower than that in the control group (7.79% ［19/244］ vs 13.41% ［55/410］;χ²=4.828, P=0.028). By the end of the 90-day follow-up period, the cumulative infection risks of the control group and intervention group were 14.67% and 8.26%, respectively, with a statistically significant difference between the two groups (P<0.05). The implementation of MDT management mode was a protective factor for post-operative CRE infection in lung transplant recipients, while duration of surgery, duration of ventilator use, and duration of urinary catheterization were risk factors for CRE infection (all P<0.05). Conclusion Implementing MDT management mode in lung transplant recipients can effectively reduce the risk of post-operative CRE infection. Continuously standardizing and implementing MDT management of multidrug-resistant organisms in hospitals is an important mean of preventing CRE infection and controlling transmission.

Abstract:Objective To meet the clinical need for dynamic monitoring on lactate metabolism in septic shock patients, a time-series prediction model based on a long short-term memory (LSTM) network was developed to predict 24-hour lactate clearance rate at admission. Methods A multi-stage retrospective cohort design was adopted to enroll septic shock patients admitted to the department of critical care medicine of a hospital from January 2018 to September 2024. By conducting univariate analysis and LASSO combined feature screening, predictive factors were extracted from multidimensional clinical data. An end-to-end LSTM framework (two-layer 64/32 units, dropout rate=0.3) was constructed. A sliding window strategy (six-hour step size) was adopted for dynamic prediction and compared with traditional logistic model in terms of three dimensions: calibration (Brier score), discrimination (area under the curve ［AUC］ of time-dependent receiver operating characteristic ［ROC］), and clinical practicality (decision curve analysis). Consistency between model prediction result and actual lactate clearance rate was analyzed, and the accuracy of prediction was evaluated. Results A total of 112 septic shock patients were enrolled in the analysis, including 65 males and 47 females, with an average age of (67.35±7.28) years. 65 patients were assigned in the lactate good clearance rate group (lactate good clearance rate ≥10%) and 47 in the lactate poor clearance rate group (lactate good clearance rate ＜10%); 78 patients were in the training set and 34 in the validation set. Time-depen-dent AUC analysis revealed that the predictive performance of the LSTM model in the time windows of 6, 12, and 24 hours were 0.89 (0.85-0.93), 0.91 (0.88-0.95), and 0.92 (0.89-0.96), respectively, superior to the logistic regression model (ΔAUC=0.085, P<0.01). The core predictive factors included APACHE Ⅱ score (OR=1.38), lactate level at admission (OR=1.65), vasoactive drug dosage (OR=1.42), and 6-hour fluid resuscitation dosage (OR=1.35). The Pearson correlation coefficient between the predicted value of the model and the actual 24-hour lactate clearance rate was 0.83 (P<0.001), with an average absolute error of 8.2%. Decision curve analysis confirmed that when the threshold probability was 15%-60%, the LSTM model could increase clinical net benefits by 27.3%. The validation of each subgroup showed that the model maintained the optimal predictive performance (AUC=0.87) in the lung infection subgroup (n=16). Conclusion The LSTM-based dynamic prediction model for predicting 24-hour lactate clearance rate through integrating early admission indicators demonstrates excellent predictive performance and clinical application value, which can provide important reference for individualized treatment decisions in septic shock patients.

Abstract:Objective To explore the risk factors for early-onset sepsis (EOS) in extremely low birth weight (ELBW) premature infants, and construct a nomogram model for EOS in ELBW premature infants. Methods A total of 200 ELBW premature infants who admitted to a hospital from January 2021 to December 2023 were selected as the training set, and 86 ELBW premature infants who admitted to the hospital from January to December 2024 were selected as the validation set. The ELBW premature infants in the training set were divided into an EOS group and a non-EOS group based on the occurrence of EOS. The risk factors for EOS in ELBW premature infants were screened out by logistic regression, and a nomogram model for EOS in ELBW premature infants was constructed using R-based software. Results Maternal gestational age >35 years, prenatal fever, premature rupture of membranes, peripherally inserted central venous catheter (PICC) insertion, mechanical ventilation, amniotic fluid contamination, gestational age ≤32 weeks, and neonatal fever were independent risk factors for EOS in ELBW premature infants (all P<0.05). The area under the receiver operating characteristic (ROC) curve for the training set and validation set were 0.797 (95%CI: 0.755-0.859) and 0.769 (95%CI: 0.661-0.877), respectively. The calibration curve showed that the model had good consistency, and the decision curve showed that the model had high clinical application value. Conclusion The dynamic nomogram model for predicting EOS in ELBW premature infants has good accuracy and clinical practicality.

Abstract:Objective To study the economic burden caused by healthcare-associated infection (HAI) in patients with severe acute pancreatitis (SAP), and provide theoretical basis for formulating HAI prevention and control measures. Methods Patients with SAP discharged from a tertiary first-class hospital in Jiangxi Province from July 1, 2023 to June 30, 2024 were selected as the study subjects. Information including demographic characteristics, clinical data, and hospitalization expense were collected. Patients were divided into a HAI group and a non-HAI group according to HAI occurrence. A propensity score matching (PSM) method was used to conduct a 1 ∶2 ma-tching, and differences in the length of hospital stay and hospitalization expense between the two groups of patients after PSM were compared. Results A total of 709 patients were included in the analysis, out of which 65 cases experienced HAI, with a HAI incidence of 9.17%. After PSM, all 65 patients in the HAI group were successfully matched. The length of hospital stay, total hospitalization expense, expenses of medication and hygiene product of patients in the HAI group were all higher than those in the non-HAI group, and differences were all statistically significant (all P<0.001). Patients who experienced ≥2 episodes of HAI had a higher economic burden than those who experienced only once (P<0.05). HAI of bloodstream, abdomen, digestive system, and respiratory system significantly increased the economic burden of patients (all P<0.05). Conclusion HAI in SAP patients can extend the length of hospital stay and increase economic burden of patients. Targeted infection prevention and control mea-sures should be formulated to reduce the incidence of HAI and save medical resources.

Abstract:Objective To explore the relevant factors for infection in patients with non-small cell lung cancer (NSCLC) during chemotherapy period, and construct a prediction model. Methods 387 NSCLC chemotherapy patients who admitted to a hospital from May 2020 to January 2023 were selected as the modeling set. They were divided into an infection group and a control group based on the occurrence of infection during chemotherapy period. General data, diagnosis and treatment information, and biochemical examination results of patients were collected for univariate analysis. Items with statistically significant differences were included in logistic regression analysis, and factors related to infection were screened out. A infection risk prediction model for NSCLC chemotherapy patients was constructed using the RMS package in R-based software. The discrimination and consistency of the model in infection prediction were validated through the area under the curve (AUC) of the receiver operating characteristic (ROC) curve and the calibration curve. Clinical benefits were evaluated through the decision curve analysis (DCA). A total of 165 NSCLC chemotherapy patients who admitted to the hospital from February 2023 to October 2024 were included as the validation set, and external validation of the model was conducted. Results Among the 387 patients in the modeling set, 93 cases developed infection during chemotherapy period, with an infection rate of 24.03%. The main infection sites were respiratory system (39.79%) and digestive system (24.73%). There were statistically significant differences in age, combined chronic respiratory disease, tumor-node-metastasis-based (TNM) staging system, chemotherapy cycle, combined radiotherapy, episode number of invasive procedures, and glucocorticoid use between two groups of patients in the modeling set (all P<0.05). Logistic regression analysis showed 6 major risk factors for co-infection in NSCLC chemotherapy patients, namely age, TNM stage Ⅲ-Ⅳ, long chemotherapy cycle, combined radiotherapy, more than 2 episodes of invasive procedures, and glucocorticoid use. A risk prediction model for the infection in NSCLC chemotherapy patients was constructed using the 6 predictive indicators. The results showed that the AUCs of the modeling set and the validation set were 0.792 and 0.773, respectively. The predicted probability of infection was close to the actual probability. The HL test of goodness of fit of the modeling set showed χ² value of 8.760 and P value of 0.316, and those of the modeling set were 9.013 and 0.287, respectively. DCA revealed a high clinical benefit of the model. Conclusion A nomogram prediction model based on age, TNM stage, chemotherapy cycle, combined radiotherapy, episodes of invasive procedures, and glucocorticoid use can effectively predict co-infection in NSCLC chemotherapy patients.

Abstract:Objective To evaluate the improvement efficacy of pathogen detection management strategies before antimicrobial treatment, and provide evidence-based basis for standardizing the clinical application of antimicrobial agents. Methods Data reported from 568 sentinel hospitals nationwide from the first quarter of 2022 to the third quarter of 2023 were selected. The baseline survey stage was the first quarter of 2022, improvement strategies began to be implemented from the second quarter of 2022. Change in pathogen detection rate before antimicrobial treatment, pathogen detection rate related to healthcare-associated infection (HAI) diagnosis, pathogen detection rate before the combination use of key antimicrobial agents, percentage of blood culture, as well as length of hospital stay before and after improvement of strategies were compared. Results After implementing the improvement strategy (the third quarter of 2023), pathogen detection rate before antimicrobial treatment was 57.55%, which was higher than 39.08% before improvement (the first quarter of 2022) (P<0.001). Pathogen detection rate rela-ted to HAI diagnosis was 90.85%, which was higher than 80.33% before improvement (P<0.001). Pathogen detection rate before the combination use of key antimicrobial agents was 92.05%, which was higher than 87.75% before improvement (P<0.001). Percentage of blood culture was 12.35%, which was higher than 7.54% before improvement (P<0.001). In addition, the average length of hospital stay for patients shortened from 9.49 days to 8.24 days. Conclusion Comprehensive management strategies can effectively improve the pathogen detection rate and detection quality before antimicrobial treatment, shorten the length of hospital stay of patients, and provide practical basis for the rational use of antimicrobial agents as well as the prevention and control of antimicrobial resistance.

Abstract:Severe Chlamydia psittaci (C. psittaci) pneumonia with sudden sensorineural hearing loss (SSNHL)as the initial symptom is clinically rare. This paper reports a case of C. psittaci pneumonia whose initial symptom was hearing loss. During the disease course, clinical manifestations such as high fever, cough, and shortness of breath appeared successively. Chest CT results suggested pulmonary infection. After metagenomic next-generation sequencing of bronchoalveolar lavage fluid, the diagnosis of C. psittaci pneumonia was confirmed. After anti-infection treatment with moxifloxacin combined with doxycycline, hearing loss and pulmonary infection improved significantly. Combined with literature review, this study systematically explores the epidemiological characteristics, clinical manifestations, diagnostic methods, treatment schemes, and prevention strategies of C. psittaci pneumonia, aiming to provide diagnostic and treatment references for clinicians and microbiology laboratories to achieve early diagnosis and treatment, avoid misdiagnosis and underdiagnosis, and improve patient prognosis.

Abstract:Human infection with Orf virus is a rare zoonotic disease in clinical practice, mainly caused by human contact with infected sheep or its pollutants. It is commonly seen in shepherds and slaughterhouse workers. The lesion mainly involves the skin. Since it is rare in clinic and difficult to diagnose and treat, it is easy to be misdiagnosed and underdiagnosed. This paper reports a case of human infection with Orf virus, with locally dense skin lesions. The clinical diagnosis and treatment processes of this case are analyzed, and relevant literatures are reviewed retrospectively, so as to improve clinical understanding on this disease.

Abstract:Here reports a rare case of severe pneumonia with pulmonary abscess and empyema caused by Trophe-ryma whipplei (TW) infection. TW infection was confirmed by clinical manifestations as well as polymerase chain reaction (PCR) of bronchoalveolar lavage fluid (BALF) and pleural effusion. After treatment with meropenem (fo-llowed by sequential ceftriaxone) combined with compound sulfamethoxazole, the patient improved and was discharged from hospital. Combined with literature review, this study explores the clinical manifestations, laboratory examinations, and treatment scheme of TW infection, aiming to improve the awareness and vigilance of clinicians on TW infection, conduct targeted anti-infection therapy as early as possible, and reduce the mortality of patients.

Abstract:Healthcare-associated infection (HAI) is a global public health problem that poses a significant socio-economic burden. Hand hygiene is still considered as one of the most effective measures to prevent the spread of pathogens and reduce the incidence of HAI. This paper systematically reviews the latest progress in hand hygiene-related new products, intelligent monitoring technology, and compliance promotion strategies, aiming to provide scientific basis for the management and optimized scheme of hand hygiene in clinical practice in medical institutions in China, ultimately enhance the hand hygiene compliance of healthcare workers, ensure patient safety, and reduce the burden of HAI.

Abstract:The increasing trend of multidrug-resistant organism (MDRO) infection in rehabilitation medical institutions has become one of the major challenges in the global public health field. On one hand, this is due to the fact that rehabilitation patients themselves have a variety of susceptibility factors, such as older age, complex underlying diseases, low immune function, long length of hospital stay, and frequent use of antimicrobial agents in the early stage; on the other hand, the improper implementation of prevention and control measures in rehabilitation medical institutions also provides opportunities for the spread of MDRO. This paper reviews domestic and foreign research literatures, summarizes the current status of MDRO infection and progress in prevention and control measures in rehabilitation medical institutions, hoping to reduce the risk of infection in patient and improve the quality of medical care.

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